Food intake and anthropometric data on children under 4 years old living in the south of England [proceedings].
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Anthropometry↗
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Estimating the prevalence of uninsured children: an evaluation of data from the National Survey of Children with Special Health Care Needs, 2001. Data evaluation and methods research.
UNLABELLED: The National Survey of Children with Special Health Care Needs revealed that 8.3% of children under 18 years of age were uninsured, a rate lower than the rate estimated by other national surveys. This report presents the results of an evaluation of the quality of this estimate, based on analyses of non-response, question design, interviewer and respondent effects, and the weighing and estimation process. National and State-level statistics on health insurance coverage for children with special health care needs (CSHCN) and for children without special needs are included in an appendix. SOURCE OF DATA: The National Survey of CSHCN is a survey module of the State and Local Area Integrated Telephone Survey. This survey of parents and guardians collected health insurance coverage information for a national sample of 215, 162 children. Data were collected from October 2000 through April 2002. RESULTS: Compared with other surveys, weighted data from the National Survey of CSHCN describe a population with a slightly larger proportion of Hispanic children and children from households with higher incomes. The National Survey of CSHCN was also the only survey to use a child-level design: A randomized experiment that varied the health insurance questions found that repeating the coverage questions for each child produced lower unisurance rates than household-level questions that first asked if anyone in the househol was insured. CONCLUSION: Question design differences explain much of the discrepancy between survey estimates of the uninsurance rate, but a definitive conclusion regarding the relative accuracy of the uninsurance rates is not possible.
Adolescent↗
Developmental changes in laryngeal and respiratory function with variations in sound pressure level.
The development of the speech production system was investigated using a cross-sectional design that included children aged 4-14 years and adults. Given that the size and internal structure of the laryngeal and respiratory systems differ between children and adults, it was predicted that children would show functional distinctions from adults during speech. Aerodynamic, acoustic, and respiratory kinematic techniques were used to assess laryngeal and respiratory function while participants varied their sound pressure level. In general, the aerodynamic and acoustic results show that men and 14-year-old boys function differently than women and all other groups of children. For the respiratory function data, children's values are similar to adults' by the time they are 12-14 years of age. These changes correspond closely to developmental laryngeal and respiratory anatomic data. All participants used a combination of laryngeal and respiratory mechanisms to increase sound pressure level, but the combination of mechanisms differed across age groups. These data emphasize that the laryngeal and respiratory behavior of children is not easily predicted from an adult model.
Adolescent↗
Managed care organizational characteristics and health care use among children with special health care needs.
OBJECTIVE: To examine the relationship between features of managed care organizations (MCOs) and health care use patterns by children. DATA SOURCES: Telephone survey data from 2,223 parents of children with special health care needs, MCO-administrator interview data, and health care claims data. STUDY DESIGN: Cross-sectional survey data from families about the number of consequences of their children's conditions and from MCO administrators about their plans' organizational features were used. Indices reflecting the MCO characteristics were developed using data reduction techniques. Hierarchical models were developed to examine the relationship between child sociodemographic and health characteristics and the MCO indices labeled: Pediatrician Focused (PF) Index, Specialist Focused (SF) Index, and Fee for Service (FFS) Index, and outpatient use rates and charges, inpatient admissions, emergency room (ER) visits, and specialty consultations. DATA COLLECTION/EXTRACTION METHODS: The telephone and MCO-administrator survey data were linked to the enrollment and claims files. PRINCIPAL FINDINGS: The child's age, gender, and condition consequences were consistent predictor variables related to health care use and charges. The PF Index was associated with decreased outpatient use rates and charges and decreased inpatient admissions. The SF Index was associated with increased ER visits and decreased specialty consultations, while the FFS Index was associated with increased outpatient use rates and charges. CONCLUSION: After controlling for sociodemographic and health characteristics, the PF, SF, and FFS indices were significantly associated with children's health care use patterns.
Adolescent↗
Step-parents and infanticide: new data contradict evolutionary predictions.
Evolutionary psychologists have hypothesized, inspired by evolutionary biology, that parents should care less for children with whom they are not genetically related since these young do not contribute to the genetic fitness of the parents. Based on this, evolutionary psychologists have predicted that there will be an overrepresentation of step-parents as offenders in family-related killings of children. Data on child homicide, particularly from Canada, have supported this prediction in that the frequency of children killed was relatively high in families where one of the two parents was a step-parent. Here we present a survey of all child homicide that occurred in Sweden between 1975 and 1995. In contrast to the Canadian data, children in Sweden living in families with a step-parent were not at an increased risk compared with children living together with two parents to whom they were genetically related. In addition, there were no other indications that step-parents are overrepresented as offenders.
Adolescent↗
High prevalence of atypical enteropathogenic Escherichia coli (EPEC) in Norwegian children with diarrhoea.
The aim of the present study was to investigate the relative contribution of enteropathogenic Escherichia coli (EPEC) as a cause of infectious diarrhoea in Norwegian children. Data from faecal specimens from children <2 years old with diarrhoea during the year 2001 were analysed. E. coli isolates with the attaching and effacing genotype (eae+) were examined for the presence of the bundle-forming pilus (bfpA) and Shiga toxin genes by PCR, and for genetic relatedness by PFGE. During the 1-year period, 598 specimens from 440 patients <2 years old were analysed. Potential enteric pathogens were identified in 124 patients (28.2 %). EPEC was the most frequently identified agent (44 patients), followed by rotavirus (41 patients), Campylobacter jejuni (17 patients) and adenovirus (17 patients). All other agents were detected in five patients or less. Only one of the eae+ E. coli isolates was classified as typical EPEC (bfpA+). Among the 43 isolates that were classified as atypical EPEC (bfpA-), eight strains belonged to EPEC serogroups, whereas the majority of strains (n = 35) were not agglutinated by EPEC antisera. None of the EPEC isolates were genetically related. This study demonstrates that atypical EPEC of non-EPEC serogroups is highly prevalent among Norwegian children with diarrhoea.
Diarrhea, Infantile↗
The relations of parental warmth and positive expressiveness to children's empathy-related responding and social functioning: a longitudinal study.
This study examined the concurrent and cross-time relations of parental observed warmth and positive expressivity to children's situational facial and self-reported empathic responding, social competence, and externalizing problems in a sample of 180 elementary school children. Data was collected when the children were in second to fifth grades (age: M = 112.8 months), and again 2 years later. Cross-sectional and longitudinal structural equation models supported the hypothesis that parents' (mostly mothers') positive expressivity mediated the relation between parental warmth and children's empathy, and children's empathy mediated the relation between parental positive expressivity and children's social functioning. These relations persisted after controlling for prior levels of parenting and child characteristics. Moreover, concurrent and cross-time consistencies were found on measures of parenting, children's situational empathic responding, and social functioning.
Child↗
Morbidity among pediatric motor vehicle crash victims: the effectiveness of seat belts.
It is well established that seat belts reduce mortality and morbidity among children. Data are presented for 413 children injured severely enough in motor vehicle crashes to require hospitalization. Of the unrestrained children, 4.5% died, compared with 2.4% of the belted children. Unrestrained children had a higher proportion of injuries in four of five anatomical regions, were more severely injured, stayed longer in the hospital, and were 15% more likely than belted children to be discharged with impairments.
Abdominal Injuries↗
A network data base system for children with cardiac disease--echocardiographic data of MCLS.
We developed a computer-assisted network data base system for children with cardiac diseases. It aims at storage and exchange of medical information from many hospitals to prevent school children from sudden death caused by heart diseases. The computer system used was PANAFACOM U-1500 introduced at Shimane Medical University Hospital in 1980. The format of the questionnaire is designed to standardize the computer-assisted data-entry method among different hospitals. The entries of questionnaires are composed of basic information about the patient and laboratory information. The former is identification data of the patient, and the latter principally the values of M-mode echocardiographic measurement. Two types of output-tables were made from the data base. One is a table of each disease, and the other each hospital.
Child↗
Electrolyte abnormalities in critically ill children.
OBJECTIVE: To provide a brief overview of the causes, diagnosis, and therapies of electrolyte abnormalities frequently seen in critically ill children. DATA SOURCE: Published articles and bibliographies identified from pertinent review articles and books published in the past 20 yrs on fluid and electrolyte therapy in children. CONSTRAINT: The review includes only human studies and articles published in the English language. STUDY SELECTION: Human studies pertaining to abnormalities of water homeostasis, sodium, potassium, calcium, and magnesium homeostasis in children were selected. Prospective randomized studies were selected as much as possible. DATA EXTRACTION: Pertinent data abstracted from multiple, independent clinical studies were used to develop an approach to electrolyte abnormalities in critically ill children. DATA SYNTHESIS: An approach to diagnosis and therapies of common electrolyte abnormalities in critically ill children. CONCLUSIONS: Electrolyte abnormalities are common in critically ill children and can be easily treated once recognized. Further studies are needed to better understand the role of ionized calcium and magnesium in neonatal and pediatric critical illness.
Calcium↗
Estimation of coronary risk factors in British schoolchildren: a preliminary report.
Surveys from several countries have identified the presence of risk factors known to be associated with coronary heart disease in children. Data on the distribution of coronary risk factor variables in British children are scarce. This study was therefore designed to test the feasibility of collecting coronary risk factor data from British children and to conduct a preliminary examination of the problem. One hundred and seven children (mean age 12.8 yr) had their height, weight, triceps skinfold and blood pressure checked. Blood samples for cholesterol and HDL-cholesterol analysis were obtained from 93 children. Peak VO2 was determined on 48 children, 76 children had their daily activity monitored and 59 children's stage of sexual maturity was assessed. The boys' peak VO2 was significantly higher than the girls, whether expressed in l.min-1 (p less than 0.05) or ml.kg.-1min-1 (p less than 0.01). No other significant differences (p greater than 0.05) between the sexes were detected. The results indicate that children have relatively high serum cholesterol levels (boys 4.58 +/- 0.79; girls 4.72 +/- 0.80 mmol.l-1). The willingness and enthusiasm of the children, parents and schools to take part in the study clearly demonstrated the feasibility of a large scale study being successfully pursued in the United Kingdom.
Adolescent↗
Age-related effects on nelfinavir and M8 pharmacokinetics: a population study with 182 children.
As a relationship between nelfinavir antiretroviral efficacy and plasma concentrations has been previously established, nelfinavir pharmacokinetics was investigated in order to optimize the individual treatment schedule in a pediatric population. A population pharmacokinetic model was developed to describe the concentration-time course of nelfinavir and its active metabolite M8. Individual characteristics were used to explain the large interindividual variability in children. Data from therapeutic drug monitoring in 182 children treated with nelfinavir were analyzed with NONMEM. Then Food and Drug Administration (FDA) current recommendations were evaluated estimating the percentage of children who reached the target minimum plasma concentration (0.8 mg/liter) by using Bayesian estimates. Nelfinavir pharmacokinetics was described by a one- compartment model with linear absorption and elimination. Pharmacokinetic estimates and the corresponding intersubject variabilities for the model were as follows: nelfinavir total clearance, 0.93 liters/h/kg (39%); volume of distribution, 6.9 liters/kg (109%); absorption rate, 0.5 h(-1); formation clearance fraction to hydroxy-tert-butylamide (M8), 0.025; M8 elimination rate, 1.88 h(-1) (49%). Apparent nelfinavir total clearance and volume of distribution decreased as a function of age. M8 elimination rate was increased by concomitant administration of nevirapine or efavirenz. Our data confirm that the FDA recommendations for children from 2 to 13 years are optimal and that the dose recommended for children younger than 2 years is adequate for the children from 2 months to 2 years old. However, in children younger than 2 months, the proposed nelfinavir newborn dose of 40 mg/kg of body weight twice daily is inadequate and we suggest increasing the dose to 50 to 60 mg/kg administered thrice daily. This assumption should be further evaluated.
Aging↗
Incidence of malignant disease in childhood: a 24-year review of the Manchester Children's Tumour Registry data.
The Manchester Children's Tumour Registry data for the period 1954-1977 have been analysed. The overall incidence of malignant disease in children aged 0-14 years in the north-west of England is estimated to be 100 per million person-years. The most common disease group is leukaemia, which forms about one third of the total number of cases. Among solid tumours, by far the most common presenting site is the central nervous system, representing nearly a quarter of all neoplasms. Wilms' tumour, neuroblastoma and soft-tissue sarcomas comprise approximately 5%, 6.5% and 6% respectively of the total. The tumours most frequently seen in adults (e.g. carcinoma of colon, lung and breast) are extremely rare in childhood. A significant excess of males was seen in acute lymphoid leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease, medulloblastoma and hepatoblastoma. A female excess was found among germ-cell tumours. During the study period significant increases in incidence were seen among acute lymphoid leukaemia and epithelial tumours, and an increase in germ cell tumours approached significance.
Adolescent↗
Disease patterns in homeless children: a comparison with national data.
Although homeless children have increased in numbers as poverty has become feminized, minorities have become poorer, and low-income housing has become less accessible, little is known of their health problems. This study compared the health problems of a group of uninsured and homeless children visiting a free, nurse-managed, primary care clinic on Los Angeles' Skid Row with data from children's primary care visits to pediatricians and general and family physicians sampled in the National Ambulatory Medical Care Survey. Diagnoses were classified into the following health service categories: (a) acute, (b) communicable, and (c) chronic disease; (d) preventive and (e) injury care. Comparisons indicated that services to homeless children differed significantly from reimbursed services in the national sample in all categories except chronic disease. Demographic analysis indicated that homeless children were predominantly Hispanic Americans. When data from Hispanic children were examined, the pattern of differences between the homeless and National Ambulatory Medical Care Survey diagnostic categories persisted. This study shows the variations in nursing care which a group of high-risk, severely impoverished, uninsured children require.
Adolescent↗
Age-related outcomes of sleep apnea surgery in infants and children.
This study was designed to determine whether age at the time of surgery is an important influencing factor on outcomes following surgical correction of severe refractory obstructive sleep apnea (OSA) in infants and children. Data were collected prospectively on 55 children, all with severe OSA refractory to conservative medical and surgical measures, who underwent combinations of soft-tissue and skeletal procedures aimed at relieving their airway obstruction. The study population was subdivided for analysis into three groups based on age at the time of surgery (> 36 months, > 12 to < 36 months, and < or = 12 months). Each child was assessed for clinical outcomes, polysomnography results, and complications. Children in the > 36 months group demonstrated a significant improvement in respiratory disturbance index (RDI), apnea index, and lowest overnight oxygen saturation postoperatively. Only RDI improved significantly in the > 12 to < 36 months group. Although there was a trend toward improvement in the respiratory indices for the children < or = 12 months of age, they had a significantly longer intensive care and hospital stay, a greater mean number of extubation attempts, and the highest surgical failure rate (29%). Other complications such as infection, atelectasis, or temporary postoperative nasopharyngeal tube dependence occurred most frequently in the > 36 months group. Surgical management of severe refractory OSA in children age < or = 12 months is more difficult and less likely to succeed. The reasons for this are discussed and recommendations for management are given.
Adolescent↗
Hospitalization trends for paediatric asthma in eastern Finland: a 10-yr survey.
The prevalence of childhood asthma has increased during the past 20 yrs in eastern Finland. The use of regular medication for asthma has, consequently, also risen at the same time. The aim of the present study was to assess how these factors have influenced hospitalization for asthma in children. Data concerning the annual number of children aged <16 yrs treated for asthma, their number of hospital periods, and length of hospitalization were collected using patient-specific medical records for the years 1988-1997. Admissions for asthma more than doubled (from 1.2 in 1,000 to 2.7 in 1,000) (p<0.001), whereas re-admissions decreased from 28.1% to 8.7% (p<0.001) during the study period. The greatest increase was seen among children aged <2 yrs, whereas during recent years the admission rate among children aged >2 yrs has declined by one-third. Despite the increased prevalence of asthma, the decline in admissions seen in all but the youngest children may, at least partly, be attributed to the decrease in re-admissions, resulting from the early onset and increased use of inhaled steroids.
Adolescent↗
School-based helminthiases control: I. A baseline study of soil-transmitted helminthiases in Nakhon Si Thammarat Province, Thailand.
A baseline study of soil-transmitted helminthiases was carried out in Nakhon Si Thammarat Province, southern Thailand. The study sites were Wat Krou Chou Primary School and nearby villages in Sichon district, and Wat Thang Phoon Primary School and nearby villages in Chalerm Phrakiat District. Surveys of the schoolchildren's stools were conducted by the Kato-Katz technique. The results showed that 23.7% of schoolchildren in Wat Krou Chou and 24.7% of those in Wat Thang Phoon were infected with soil-transmitted helminths, with a 24.1% overall infection rate. The major infection was hookworm (22.2% and 19.6%) and the minor one was trichuriasis, (2.9% and 8.7% respectively). The intensity of infection was similar in both schools, 85.7% and 90.2% respectively for light intensity hookworm. Schoolchildren with hookworm infection were not anemic. The hemoglobin value of children with hookworm infection was not significantly different from that of uninfected children. Data regarding the health behavior of children's parents in both schools were reported.
Female↗
Responsibilities of children in Latino immigrant homes.
Using survey and observational data, children's contributions to households in a Mexican immigrant community in Chicago are examined. Children provide essential help to their families, including translating, interpreting, and caring for siblings. These daily life activities shape possibilities for learning and development.
Acculturation↗