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PubMed1998

Psychopathology in the relatives of depressed-abused children.

OBJECTIVE: To determine if the type of symptomatology abused children manifest is related to family history of psychopathology. METHOD: Lifetime history of psychopathology was assessed in the relatives of 26 preadolescents--13 depressed abused (MDD-AB) and 13 depressed nonabused (MDD-NA) children. Rates of disorder in the relatives of these children were compared to published rates of psychopathology in relatives of 27 normal control (NC) children. Data were obtained on 104 first-degree relatives (MDD-AB = 25, MDD-NA = 29, NC = 50) and 503 second-degree relatives (MDD-AB = 127, MDD-NA = 117, NC = 259). The Schedule for Affective Disorders and Schizophrenia was used to assess psychopathology in parents, and Family History method was used to obtain lifetime psychiatric data for all other relatives. RESULTS: When compared to first-degree relatives of NC children, first-degree relatives of MDD-AB children had approximately a nine-fold increased risk for major depression, and a three- to nine-fold increased risk for other disorders associated with the familial subtype of affective illness known as Depression Spectrum Disease (e.g., antisocial personality, alcohol and substance dependence). Similar findings were reported in second-degree relatives, and comparisons between the relatives of MDD-NA and NC children. CONCLUSION: The findings extend results of prior research and (1) suggest familial vulnerability factors influence the symptom profile of abused children; and (2) highlight the value of incorporating psychiatric formulations into multidisciplinary models of child abuse research and treatment programs.

Adolescent↗

PubMed2007

Benefit Finding Scale for Children: preliminary findings from a childhood cancer population.

OBJECTIVE: To describe the development of a brief measure of benefit finding for children. Data regarding the psychometrics and validity of the instrument were examined in a sample of children with cancer. METHODS: A cross-sectional sample of children with cancer (N = 199, ages 7-18 years) completed the Benefit Finding Scale for Children (BFSC) along with measures of adaptive style, optimism/pessimism, post-traumatic stress symptoms, and health-related quality of life. RESULTS: The BFSC was found to be a unidimensional measure with excellent internal reliability. Benefit finding was not related to age or gender, but differed as a function of race/ethnicity. No differences were found by diagnostic category, but a significant relationship was found with age at diagnosis and time elapsed since diagnosis. Small, but significant positive correlations were found with measures of optimism and self-esteem, and a negative correlation with anxiety. No relation was found between benefit finding and post-traumatic stress symtpoms or other domains of health-related quality of life. CONCLUSION: The BFSC shows promise as a measure of benefit finding in children. The measure could be readily adapted for other populations of children experiencing trauma.

Adaptation, Psychological↗

PubMed1993

An examination of phonemic processing abilities in children during their first-grade year.

The present study examined the development of reading and phonological processing abilities of 209 first graders (118 males, 91 females; mean age = 86.7 months) assessed during the first and last quarters of their first-grade year. The children were arranged into three different groups based on their Time 2 reading and intelligence data (children with and without reading disabilities, and "garden-variety" poor readers). Analyses indicated that the children with reading disabilities and the garden-variety poor readers did not differ significantly on many of the tasks, but both performed differently than the children without reading disabilities. Developmental analyses indicated that all three groups increased their reading and phonological skills; however, the gap between the performance of the children without reading disabilities and the other two groups widened from Time 1 to Time 2. The most important finding of the present study concerned the classification results of the discriminant analysis, which correctly identified the group membership of 207 of the 209 children (99.04% correct).

Awareness↗

PubMed2006

Pharmacokinetics of desmopressin administrated as an oral lyophilisate dosage form in children with primary nocturnal enuresis and healthy adults.

The population pharmacokinetics of desmopressin in children with nocturnal enuresis and in healthy adults were compared using a 1-compartment model with first-order absorption and first-order elimination. In addition, the model consisted of a number of transit compartments before absorption to describe a lag-time. The model gave an adequate description of adult as well as children data and provided a statistically significant better fit to data than a standard lag-time model. The main difference in the pharmacokinetics between children and adults was the absorption delay. The pharmacokinetic difference was minor and presumably of no clinical relevance.

Administration, Sublingual↗

PubMedDate not supplied

Children's utilization of dental care in the NC Medicaid program.

PURPOSE: To characterize the patterns of dental care in the North Carolina (NC) Medicaid Program for three- and eight-year-old children who began dental treatment in the 1985-86 and 1990-91 groups. We also compared the children's patterns of care by provider (general dentists versus pediatric dentists). METHODS: Our extensive data set included claims, enrollment, and provider data. Children were assigned to one of five categories or patterns of care as follows: complete care, general anesthesia care, sporadic care, emergency only care, and no care. Statistical comparisons of the variables age, cohort year, and provider groups were made. RESULTS: The use of Medicaid dental services by both age groups was severely limited in both yearly cohorts. Pediatric dentists tended to provide more complete and less sporadic care for both age groups and both yearly cohorts. CONCLUSIONS: Financing dental care through Medicaid results in very low levels of complete care among enrollees, and any plan that limits referral to pediatric dentists might adversely affect the number of enrollees who receive complete care.

Age Factors↗

PubMed2005

[Pneumatosis intestinalis in 9 children with an oncologic disease].

OBJECTIVE: To acquire knowledge regarding the rare condition pneumatosis intestinalis (PI) in children treated for malignant disease. DESIGN: Retrospective. METHOD: In 1998-1999 PI was diagnosed in 9 of the 140 children with malignant disease in the department of Paediatric Oncology of the UMC St Radboud, Nijmegen, the Netherlands. By examination of the records of these 9 children, data were collected on the symptomatology, diagnostics, treatment and prognosis of PI. RESULTS: The 9 children included 7 boys and 2 girls, varying in age from 2 to 12 years. In 7 patients the underlying disease was acute lymphocytic leukaemia and in 2 it was a stage IV neuroblastoma. The presenting symptoms were nonspecific and included: a distended abdomen, abdominal pain, diarrhoea and constipation. In all children, PI was located in the colon. Supplemental blood and microbiological analysis did not reveal any typical abnormalities. 8 children were treated with lactitol because of constipation. A laparotomy was performed in the first patient, while the other 8 were treated with gastric suctioning, parenteral nutrition and antibiotics. All 9 children recovered within a few weeks. CONCLUSION: With supportive care, PI in children with malignant disease is mostly a self-limiting condition. A pneumoperitoneum in PI is no indication for surgery, except in the presence of an acute abdomen. Chemotherapy can be continued.

Antineoplastic Agents↗

PubMed1983

The value of children to children.

The data included in this paper demonstrate that the Hoffman scheme for conceptualizing the values of children applies about as well to responses from children aged 10 to 18 as it does to the responses of adults. Some of the same variables related to adult perceptions of values of children show similar relationships among children. Data are included from both mothers and children in the families sampled. Alternative wording of the questions about the values of children indicates that while children and mothers may be aware of the dominant cultural values, they may not have internalized these for themselves.

Adolescent↗

PubMed2001

Behavioural and cognitive interventions with or without other treatments for defaecation disorders in children.

BACKGROUND: Faecal soiling is a common and potentially distressing disorder of childhood. OBJECTIVES: To assess the effects of behavioural and/or cognitive interventions for the management of defaecation disorders in children. SEARCH STRATEGY: The following databases were searched: the Cochrane Incontinence Group Trials Register (March 2001), the Cochrane Controlled Trials Register (Issue 4, 2000), The Enuresis Resource and Information Centre Register of studies of encopresis and soiling, AMED (1985 to April 2000), PsycINFO (1887 to June 2000), Index to Theses - Great Britain and Ireland (October 2000), Dissertation Abstracts (November 2000), EMBASE (January 1998 to October 1999), SIGLE (January 1980 to December 1996), BIOSIS (January 1998 to March 1999), Science Citation Index (January 1998 to March 1999), ISTP (January 1982 to March 1999). Date of the most recent searches: March 2001. Bibliographies of trials retrieved were also searched and colleagues and experts in the field were contacted for information. SELECTION CRITERIA: Randomised and quasi-randomised trials of behavioural and/or cognitive interventions with or without other treatments for the management of defaecation disorders in children. DATA COLLECTION AND ANALYSIS: Two reviewers independently selected studies from the literature. One reviewer assessed the methodological quality of eligible trials and extracted data. Data were combined in a meta-analysis when appropriate. MAIN RESULTS: Sixteen randomised trials with a total of 843 children met the inclusion criteria. Sample sizes were generally small. Interventions varied among trials and few outcomes were shared by trials addressing the same comparisons. The synthesis of data from eight trials showed higher rather than lower rates of persisting problem up to 12 months when biofeedback was added to conventional treatment (OR 1.34 CI 95% 0.92 to 1.94). In two trials significantly more encopretic children receiving behavioural intervention plus laxative therapy improved compared with those receiving behavioural intervention alone at both the 6-month (OR 0.51 CI 95% 0.29 to 0.89) and the 12-month follow-up (OR 0.52 CI 95% 0.30 to 0.93). Similarly in another trial the addition of behaviour modifications to laxative therapy was associated with a marked reduction in children's soiling episodes (OR 0.14 CI 95% 0.04 to 0.51). REVIEWER'S CONCLUSIONS: There is no evidence that biofeedback training adds any benefit to conventional treatment in the management of encopresis and constipation in children. There is some evidence that behavioural intervention plus laxative therapy, rather than behavioural intervention or laxative therapy alone, improves continence in children with primary and secondary encopresis.

Behavior Therapy↗

PubMedDate not supplied

Fertility of male workers of the italian mint.

Fertility among workers exposed to metal fumes and solvents in the Italian mint (stampers, founders, and other technical workers) was compared to the reproductive experience of the administrative staff. Data on the reproductive history and time to pregnancy were collected by interview. For workers with children, data on the time to pregnancy (TTP) for the first pregnancy was assessed in relation to occupational risk factors. The groups with the highest prevalence of pregnancy delay beyond 6 months were stampers (21%) and those exposed to solvents (21.5%). Logistic regression did not show a significant association of these job exposures with pregnancy delay, but the power of the study to show an important difference was low. The data are not inconsistent with the hypothesis that male exposure to solvents and metal fumes is associated with an increase in the TTP.

Adult↗

PubMed2002

In search of childhood asthma: questionnaire, tests of bronchial hyperresponsiveness, and clinical evaluation.

BACKGROUND: The definition or diagnosis of asthma is a challenge for both clinicians and epidemiologists. Symptom history is usually supplemented with tests of bronchial hyperresponsiveness (BHR) in spite of their uncertainty in improving diagnostic accuracy. METHODS: To assess the interrelationship between respiratory symptoms, BHR, and clinical diagnosis of asthma, the respiratory symptoms of 1633 schoolchildren were screened using a questionnaire (response rate 81.2%) and a clinical study was conducted in a subsample of 247 children. Data from a free running test and a methacholine inhalation challenge test were available in 218 children. The diagnosis of asthma was confirmed by a paediatric allergist. RESULTS: Despite their high specificity (>0.97), BHR tests did not significantly improve the diagnostic accuracy after the symptom history: area under the receiver operator characteristic (ROC) curve was 0.90 for a logistic regression model with four symptoms and 0.94 for the symptoms with free running test and methacholine inhalation challenge results. On the other hand, BHR tests had low sensitivity (0.35-0.47), whereas several symptoms had both high specificity (>0.97) and sensitivity (>0.7) in relation to clinical asthma, which makes them a better tool for asthma epidemiology than BHR. CONCLUSIONS: Symptom history still forms the basis for defining asthma in both clinical and epidemiological settings. BHR tests only marginally increased the diagnostic accuracy after symptom history had been taken into account. The diagnosis of childhood asthma should not therefore be overlooked in symptomatic cases with no objective evidence of BHR. Moreover, BHR should not be required for defining asthma in epidemiological studies.

Asthma↗

PubMed1998

Reactive aggression among maltreated children: the contributions of attention and emotion dysregulation.

Examined the complex interplay among emotion, attention, and aggression in a sample of 141 maltreated and 87 non-maltreated impoverished, inner-city children. Data were collected during a summer day camp, which provided an ecologically valid setting for studying children's behavior in social contexts. Maltreated children were more likely than non-maltreated children to be aggressive, with findings suggesting that physically abused children were at heightened risk for reactive aggression. Maltreated children also evidenced attention deficits, and subclinical or nonpathological dissociation was more likely among children who had experienced physical or sexual abuse. A history of abuse also predicted emotion dysregulation, affective lability/negativity, and socially inappropriate emotion expressions. This emotion dysregulation, fostered by poor attention modulation, was a mechanism of the effects of maltreatment on reactive aggression.

Affective Symptoms↗

PubMed1999

Recent advances in paediatric ventilation.

BACKGROUND: To review the recent advances in ventilatory therapy for acute respiratory failure in children. DATA SOURCES: Recent published peer-review articles on mechanical ventilation for acute respiratory failure in children. SUMMARY OF REVIEW: Advances in conventional treatment for acute respiratory failure (e.g. mechanical ventilation) have not increased survival in children. However, recent therapies including high frequency ventilation, extracorporeal membrane oxygenation, nitric oxide and liquid ventilation have reported improved outcomes. The rationale and use of each are presented. CONCLUSIONS: High frequency ventilation exists in three forms, although only high frequency oscillation appears to show any benefit in the management of acute respiratory failure refractory to conventional mechanical ventilation. Extracorporeal oxygenation has halved mortality in neonates with acute respiratory failure, and has been used successfully in non-neonate patients. Inhaled nitric oxide from 6 to 20 parts per million improves oxygenation in paediatric patients with acute respiratory failure and congenital heart disease (particularly in the presence of pulmonary arterial hypertension). Liquid ventilation or perfluorocarbon-associated gas exchange has also been used to treat acute respiratory failure in paediatric patients, with partial liquid ventilation particularly appearing to show promise.

Journal Article↗

PubMed1991

Antimicrobial therapy for otitis media with effusion ('secretory' otitis media).

OBJECTIVE: To determine the effectiveness of antimicrobial treatment for otitis media with effusion ("secretory" otitis media) in children. DATA SOURCE: We report the reexamination of a previously published study by Mandel et al that evaluated the efficacy of a 2-week course of antimicrobials (amoxicillin trihydrate) with and without a 4-week course of an oral decongestant-antihistamine combination in a double-blind, placebo-controlled, randomized trial involving 518 infants and children with otitis media with effusion. DATA SYNTHESIS: At 4 weeks, amoxicillin efficacy as determined by a tympanometric criterion (P = .121) or by a measure of improvement in hearing (P = .311) was insignificant. Only by otoscopic judgment, which is shown to contain a systematic bias as used in this clinical trial, could an argument be made for a marginal efficacy of amoxicillin at the 4-week end point. Logistic regression analyses of the combined effects of treatment and prognostic factors showed no significant differences between placebo- and antibiotic-treated groups for unilateral effusions and for bilateral effusions. When subjects with unilateral and bilateral effusions were combined, the estimated efficacy of antibiotic treatment was 12.3% by otoscopy (P = .014) and 4.8% by tympanometry (P = .171). We also demonstrate the sensitivity of outcome to diagnostic measures used and provide statistical evidence questioning the validity of otoscopic observations in this study. Six weeks after the termination of amoxicillin therapy, the recurrence of effusion was two to six times higher in the amoxicillin-treated children than in those treated with placebo (P = .001), and resolution of effusion was not significantly different among antibiotic and placebo groups (13.6% and 11.3%, respectively; P = .477). CONCLUSIONS: Amoxicillin with and without decongestant-antihistamine combination is not effective for the treatment of persistent asymptomatic middle-ear effusions in infants and children.

Amoxicillin↗

PubMedDate not supplied

The effect of traumatic brain injury on children with learning disability.

The psychometric performance of 10 children with a history of learning disability (LD) who subsequently experienced a moderate to severe traumatic brain injury (TBI) was evaluated. Compared to premorbid data, children with LD experienced, after TBI, a statistically significant decline on a measure of psychometric intelligence, whereas their performance on measures of academic achievement remained stable. On specific neuropsychological measures, children with LD and TBI did not differ significantly post-injury from matched controls who also had TBI but no prior history of LD. It is concluded that moderate to severe TBI can cause significant additional cognitive impairment in children with LD, and that periodic modifications in the academic curriculum of these children are often needed after injury. Comparison of premorbid and postmorbid psychometric test data is crucial in this respect.

Achievement↗

PubMed2006

Neonatal frequency discrimination in 250-4000-Hz range: electrophysiological evidence.

OBJECTIVE: The precision of sound frequency discrimination in newborn infants in the 250-4000-Hz frequency range was determined using the neonatal electrophysiological mismatch response (MMR), the infant equivalent of adult mismatch negativity (MMN). METHODS: The electroencephalogram (EEG) was recorded in 11 full-term sleeping newborn infants mostly in active sleep (67% of the time). Pure tones were presented through loudspeakers in an oddball paradigm with a 800-ms stimulus onset asynchrony (SOA). Each stimulus block contained a standard (p=0.76) of 250, 1000, or 4000Hz in frequency (in separate blocks) and deviants with a frequency change of either 5% or 20% of the standard (p=0.12 of each). RESULTS: A positive ERP deflection was found at 200-300ms from stimulus onset in response to the 20% deviation from the 250, 1000, and 4000Hz standard frequencies. The amplitude of the response in the 200-300ms time window was significantly larger for the 20% than 5% deviation. CONCLUSIONS: We observed in newborn infants automatic frequency discrimination as reflected by a positive MMR. The newborns were able to discriminate frequency change of 20% in the 250-4000-Hz frequency range, whereas the discrimination of the 5% frequency change was not statistically confirmed. SIGNIFICANCE: The present data hence suggest that the neonatal frequency discrimination has lower resolution than that in adult and older children data.

Acoustic Stimulation↗

PubMed1991

Inter-observer agreement in assessing comatose children.

Inter-observer agreement was evaluated for twelve items used in the neurological assessment of comatose children. Data were obtained prospectively on fifteen patients examined independently by two observers in a double-blind fashion. Observer variability was measured by using the Disagreement Rate and Kappa statistic. The Disagreement Rate ranged from 0.01 to 0.12 for all items. Values for Kappa statistic were generally in accordance with those for Disagreement Rate. The data suggest fair to almost perfect inter-observer agreement for the items used to assess comatose children in this study.

Adolescent↗

PubMed1997

Nutritional survey in Greek children: nutrient intake.

The aim of the survey was to record the food habits and nutrient intake of Greek children. Data was obtained by a 3 d household measured diet record from a random stratified sample (1936 children aged 2-14 y). Mean daily protein intake was much higher than PRI and none of the children had lower intake than AR. Mean energy intake from protein was 15%, carbohydrate 44% and fat 41%. Eighty-four percent of children had energy intake from fat higher than the AR. Saturated fatty acids (SFA) provided approximately 15%, monounsaturated (MUFA) 17% and polyunsaturated (PUFA) 6% of energy. Eighty-seven percent of children had higher intake of SFA than the AR. Six percent of children had SFA intake lower than the AR and 50% higher than the AR. None of the children had PUFA intake lower than PRI and 0.3% higher than the maximum limit. 4.2% of children had calcium intake lower than LTI and 88% higher or equal to PRI. All children had phosphorus intake higher than PRI and less than the lower safe ratio of Ca/P; 50% of them had P intake higher than 1.5 g/d. The majority of children had sufficient iron intake with the exception of menstruated girls. Mean vitamin A intake was higher than PRI and lower than the toxic levels. All children had vitamin C intake higher than LTI. Median vitamin D intake varied from 1.7-2.1 micrograms. Median energy intake was higher than the AR in preschool children, but lower in the older children. We conclude that Greek children do not underintake energy and protein, overintake SFA, have safe intake of PUFA, vitamin A and C and high intake of MUFA, underintake carbohydrates, have adequate Ca, but a considerably high P intake. Vitamin D is low in small children, but the biological available vitamin D is obviously higher due to sunlight.

Adolescent↗

PubMed1980

Children's pure-tone detection.

A three-alternative, forced-choice adaptive procedure, with suitable reinforcement, is appropriate for testing auditory sensitivity in young children. Data obtained using this rigidly specified test protocol support previous findings of reduced auditory sensitivity in young children.

Audiometry↗