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PubMed2004

Maternal prenatal stress and 4-6 year old children's salivary cortisol concentrations pre- and post-vaccination.

In this study influences of maternal prenatal stress on the cortisol reactions of children to a vaccination were determined. Prenatal stress at around 16 weeks of gestation was measured through questionnaires and a cortisol day curve. Cortisol reactions were determined preceding and following the vaccination. A total of 24 children (age between 3.11 and 5.9 years, mean age 4.9 years) and their mothers participated in this study. Multilevel analysis (hierarchical linear modelling) was used to analyze the data. Children of mothers who had higher concentrations of morning cortisol during pregnancy had higher concentrations of cortisol as compared to children of mothers who had lower concentrations of morning cortisol. Furthermore, more daily hassles and a higher level of fear of bearing a handicapped child during pregnancy were associated with higher concentrations of cortisol in the children.

Adult↗

PubMed2003

Reliability, validity, and preliminary normative data for the Children's Aggression Scale-Teacher Version.

OBJECTIVE: To provide preliminary psychometric data on the Children's Aggression Scale-Teacher Version (CAS-T), which was designed to assess severity and frequency of aggressive, as distinct from nonaggressive, disruptive behaviors. METHOD: The CAS-T has 23 items representing five domains: Verbal aggression, Aggression against objects and animals, Provoked physical aggression, Unprovoked physical aggression, and Use of weapons. The CAS-T was completed for 273 nonreferred boys and 67 clinically referred children (60 boys; 7 girls). Coefficient alpha was assessed separately in clinical and nonreferred groups. Validity was evaluated by comparing CAS-T scores of children with different disruptive behavior disorder diagnoses and by examining the relationship of CAS-T scores to other parent and teacher ratings. RESULTS: The scale as a whole had excellent reliability as measured by coefficient alpha. Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, attention-deficit/hyperactivity disorder, and no disruptive behavior disorder diagnosis. Further, patterns of correlations with other rating scales provide strong support for the convergent and discriminant validity of the CAS-T. CONCLUSIONS: The CAS-T may fill a gap in that it distinguishes among various types and severity of aggression, as distinct from oppositional-defiant behaviors.

Aggression↗

PubMedDate not supplied

The significance of being occupied: the social construction of childhood occupations.

The purpose of this paper is to explore theoretical and developmental foundations for interpreting childrens hood engagement with activity in the typically social worlds of childhood. Drawing upon longitudinal ethnographic children data, I argue for the need to reframe the study of childhood occupation to the study of "socially occupied beings" as a means of enhancing our understanding of children's experiences. The focus is on childhood experiences that are socially constructed through adult and child co-created action sequences. The unit of analysis is constructed around a child or children, their adult partners in action, the social world of engagement, and proposed the cultural context. The interpretive focus is on acts and actors, acting in a socially constructed world. Two pation, microethnographic examples are provided; the first relates to an observation of a mother and her children playing in a hospital corridor and the second to an occupational therapist and child engaged in jointly constructed activity within a therapy session. These segments illustrate pragmatic and conceptual understandings of the interconnectedness of social relatedness, intersubjectivity, social action, and engagement. Further development of theoretical and research models is needed to capture the essence of children as socially occupied beings, doing something with someone else that matters.

Adult↗

PubMed2004

[Effects of a comprehensive intervention program on simple obesity of children in kindergarten].

OBJECTIVE: The purpose of the study was to explore a comprehensive management program for the obese children in kindergarten. The program should be scientific, rational, suitable for kindergarten, and easy to apply. Child care workers, parents, and child health care doctors participated in the program to help obese children establish a scientific life style through their daily life, to control their weight and to maintain their physical and mental health. METHODS: The theories of behavior science, nutriology and kinematics were applied to make the weight control of obese children in kindergarten quantified and relatively standardized. Children were divided into three groups, intervened obese children, non-intervened obese children and normal children. Data such as weight, height, and body mass index (BMI) were observed to assess the effect of weight control and define whether it affects the linear gain of children's height. RESULTS: The recovery rate of intervened obese group, non-intervened group was 62.5% and 5.3%, respectively. The general effective rate was 91.7% and 15.8%, respectively. The weight gain of intervened group was 4.15 kg lower than that of non-intervened group. The BMI of intervened group significantly decreased by 2.9 as compared to the non-intervened group. The height gain of intervened group was similar to that of normal group. Parents and health care workers' realization of children obesity and their corresponding actions, the behaviors of obese children at home and in kindergarten were changed toward the direction beneficial to weight control. CONCLUSION: The implementation of the comprehensive intervention program for obesity in children, which involved obese children, child care worker, parents, and child care doctors alleviated the obesity level of those obese children without affecting their normal height gain. The program was safe and effective. Through the comprehensive intervention, the obese children could establish good habits during the sensitive period.

Body Height↗

PubMed2002

Migration inhibitory factor in the cerebral and systemic endothelium in sepsis and malaria.

OBJECTIVE: We have included migration inhibitory factor (MIF) in an ongoing immunohistochemical study comparing the site and intensity of the generation of inflammatory mediators in falciparum malaria, sepsis, and other causes of pediatric death in Africa. We wanted to determine whether it could account for our observation that inducible nitric oxide synthase is less strongly induced in the cerebral, compared with the systemic, vasculature. DATA SOURCES: Comparisons of tissue samples taken from blood vessel walls from the brain and the axillary space in a series of sepsis and falciparum malaria autopsies of African children. DATA SUMMARY: Intense staining for MIF has been detected in endothelial cells of axillary region vessels of all sepsis cases and most of the malaria cases examined. This parallels our findings with inducible nitric oxide synthase staining. African and Western control tissues from noninfectious causes of death stained lightly or not at all. In contrast, MIF could not be detected in vascular endothelial cells within the brain, where inducible nitric oxide synthase staining was much less intense. Detection of both MIF and inducible nitric oxide synthase in ependymal and glial cells in the same brains served as an internal positive staining control. CONCLUSION: These outcomes add weight to the proposal that endothelial cells are a site of intense inflammatory mediator activity in sepsis and malaria. They also suggest that suppression of anti-inflammatory glucocorticoids by MIF may be lower in the brain than elsewhere in the body. The lack of MIF in cerebral vasculature endothelial cells may be linked to the absence of thrombomodulin in these cells. The systemic cellular distribution and intensity of MIF in human systemic inflammatory states has not been described.

Adult↗

PubMed1980

The father's parenting experience in divorce.

The author discusses the father-child relationship as it is influenced by divorce. Psychiatrists are often consulted by individuals considering dovorce who are concerned about its probable impact on their children. Data gathered from the treatment of fathers during divorce indicate that there can be positive changes in their parental bonds as a result of increased opportunities to relate to children in a conflict-free atmosphere. In such a setting, the father's nurturing experience provides him with a new perspective on parenting. Psychotherapeutic help can lead to a strengthening of parental bonds, with subsequent benefits to both father and child. The author encourages professionals to support men in improving their fathering during the postdivorce period.

Adaptation, Psychological↗

PubMed1996

Abductive machine learning for modeling and predicting the educational score in school health surveys.

The use of modern abductive machine learning techniques is described for modeling and predicting outcome parameters in terms of input parameters in medical survey data. The AIM (Abductory Induction Mechanism) abductive network machine-learning tool is used to model the educational score in a health survey of 2,720 Albanian primary school children. Data included the child's age, gender, vision, nourishment, parasite infection, family size, parents' education, and educational score. Models synthesized by training on just 100 cases predict the educational score output for the remaining 2,620 cases with 100% accuracy. Simple models represented as analytical functions highlight global relationships and trends in the survey population. Models generated are quite robust, with no change in the basic model structure for a 10-fold increase in the size of the training set. Compared to other statistical and neural network approaches, AIM provides faster and highly automated model synthesis, requiring little or no user intervention.

Achievement↗

PubMed2005

[Pleading to maintain hydroxychloroquine throughout Lupus pregnancies].

PURPOSE: The use of Hydroxychloroquine (HCQ) during pregnancy has remained controversial for a long time. However, it is generally agreed that pregnancy per se increases disease activity in patients with systemic lupus erythematosus (SLE) and that withdrawal of HCQ at the onset of pregnancy may result in exacerbation of SLE. Therefore, stopping HCQ at the onset of pregnancy may result in exacerbation of SLE which could be detrimental to both mother and fetus. CURRENT KNOWLEDGE AND KEY POINTS: The available data suggest that HCQ can be continued safely throughout pregnancy. After the first report by Parke of successful continuation of HCQ throughout gestation, more than 250 pregnancies resulting in live births have been reported and no increase in the rate of birth defects have been demonstrated. When studied, no retinal toxicity and ototoxicity have been found in the children. Data concerning lactation and HCQ treatment are rare. However, the amount of HCQ received by children through lactation seems very low. FUTURE PROSPECTS AND PROJECTS: For patients with SLE already taking HCQ, the benefits of continuing treatment with this medication throughout pregnancy seem to outweigh the hypothetical risks associated with its use. HCQ should probably be maintained throughout pregnancy in these patients with SLE and it does not seem necessary to advise against breastfeeding. Further studies with prospective follow-up of children exposed in utero to HCQ remain however needed to provide a definitive answer.

Antirheumatic Agents↗

PubMed2003

Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors.

A model of household dietary behaviors based on adults' and children's intrapersonal, interpersonal, and communicative factors is introduced and tested. To the extent that children's health behaviors are influenced by adults' health behaviors, it is hypothesized that children's behavioral determinants, including self-efficacy, knowledge, and use of health information, will be affected by household adults' behavioral determinants. Household communication is expected to affect the behaviors and the behavioral determinants of adults and children. Data come from the Stanford Five-City Project. Structural equation models revealed that adults' dietary behavior was influenced by their self-efficacy, knowledge, and discussion between adults and children. Children's dietary behavior was influenced by their self-efficacy, knowledge, and use of health information. Adults' intrapersonal determinants of dietary behavior predicted corresponding children's measures. Implications for health education efforts directed at children include encouraging household discussion about health and focusing on adults as agents of change as an integral campaign strategy.

Adolescent↗

PubMed2003

Field study on the choice of friends in two multi-racial pre-schools (South Africa/London).

The present research examined the influence of the two independent variables sex and race on the choice of friends in pre-school children. Data for this investigation were collected in two pre-schools, one situated in Stellenbosch, South Africa, the other in London, U.K. Both schools have in common that they accommodate children of different racial backgrounds (black, white, and coloured children), but the children's experience with desegregated classrooms differ. Friendship was operational defined with thirteen categories, summarized to the basic category pro-social behaviour. Fifty hours of free-play time were taped with one video camera in South Africa, and hundred hours were taped with two video cameras in London. The results showed that sex and race interact in their effect on the choice of friends. In South Africa race is supposed to be a strong indicator for friendship choices, especially for black children, whereas the black children in London choose friends more or less on the basis of sex.

Black People↗

PubMed1994

The influence of subsequent neoplasms on incidence trends in childhood cancer.

The purpose of this analysis was to evaluate to what extent subsequent malignant neoplasms account for the increasing rates of cancer occurrence among children. Data from the population-based Surveillance, Epidemiology, and End Results program were used to calculate age-standardized annual incidence rates from 1974-1989 for 10 common cancers among children 14 years of age or younger. Mean rates and linear trends were evaluated using least squares regression, first for all neoplasms and then excluding subsequent neoplasms, to determine if the removal of subsequent neoplasms would attenuate increasing trends. Increasing annual incidence rates were found for all childhood cancers combined, acute lymphoid leukemia, and brain tumors, but not for other cancer types. Excluding subsequent neoplasms from the analysis had a negligible effect on the trends we observed. Although it remains largely undetermined why childhood cancer incidence rates are increasing in the United States, this study presents evidence that subsequent primary neoplasms do not substantively contribute to these observed trends.

Adolescent↗

PubMed1994

Severe cryptosporidiosis in children with normal T-cell subsets.

Though Cryptosporidium spp. is considered to cause only a self-limiting illness in immunocompetent children, data from Guinea Bissau suggest that cryptosporidiosis may be a significant cause of deaths in developing countries. An impaired cellular immune function could explain the severe course of cryptosporidiosis in these children. We therefore investigated in a community study whether pre-infectious CD4/CD8 status had an impact on incidence and severity of cryptosporidiosis. Of 168 children below two years of age 21 experienced Cryptosporidium-infection within 156 days after blood sampling, but no tendencies of pre-infectious impaired cellular immune function was found in the cases compared with controls, nor did nine children who acquired persistent diarrhoea or three who died have impaired CD4/CD8 status.

CD4-Positive T-Lymphocytes↗

PubMed2005

Weight and energy: parents' and children's perspectives on managing cystic fibrosis diet.

AIMS: To explore the meanings that parents and children attach to food and eating, and how these influence their approaches to dietary management of cystic fibrosis (CF). METHODS: Ethnographic design using in-depth interviews with 32 children with CF (aged 6-14 years) and their parents, and participant observations during visits to CF clinics with a sub-group of 21 children. Data were analysed using the constant comparative method and theoretical sampling was used to further explore and develop emergent themes. RESULTS: Dietary management was found to be a demanding task for children and their parents, and priorities differed between them. A priority of feeding for parents was to protect their children's long term physical health and survival by keeping their weight up. A challenge for parents was to ensure their children's cooperation with eating. A priority for children in being healthy was to have energy for physical activities and so energy rather than weight was of immediate relevance to their daily lives. These differences between parents and children gave rise to tensions and conflicts in their interactions with one another in managing diet. CONCLUSIONS: Healthcare professionals should take account of the meanings that children and their parents attach to food and eating that can influence their decisions about implementing CF dietary recommendations. The role of children in making food choices has implications for acknowledging them as active participants in their dietary care and for adopting child centred approaches to dietary advice for CF.

Adolescent↗

PubMed2002

Tobacco spending and children in low income households.

OBJECTIVE: To examine the role of tobacco use in creating financial hardship for New Zealand (NZ) low income households with children. DATA: The 1996 NZ census (smoking prevalence by household types), Statistics NZ (household spending surveys 1988-98), and NZ Customs (tobacco released from bond 1988-98). MAIN OUTCOME MEASURES: Proportion of children in households with smokers and < or = 15,000 NZ dollars gross income per adult. Proportion of spending on tobacco of second lowest equivalised household disposable income decile and of solo parent households. RESULTS: In < or = 15,000 NZ dollars gross income per adult households with both children and smokers, there were over 90,000 children, or 11% of the total population aged less than 15 years. Enabling second lowest income decile households with smokers to be smoker-free would on average allow an estimated 14% of the non-housing budgets of those households to be reallocated. CONCLUSIONS: The children in low income households with smokers need to be protected from the financial hardship caused by tobacco use. This protection could take the form of more comprehensive government support for such households and stronger tobacco control programmes. A reliance on tobacco price policy alone to deter smokers is likely to have mixed outcomes-for example, increased hardship among some of these households. The challenge for tobacco control is to move from a sole focus on "doing good" towards incorporating the principle of "doing no harm".

Adolescent↗

PubMedDate not supplied

[Immunological status of the pediatric patient who has undergone heart surgery].

UNLABELLED: Communication of results a study the effect of open and closed-heart surgery in the immune system of infants and children. Data collected 24 hrs before anesthesia and surgery and five days after surgery. Operating room and pediatric intensive care of Hospital Central de Petróleos Mexicanos (PEMEX) in the South, Mexico City. Children undergoing surgery for correction of congenital heart disease (age 16 months to 14 years). A total of 16 patients. MEASUREMENTS AND RESULTS: increased neutrophil counts with luymphopenia in both groups (p < 0.05), serum levels of the complement components C3 and C4 were higher after surgery, serum immunoglobulin IgG, IgA and IgM were higher after surgery, serum immunoglobulin IgG, IgA and IgM were decreased form preoperative levels (p < 0.01). Two patients had infection in the surgical wound. The effect of open and closed-heart surgery produced transitory immunodeficiency with recuperation of his immune systems and 5th day after surgery.

Adolescent↗

PubMed2000

Outcome data on pediatric dialysis patients from the end-stage renal disease clinical indicators project.

Network 1 (New England) initiated the Clinical Indicator Project to survey dialysis adequacy (Kt/V), nutrition (serum albumin level), and anemia management in patients maintained on chronic dialysis. Because little information is available in children, data were specifically recorded covering these variables in patients (age, 1 to 18 years) maintained on either hemodialysis (HD) or peritoneal dialysis (PD). During the 18 months of data collection, 29 observations were recorded on 23 HD patients (age, 14.3 +/- 3.6 years), and 43 observations were made on 30 PD patients (age,10.6 +/- 4.7 years). Kt/V correlated inversely with the age of the patient (HD, P < 0.004; PD, P < 0.0007). Although serum albumin level was not associated with dialysis adequacy in HD patients, there was a strong inverse relationship between albumin level and Kt/V in PD patients (P < 0.002). Hematocrit values were not significantly different in the two groups (HD, 31.0% +/- 5.5% versus PD, 32.9% +/- 4.8%) and could not be correlated with weekly erythropoietin dose. Weekly erythropoietin dose was directly related to patient age in both groups (HD, P < 0.05; PD, P < 0.02). The weekly erythropoietin dosage needed to maintain the hematocrit was greater in HD patients (HD, 11,211 +/- 7,484 U versus PD, 3,790 +/- 1,968 U; P < 0.0001). We conclude that (1) smaller children in both groups tend to have a greater Kt/V, (2) Kt/V greater than 2.75 in PD patients may not improve nutrition per se and could result in increased albumin losses, and (3) erythropoietin dosing appears to correlate best with patient size (age) rather than degree of anemia.

Adolescent↗

PubMedDate not supplied

Influence of health locus of control and parental health perceptions on follow-through with school nurse referral.

The health perceptions and health locus of control of 50 parents of students in a school district in New Jersey were investigated in this comparative descriptive study. The study was based on the Health Belief Model and Roger's Science of Unitary Human Beings. Subjects were categorized into two groups, depending on whether or not they followed through with school nurse referrals for their children. Data were collected from each subject to measure levels of health locus of control and health perceptions. The hypothesis stated that parents who do not follow up on health referrals for their children will score lower on health perceptions and health locus of control than parents who schedule referrals for their children. Results revealed no significant differences between compliant and noncompliant parents in health perceptions and health locus of control. Chi-square analyses were used to determine the relationships between sample characteristics and participants' responses to the Health Locus of Control scale and the Health Perceptions Questionnaire.

Adult↗

PubMed2000

Biochemical, cellular, and molecular mechanisms in the evolution of secondary damage after severe traumatic brain injury in infants and children: Lessons learned from the bedside.

OBJECTIVE: To present a state-of-the-art review of mechanisms of secondary injury in the evolution of damage after severe traumatic brain injury in infants and children. DATA SOURCES: We reviewed 152 peer-reviewed publications, 15 abstracts and proceedings, and other material relevant to the study of biochemical, cellular, and molecular mechanisms of damage in traumatic brain injury. Clinical studies of severe traumatic brain injury in infants and children were the focus, but reports in experimental models in immature animals were also considered. Results from both clinical studies in adults and models of traumatic brain injury in adult animals were presented for comparison. DATA SYNTHESIS: Categories of mechanisms defined were those associated with ischemia, excitotoxicity, energy failure, and resultant cell death cascades; secondary cerebral swelling; axonal injury; and inflammation and regeneration. CONCLUSIONS: A constellation of mediators of secondary damage, endogenous neuroprotection, repair, and regeneration are set into motion in the brain after severe traumatic injury. The quantitative contribution of each mediator to outcome, the interplay between these mediators, and the integration of these mechanistic findings with novel imaging methods, bedside physiology, outcome assessment, and therapeutic intervention remain an important target for future research.

Journal Article↗