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Blood lead levels of 4-11-year-old Mexican American, Puerto Rican, and Cuban children.

Data from the Hispanic Health and Nutrition Examination Survey were used to estimate arithmetic mean blood lead and percent with elevated blood lead [25 micrograms per deciliter (micrograms per dl) or greater] for 4-11-year-old Mexican American, Puerto Rican, and Cuban children. The sample size was 1,390 for Mexican American children, 397 for Puerto Rican children, and 114 for Cuban children. Puerto Rican children had the highest mean blood lead levels (11.5 micrograms per dl), followed by Mexican American children (10.4 micrograms per dl) and Cuban children (8.6 micrograms per dl, P less than .05). Puerto Rican children had the highest percent with elevated blood lead (2.7 percent); 1.6 percent of Mexican American children had elevated blood lead; less than 1 percent (0.9 percent) of the Cuban children had elevated blood lead (P less than .05). Mexican American girls had a lower mean blood lead level than did boys: 9.7 micrograms per dl versus 11.0 micrograms per dl (P less than .05). For both Puerto Rican and Mexican American children, younger age indicated a higher risk of having elevated blood lead levels. Mexican American children who lived in poverty had higher mean blood lead levels than did Mexican American children who did not live in poverty--11.6 micrograms per dl versus 9.6 micrograms per dl (P less than .05). Despite advances in primary prevention of lead toxicity in children during the past 10 years, many Hispanic children are at risk of lead toxicity. Approximately 19,000 Mexican American 4-11-year-old children living in the Southwest and approximately 8,000 Puerto Rican children living in the New York City area had elevated blood lead levels (greater than or equal to 25 micrograms per dl) during 1982-84.

Child↗

Cochlear implant candidacy and performance trends in children.

Data from Clarion cochlear implant pediatric clinical trials were examined retrospectively to uncover trends in candidacy and postimplant benefit over time. In particular, age at implantation, educational setting, and communication mode were examined with respect to speech perception performance after implantation. The results showed that 1) age at implantation is decreasing, 2) children in oral education programs obtain more benefit from a cochlear implant than children in total communication programs, 3) children who undergo implantation before 2 years of age show greater benefit than children who undergo implantation between 2 and 3 years of age, 4) more younger children are using oral communication than older children, and 5) more children with good auditory skills before implantation and more residual hearing are undergoing implantation. In sum, in the 11 years since implants have been available to children in the United States, candidacy criteria have evolved and benefit has increased as cochlear implant technology has advanced.

Age Factors↗

The extent of barriers and linkages to health care for head start children.

Data were gathered as part of a larger survey of 218 Head Start Programs in Region II (New York City, New York State (excluding New York City), New Jersey, Puerto Rico and U.S. Virgin Islands) in 1993-94. The general purpose of the survey was to obtain information on child health, screening practices, training needs, family health and community problems, barriers to diagnosis and treatment and the extent of linkages between Head Start programs and health and nutrition providers at the local level. In this study barriers to the care of Head Start children and their families were examined as perceived by the Health Coordinators or other health related staff of the Health Services Component of these programs. The extent of linkages with health and nutrition service providers were also examined. The most frequently reported barriers were lack of parent participation (72%), private transportation not available (67%), parents' perception of quality of care (64%), distance to provider (63%), cost of transportation (63%), lack of funding (56%), limited/inconvenient hours (56%), and health services not available in the community (55%). On average, programs reported linkages to 14.5 providers (including an average of 4 nutrition programs). More than 90% of them reported linkages with public health services, child protective services, WIC and private physicians/dentists. Finally, the extent of barriers and linkages were compared across different geographic areas. Significant barriers were identified in this study, yet the survey confirmed and validated the extensive nature of formal linkages with health and nutrition service providers at the local levels. These findings may indicate that the current levels of service availability may not be sufficient to meet the severity and diversity of health needs of this population.

Analysis of Variance↗

Prediction of dental caries in pre-school children.

Data obtained in a longitudinal study of caries incidence and caries-related factors were analysed with a view to producing a model for the prediction of caries. In direct correlations, caries incidence was significantly associated with bacterial, dietary and salivary variables; but when the data were examined by stepwise regression the strongest variables were the baseline caries score and misuse of sugar. Counts of Streptococcus mutans entered into the analysis but only as a relatively minor component. Similar significant relationships were seen with the determination of odds ratios. A caries activity test was formulated combining the following caries-associated variables: high counts of S. mutans, or lactobacilli, or the misuse of sugar, or frequent consumption of paediatric medicines. Regular use of fluoride tablets could compensate for paediatric medicine use or misuse of sugar. Such a caries activity test if it had been applied to the children at baseline would have had a positive predictive value of 0.76, a negative predictive value of 0.82, a sensitivity of 0.8 and a specificity of 0.78. Combining tests made the prediction of caries more accurate and in the population for which it was intended gave a reliable means of detecting those children most in need of enhanced caries prevention.

Child↗

Policy relevance of a survey on smoking and drinking behaviour among Dutch school children.

Data from the first measurement of a cohort study among secondary schoolchildren allowed us to investigate policy correlates to smoking and drinking behaviour to some extent. Regular smoking is related to anti-smoking campaigns among boys and regular drinking is related to alcohol education at primary school. Regular drinking is also related to economic availability (free availability of alcohol and pocket money). The findings on economic availability and health education are directly policy relevant.

Adolescent↗

Physical knowledge of sugar water solutions: cross-cultural data.

Children's understanding of sugar water solutions may progress through universal stages: from nonpreservation to preservation to liquefaction to atomism. This claim was investigated in the current study; the claim was originally prefigured in the work of Piaget and Inhelder (1974) and more recently consolidated by Slone (1987). Our sample consisted of 270 South African children drawn from three cultural groups and ranging in age from 4 to 14 years. Children watched a demonstration in which a sugar lump was dissolved in water. Then, using structured interviews, we explored their understanding of this phenomenon. The results generally confirmed the hypothesized developmental sequence. Moreover, because the sequence was consistent across cultural groups, the claim that physical knowledge evolves through universal stages also was supported. Perhaps significantly, however, the progression of knowledge development did not unequivocally lead to the concept of atomism. Developmental implications of these findings are discussed.

Adolescent↗

Spondyloarthropathies and psoriatic arthritis in children.

Data that are relevant to the general understanding of the juvenile-onset spondyloarthropathies are reviewed here. Seronegative enthesopathy and arthropathy syndrome is considered the earliest recognizable form of juvenile-onset spondyloarthropathy, from which other syndromes and diseases emerge. The group also includes juvenile-onset ankylosing spondylitis, a disease defined in adult-based terms when definite changes have occurred in the axial joints; ankylosing tarsitis, a complex disorder in which foot problems resemble those of the spine in ankylosing spondylitis; Crohn's disease and ulcerative colitis-related peripheral and, especially, HLA-B27 axial disease; reactive arthritis and Reiter's syndrome, which might be further classified according to its cause; and juvenile psoriatic arthritis, a disease that resembles juvenile rheumatoid arthritis more than does juvenile-onset spondyloarthropathy.

Arthritis, Psoriatic↗

Familial drinking history as a predictor of alcohol and drug consumption among adolescent children.

Data concerning adolescent alcohol and drug using behaviors, as well as the drinking patterns of their parents, were obtained from a sample of 1,380 New Jersey youth born between 1961 and 1969. Initially tested between 1979 and 1981 at ages 12, 15 or 18, these subjects were retested between 1982 and 1984 (retest rate = 95%). We wish to describe the early differences in patterns of alcohol and drug use between offspring of families exhibiting a positive history of alcoholism (FH+) and those without such backgrounds (FH-). FH+ subjects are compared to three other groups from varying parental backgrounds (heavy drinking nonalcoholic parents, high stress families and symptom-free families) as regarding problem use. Several indicators of problem use (e.g., early onset of intoxication, frequent intoxication, escape drinking) were not found to be more prevalent among FH+ than FH- adolescents. Analyses indicate, however, that FH+ adolescents are more likely than FH- adolescents from symptom-free families to report experiencing problems/consequences related to both drinking and drug taking.

Adaptation, Psychological↗

[Peritoneal dialysis in acute renal failure in children].

Data on the treatment of infants with acute renal failure are presented. Indications for renal substitute therapy are enumerated and hemodialysis and peritoneal dialysis are compared. Complications of peritoneal dialysis are discussed and methods for their treatment are presented. The authors demonstrate that peritoneal dialysis is an effective, safe, and available method for treating acute renal failure in infants.

Acute Kidney Injury↗

Genetic studies of febrile convulsions: analysis of twin and family data.

Children with febrile convulsions (FC) including 46 twin pairs, 1913 families including 393 sibling pairs, and 42 three-generation FC kindreds have been studied. Twin studies: (1) The pairwise concordance rate for FC was 69% (18/26 pairs) in monozygotic (MZ) and 20% (4/20 pairs) in dizygotic (DZ) twins (P less than 0.01). (2) The intra-pair similarity of clinical symptoms in 18 concordant MZ twin pairs showed a positive significant correlation, particularly in 4 items--duration of seizure, exogenous factors, intelligence level, and background EEG abnormality. These correlations were greater than those in sibling pairs. (3) No evident cause for discordance was detected in 8 discordant MZ twin pairs, and many dissimilar symptoms were observed in 4 concordant DZ twin pairs. Sibship studies: A large positive correlation of some clinical symptoms was observed in sibling pairs concordant for FC: age at onset of FC, degree of fever, duration of seizure, exogenous factors, and background EEG abnormality (r = +0.2- +0.6). Family history analysis: Morbidity risk among near relatives (17% in parents, 23% in siblings) than in second- (6.1%) or third-degree relatives (4.6%). The difference was found between: sibling greater than parents, uncles greater than aunts, male cousins greater than female cousins. Segregation analysis showed maternal preponderance. In 42 three-generation kindreds the morbidity risk was higher in siblings (32%), uncles/aunts (14%), and cousins (6.4%) than in relatives of other probands. Characteristic findings in FC patients with family history: Characteristic findings in FC patients with an FC parent or sibling, compared with those with no family history, were early onset of FC, lower degree of fever, longer duration of seizure, many recurrences, FC recurrence after age 3, and background EEG abnormality. Similar findings were more markedly observed in 42 3-generation kindreds. Mode of inheritance: A multifactorial mode of inheritance for FC receives some support from this study, and the heritability was estimated as 75%.

Child, Preschool↗

The prevalence of visual disorders in a school for emotionally disturbed children.

Data on the prevalence of visual disorders in special populations as well as in normal populations is sparse. Fifty-five students in a special education school were given a comprehensive screening for pathology, acuity, refractive error, fusion, oculomotor, and perceptual motor skills. This group had a very high prevalence of visual disorders especially perceptual motor, oculomotor and fusion disorders.

Affective Symptoms↗

Growth hormone secretion and long-term growth data in children with psychosocial short stature treated by different changes in environment.

OBJECTIVES: We assessed auxological and endocrine data of 65 children (32 girls) from 51 families with an average age of 6.6 years (range, 0.9 to 16.5 years, all but five prepubertal) with psychosocial short stature. METHODS: Fifty-one patients had an assessment of growth hormone (GH) secretion. Thirty-four were subjected to repeated testing with the first test being performed when the child was still in the adverse environment and the next testing after the child was removed. Twenty-five out of those 34 were repeatedly tested during one uninterrupted hospital admission with limited parental access. Thirty patients had a definite, long-term change in their environment (13 were separated from their families) and were assessed concerning their auxological data. RESULTS: Of the 34 patients who had repeated endocrine testing, 11 (32%) showed reversible GH deficiency (GHD), nine (26%) increased their previously normal peak GH concentration, and six (18%) had apparently irreversible GHD. Patients who had a change in environment increased their mean height velocity SDS from -0.9 (SD 1.5) to +1.5 (2.3) (p < 0.0001). Accordingly, height SDS increased from -2.9 (SD 0.8) before to -2.6 (SD 0.8) after the change (p < 0.001). CONCLUSION: One of the diagnostic features of psychosocial short stature is reversible GH insufficiency, which usually normalises after the child is separated from the adverse environment. Catch-up growth is always found after a positive change in the environment, and may occur within the family. However, if a change in environment is not possible, GH therapy may be an option.

Adolescent↗

Pregnancy outcome and neonatal data of children born after ICSI using testicular sperm in obstructive and non-obstructive azoospermia.

BACKGROUND: Registries on outcome of ICSI pregnancies obtained with testicular sperm do not differentiate between obstructive (OA) and non-obstructive azoospermia (NOA). We evaluated the pregnancy outcome and neonatal data on children born after ICSI using testicular sperm of men with histologically proven OA or NOA. METHODS: Pregnancies obtained after ICSI using testicular sperm of men with defined NOA (n = 70) were compared with those of men with OA (n = 204). RESULTS: Multiple birth rates in NOA and OA couples, respectively, were 21 versus 27% (P = NS), overall preterm delivery rates were 38 versus 26% (NS), and prematurity rates were 24 versus 13% for singletons (NS) and 86 versus 54% for twins (relative risk 1.59, 95% confidence interval 1.04-2.42). Median gestational age for singletons was 38.3 versus 39.3 weeks, respectively (P < 0.05). The low birth weight rates were 34 versus 31%, respectively (NS). The early perinatal mortality rate was 66 versus 15 per 1000 births, respectively, (NS). Major congenital malformations were observed in 4 versus 3%, respectively, of the live born babies (NS). Prenatal karyotypes showed 7% de-novo abnormalities in the NOA group versus 1% in the OA group (NS). CONCLUSIONS: Our data do not show differences between NOA and OA pregnancies except for a strong tendency towards a lower gestational age in singletons and a higher percentage of premature twins in the NOA group. Although our data are based on a limited sample, the differences observed call for further analysis. Given the low pregnancy rates after ICSI with NOA, a multicentre study, differentiating NOA and OA patients, would be recommended.

Adult↗

Patterns of change in weight/stature2 from 2 to 18 years: findings from long-term serial data for children in the Fels longitudinal growth study.

Serial weight/stature2 (W/S2) data recorded semi-annually from 2 to 18 years in the Fels longitudinal study were analyzed to establish an approach for the investigation of long-term serial changes in body fatness during childhood and adolescence in individuals. To describe patterns of change in body fatness during childhood and adolescence, a family of mathematical models was fitted to individual serial W/S2 data recorded from 250 boys and 246 girls. The selected models fitted the W/S2 data well as judged by the root mean square errors. Based on the fitted models, variables representing patterns of change in an individual were derived. These included estimated value of W/S2 at 2 years of age (W/S(2)2yr), minimum value of W/S2 (W/S2min), age at minimum value of W/S2 (Amin), maximum velocity of W/S (Vmax), age at maximum velocity of W/S2 (AVmax), maximum value of W/S2 (W/S2max), and age at maximum value of W/S2 (Amax). There were highly significant correlations between observed W/S2 at 18 years and all the derived variables except AVmax indicating, for example, that in both sexes about 25 percent of the variation in W/S2 at 18 years could be explained by when Amin occurs or by the value of W/S2min. The negative correlations (r = -0.5) between Amin and W/S2 at 18 years suggested that the earlier children reach their nadir in W/S2, the earlier they began to increase in adiposity and the fatter they were at 18 years. Likewise, the positive correlations (r approximately 0.3 and 0.5, respectively) between the W/S(2)2yr or W/S2min and W/S2 at 18 years indicated that increased childhood adiposity may lead to increased adult adiposity.

Adipose Tissue↗

Testing the agreement/tense omission model: why the data on children's use of non-nominative 3psg subjects count against the ATOM.

One of the most influential recent accounts of pronoun case-marking errors in young children's speech is Schütze & Wexler's (1996) Agreement/Tense Omission Model (ATOM). The ATOM predicts that the rate of agreeing verbs with non-nominative subjects will be so low that such errors can be reasonably disregarded as noise in the data. The present study tests this prediction on data from 12 children between the ages of 1; 8.22 and 3 ; 0.10. This is done, first, by identifying children who produced a reasonably large number of non-nominative 3psg subjects; second, by estimating the expected rate of agreeing verbs with masculine and feminine non-nominative subjects in these children's speech; and, third, by examining the actual rate at which agreeing verb forms occurred with non-nominative subjects in those areas of the data in which the expected error rate was significantly greater than 10%. The results show, first, that only three of the children produced enough non-nominative subjects to allow a reasonable test of the ATOM to be made; second, that for all three of these children, the only area of the data in which the expected frequency of agreeing verbs with non-nominative subjects was significantly greater than 10% was their use of feminine case-marked subjects; and third, that for all three of these children, the rate of agreeing verbs with nonnominative feminine subjects was over 30%. These results raise serious doubts about the claim that children's use of non-nominative subjects can be explained in terms of AGR optionality, and suggest the need for a model of pronoun case-marking error that can explain why some children produce agreeing verb forms with non-nominative subjects as often as they do.

Child↗

Normative data on the Missouri Children's Picture Series and the Missouri Children's Behavior Checklist with Southern black children.

Normative data are presented for Southern black children on two objective personality inventories for children: the Missouri Children's Picture Series (MCPS), a child picture-sorting task, and the Missouri Children's Behavior Checklist (MBCL), a parent rating scale. The MCPS was administered to 615 black children attending public schools in a low socioeconomic area of the southeast United States. Parents returned the MBCL on 437 of the children. Means and standard deviations on eight MCPS personality scales and six MCBL behavior rating scales are presented for black males and females at ages 5 through 16, and effects of age, sex, and various scale intercorrelations are discussed. Results suggest systematic age and sex differences on the various scales for black children that are quite atypical when compared with the MCPS in other samples. Various empirical questions regarding the validity of these instruments when used with Southern black children are raised.

Adolescent↗

[Atrial septum defect: comparison of pre-and postsurgery echocardiographic data in adults and children].

Echocardiographic data in 13 adults and 17 children before and after surgical closure of an atrial septum defect are compared. Before surgery the enddiastolic dimension of the right ventricle was bigger in children than in adults. Septal motion was paradoxal or abnormal in 92% of adults and 65% of children (NS). Two weeks after surgery the right ventricle had decreased similarly in adults and in children, but often remained dilated. Septal motion was normal in 25% of adults and 76% of children (p less than 0.01). Four months after surgery, the right ventricle dimension was unchanged; septal motion was normal in all children but only in 50% of adults (p less than 0.005). This remaining abnormal septal motion after surgery may be explicable by the long-standing presence before surgery of a major shunt inducing chronic disturbances of right ventricular compliance.

Adolescent↗

Comparison of biometric data of children with high and low levels of lead in the blood.

This paper deals with a biometric study of 312 boys and girls, aged 2.5-16 years, living in an area with a long history of pollution by lead. The aim was to search for eventual relationships between ten biometric variables and measures of lead absorption in the bodies, i.e. the amount of lead in the blood (PbB), of these children. Standardized values of the biometric variables were compared in the high-PbB and low-PbB categories, by multivariate analysis of variance. Comparison of the vectors of the ten biometric variables reveals a significant difference between the two categories of PbB levels. We found some evidence that the younger children (below 8 years of age) are more likely to absorb lead in the body and are more vulnerable to the effects of subclinical lead intoxication than their older counterparts. The differences between the averages of biometric variables in the two PbB categories are consistently (although not significantly) greater among younger children. This trend disappeared in the older age group. These results confirm data from the literature that young children are especially at risk. It can be concluded that there is a subtle, but significant, influence of lead absorption on the biometric profiles of children and that this effect is probably more important in children below 8 years of age.

Adolescent↗