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Cuenca Alcocel J, Villalba-Heredia L, Martínez Redondo I, Berrozpe-Villabona C, Casajús JA, Arbonés-Mainar JM, Calmarza P. Metabolismo óseo en niños aragoneses con normopeso y niños con sobrepeso/obesidad. Adv Lab Med 2024; 5:75-84. [PMID: 38634080 PMCID: PMC11019878 DOI: 10.1515/almed-2023-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/28/2023] [Indexed: 04/19/2024]
Abstract
Objetivos En la infancia y adolescencia se produce un aumento de masa ósea, hasta alcanzar un pico máximo, determinante para la salud ósea. Los marcadores óseos evalúan los procesos de formación-resorción ósea. Sin embargo, los estudios sobre la influencia de la obesidad en los marcadores de recambio óseo en esta edad, son escasos y los resultados contradictorios. El objetivo de nuestro estudio fue evaluar si el sobrepeso/obesidad influían en el metabolismo óseo. Métodos Se compararon parámetros relacionados con el metabolismo óseo, en 45 niños y niñas normopeso (controles) y en un grupo de 61 niños y niñas con sobrepeso/obesidad (casos), procedentes del estudio Exergames (Universidad de Zaragoza), de edades comprendidas, todos ellos, entre 8 y 12 años. Resultados La concentración de fósforo y la de IGFBP-3 fueron superiores en los niños con sobrepeso/obesidad, respecto a la de los niños normopeso, (p=0,042) y (p=0,042), respectivamente. Las concentraciones de BAP, osteocalcina, magnesio, vitamina D e IGF-I fueron más bajas en el grupo de los niños con sobrepeso/obesidad y la de calcio más elevada, pero las diferencias no fueron estadísticamente significativas. Existe correlación negativa (r=−0,193) (p=0,049) entre BAP e IMC. Conclusiones En los niños con sobrepeso/obesidad pese a que no se llegó a alcanzar significación estadística, la concentración de BAP y osteocalcina fue inferior a la de los niños normopeso, lo cual junto con la correlación negativa de BAP respecto al IMC encontrada, puede indicar que ya en edades tan tempranas el sobrepeso/obesidad puede afectar a la salud ósea.
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Affiliation(s)
| | | | | | | | - José Antonio Casajús
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón)Zaragoza, España
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos IIIMadrid, España
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y el Deporte, Universidad de ZaragozaZaragoza, España
| | - José Miguel Arbonés-Mainar
- Adipocyte and Fat Biology Laboratory (AdipoFat), Unidad de Investigación Transversal, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria (IIS), Zaragoza, Aragón, España
- Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España
| | - Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBERCV), Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón)Zaragoza, España
- Miembro de las Comisiones de Estrés Oxidativo y Lipoproteínas y Enfermedades vasculares de la SEQC-ML, Servicio de Bioquímica Clínica, Hospital Universitario Miguel ServetZaragoza, España
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Sille Schandorph Løkkegaard, Ask Elklit, Maria Louison Vang. Examination of ICD-11 PTSD and CPTSD using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) in a sample of Danish children and adolescents exposed to abuse. Eur J Psychotraumatol; 14:2178761. [PMID: 37052084 PMCID: PMC9980161 DOI: 10.1080/20008066.2023.2178761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background: International research has established that children and adolescents are at risk for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the WHO ICD-11. There is a need for a Danish language version of the International Trauma Questionnaire – Child and Adolescent (ITQ-CA) to assess symptoms of PTSD and CPTSD. Objective: To test the ICD-11 formulations of PTSD and DSO (Disturbances of Self-Organization) using the ITQ-CA version in a sample of children exposed to abuse. Additionally, to study the distribution of symptoms and probable prevalence of ICD-11 PTSD and CPTSD among the population of children exposed to violence or sexual abuse. Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among a sample of 119 children and adolescents that were referred to the Danish Children Centres on suspicion of physical or sexual abuse or both. Latent class analysis (LCA) was used to study the distribution of symptoms and consequences of different operationalisations of functional impairment were explored. Results: Findings supported a two-factor second-order model corresponding to the operationalisation of CPTSD in ICD-11 as the best representation of the data. Findings from the LCA suggested that symptoms were distributed in a pattern consistent with the ICD-11 proposal for CPTSD. CPTSD was more prevalent than PTSD regardless of the operationalisation of functional impairment. Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD among Danish children exposed to physical or sexual abuse. Further research is needed to study the relationship between ICD-11 C/PTSD symptomatology and anxiety and depression in this population. The International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) is a valid measure of symptoms of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among Danish children exposed to physical or sexual violence. The structure of the ITQ-CA in the Danish sample reflects the ICD-11 diagnostic algorithm. CPTSD is a more prevalent disorder among children recently exposed to violence than PTSD.
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de Melo EB, Almeida PD, Pereira BM, Borges PDTM, Gir E, de Araújo TME. Vaccination hesitation in children under five years of age: a scoping review. Rev Bras Enferm 2023; 76:e20220707. [PMID: 38018617 PMCID: PMC10680390 DOI: 10.1590/0034-7167-2022-0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/08/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to synthesize scientific evidence on vaccine hesitancy in children under five years of age and its associated factors. METHODS a scoping review, conducted according to the methodological structure proposed by the JBI. Searches were carried out in the Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and PubMed databases, including gray literature. Studies in English, Spanish and Portuguese were included, without temporal delimitation. Editorials, studies that did not address vaccine hesitancy in children under five years of age and were not aligned with the objective and research question were excluded. The sample consisted of 18 articles. RESULTS misinformation, concern about adverse effects, distrust about efficacy, affliction regarding administration simultaneously, and insecurity in relation to the laboratories were the reported reasons. CONCLUSIONS strategies are needed to combat the lack of information about immunobiological agents, as misinformation was the main factor in parents' vaccine hesitation.
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Affiliation(s)
| | | | | | | | - Elucir Gir
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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Coelho B, Mota B, Viana V, Igreja AI, Candeias L, Rocha H, Rocha DFD, Guardiano M. Theory of mind in children with attention deficit hyperactivity disorder. Rev Neurol 2023; 77:109-114. [PMID: 37612827 PMCID: PMC10662233 DOI: 10.33588/rn.7705.2023099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Theory of mind (TM) is involved in social cognition, as it evaluates our ability to impute our mental states to the others in order to predict and explain behaviour. In the literature, it has been noticed that children with attention deficit hyperactivity disorder (ADHD) show some impairments of TM when compared with children not neurodevelopmental impaired. Our goal in this study was to compare the TM in two groups: schooler children with normal development and schooler children with ADHD. SUBJECTS AND METHODS A total of 35 children, aged between 6 and 12 years, were recruited: 17 with ADHD and 18 not neurodevelopmental impaired. TM was evaluated using an assessment method validated for the Portuguese population: Turtle on the Island-Battery of Assessment of Executive Functions in Children. RESULTS We obtained two comparable groups concerning sociodemographic data. There were no significant differences between the two groups regarding TM. CONCLUSION The TM assessment in Portuguese children did not reveal significant impairment regarding this cognitive skill in children with ADHD.
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Affiliation(s)
- Beatriz Coelho
- Faculty of MedicineFaculty of MedicineFaculty of MedicinePortoPortugal
| | - Bárbara Mota
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Victor Viana
- Faculty of Food Sciences and Nutrition SciencesFaculty of Food Sciences and Nutrition SciencesFaculty of Food Sciences and Nutrition SciencesPortoPortugal
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Ana I. Igreja
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Linda Candeias
- Prisma-Centro de Desenvolvimento e Terapias. Custóias, PortugalPrisma-Centro de Desenvolvimento e TerapiasPrisma-Centro de Desenvolvimento e TerapiasCustóiasPortugal
| | - Hélia Rocha
- Psychology Center. Universidade do PortoUniversidade do PortoUniversidade do PortoPortoPortugal
| | - Diogo Fernandes-da Rocha
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Micaela Guardiano
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
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Suárez Ardura M, García-Pola M, Cuervo Menéndez JM. [Prevalence of dental and mucosal lesions among the pediatric population who attended the emergency department of a general hospital]. An Sist Sanit Navar 2023; 46:e1041. [PMID: 37635690 PMCID: PMC10518804 DOI: 10.23938/assn.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The high prevalence of oral pathology in children encourages to gain further understanding on their manifestations and urgent nature, objective of the present study Methodology. Cross-sectional study that included patients aged <14 years of age who attended an emergency department over a one-year period. The relationship between the variables collected and oral pathology was analyzed. RESULTS Fifty-five patients were included, 45.5% girls, mean age 4.11 years (10 days to 13 years). Overall, mucosal pathology (74.5%) prevailed over dental ones, and lesions of infectious origin (54.6%) over the traumatic ones (14.5%). Dental pathology (50% toothache and 35.7% infections) was significantly associated with being >6 years (66.7 vs 10%), pain (40.7 vs 10.7%) and absence of fever (37.9 vs 11.5%). Mucosal pathology (61% infections: 53.7% viral and 31.7% due to herpangina) was significantly associated with being =6 years (60 vs 6.7%) and having fever (76.9 vs 17.2%). Six traumatic lesions on the mucosa and two on the teeth were observed; significantly more patients attended the emergency room within 24 hours (median =1 hour) than in the case of infection (100 vs 51.7%). Being =6 years was significantly associated with fever, mucosal pathology, mucosal infection, and herpangina, and being >6 years was associated with pain, previous antibiotic treatment and at discharge, and previous NSAID regimen. CONCLUSIONS The analyzed pediatric oral pathologies treated in the emergency department are of mucosal and infectious origin. Dental disease prevail in children >6 years of age and mucosal lesions in those =6 years; no sex differences are observed.
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Affiliation(s)
| | - María García-Pola
- Área de Estomatología. Departamento de Cirugía y Especialidades Médico-Quirúrgicas. Universidad de Oviedo. Asturias. España. .
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Régio L, Barros S, Ballan C, Aguiar C, Candido BDP, de Oliveira MAF. The care provided to black-skinned children and adolescents with mental health problems in the intersection between gender and race. Rev Lat Am Enfermagem 2023; 31:e3941. [PMID: 37341257 PMCID: PMC10306061 DOI: 10.1590/1518-8345.6058.3941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/28/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE to characterize the sociofamily profile of black-skinned children and adolescents with mental health problems and to intersectionally describe who assumes responsibility for their care. METHOD a descriptive and exploratory study with a quantitative approach, developed in the Psychosocial Care Center for Children and Adolescents from the North region of the municipality of São Paulo. The data were collected from 47 family members of black-skinned children and adolescents, using a script with predefined variables submitted to statistical analysis. RESULTS a total of 49 interviews were conducted: 95.5% women with a mean age of 39 years old, 88.6% mothers and 85.7% black-skinned. Family income comes from wages for all the male caregivers and for 59% of the women. Among the black-skinned female caregivers, 25% live in their own house, whereas this percentage is 46.2% among the brown-skinned ones. Of all the caregivers, 10% have a job, 20% live in transferred properties, 35% in houses of their own and 35% in rented places. The social support network is larger among white-skinned people (16.7%), followed by brown-skinned (3.8%), and absent among black-skinned individuals (0%). CONCLUSION those responsible for the care of black-skinned children and adolescents monitored by the CAPS-IJ are almost entirely women, black-skinned (black or brown) "mothers or grandmothers", with unequal access to education, work and housing, constitutional social rights in Brazil.
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Affiliation(s)
- Luciane Régio
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Faculdade de Ciências Médicas da Santa Casa, Curso de Enfermagem, São Paulo, SP, Brasil
| | - Sônia Barros
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Universidade de São Paulo, Instituto de Estudos Avançados, São Paulo, SP, Brasil
| | - Caroline Ballan
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Carla Aguiar
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
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Elena Alcover Bloch, Anna Gatell Carbó, Josep Vicent Balaguer Martínez, Tomás Perez Porcuna, Olga Salvado Juncosa, Emilio Fortea Gimeno, Patricia Álvarez Garcia. Evolución De La Salud Mental Infanto-Juvenil En Catalunya En El Contexto De La Pandemia Por La Covid-19 Durante El Curso Escolar 2020-2021 ◊◊. An Pediatr (Barc) 2023. [ DOI: 10.1016/j.anpedi.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Introducción: La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte poblacional a lo largo del curso 2020-21. Métodos: estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14 años en Cataluña entre septiembre 2020 y julio 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del cuestionario Strengths and Difficulties Questionnaire (SDQ) contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4 cortes). Resultados: Al inicio del curso escolar el 9,8% de los pacientes fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con el COVID-19 se asoció con resultado alterado del SDQ. Conclusiones: A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró y pasó del 9,8% al 6,2%.
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Bañuelos Marco B, Donmez I, Geppert T, Prudhomme T, Campi R, Mesnard B, Hevia V, Boissier R, Pecoraro A, Territo A. Renal transplantation in pediatric recipients: Considerations and preoperative assessment strategies. Actas Urol Esp 2023:S2173-5786(23)00038-0. [PMID: 36965856 DOI: 10.1016/j.acuroe.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION AND OBJECTIVE Renal transplantation in the pediatric population differs from adults in many aspects. This review will focus on the unique issues of the pediatric recipient. MATERIAL AND METHODS A narrative review on the scarce literature regarding preoperative evaluation before kidney transplantation of the paediatric recipient with an educational focus was conducted. The literature search allowed for identification of publications in English from January 2000 to October 2022. Published studies were identified by searching the following electronic databases: PubMed (MEDLINE), WHO/UNAIDS, Google-Scholar, Semantic-Scholar and Research Gate. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information (definitions, policies or guidelines). RESULTS Management of congenital urogenital anomalies and lower urinary tract dysfunction along with optimal pediatric urological preoperative assessment for renal transplantation in children is addressed in the light of the available literature. Furthermore, particular considerations including pre-emptive transplantation, transplantation of an adult-size kidney into an infant or small child is discussed. CONCLUSIONS Outcomes of RT in children have shown progressive improvement over the past 15 years. Transplantation with living related donor gives the best results and pre-emptive transplantation provides with benefits of avoiding dialysis. Surgical and medical considerations in both the pre-transplant and post-transplant management of the pediatric kidney recipient are extremely crucial in order to achieve better short and long-term results.
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Affiliation(s)
- B Bañuelos Marco
- Department of Urology, Renal Transplant Unit Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - I Donmez
- Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Estambul, Turkey
| | - T Geppert
- Division of Pediatric Urology, Department of Urology, University Hospital Charité Berlin, Berlin, Germany
| | - T Prudhomme
- Department of Urology and Kidney Transplantation, Toulouse University Hospital, Toulouse, France
| | - R Campi
- Department of Urology, Florence University Hospital, Florence, Italy
| | - B Mesnard
- Institut de Transplantation Urologie Néphrologie, CHU Nantes, Nantes, France
| | - V Hevia
- Urology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Boissier
- Department of Urology, La Conception University Hospital, Marseille, France
| | - A Pecoraro
- Department of Urology, Florence University Hospital, Florence, Italy
| | - A Territo
- Oncology and Renal Transplant Units, Puigvert's Foundation, Barcelona, Spain
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Khan YS, Khan AW, Alabdulla M. The psychological impact of the Turkey-Syria earthquake on children: addressing the need for ongoing mental health support and global humanitarian response. Eur J Psychotraumatol 2023; 14:2249788. [PMID: 37682068 PMCID: PMC10494726 DOI: 10.1080/20008066.2023.2249788] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/31/2023] [Accepted: 08/12/2023] [Indexed: 09/09/2023] Open
Abstract
This letter aims to explore the potential impact of the Turkey-Syria earthquake on the psychological well-being of the affected children and adolescents. It emphasises the crucial importance of prompt identification and management of emerging mental health disorders in this vulnerable population. The letter draws on existing research evidence to highlight the need for suitable mental health interventions to mitigate the anticipated suffering of many children and adolescents affected by the earthquake. A comprehensive overview of the mediating factors which may play a role in the extent of the impact of an earthquake on the mental health of children is discussed. A range of appropriate strategies and interventions are recommended and the call for continued global support is renewed. We have concluded that major earthquakes can potentially contribute to the development of mental health disorders among children and adolescents. However, by providing timely and effective support, it is possible to prevent long-term psychological consequences and facilitate early recovery. We propose the urgent implementation of effective mental health interventions in the aftermath of the Turkey-Syria earthquake to foster the recovery and resilience of the affected young population.
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Affiliation(s)
| | | | - Majid Alabdulla
- Mental Health Service Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
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Fagermoen EM, Skjærvø I, Jensen TK, Ormhaug SM. Parent-led stepped care for traumatised children: parental factors that predict treatment completion and response. Eur J Psychotraumatol 2023; 14:2225151. [PMID: 37366166 DOI: 10.1080/20008066.2023.2225151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Stepped care cognitive behavioural therapy for children after trauma (SC-CBT-CT; aged 7-12 years) can help to increase access to evidence-based trauma treatments for children. SC-CBT-CT consists of a parent-led therapist-assisted component (Step One) with an option to step up to standard therapist-led treatment (Step Two). Studies have shown that SC-CBT-CT is effective; however, less is known about what parent variables are associated with outcome of Step One.Objective: To examine parent factors and their relationship with completion and response among children receiving Step One.Method: Children (n = 82) aged 7-12 (M = 9.91) received Step One delivered by their parents (n = 82) under the guidance of SC-CBT-CT therapists. Logistic regression analyses were used to investigate whether the following factors were associated with non-completion or non-response: the parents' sociodemographic variables, anxiety and depression, stressful life experiences and post-traumatic symptoms, negative emotional reactions to their children's trauma, parenting stress, lower perceived social support, and practical barriers to treatment at baseline.Results: Lower level of educational achievement among parents was related to non-completion. Higher levels of emotional reactions to their child's trauma and greater perceived social support were related to non-response.Conclusions: The children seemed to profit from the parent-led Step One despite their parents` mental health challenges, stress, and practical barriers. The association between greater perceived social support and non-response was unexpected and warrants further investigation. To further increase treatment completion and response rates among children, parents with lower education may need more assistance on how to perform the interventions, while parents who are very upset about their child's trauma may need more emotional support and assurance from the therapist.Trial registration: ClinicalTrials.gov NCT04073862; https://clinicaltrials.gov/ct2/show/NCT04073862. Retrospectively registered 03 June 2019 (first patient recruited May 2019).
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Affiliation(s)
| | - Ingeborg Skjærvø
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tine K Jensen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Golemba MD, Moragas M, Fernández MF, Borgnia D, Ruhle M, Palladino M, Arias AP, Ruvinsky S, Bologna R, Mangano A. Comparison of SARS-CoV-2 viral load in asymptomatic and symptomatic children attended in a referral public pediatric hospital in Argentina. Rev Argent Microbiol 2022. [PMID: 36402614 PMCID: PMC9618439 DOI: 10.1016/j.ram.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/15/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
At present, different reports have shown that children reach similar SARS-CoV-2 viral load (VL) levels compared to adults; however, the impact of VL on children remains ambiguous when asymptomatic versus symptomatic cases are compared. Thus, the aim of this study was to assess VL at the time of diagnosis in asymptomatic and symptomatic SARS-CoV-2 infected children. VL analysis was retrospectively carried out from nasopharyngeal swabs on 82 SARS-CoV-2 infected children, from March to October 2020. Of the 82 children, 31 were asymptomatic. Symptomatic patients had significantly higher VL values compared to asymptomatic ones (median = 7.41 vs 4.35 log10 copies/ml, respectively). Notwithstanding, 8 out of 31 asymptomatic children had high VL levels, overlapping levels observed above the first quartile in the symptomatic group. Analysis of different age groups revealed that median VL values were higher in the symptomatic groups, although there was only a significant difference in children younger than 5 years of age. On the other hand, there was no significant difference between the VL values from the 82 SARS-CoV-2 infected children according to age, sex, underlying disease, symptoms or severity of COVID-19 related disease. This study emphasizes the importance of VL analysis in SARS-CoV-2 infected children, who could contribute to viral spread in the community. This concern could be extended to healthcare workers, who are in contact with children.
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Bisagni F. LET ME GO: Depression and suicidal fantasies in children. J Anal Psychol 2022; 67:939-961. [PMID: 36165301 DOI: 10.1111/1468-5922.12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 12/01/2022]
Abstract
The paper explores the phenomenology of major depression and suicidal ideation in children, offering a brief overview of relevant findings in psychiatry, with particular reference to statistical evidence, and outlining psychoanalytic models, including Jungian as well as the post-Kleinian and Bionian vertices. Bowlby's seminal contribution to the understanding of mourning processes in relation to Freud's theory is also considered. The case of an eight-year-old boy is examined, with particular attention to a series of drawings that the patient produced over the two years of his psychoanalytic psychotherapy. The therapy was interrupted abruptly by his parents.
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13
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Giannotti M, Mazzoni N, Bentenuto A, Venuti P, de Falco S. Family adjustment to COVID-19 lockdown in Italy: Parental stress, coparenting, and child externalizing behavior. Fam Process 2022; 61:745-763. [PMID: 34195986 PMCID: PMC8444949 DOI: 10.1111/famp.12686] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/12/2021] [Accepted: 04/22/2021] [Indexed: 05/04/2023]
Abstract
Evidence of psychological distress in families during COVID-19 outbreak are arising. However, the perceived changes in psychological adjustment during home confinement with respect to the period before the pandemic have not been addressed yet. Moreover, little is known about the role of coparenting and specific COVID-19 contextual variables on parental stress and children's behavioral difficulties in the Italian context. Using a cross-sectional survey, we collected data on 841 Italian parents of children aged 3-11 years with typical development during the home confinement (20th April-18th May). We analyzed levels of parental stress, coparenting, and child externalizing behaviors before and during the home confinement. Additionally, hierarchical regressions were performed to investigate predictors of parental stress and child externalizing behaviors during the lockdown. Results showed that parental stress (especially in mothers) and child externalizing behaviors increased during the lockdown period. Coparenting was a strong predictor of parental stress, together with being a mother, younger child age, less time dedicated to the child, and scarce feasibility of remote working. Besides, child externalizing behaviors were predicted by male gender, less parental time dedicated to the child, higher parental stress, and child distance learning workload. Our findings indicate a negative impact of COVID-19 lockdown in both parents and children, suggesting that positive coparenting and time dedicated to children may help to reduce the detrimental effect of pandemic restrictions on family adjustment.
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Affiliation(s)
- Michele Giannotti
- Department of Psychology and Cognitive SciencesObservation, Diagnosis and Education LabUniversity of TrentoRovereto, TrentoItaly
| | - Noemi Mazzoni
- Department of Psychology and Cognitive SciencesObservation, Diagnosis and Education LabUniversity of TrentoRovereto, TrentoItaly
| | - Arianna Bentenuto
- Department of Psychology and Cognitive SciencesObservation, Diagnosis and Education LabUniversity of TrentoRovereto, TrentoItaly
| | - Paola Venuti
- Department of Psychology and Cognitive SciencesObservation, Diagnosis and Education LabUniversity of TrentoRovereto, TrentoItaly
| | - Simona de Falco
- Department of Psychology and Cognitive SciencesObservation, Diagnosis and Education LabUniversity of TrentoRovereto, TrentoItaly
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14
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Katz C, Glucklich T. "Please, Help Me!": Children's Perceptions of Parental Dispute as Shared in Forensic Interviews Following Alleged Maltreatment. Fam Process 2021; 60:570-585. [PMID: 32557618 DOI: 10.1111/famp.12557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Over the last few decades, the phenomenon of child maltreatment (CM) has been recognized as a major social problem by professionals, policymakers, and researchers. Relatedly, high-intensity parental dispute (HIPD) has been increasingly recognized, particularly in terms of its detrimental effect on the family unit and on child welfare in particular. Few studies, however, have considered these two phenomena jointly. The present study examines experiences and perceptions of children situated at their intersection. The sample comprised forensic interviews with 42 children referred to the Israeli Service of Child Forensic Interviews following alleged maltreatment. The results of a thematic analysis pointed to the centrality of children's exposure to HIPD in the context of the CM allegations for which they were referred to and about which they were asked during the interview. In addition, the analysis identified various displays of potential deficiencies in parent-child relationship in the context of HIPD and two main profiles for the disclosure of the CM allegations. The discussion stresses the exposure of the children to HIPD as a possible risk context that should receive further attention by scholars and practitioners. Moreover, it highlights the multifaceted nature of the children's experiences, which generate enormous challenges for practitioners in both clinical and forensic contexts, as well as the importance of an integrated approach that considers the HIPD context while not ignoring the CM allegations.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
| | - Talia Glucklich
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
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15
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Simmons C, Meiser-Stedman R, Baily H, Beazley P. A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people. Eur J Psychotraumatol 2021; 12:1947570. [PMID: 34377359 PMCID: PMC8344790 DOI: 10.1080/20008198.2021.1947570] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Despite the established evidence base of psychological interventions in treating PTSD in children and young people, concern that these trauma-focused treatments may 'retraumatise' patients or exacerbate symptoms and cause dropout has been identified as a barrier to their implementation. Dropout from treatment is indicative of its relative acceptability in this population. OBJECTIVE Estimate the prevalence of dropout in children and young people receiving a psychological therapy for PTSD as part of a randomized controlled trial (RCT). METHODS A systematic search of the literature was conducted to identify RCTs of evidence-based treatment of PTSD in children and young people. Proportion meta-analyses estimated the prevalence of dropout. Odds ratios compared the relative likelihood of dropout between different treatments and controls. Subgroup analysis assessed the impact of potential moderating variables. RESULTS Forty RCTs were identified. Dropout from all treatment or active control arms was estimated to be 11.7%, 95% CI [9.0, 14.6]. Dropout from evidence-based treatment (TFCBTs and EMDR) was 11.2%, 95% CI [8.2, 14.6]. Dropout from non-trauma focused treatments or controls was 12.8%, 95% CI [7.6, 19.1]. There was no significant difference in the odds of dropout when comparing different modalities. Group rather than individual delivery, and lay versus professional delivery, were associated with less dropout. CONCLUSIONS Evidence-based treatments for children and young people with PTSD do not result in higher prevalence of dropout than non-trauma focused treatment or waiting list conditions. Trauma-focused therapies appear to be well tolerated in children and young people.
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Affiliation(s)
- Caroline Simmons
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK.,Child and Adolescent Mental Health Services Eating Disorder Pathway, Cambridgeshire and Peterborough Mental Health Foundation Trust (CPFT)
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Hannah Baily
- Child and Adolescent Mental Health Services Eating Disorder Pathway, Cambridgeshire and Peterborough Mental Health Foundation Trust (CPFT)
| | - Peter Beazley
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
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16
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Chou JL, Cooper-Sadlo S, Diamond RM, Muruthi BA, Beeler-Stinn S. An Exploration of Mothers' Successful Completion of Family-Centered Residential Substance Use Treatment. Fam Process 2020; 59:1113-1127. [PMID: 31617203 PMCID: PMC7160039 DOI: 10.1111/famp.12501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 06/10/2023]
Abstract
Behavioral health and substance use centers have started focusing efforts on creating, adopting, and implementing evidence-based practices and programs that effectively address the needs of women and, particularly, mothers entering treatment with children. However, women with substance use disorders (SUDs) remain an underserved and understudied population; even less studied are the complexities and unique SUD treatment needs of women who have children. Family therapists' systemic training is a valued approach in conceptualizing and implementing treatment for mothers with SUDs and their families. This study explored the construct of mothering children during family-centered substance use treatment using a transcendental phenomenological approach. Analysis revealed themes related to motherhood, parenting, and support for mothers and children. Two themes emerged from the data: (a) grappling with motherhood and addiction leading to the decision for treatment and (b) specific aspects of the treatment program conducive to motherhood. Results indicated the positive impact of mothers' experiences in family-centered substance use treatment, aligning with previous literature that suggests mothers are more engaged in treatment when their children remain in their care. The insights gleaned from the participants in this study provide suggestions for further improving programming that supports mothers and their children during the recovery process. Treatment considerations are offered for family therapists working with mothers with SUDs and their families.
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Affiliation(s)
- Jessica L Chou
- Department of Counseling and Family Therapy, Drexel University, Philadelphia, PA
| | - Shannon Cooper-Sadlo
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO
| | - Rachel M Diamond
- Couple and Family Therapy Department, Adler University, Chicago, IL
| | - Bertranna A Muruthi
- Department of Counseling Psychology and Human Services, Couples and Family Therapy Program, University of Oregon, Eugene, OR
| | - Sara Beeler-Stinn
- George Warren Brown School of Social Work, Washington University in Saint Louis, Saint Louis, MO
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17
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Ramos JT, Romero CA, Belda S, Candel FJ, Gallego BC, Fernández-Polo A, Antolín LF, Colino CG, Navarro ML, Neth O, Olbrich P, Rincón-López E, Contreras JR, Soler-Palacín P. Clinical practice update of antifungal prophylaxis in immunocompromised children. Rev Esp Quimioter 2019; 32:410-425. [PMID: 31507152 PMCID: PMC6790888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Due to the rise in the number and types of immunosuppressed patients, invasive fungal infections (IFI) are an increasing and major cause of morbidity and mortality in immunocompromised adults and children. There is a broad group of pediatric patients at risk for IFI in whom primary and/or secondary antifungal prophylaxis (AFP) should be considered despite scant evidence. Pediatric groups at risk for IFI includes extremely premature infants in some settings, while in high-risk children with cancer receiving chemotherapy or undergoing haematopoietic stem cell transplantation (HCT), AFP against yeast and moulds is usually recommended. For solid organ transplanted, children, prophylaxis depends on the type of transplant and associated risk factors. In children with primary or acquired immunodeficiency such as HIV or long-term immunosuppressive treatment, AFP depends on the type of immunodeficiency and the degree of immunosuppression. Chronic granulomatous disease is associated with a particular high-risk of IFI and anti-mould prophylaxis is always indicated. In contrast, AFP is not generally recommended in children with long stay in intensive care units. The choice of AFP is limited by the approval of antifungal agents in different age groups and by their pharmacokinetics characteristics. This document aims to review current available information on AFP in children and to provide a comprehensive proposal for each type of patient.
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Affiliation(s)
- José Tomás Ramos
- Department of Public and Mother-Child Health. Hospital Clínico San Carlos, Complutense University. Madrid.,Correspondence: José T. Ramos Amador Departmento de Salud Pública y Materno-Infantil. Complutense University. Madrid. Hospital Clínico San Carlos. IdISSC Health Research Institute Madrid. Spain. Avda Profesor Martín Lagos s/n. 28040. Phone: + 34 91 330 3486 E-mail:
| | - Concepción Alba Romero
- Department of Salud Pública y Materno-Infantil.Complutense University. Neonatology Unit. Hospital 12 de Octubre. Madrid
| | - Sylvia Belda
- Department of Pediatrics. Intensive Care Unit. Hospital 12 de Octubre. Madrid. Complutense University. Madrid
| | - Francisco Javier Candel
- Clinical Microbiology and Infectious Diseases Department. Transplant. Coordination Unit. IdISSC and IML Health Institutes. Hospital Clínico San Carlos. Madrid. Spain
| | - Begoña Carazo Gallego
- Department of Pediatrics. Sección de Enfermedades Infecciosas. Hospital Carlos Haya, Málaga
| | | | | | - Carmen Garrido Colino
- Department of Pediatrics. Sección de Hemato-oncología. Hospital Gregorio Marañón. Madrid
| | - María Luisa Navarro
- Department of Pediatrics. Sección de Enfermedades Infecciosas. Hospital Gregorio Marañón. Madrid
| | - Olaf Neth
- Department of Pediatrics. Sección Infectología, Reumatología e Inmunología Pediátrica. Hospital Universitario Virgen del Rocío, Sevilla
| | - Peter Olbrich
- Department of Pediatrics. Sección Infectología, Reumatología e Inmunología Pediátrica. Hospital Universitario Virgen del Rocío, Sevilla
| | - Elena Rincón-López
- Department of Pediatrics. Sección de Enfermedades Infecciosas. Hospital Gregorio Marañón. Madrid
| | - Jesús Ruiz Contreras
- Department of Pediatrics. Hospital 12 de Octubre. Madrid. Complutense University. Madrid
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit. Hospital Universitari Vall d’Hebron. Barcelona
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18
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Moyano D, Perovic NR. [Nutritional contribution the school canteens program to the children of ten municipal schools in the city of Córdoba, Argentina.]. ACTA ACUST UNITED AC 2018; 75:194-202. [PMID: 30296027 DOI: 10.31053/1853.0605.v75.n3.17559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/04/2018] [Accepted: 03/08/2018] [Indexed: 11/21/2022]
Abstract
Introduction School canteens are one of the most widespread programs in recent decades which may have significant impacts on nutrition, health, growth and development in children. Objetive To assess the nutritional contribution of School Canteens (PCE) program to children from municipal schools of Cordoba. Material and methods Was a descriptive and analytical study. I applied an observation guide and ration weighing measurements of the school canteens food supply and food recall method was used 24 hours a sample of 170 school children. Results The breakfasts/snacks they had a deficit in Calcium, vitamin A and C and iron and excess of simple sugars. The lunches they had a excess of saturated fats and deficit of energy, calcium, iron, fiber and vitamin A. The food consumption of school children was high in discretionary calories, sugars and saturated fats and deficit in fiber, calcium and vitamin A, associated with some sociodemographic characteristics.
There had associations between the inadequacy of the target intake of calcium and vitamin found and suboptimal quality and dining in these nutrients (p< 0,05). Conclusions We conclude what in this context there are nutritional aspects that are necessary improve.
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19
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Jensen TM, Lippold MA, Mills-Koonce R, Fosco GM. Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems. Fam Process 2018; 57:477-495. [PMID: 28266715 PMCID: PMC5705583 DOI: 10.1111/famp.12284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.
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Affiliation(s)
- Todd M Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melissa A Lippold
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Roger Mills-Koonce
- Department of Human Development and Family Studies, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Gregory M Fosco
- Department of Human Development and Family Studies, The Pennsylvania State University, State College, PA, USA
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20
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Abstract
The current study examines a military family stress model, evaluating associations between deployment-related stressors (i.e., deployment length/number, posttraumatic stress disorder [PTSD] symptoms) and parent, child, parenting, and dyadic adjustment among families in which a parent had previously deployed to Iraq or Afghanistan in the recent conflicts. Married families (N = 293) with at least one child between the ages of 4 and 12 were recruited from a Midwestern state. Service members were from the Reserve Component (National Guard or Reserves); fathers (N = 253) and/or mothers had deployed (N = 45) to the recent conflicts in the Middle East. Multiple-method (observations of parenting and couple interactions; questionnaires) and multiple informant measures were gathered online and in the homes of participants, from parents, children, and teachers. Findings demonstrated associations between mothers' and fathers' PTSD symptoms and a latent variable of child adjustment comprising teacher, parent, and child report. Mothers' but not fathers' PTSD symptoms were also associated with dyadic adjustment and parenting practices; parenting practices were in turn associated with child adjustment. The results are discussed in terms of their implications for military family stress research and interventions to support and strengthen parents and families after deployment.
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Affiliation(s)
- Abigail H Gewirtz
- Department of Family Social Science & Institute of Child Development, & Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, MN
| | - David S DeGarmo
- Department of Educational Methodology, Policy, and Leadership, Prevention Science Institute, University of Oregon, Eugene, OR
| | - Osnat Zamir
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
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21
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Ma JLC, Lai KYC, Xia LLL. Treatment Efficacy of Multiple Family Therapy for Chinese Families of Children with Attention Deficit Hyperactivity Disorder. Fam Process 2018; 57:399-414. [PMID: 28560725 DOI: 10.1111/famp.12297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The treatment efficacy of multiple family therapy (MFT) for Chinese families of children with attention deficit hyperactivity disorder (ADHD) has not been studied in the past. In this paper, the effect of MFT on different aspects of the lives of the parents in the experimental group (n = 61) was compared with the effect of only the psychoeducational talks on parents in the control group (n = 53). The results of a MANOVA have shown that by the time they reached the posttreatment phase, the parents who had completed the full 42 hours of the MFT program perceived their children's ADHD symptoms as being less serious and less pathological than they had originally thought compared to the parents in the control group. The effect of MFT on parent-child relationships, parenting stress, parental efficacy, hope, and perceived social support was statistically insignificant. Contributions and limitations of our study are discussed.
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Affiliation(s)
- Joyce L C Ma
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Kelly Y C Lai
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Lily Li Li Xia
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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22
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Davis M, Bilms J, Suveg C. In Sync and in Control: A Meta-Analysis of Parent-Child Positive Behavioral Synchrony and Youth Self-Regulation. Fam Process 2017; 56:962-980. [PMID: 27774598 DOI: 10.1111/famp.12259] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A growing body of research has highlighted the connection between parent-child positive behavioral synchrony and youth self-regulation; however, this association has yet to be the focus of a meta-analytic review. Therefore, the present meta-analysis aimed to estimate the magnitude of the relation between parent-child positive behavioral synchrony and youth self-regulation and to identify moderator variables that can explain the variability in the degree of this association across the extant literature. A thorough literature search of two major databases, in addition to scanning the reference sections of relevant articles, yielded a total of 10 peer-reviewed articles (24 effect sizes, 658 children) that were eligible for inclusion in the current meta-analysis. Results from the overall mean effect size calculation using a random-effects model indicated that parent-child positive behavioral synchrony was significantly, positively correlated with youth self-regulation and the effect size was medium. Children's ages at the time of synchrony and self-regulation measurements, as well as parent gender, served as significant moderator variables. Findings from the present meta-analysis can help to refine existing theoretical models on the role of the parent-child relationship in youth adjustment. Prevention and intervention efforts may benefit from an increased emphasis on building parent-child positive behavioral synchrony to promote youth self-regulation and thus children's overall well-being.
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Affiliation(s)
- Molly Davis
- Department of Psychology, University of Georgia, Athens, GA
| | - Joanie Bilms
- Department of Psychology, University of Georgia, Athens, GA
| | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, GA
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23
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Hofer CB, Egger M, Davies MA, Frota ACC, de Oliveira RH, Abreu TF, Araújo LE, Witthlin BB, Carvalho AW, Cordeiro JR, Lima GP, Keiser O. The cascade of care to prevent mother-to-child transmission in Rio de Janeiro, Brazil, 1996-2013: improving but still some way to go. Trop Med Int Health 2017; 22:1266-1274. [PMID: 28707345 DOI: 10.1111/tmi.12925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the cascade of care to HIV mother-to-child transmission (PMTCT) in a Rio de Janeiro reference paediatric clinic and evaluate the main factors possibly associated with HIV transmission. METHODS Data on antenatal care (ANC), perinatal and neonatal assistance to HIV-infected and HIV-exposed but uninfected children assisted in the clinic from 1996 to 2013 were collected. The cascade of care was graphically demonstrated, and possible factors associated with HIV infection were described using regression models for bivariate and multivariate analysis. We imputed missing values of explanatory variables for the final model. RESULTS A total of 989 children were included in the analysis: 211 were HIV and 778 HEU. Graphically, the HIV PMTCT cascade of care improved from 1996/2000 to the later periods, but not from 2001/2006 to 2007/2013. The main factor independently associated with the HIV infection over time was breastfeeding. In the period 1996/2000, the lack of antiretroviral use during labour was associated HIV transmission. While in 2001/2007, other modes of delivery but elective Caesarean section, and lack of maternal antiretroviral use during ANC were associated with HIV transmission. In the last period, the main factor associated with transmission was the lack of maternal ANC. CONCLUSIONS The HIV PMTCT cascade improved over time, but HIV vertical transmission remains a problem, and better access to ANC is needed.
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Affiliation(s)
- Cristina Barroso Hofer
- Institute of Social and Preventive Medicine, Berne University, Berne, Switzerland.,Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Matthias Egger
- Institute of Social and Preventive Medicine, Berne University, Berne, Switzerland.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary-Ann Davies
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | | | | | | | | | | | | | | | - Olivia Keiser
- Institute of Social and Preventive Medicine, Berne University, Berne, Switzerland
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24
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Berendes D, Leon J, Kirby A, Clennon J, Raj S, Yakubu H, Robb K, Kartikeyan A, Hemavathy P, Gunasekaran A, Roy S, Ghale BC, Kumar JS, Mohan VR, Kang G, Moe C. Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India. Trop Med Int Health 2017; 22:1119-1129. [PMID: 28653489 PMCID: PMC5601219 DOI: 10.1111/tmi.12915] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective This study examined associations between household sanitation and enteric infection – including diarrhoeal‐specific outcomes – in children 0–2 years of age in a low‐income, dense urban neighbourhood. Methods As part of the MAL‐ED study, 230 children in a low‐income, urban, Indian neighbourhood provided stool specimens at 14–17 scheduled time points and during diarrhoeal episodes in the first 2 years of life that were analysed for bacterial, parasitic (protozoa and helminths) and viral pathogens. From interviews with caregivers in 100 households, the relationship between the presence (and discharge) of household sanitation facilities and any, pathogen‐specific, and diarrhoea‐specific enteric infection was tested through mixed‐effects Poisson regression models. Results Few study households (33%) reported having toilets, most of which (82%) discharged into open drains. Controlling for season and household socio‐economic status, the presence of a household toilet was associated with lower risks of enteric infection (RR: 0.91, 95% CI: 0.79–1.06), bacterial infection (RR: 0.87, 95% CI: 0.75–1.02) and protozoal infection (RR: 0.64, 95% CI: 0.39–1.04), although not statistically significant, but had no association with diarrhoea (RR: 1.00, 95% CI: 0.68–1.45) or viral infections (RR: 1.12, 95% CI: 0.79–1.60). Models also suggested that the relationship between household toilets discharging to drains and enteric infection risk may vary by season. Conclusions The presence of a household toilet was associated with lower risk of bacterial and protozoal enteric infections, but not diarrhoea or viral infections, suggesting the health effects of sanitation may be more accurately estimated using outcome measures that account for aetiologic agents.
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Affiliation(s)
- David Berendes
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA.,Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Juan Leon
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amy Kirby
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Clennon
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Suraja Raj
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Habib Yakubu
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Katharine Robb
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Arun Kartikeyan
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - Priya Hemavathy
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - Annai Gunasekaran
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - Sheela Roy
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - Ben Chirag Ghale
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - J Senthil Kumar
- Department of Community Health, Christian Medical College, Vellore, India
| | | | - Gagandeep Kang
- Wellcome Research Laboratory, Christian Medical College, Vellore, India
| | - Christine Moe
- Center for Global Safe Water, Sanitation, and Hygiene, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Etoka-Beka MK, Ntoumi F, Kombo M, Deibert J, Poulain P, Vouvoungui C, Kobawila SC, Koukouikila-Koussounda F. Plasmodium falciparum infection in febrile Congolese children: prevalence of clinical malaria 10 years after introduction of artemisinin-combination therapies. Trop Med Int Health 2016; 21:1496-1503. [PMID: 27671736 DOI: 10.1111/tmi.12786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate the proportion of malaria infection in febrile children consulting a paediatric hospital in Brazzaville, to determine the prevalence of submicroscopic malaria infection, to characterise Plasmodium falciparum infection and compare the prevalence of uncomplicated P. falciparum malaria according to haemoglobin profiles. METHODS Blood samples were collected from children aged <10 years with an axillary temperature ≥37.5 °C consulting the paediatric ward of Marien Ngouabi Hospital in Brazzaville. Parasite density was determined and all samples were screened for P. falciparum by nested polymerase chain reaction (PCR) using the P. falciparum msp-2 marker to detect submicroscopic infections and characterise P. falciparum infection. Sickle cell trait was screened by PCR. RESULTS A total of 229 children with fever were recruited, of whom 10% were diagnosed with uncomplicated malaria and 21% with submicroscopic infection. The mean parasite density in children with uncomplicated malaria was 42 824 parasites/μl of blood. The multiplicity of infection (MOI) was 1.59 in children with uncomplicated malaria and 1.69 in children with submicroscopic infection. The mean haemoglobin level was 10.1 ± 1.7 for children with uncomplicated malaria and 12.0 ± 8.6 for children with submicroscopic infection. About 13% of the children harboured the sickle cell trait (HbAS); the rest had normal haemoglobin (HbAA). No difference in prevalence of uncomplicated malaria and submicroscopic infection, parasite density, haemoglobin level, MOI and P. falciparum genetic diversity was observed according to haemoglobin type. CONCLUSION The low prevalence of uncomplicated malaria in febrile Congolese children indicates the necessity to investigate carefully other causes of fever.
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Affiliation(s)
- Mandingha Kosso Etoka-Beka
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo.,Faculté des Sciences et Techniques, Marien Ngouabi University, Brazzaville, Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo.,Faculté des Sciences et Techniques, Marien Ngouabi University, Brazzaville, Congo.,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Michael Kombo
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo
| | - Julia Deibert
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Pierre Poulain
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo.,Institut National de la Santé et de la Recherche Médicale U 1134, Paris, France.,UMR_S 1134, DSIMB, Sorbonne Paris Cité, Université Paris Diderot, Paris, France.,Institut National de la Transfusion Sanguine, DSIMB, Paris, France.,UMR_S 1134, Laboratory of Excellence GR-Ex, DSIMB, Paris, France
| | - Christevy Vouvoungui
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo
| | | | - Felix Koukouikila-Koussounda
- Fondation Congolaise pour la Recherche Médicale, Faculté des Sciences de la Santé, Marien Ngouabi University, Brazzaville, Congo.,Faculté des Sciences et Techniques, Marien Ngouabi University, Brazzaville, Congo
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Morita T, Godfrey S, George CM. Systematic review of evidence on the effectiveness of safe child faeces disposal interventions. Trop Med Int Health 2016; 21:1403-1419. [PMID: 27546207 DOI: 10.1111/tmi.12773] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To review and synthesise the available evidence on the effectiveness of interventions targeting unsafe child faeces disposal in reducing this behaviour and improving child health in low- and middle-income countries. METHODS PubMed and EMBASE were systematically searched. Studies meeting the inclusion criteria were reviewed and key information on study methodologies and outcomes were extracted. RESULTS A total of 1048 articles were screened, and eight studies representing five countries were included for the review. Three were randomised controlled trials, and five were prospective cohort studies. There was wide variability across studies in the definition of 'safe disposal' of child faeces. Six studies reported the change in child faeces disposal practices associated with safe child faeces disposal interventions. However, only one study found a significant improvement in this behaviour. Two of the six studies that evaluated the health impact of delivered interventions found significant reductions in childhood diarrhoea associated with safe faeces disposal practices, and one study reported a positive effect on child growth and ascariasis. Only one study was identified that delivered a single intervention solely focused on safe child faeces disposal. Unfortunately, this study did not investigate the impact of this intervention on child health. CONCLUSIONS There are major methodological limitations in studies that assessed the impact of safe child faeces disposal interventions. The health impact of these interventions is inconclusive because the quality of the current evidence is poor. Randomised controlled trials are urgently needed to assess the impact of safe faeces disposal interventions on child health.
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Affiliation(s)
- Tomohiko Morita
- Program in Global Disease Epidemiology and Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Samuel Godfrey
- Water, Sanitation and Hygiene Section, UNICEF Ethiopia, Addis Ababa, Ethiopia
| | - Christine Marie George
- Program in Global Disease Epidemiology and Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Annamalay AA, Lanaspa M, Khoo SK, Madrid L, Acácio S, Zhang G, Laing IA, Gern J, Goldblatt J, Bizzintino J, Lehmann D, Le Souëf PN, Bassat Q. Rhinovirus species and clinical features in children hospitalised with pneumonia from Mozambique. Trop Med Int Health 2016; 21:1171-80. [PMID: 27353724 PMCID: PMC7169728 DOI: 10.1111/tmi.12743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives To describe the prevalence of human rhinovirus (RV) species in children hospitalised with pneumonia in Manhiça, Mozambique, and the associations between RV species and demographic, clinical and laboratory features. Methods Nasopharyngeal aspirates were collected from children 0 to 10 years of age (n = 277) presenting to Manhiça District Hospital with clinical pneumonia. Blood samples were collected for HIV and malaria testing, blood culture and full blood counts, and a chest X‐ray was performed. A panel of common respiratory viruses was investigated using two independent multiplex RT‐PCR assays with primers specific for each virus and viral type. RV species and genotypes were identified by seminested PCR assays, sequencing and phylogenetic tree analyses. Results At least one respiratory virus was identified in 206 (74.4%) children hospitalised with clinical pneumonia. RV was the most common virus identified in both HIV‐infected (17 of 38, 44.7%) and HIV‐uninfected (74 of 237, 31.2%; P = 0.100) children. RV‐A was the most common RV species identified (47 of 275, 17.0%), followed by RV‐C (35/275, 12.6%) and RV‐B (8/275, 2.9%). Clinical presentation of the different RV species was similar and overlapping, with no particular species being associated with specific clinical features. Conclusions RV‐A and RV‐C were the most common respiratory viruses identified in children hospitalised with clinical pneumonia in Manhiça. Clinical presentation of RV‐A and RV‐C was similar and overlapping.
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Affiliation(s)
- Alicia A Annamalay
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Miguel Lanaspa
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Lola Madrid
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Guicheng Zhang
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,School of Public Health, Curtin University, Perth, WA, Australia
| | - Ingrid A Laing
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - James Gern
- University of Wisconsin-Madison, Madison, WI, USA
| | - Jack Goldblatt
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Deborah Lehmann
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
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Kiemde F, Spijker R, Mens PF, Tinto H, Boele M, Schallig HDFH. Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa. Trop Med Int Health 2016; 21:943-955. [PMID: 27159214 DOI: 10.1111/tmi.12722] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. METHODS MEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which were published between January 1990 and July 2015. Case reports and conference abstracts were excluded. RESULTS In total, 3851 titles and abstracts were reviewed, and 153 were selected for full screening of which 18 were included in the present review. Bloodstream infection (BSI) was most commonly investigated (nine of 18) followed by urinary tract infection (UTI) (four of 18) and respiratory tract infection (RTI) (two of 18). Few studies investigated BSI and UTI in the same children (two of 18), or BSI and gastrointestinal infection (GII) (one of 18). As for BSI, the most frequently isolated bacteria were E. coli (four of 12), Streptococcus pneumonia (four of 12), Salmonella spp (three of 12) and Staphylococcus aureus (two of 12) with a positive identification rate of 19.7-33.3%, 5.2-27.6%, 11.7-65.4% and 23.5-42.0%, respectively. As for UTI, the main bacteria isolated were E. coli (six of six) and Klebsiella spp (six of six) with a positive rate of 20.0-72.3% and 10.0-28.5%, respectively. No bacterium was isolated in RTI group, but Human influenzae A and B were frequently found, with the highest positive identification rate in Tanzania (75.3%). Dengue virus (two of 12) was the most frequently reported viral infection with a positive identification rate of 16.7-30.8%. Finally, only rotavirus/adenovirus (69.2% positive identification rate) was found in GII and no bacterium was isolated in this group. CONCLUSIONS The high prevalence of treatable causes of non-malaria fever episodes requires a proper diagnosis of the origin of fever followed by an appropriate treatment, thereby reducing the under-5 mortality in sub-Saharan Africa and preventing the overprescription of antibiotics and thus circumventing the rise of antibiotic resistance.
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Affiliation(s)
- Francois Kiemde
- Institut de Recherche en Science de la Santé, Nanaro, Burkina Faso.,Parasitology Unit, Royal Tropical Institute, Amsterdam, The Netherlands
| | - René Spijker
- Medical Library, University of Amsterdam, Amsterdam, The Netherlands.,Cochrane Netherlands, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra F Mens
- Parasitology Unit, Royal Tropical Institute, Amsterdam, The Netherlands.,Centre of Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Halidou Tinto
- Institut de Recherche en Science de la Santé, Nanaro, Burkina Faso
| | - Michael Boele
- Global Child Health Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
OBJECTIVE With increasing maternal antiretroviral treatment (ART), the number of children newly infected with HIV has declined. However, the possible increased mortality in the large number of HIV-exposed, uninfected (HEU) children may be of concern. We quantified mortality risks among HEU children and reviewed associated factors. METHODS Systematic search of electronic databases (PubMed, Scopus). We included all studies reporting mortality of HEU children to age 60 months and associated factors. Relative risk of mortality between HEU and HIV-unexposed, uninfected (HUU) children was extracted where relevant. Inverse variance methods were used to adjust for study size. Random-effects models were fitted to obtain pooled estimates. RESULTS A total of 14 studies were included in the meta-analysis and 13 in the review of associated factors. The pooled cumulative mortality in HEU children was 5.5% (95% CI: 4.0-7.2; I(2) = 94%) at 12 months (11 studies) and 11.0% (95% CI: 7.6-15.0; I(2) = 93%) at 24 months (four studies). The pooled risk ratios for the mortality in HEU children compared to HUU children in the same setting were 1.9 (95% CI: 0.9-3.8; I(2) = 93%) at 12 months (four studies) and 2.4 (95% CI: 1.1-5.1; I(2) = 93%) at 24 months (three studies). CONCLUSION Compared to HUU children, mortality risk in HEU children was about double at both age points, although the association was not statistically significant at 12 months. Interpretation of the pooled estimates is confounded by considerable heterogeneity between studies. Further research is needed to characterise the impact of maternal death and breastfeeding on the survival of HEU infants in the context of maternal ART, where current evidence is limited.
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Affiliation(s)
- Shino Arikawa
- Inserm U1219, Bordeaux Population Health Research Centre, Bordeaux University, Bordeaux, France
| | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Marie-Louise Newell
- Human Health and Development, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Renaud Becquet
- Inserm U1219, Bordeaux Population Health Research Centre, Bordeaux University, Bordeaux, France
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Buchanan AM, Fiorillo SP, Omondi MW, Cunningham CK, Crump JA. Establishment of biochemistry reference values for healthy Tanzanian infants, children and adolescents in Kilimanjaro Region. Trop Med Int Health 2015. [PMID: 26224122 DOI: 10.1111/tmi.12580] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To establish common biochemistry reference intervals for Tanzanian infants, children and adolescents living in the Kilimanjaro Region. METHODS We recruited healthy, HIV-uninfected Tanzanian infants, children and youth between the ages of 1 month and 17 years from local schools and clinics to participate in this study. Only afebrile children without signs of physical or chronic illness were enrolled. Nonparametric methods were used to determine 95% reference limits and their 90% confidence intervals, with outliers removed by the Tukey method. RESULTS A total of 619 healthy infants, children and adolescents were enrolled into the study. Twenty-three biochemistry parameters were measured. Compared to US reference intervals, several of the biochemistry parameters showed notable differences, namely alkaline phosphatase, phosphorus, amylase and lipase. Comparing our data to the US National Institutes of Health (NIH) Division of AIDS (DAIDS) grading criteria for classification of adverse events, we found that for selected parameters, up to 15% of infants or children in certain age groups would have been categorised as having an adverse event as defined by DAIDS. CONCLUSIONS Our study further confirms the need to use locally established reference intervals to define reference laboratory parameters among children in Africa, rather than relying on those derived from US or European populations. To our knowledge, this study provides the first set of locally validated biochemistry reference ranges for a paediatric population in Tanzania.
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Affiliation(s)
- Ann M Buchanan
- Division of Infectious Diseases, Department of Pediatrics, Duke University, Durham, NC, US.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Suzanne P Fiorillo
- Division of Infectious Diseases, University of Colorado, Denver School of Medicine, Aurora, CO, USA
| | | | - Coleen K Cunningham
- Division of Infectious Diseases, Department of Pediatrics, Duke University, Durham, NC, US
| | - John A Crump
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania.,Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, NC, USA.,Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Abstract
INTRODUCTION Low-flow vascular malformation, which usually develops during the first stage of infancy, is a rare cause of recurrent effusion of the knee. History, laboratory and X-rays are usually non-specific. OBJECTIVE To describe a rare disease in pediatrics, emphasizing the correct classification and suspicion. CASE REPORT A case is presented of a two-year-old patient with a history of effusion of the right knee who required multiple hospitalizations and antibiotic treatments. Laboratory work-up was normal. Plain X-rays of the knee revealed no bone changes. MR imaging reported low-flow vascular malformation. Surgical resection was performed, evidencing vascular lesion among the muscle fibers of the vastus lateralis of quadriceps until the capsule of the knee, as well as dissection of the fibers until the vastus lateralis of the right leg. Histology was consistent with low-flow vascular malformation. Due to the benign outcome and favorable evolution, an outpatient management was possible. CONCLUSIONS Although low-flow synovial vascular malformation is a rare disease among the pediatric population, it should be considered in the differential diagnosis of patients with repeated hemarthrosis and no history of either coagulopathy or hemophilia.
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Affiliation(s)
- B Andrea Parra
- Pediatra, Hospital Pablo Tobón Uribe, Docente de la Universidad Pontificia Bolivariana, Colombia..
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Hernández Holguín DM, Páez Zapata E, Múnera Restrepo LM, Duque Ramírez LF. Diseño de un programa basado en la promoción del desarrollo positivo en la infancia para la prevención temprana de la violencia en Colombia. Glob Health Promot 2015; 24:83-91. [PMID: 26187923 DOI: 10.1177/1757975915591683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aunque algunos informes identifiquen a Colombia como ejemplo de un país que ha logrado revertir los niveles crecientes de violencia, estos siguen siendo altos. Por este motivo se han convocado acciones de promoción de la convivencia y prevención de la violencia, a las cuales responde el programa que presentamos en este artículo. Este programa está basado en la perspectiva contextual-evolutiva del modelo ecológico y en la educación para la salud, tendiente al cuidado de sí en los padres o cuidadores, y al ejercicio de una crianza, centrada en los derechos de los niños, el desarrollo infantil y la promoción de la salud mental, con el fin de promover el desarrollo saludable y prevenir comportamientos agresivos en los niños; éste es presentado como una alternativa de orientación psicosocial para el fortalecimiento de estrategias y programas dirigidos a la primera infancia.
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Affiliation(s)
| | - Esteban Páez Zapata
- 1. Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | | | - Luis F Duque Ramírez
- 1. Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
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Kegele J, Hurth H, Lackner P, Enimil A, Sylverkin J, Ansong D, Nkyi C, Bonsu B, Agbenyega T, Schartinger VH, Schmutzhard E, Zorowka P, Kremsner P, Schmutzhard J. Otoacoustic emission testing in Ghanaian children with sickle-cell disease. Trop Med Int Health 2015; 20:1209-1212. [PMID: 25941122 DOI: 10.1111/tmi.12533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate hearing loss in children as a complication of sickle-cell disease. METHODS In Kumasi, Ghana, 35 children with SCD aged 6 months to 10 years underwent transient-evoked otoacoustic emissions testing (TEOAE) to investigate the function of the inner ear. Healthy Ghanaian children recruited in school and kindergarten served as controls. RESULTS One of 35 children with SCD and 13 of 115 control children failed the otoacoustic emissions testing. This difference between the control group and the children with SCD was not statistically significant. CONCLUSION Early hearing impairment does not regularly occur in sickle-cell disease, and in children, it is not a likely cause of delayed or impaired language development.
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Affiliation(s)
- Josua Kegele
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Helene Hurth
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Lackner
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Anthony Enimil
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justice Sylverkin
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Ansong
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Clara Nkyi
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benedicta Bonsu
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Tsiri Agbenyega
- Komfo Anokye Teaching Hospital & Kwama Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Volker H Schartinger
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
| | - Erich Schmutzhard
- Department of Neurology, NICU, Medical University Innsbruck, Innsbruck, Austria
| | - Patrick Zorowka
- Department of Hearing, Speech and Voice Disorders, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Kremsner
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
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Muro F, Mtove G, Mosha N, Wangai H, Harrison N, Hildenwall H, Schellenberg D, Todd J, Olomi R, Reyburn H. Effect of context on respiratory rate measurement in identifying non-severe pneumonia in African children. Trop Med Int Health 2015; 20:757-65. [PMID: 25728867 PMCID: PMC4642338 DOI: 10.1111/tmi.12492] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective Cough or difficult breathing and an increased respiratory rate for their age are the commonest indications for outpatient antibiotic treatment in African children. We aimed to determine whether respiratory rate was likely to be transiently raised by a number of contextual factors in a busy clinic leading to inaccurate diagnosis. Methods Respiratory rates were recorded in children aged 2–59 months presenting with cough or difficulty breathing to one of the two busy outpatient clinics and then repeated at 10‐min intervals over 1 h in a quiet setting. Results One hundred and sixty‐seven children were enrolled with a mean age of 7.1 (SD ± 2.9) months in infants and 27.6 (SD ± 12.8) months in children aged 12–59 months. The mean respiratory rate declined from 42.3 and 33.6 breaths per minute (bpm) in the clinic to 39.1 and 32.6 bpm after 10 min in a quiet room and to 39.2 and 30.7 bpm (P < 0.001) after 60 min in younger and older children, respectively. This resulted in 11/13 (85%) infants and 2/15 (13%) older children being misclassified with non‐severe pneumonia. In a random effects linear regression model, the variability in respiratory rate within children (42%) was almost as much as the variability between children (58%). Changing the respiratory rates cut‐offs to higher thresholds resulted in a small reduction in the proportion of non‐severe pneumonia mis‐classifications in infants. Conclusion Noise and other contextual factors may cause a transient increase in respiratory rate and consequently misclassification of non‐severe pneumonia. However, this effect is less pronounced in older children than infants. Respiratory rate is a difficult sign to measure as the variation is large between and within children. More studies of the accuracy and utility of respiratory rate as a proxy for non‐severe pneumonia diagnosis in a busy clinic are needed.
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Affiliation(s)
- Florida Muro
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Hall C, Sukijthamapan P, dos Santos R, Nourse C, Murphy D, Gibbons M, Francis JR. Challenges to delivery of isoniazid preventive therapy in a cohort of children exposed to tuberculosis in Timor-Leste. Trop Med Int Health 2015; 20:730-6. [PMID: 25682846 DOI: 10.1111/tmi.12479] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the number and geographic location of children aged <5 years exposed to sputum smear-positive tuberculosis (TB) in Timor-Leste, to determine the proportion evaluated for isoniazid preventive therapy (IPT) and to review the programmatic challenges present in delivering IPT to this cohort. METHODS A total of 256 consecutive sputum smear-positive TB index cases diagnosed at Bairo Pite Clinic between August 2013 and July 2014 were interviewed about places of residence and household contacts <5 years of age in the 3 months preceding diagnosis. Attendance of these contacts for screening and the outcome of screening were recorded prospectively. RESULTS The majority (225 of 256, 88%) of index cases resided in Dili, but 73 of 225 (32%) of these also had a second address outside the capital. A total of 255 contacts were identified; 172 of 255 (67%) of whom lived in Dili district and 83 of 255 (33%) of whom resided in remote districts. Only 66 of 255 (26%) contacts attended for evaluation for IPT, of whom 46 of 255 (18%) started IPT and nine of 255 (3.5%) were diagnosed with TB. Attendance was significantly less likely when the index case was not the parent of the child contact. CONCLUSIONS Sputum smear-positive pulmonary TB cases frequently result in household exposure of children <5 years in Timor-Leste, and provision of IPT is suboptimal. Contacts are located in diverse and distant locations. Further studies to delineate access barriers to IPT and review programmatic models that will facilitate IPT scale up in Timor-Leste are needed.
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Affiliation(s)
- Charlotte Hall
- Bairo Pite Clinic, Dili, Timor-Leste; Hull and East Yorkshire NHS Trust, Hull, East Yorkshire, UK
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Boerma RS, Wit FWNM, Orock SO, Schonenberg-Meinema D, Hartdorff CM, Bakia A, van Hensbroek MB. Mortality risk factors among HIV-exposed infants in rural and urban Cameroon. Trop Med Int Health 2014; 20:170-6. [PMID: 25345882 DOI: 10.1111/tmi.12424] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES HIV-exposed infants, including those who do not become infected, have higher morbidity and mortality rates than HIV unexposed infants. The underlying mechanisms of this difference are largely unknown. The objective of this study was to identify the risk factors for mortality among HIV-exposed (infected as well as uninfected) infants in a prevention of mother-to-child transmission (PMTCT) programme in Cameroon. METHODS We analysed the data from 319 mother-infant pairs included in a PMTCT programme at a rural and an urban hospital between 2004 and 2012. The programme offered free formula feeding, monthly follow-up visits and antiretroviral therapy (ART) according to national PMTCT guidelines. Mother-infant pairs were divided in three study groups, based on year of recruitment and study site: (I) rural hospital, 2004-07; (II) rural hospital, 2008-12; (III) urban hospital, 2008-12. RESULTS Two hundred and eighty-five medical records were included in the final analysis. Infant mortality rates were 23.9%, 20.0% and 5.3% in group I, II and III, respectively (P = 0.02). Hazard ratios of infant mortality were 6.4 (P < 0.001) for prematurity, 4.6 (P = 0.04) for no maternal use of ARTs, 5.6 (P = 0.025) for mixed feeding, 2.7 for home deliveries (P = 0.087) and 0.4 (P = 0.138) for urban study group. CONCLUSIONS In this programme, prematurity, no ART use, and the practice of mixed feeding were independent predictors of infant mortality. Mixed feeding and not using ART increased the hazard of death, probably through its increased risk of HIV infection. Although mortality rates were significantly higher in the rural area, rural setting was not a risk factor for infant mortality. These findings may contribute to the development of tailor-made programmes to reduce infant mortality rates among HIV-exposed infants.
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Affiliation(s)
- Ragna S Boerma
- Global Child Health Group, Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands
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Seguin M, Niño Zarazúa M. Non-clinical interventions for acute respiratory infections and diarrhoeal diseases among young children in developing countries. Trop Med Int Health 2014; 20:146-69. [PMID: 25345845 DOI: 10.1111/tmi.12423] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the effectiveness of non-clinical interventions against acute respiratory infections and diarrhoeal diseases among young children in developing countries. METHODS Experimental and observational impact studies of non-clinical interventions aimed at reducing the incidence of mortality and/or morbidity among children due to acute respiratory infections and/or diarrhoeal diseases were reviewed, following the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. RESULTS Enhancing resources and/or infrastructure, and promoting behavioural changes, are effective policy strategies to reduce child morbidity and mortality due to diarrhoeal disease and acute respiratory infections in developing countries. Interventions targeting diarrhoeal incidence generally demonstrated a reduction, ranging from 18.3% to 61%. The wide range of impact size reflects the diverse design features of policies and the heterogeneity of socio-economic environments in which these policies were implemented. Sanitation promotion at household level seems to have a greater protective effect for small children. CONCLUSION Public investment in sanitation and hygiene, water supply and quality and the provision of medical equipment that detect symptoms of childhood diseases, in combination of training and education for medical workers, are effective policy strategies to reduce diarrhoeal diseases and acute respiratory infections. More research is needed in the countries that are most affected by childhood diseases. There is a need for disaggregation of analysis by age cohorts, as impact effectiveness of policies depends on children's age.
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Condo JU, Gage A, Mock N, Rice J, Greiner T. Sex differences in nutritional status of HIV-exposed children in Rwanda: a longitudinal study. Trop Med Int Health 2014; 20:17-23. [PMID: 25345559 DOI: 10.1111/tmi.12406] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda. METHODS We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns. RESULTS Among 222 boys and 258 girls, the mean (±SD) Z-score of stunting, wasting and underweight was -2.01 (±1.59), -0.15 (±1.46), -1.19 (±1.29) for boys; for girls they were -1.46 (±1.56), 0.22 (±1.29), -0.63 (±1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex. CONCLUSIONS HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns.
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Affiliation(s)
- Jeanine U Condo
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Diro E, Lynen L, Gebregziabiher B, Assefa A, Lakew W, Belew Z, Hailu A, Boelaert M, van Griensven J. Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia. Trop Med Int Health 2014; 20:8-16. [PMID: 25329449 DOI: 10.1111/tmi.12407] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients. METHODS A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted. RESULTS A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%). CONCLUSION While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.
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Affiliation(s)
- Ermias Diro
- University of Gondar, Gondar, Ethiopia; Institute of Tropical Medicine, Antwerp, Belgium
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Mbeye NM, ter Kuile FO, Davies MA, Phiri KS, Egger M, Wandeler G. Cotrimoxazole prophylactic treatment prevents malaria in children in sub-Saharan Africa: systematic review and meta-analysis. Trop Med Int Health 2014; 19:1057-67. [PMID: 25039469 DOI: 10.1111/tmi.12352] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Cotrimoxazole prophylactic treatment (CPT) prevents opportunistic infections in HIV-infected or HIV-exposed children, but estimates of the effectiveness in preventing malaria vary. We reviewed studies that examined the effect of CPT on incidence of malaria in children in sub-Saharan Africa. METHODS We searched PubMed and EMBASE for randomised controlled trials (RCTs) and cohort studies on the effect of CPT on incidence of malaria and mortality in children and extracted data on the prevalence of sulphadoxine-pyrimethamine resistance-conferring point mutations. Incidence rate ratios (IRR) from individual studies were combined using random effects meta-analysis; confounder-adjusted estimates were used for cohort studies. The importance of resistance was examined in meta-regression analyses. RESULTS Three RCTs and four cohort studies with 5039 children (1692 HIV-exposed; 2800 HIV-uninfected; 1486 HIV-infected) were included. Children on CPT were less likely to develop clinical malaria episodes than those without prophylaxis (combined IRR 0.37, 95% confidence interval: 0.21-0.66), but there was substantial between-study heterogeneity (I-squared = 94%, P < 0.001). The protective efficacy of CPT was highest in an RCT from Mali, where the prevalence of antifolate resistant plasmodia was low. In meta-regression analyses, there was some evidence that the efficacy of CPT declined with increasing levels of resistance. Mortality was reduced with CPT in an RCT from Zambia, but not in a cohort study from Côte d'Ivoire. CONCLUSIONS Cotrimoxazole prophylactic treatment reduces incidence of malaria and mortality in children in sub-Saharan Africa, but study designs, settings and results were heterogeneous. CPT appears to be beneficial for HIV-infected and HIV-exposed as well as HIV-uninfected children.
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Affiliation(s)
- Nyanyiwe M Mbeye
- College of Medicine, University of Malawi, Blantyre, Malawi; Liverpool School of Tropical Medicine, Liverpool, UK
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Kyeyune FX, Calis JCJ, Phiri KS, Faragher B, Kachala D, Brabin BJ, van Hensbroek MB. The interaction between malaria and human immunodeficiency virus infection in severely anaemic Malawian children: a prospective longitudinal study. Trop Med Int Health 2014; 19:698-705. [PMID: 24628893 DOI: 10.1111/tmi.12295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Malaria and human immunodeficiency virus (HIV) infection are co-prevalent in sub-Saharan Africa and cause severe anaemia in children. Interactions between these infections occur in adults, although these are less clear in children. The aim of study was to determine their interaction in a cohort of severely anaemic children. METHODS Severely anaemic Malawian children were enrolled, tested for HIV and malaria, transfused and followed for 18 months for malaria incidence. Antiretrovirals were not widely available in Malawi during the study period. RESULTS Of 381 children (haemoglobin <5 g/dl), 357 consented for HIV testing, 12.6% were HIV-infected, and 59.5% had malaria parasitaemia. At enrolment, HIV-infected children had similar malaria parasitaemia prevalence (59.1% vs. 58.7%; P = 0.96) and parasite density (geometric mean [parasites/μl] 6903 vs. 12417; P = 0.18) as HIV-negative children. There were no differences in mean CD4%, or prevalence of severe immunosuppression, between those with and without malaria parasitaemia. Plasma viral load correlated negatively with log parasitaemia (r = -0.78; P = 0.01). During follow-up, HIV-infected children did not experience more frequent parasitaemias or symptomatic malaria episodes. Adjusted risk estimates (95% CI) for malaria parasitaemia in HIV-infected children at 6 and 18 months follow-up were 0.39 (0.13-1.14) and 0.40 (0.11-1.51), respectively. CONCLUSIONS Severely anaemic HIV-infected children showed no increased susceptibility to asymptomatic or symptomatic malaria during or following their anaemic episode, although all experienced lower parasite prevalence during follow-up. This contrasts with data in adults and may relate to the malaria immunity of young children which is insufficiently developed to be impaired by HIV. The negative correlation between viral load and malaria parasitaemia remains unexplained.
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Affiliation(s)
- Francis X Kyeyune
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Job C J Calis
- Global Child Health Group, Emma Children's Hospital AMC, Amsterdam, the Netherlands
| | - Kamija S Phiri
- Community Health Department, College of Medicine, University of Malawi, Blantyre, Malawi.,Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi, Blantyre, Malawi
| | - Brian Faragher
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David Kachala
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi, Blantyre, Malawi
| | - Bernard J Brabin
- Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
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Davies MA, Boulle A, Technau K, Eley B, Moultrie H, Rabie H, Garone D, Giddy J, Wood R, Egger M, Keiser O. The role of targeted viral load testing in diagnosing virological failure in children on antiretroviral therapy with immunological failure. Trop Med Int Health 2012; 17:1386-90. [PMID: 22974345 DOI: 10.1111/j.1365-3156.2012.03073.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the improvement in positive predictive value of immunological failure criteria for identifying virological failure in HIV-infected children on antiretroviral therapy (ART) when a single targeted viral load measurement is performed in children identified as having immunological failure. METHODS Analysis of data from children (<16 years at ART initiation) at South African ART sites at which CD4 count/per cent and HIV-RNA monitoring are performed 6-monthly. Immunological failure was defined according to both WHO 2010 and United States Department of Health and Human Services (DHHS) 2008 criteria. Confirmed virological failure was defined as HIV-RNA >5000 copies/ml on two consecutive occasions <365 days apart in a child on ART for ≥18 months. RESULTS Among 2798 children on ART for ≥18 months [median (IQR) age 50 (21-84) months at ART initiation], the cumulative probability of confirmed virological failure by 42 months on ART was 6.3%. Using targeted viral load after meeting DHHS immunological failure criteria rather than DHHS immunological failure criteria alone increased positive predictive value from 28% to 82%. Targeted viral load improved the positive predictive value of WHO 2010 criteria for identifying confirmed virological failure from 49% to 82%. CONCLUSION The addition of a single viral load measurement in children identified as failing immunologically will prevent most switches to second-line treatment in virologically suppressed children.
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Affiliation(s)
- Mary-Ann Davies
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital and University of Witwatersrand, Johannesburg, South Africa Red Cross Children's Hospital and School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa Wits Reproductive Health and HIV Institute (Harriet Shezi Children's Clinic, Chris Hani Baragwanath Hospital, Soweto), Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa Tygerberg Academic Hospital, University of Stellenbosch, Stellenbosch, South Africa Médecins Sans Frontières South Africa and Khayelitsha ART Programme, Khayelitsha, Cape Town, South Africa Sinikithemba Clinic, McCord Hospital, Durban, South Africa Gugulethu Community Health Centre and Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Vélez CM, Lugo LH, García HI. [Validity and Reliability of the KIDSCREEN-27 Life Quality Questionnaire, Parents' Version, in Medellin, Colombia]. Rev Colomb Psiquiatr 2012; 41:588-605. [PMID: 26572114 DOI: 10.1016/s0034-7450(14)60031-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/12/2012] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Validate the KIDSCREEN-27 for parents in the metropolitan area of Medellín, Colombia, including the Social Acceptance (SA) subscale of KIDSCREEN-52, as it evaluates the effect of bullying in Life Quality of children. METHODS The study population was made up by parents of children between 8 and 18, from Medellín and its metropolitan area. A sample of 1,150 parents was estimated according to the different psychometric properties to be measured. Construct validation was made by comparing the mean scores between groups of high and low socioeconomic conditions. The content validity and the measurement of reliability were verified by internal consistency and test-retest stability. The parent-child agreement was also measured. RESULTS The internal consistency was adequate (Cronbach alpha 0,76-0,83). Parents of children with better socio-economic status had higher scores in all dimensions (p<0,05). Scores were higher among healthy children. Women had lower scores than men, while children registered higher scores than adolescents. The intraclass correlation coefficient for the reliability assessment was above 0.7 in all dimensions, except in School Environment-SE- (ICC 0,6-0,92). The parent-child agreement reached moderate and good levels (ICC 0,49-0,69). The exploratory factorial analysis, including social acceptance subscale, registered eight dimensions, four of which in agreement with the original questionnaire: Physical activity, SE, Social Support, and SA subscale. CONCLUSIONS KIDSCREEN-27 for parents is a valid and reliable instrument to be used in the Colombian context.
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Affiliation(s)
- Claudia Marcela Vélez
- Médica, especialista en Salud Pública, estudiante de Maestría en Ciencias Clínicas, Grupo Académico de Epidemiología Clínica (GRAEPIC). Profesora de la Facultad de Medicina, de la Universidad de Antioquia, Medellín, Colombia.
| | - Luz Helena Lugo
- Médica, especialista en Medicina Física y Rehabilitación, magíster en Epidemiologia. Profesora, integrante del Grupo Académico de Epidemiologia Clínica (GRAEPIC) y del Grupo de Rehabilitación en Salud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Héctor Iván García
- Médico y cirujano, magíster en Salud Pública, magíster en Epidemiología. Profesor, integrante del Grupo Académico de Epidemiología Clínica (GRAEPIC), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Piñeiro Pérez R, Hijano Bandera F, Alvez González F, Fernández Landaluce A, Silva Rico JC, Pérez Cánovas C, Calvo Rey C, Cilleruelo Ortega MJ. [Consensus document on the diagnosis and treatment of acute tonsillopharyngitis]. An Pediatr (Barc) 2011; 75:342.e1-13. [PMID: 21920830 PMCID: PMC7105079 DOI: 10.1016/j.anpedi.2011.07.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 07/23/2011] [Accepted: 07/25/2011] [Indexed: 10/25/2022] Open
Abstract
Acute tonsillopharyngitis is one of the most common childhood diseases. Viruses are the most frequent origin. Group A Streptococcus (Streptococcus pyogenes) is the main bacterial cause. A culture or a rapid antigen-detection test of a throat-swab specimen should only be done on the basis of clinical scores, in order to avoid over-diagnosis of bacterial origin and unnecessary antibiotic prescription. The objectives of treatment are: the reduction of symptoms, reduce the contagious period, and prevent local suppurative and systemic complications. Ideally, only confirmed cases should receive antibiotics. If there is no possibility to perform a rapid antigen-detection test, or in some cases if the result is negative, it is recommended to perform a culture and, if there is high suspicious index, to prescribe antibiotics. Penicillin is the treatment of choice, although amoxicillin is also accepted as the first option. Amoxicillin/clavulanate is not indicated in any case as empirical treatment. Macrolides are not a first choice antibiotic, and should be reserved for those patients with immediate penicillin allergy reaction or for the treatment of streptococcal carriers. It is of primordial importance to adapt the prescribing of antibiotics to the scientific evidence.
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Leinaweaver J. [Distancing as a Social Process: 'Abandoned' Young and Old in Ayacucho.]. Anthropologica 2010; 28:139-162. [PMID: 25177044 PMCID: PMC4148045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
In previous research on fostering and adoption in Ayacucho, I explored how amid the creative negotiation of discourses and spaces constructed by institutions, communities, and social structures, Ayacuchanos take up and produce new social relations. This article discusses the opposite process: undoing kinship, and the social process of abandonment or distancing. When a person is withdrawn from his or her family or community, those who remain come to understand themselves as certain kinds of persons. The case studies considered here, collected through careful participant observation and ethnographic interviews recorded between 2001 and 2007, reveal how, after social distancing or abandonment, the individuals who do the distancing reinterpret themselves as subjects who are improving themselves and becoming modern.
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Abstract
There have been numerous and extensive studies into the visual requirements for reading in adults with low vision. There are far fewer studies involving children with low vision. This article compares the studies on children which do exist with the findings in adults. Acuity reserve (magnification), contrast reserve and visual field requirements are considered. We also review the literature which compares the efficacy of large print with optical magnification for children. From the few studies that exist, there are indications that the requirements for children are not the same as for adults. Therefore, we suggest that one cannot directly apply the results from adults to children and that there is a gap in the literature (and therefore our understanding) of the visual requirements for reading in children.
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Affiliation(s)
- Balsam Alabdulkader
- Corresponding author. School of Optometry, University of Waterloo, 200 University Ave West, Waterloo, Ontario, N2L 3G1, Canada.
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Ras Vidal E, Briones Carcedo O. [Television: an enemy at home]. Aten Primaria 2004; 34:506-7. [PMID: 15563792 PMCID: PMC7688682 DOI: 10.1016/s0212-6567(04)79540-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Aranceta Bartrina J, Pérez Rodrigo C, Serra Majem L, Delgado Rubio A. [Food habits of students using school dining rooms in Spain. "Tell Me How You Eat" Study]. Aten Primaria 2004; 33:131-9. [PMID: 14987496 PMCID: PMC7677920 DOI: 10.1016/s0212-6567(04)79373-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2003] [Accepted: 09/01/2003] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe food habits of school-aged population having school meals and to evaluate perceived quality of the service. STUDY DESIGN Descriptive cross-sectional study. SETTING Community School lunchrooms in different Spanish regions. PARTICIPANTS Random population sample of children and young people (3-16 year) having school meals in Spain. MEASUREMENTS The study protocol included socio-economical data, food consumption and dietary habits at the school and out of the school. Information was collected by means of two questionnaires: one completed by children at school and a second one completed by the family at home. RESULTS Valid response was collected from 322 children and 212 families, a response rate of 96.1% children and 63.3% of the families. 88% of the children reported daily consumption of breakfast, 45% used to have a midmorning snack, which consisted of a sandwich (29%); sweet bakery products (27%) or biscuits (15%). 45% of the 12-16-year-old old group reported eating only half of the portion served at lunch in the school, mainly due to disgusting taste or preparation (50%). In the school menus vegetables and fish were offered less frequently than other food groups. 81% of the children referred having an after-school snack in the afternoon, consisting of a sandwich (65%); bakery products (20%); bread and chocolate (20%); yoghurt or fruit (20%). CONCLUSIONS School meals provide a wonderful opportunity to widen the variety of foods in the daily diet of children. Recommendations about school meals should address the quality and variety of the foods served for a healthy diet and stress the educational dimension.
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Affiliation(s)
- J Aranceta Bartrina
- Unidad de Nutrición Comunitaria, Subárea Municipal de Salud Pública, Luis Briñas 18, 4a planta, 48013 Bilbao, Spain.
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Abstract
OBJECTIVE To find the state of buccal-dental health of the 6-year old population attending the schools belonging to Manresa area 4. DESIGN Four crossover, observational, epidemiological studies performed over the last 4 years (1995-1999). SETTING Health Area 4, Sagrada Familia, in the city of Manresa, Barcelona. PARTICIPANTS 489 students doing the first year of primary school in the schools belonging to Manresa area 4 from 1995-1999. MEASUREMENTS AND MAIN RESULTS There was 29.81% prevalence of caries (31.88% in boys and 27.85% in girls). The COD index (deciduous dentition) was 1.075 (1.25 in boys and 0.90 in girls) and the CAOD index (permanent dentition) was 0.115 (0.127 in boys and 0.104 in girls). CONCLUSIONS Results showed low indices of caries if we compare them with the WHO Health programme target for the year 2000 of restricting caries to under 50% of six-year old children. However, this is below target 46 in the Catalonia Health Plan, which set for the year 2000 a target of 75% of six-year old school-children free of caries.
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Abstract
OBJECTIVE The purpose of this study was to analyze children's television viewing habits and their parents attitudes towards such viewing. DESIGN Cross-sectional descriptive study. SETTING Primary care. PARTICIPANTS A survey was undertaken with 317 three to fourteen year old children and their parents as part of the primary care check-up program for healthy children. MEASUREMENTS AND MAIN RESULTS Time devoted to television viewing was 106 +/- 50 minutes on weekdays and 141 +/- 80 minutes weekends. Despite this, 49.2% of parents thought their children saw little television, especially those with children under six (57.6%). Children of parents in highly qualified positions and of parents in the uppermost socioeconomic group saw television the least, on non-working days (70 +/- 61 minutes and 144 +/- 78 minutes respectively, p < or = 0.0001). Some 71.9% of children watched television alone and 34% did so at meal-times. Altogether 48.3% of parents were unaware as to what their children watched and some 61.5% encouraged television viewing, above all those having children of under six (76%). The youngest children preferred to watch cartoons which were generally of a violent nature. For those aged from 11 to 14, 19.5% chose as their favorite programs those having a high level of violence. CONCLUSION Television habits are an educational problem for parents, an important shake-up in their attitudes being called for, in which pediatricians should be involved in developing health programs aimed at proper use of the television.
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