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School Age (school + age)
Terms modified by School Age Selected AbstractsEating problems at age 6 years in a whole population sample of extremely preterm childrenDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2010MUTHANNA SAMARA Aim, The aim of this study was to investigate the prevalence of eating problems and their association with neurological and behavioural disabilities and growth among children born extremely preterm (EPC) at age 6 years. Method, A standard questionnaire about eating was completed by parents of 223 children (125 males [56.1%], 98 females [43.9%]) aged 6 years who were born at 25 weeks' gestation or earlier (mean 24.5wks, SD 0.7wks; mean birthweight 749.1g, SD 116.8g), and parents of 148 classmates born at term (66 males [44.6%], 82 females [55.4%]). All children underwent neurological, cognitive, and anthropometric assessment, and parents and teachers completed a behaviour scale. Results, Eating problems were more common among the EPC than the comparison group (odds ratio [OR] 3.6, 95% confidence interval [CI] 2.1,6.3), including oral motor (OR 5.2, 95% CI 2.8,9.9), hypersensitivity (OR 3.0, 95% CI 1.6,5.6), and behavioural (OR 3.8, 95% CI 1.9,7.6) problems. Group differences were reduced after adjustment for cognitive impairment, neuromotor disability, and other behaviour problems. EPC with eating problems were shorter, lighter, and had lower mid-arm circumference and lower body mass index (BMI) even after adjusting for disabilities, gestational age, birthweight, and feeding problems at 30 months. Interpretation, Eating problems are still frequent in EPC at school age. They are only partly related to other disabilities but make an additional contribution to continued growth failure and may require early recognition and intervention. [source] Early motor repertoire is related to level of self-mobility in children with cerebral palsy at school ageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2009JANNEKE LM BRUGGINK MD Aim, To determine the predictive value of the early motor repertoire for the level of self-mobility in children with cerebral palsy (CP) at school age. Method, Video recordings were made at 11 to 17 weeks post-term of 37 preterm infants (20 males, 17 females) who later developed CP. The early motor repertoire was assessed by obtaining a motor optimality score. At 6 to 12 years, children were classified according to the Gross Motor Function Classification System (GMFCS). Results, Of 37 children (mean gestational age 29.1wks, SD 1.9; mean birthweight 1273g, SD 324), nine had unilateral and 28 had bilateral spastic CP. Twelve children were in GMFCS level I, three level II, 10 level III, four level IV, and eight level V. The absence of the age-adequate motor repertoire, a cramped motor repertoire, an abnormal kicking pattern, and a non-flat supine posture were associated with lower levels of self-mobility (,2 for trend test, p<0.05). Predictive for a low level of self-mobility was a cramped motor repertoire/non-flat supine posture (positive predictive values [PPV] 100%, negative predictive values [NPV] 54%). Predictive for a high level of self-mobility was a non-cramped repertoire/flat supine posture (PPV 80%, NPV 74%). Interpretation, Several aspects of the motor repertoire at 11 to 17 weeks post-term predicted the degree of functional limitations in children with CP at school age. [source] Participation and enjoyment of leisure activities in school-aged children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2008Annette Majnemer PhD OT The objective of this study was to characterize participation in leisure activities in children with cerebral palsy (CP) and identify determinants of greater involvement. Ninety-five children of school age (9y 7mo [SD 2y 1mo]) with CP were recruited, and participation was evaluated with the Children's Assessment of Participation and Enjoyment in a subset (67/95; 42 males, 25 females) who could actively participate in completion of the assessment. Most had mild motor dysfunction (Gross Motor Function Classification System: 59% level I, 23% level II, 18% levels III,V) and had a spastic subtype of CP (23 hemiplegia, 17 diplegia, 16 quadriplegia, 11 other). Biomedical, child, family and environmental predictor variables were considered in the analysis. Results demonstrated that these children were actively involved in a wide range of leisure activities and experienced a high level of enjoyment. However, involvement was lower in skill-based and active physical activities as well as community-based activities. Mastery motivation and involvement in rehabilitation services enhanced involvement (intensity and diversity) in particular leisure activities, whereas cognitive and behavioral difficulties, activity limitations, and parental stress were obstacles to participation. [source] Surveillance of vision and ocular disorders in children with Down syndromeDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2007Elma Stephen MBBS MD MRCPCH Children with Down syndrome have a high prevalence of ocular disorders. The UK Down's Syndrome Medical Interest Group (DSMIG) guidelines for ophthalmic screening were locally implemented into a protocol that included neonatal eye examination by an opthalmologist and a comprehensive ophthalmological examination (cycloplegic refraction, ophthalmoscopy, and orthoptic assessement) by at least the age of 3 years, followed by preschool follow-up as indicated. We audited retrospectively surveillance for ocular disorders before and after the DSMIG-based guidelines were locally adopted in 1995. Results were compared for children born before and after the implementation of screening guidelines. A total of 81 children (43 females, 38 males) with Down syndrome were identified. After the DSMIG protocol, 34/36 children received a full ophthalmological examination in the neonatal period, compared with 9/27 children before 1995 (p<0.001). Neonatal screening resulted in the detection of cataracts in three infants. Mean age of first comprehensive ophthalmic screening outside the neonatal period was similar in the two groups (1y 6mo before guidelines vs 1y 9mo after), as were the proportion of children receiving preschool eye checks (27/30 before; 17/18 after). Overall, 65.7% children were screened in accordance with the guidelines, improving to 100% in recent years. At school age, 43% of the study population had significant refractive errors, with 27% having hypermetropia and astigmatism. Earlier prescription of glasses for refractive errors was seen (mean age 5y 6mo before guidelines; 3y 6mo after; p<0.001). Prevalence of other ocular disorders included strabismus (34/72, 47%), nasolacrimal duct obstruction (26/73, 35.6%), cataracts (5/64, 7.8%), and nystagmus (12/72, 16%). Establishment of the DSMIG-based local protocol has streamlined ocular surveillance. It is anticipated that this will improve developmental and functional outcomes in Down syndrome. [source] Factors associated with microcephaly at school age in a very-low-birthweight populationDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2003Claudia A Chiriboga MD MPH The neonatal predictors of microcephaly, defined as a head circumference <5th centile in children born preterm, has not been systematically assessed. Children were drawn from the Developmental Epidemiology Network (DEN) cohort of very low-birth weight children (VLBW: 500,1500g) born from 1991 to 1993 at three sites in the USA. Neurological assessments were carried out among 198 singleton children (mean age 6 years 8 months, SD 0.5 years). Ninety-six children (48.5%) were male. Microcephaly was observed in 30 children (15%) and, using multivariate analysis, it was found to be associated with gestational age <26 weeks and bronchopulmonary dysplasia (BPD). Sonography-defined white-matter damage (WMD, i.e. echolucency or echodensities) was not associated with increased odds of microcephaly, while occurrence of intraventricular hemorrhage (IVH) was in univariate but not multivariate analysis. In analyses that excluded children with IVH/WMD, odds of microcephaly increased in dose-related fashion according to number of days on ventilator: >5 days, OR=4.5; 95%CI=1.4 to 15; >10 days, OR=5.7; 95%CI=1.7 to 19; >15 days OR=8.3; 95% CI=2.3 to 29.2. Among children without BPD, microcephaly was not associated with differences in IQ, while IQ scores among children with BPD or any ventilation were disproportionately lower among those with microcephaly. In multivariate analyses predicting IQ at age 7 years, microcephaly was found to modify the association between neonatal lung disease and IQ. [source] Effects of iodine supplementation during pregnancy on child growth and development at school ageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2002Karen J O'Donnell MEd PhD Growth and development of 207 children (49% males; mean age 5.4 years [SD 0.2], range 4 to 7.3 years whose mothers received iodine during pregnancy, and children who received iodine first in their 2nd year, were examined in 1996; 192 children(49% males; mean age 6.5 years[SD 0.2], range 5.8 to 6.9 years) whose mothers received iodine while pregnant were seen in 1998. Children were from the southern part of China's Xinjiang Province which has the lowest levels of iodine in water and soil ever recorded. Head circumference but not height was improved for those who received iodine during pregnancy (compared with those receiving iodine at age 2) and for those supplemented before the end of the 2nd trimester (relative to those supplemented during the 3rd trimester). Iodine before the 3rd trimester predicted higher psychomotor test scores for children relative to those provided iodine later in pregnancy or at 2 years. Results from the test for cognitive development resulted in trend only differences between those children supplemented during pregnancy versus later. The results address the question of when maternal iodine supplements should begin in public health programs world wide. Findings may be relevant to the treatment of maternal and newborn thyroid deficiency in industrialized countries, particularly for those infants delivered before the end of the second trimester. [source] Changes in alternative brain-derived neurotrophic factor transcript expression in the developing human prefrontal cortexEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2009Jenny Wong Abstract In this study, we determined when and through which promoter brain-derived neurotrophic factor (BDNF) transcription is regulated during the protracted period of human frontal cortex development. Using quantitative real-time polymerase chain reaction, we examined the expression of the four most abundant alternative 5, exons of the BDNF gene (exons I, II, IV, and VI) in RNA extracted from the prefrontal cortex. We found that expression of transcripts I,IX and VI,IX was highest during infancy, whereas that of transcript II,IX was lowest just after birth, slowly increasing to reach a peak in toddlers. Transcript IV,IX was significantly upregulated within the first year of life, and was maintained at this level until school age. Quantification of BDNF protein revealed that levels followed a similar developmental pattern as transcript IV,IX. In situ hybridization of mRNA in cortical sections showed the highest expression in layers V and VI for all four BDNF transcripts, whereas moderate expression was observed in layers II and III. Interestingly, although low expression of BDNF was observed in cortical layer IV, this BDNF mRNA low-zone decreased in prominence with age and showed an increase in neuronal mRNA localization. In summary, our findings show that dynamic regulation of BDNF expression occurs through differential use of alternative promoters during the development of the human prefrontal cortex, particularly in the younger age groups, when the prefrontal cortex is more plastic. [source] The behaviour style observation system for young children predicts teacher-reported externalizing behaviour in middle childhoodINFANT AND CHILD DEVELOPMENT, Issue 4 2009Alexa Martin-Storey Abstract The Behaviour Style Observation System for Young Children (BSOS) was used to predict preschool-aged children's externalizing and internalizing behaviour problems in middle childhood, 3,5 years after the initial assessment. This observational measurement tool was designed to sample and assess young children's disruptive, non-compliant, and unresponsive behaviour, during a brief (11,min) observation in the child's home. In the current study, the BSOS was used to predict parent and teacher ratings of child behaviour problems after school entry in a longitudinal sample (N=81) of at-risk children at time 2. The BSOS predicted teacher-reported externalizing problems at time 2. In contrast, parent reports of behaviour problems, although correlated with repeated parent reports at time 2, were not significantly predictive of teacher-reported behaviour problems at school age. The BSOS was not associated with either parent or teacher reports of internalizing problems. These findings emphasize the importance and utility of using observational measures when examining the continuity of behaviour problems in young children over time. Copyright © 2009 John Wiley & Sons, Ltd. [source] Changes in Bone Density During Childhood and Adolescence: An Approach Based on Bone's Biological OrganizationJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2001Frank Rauch Abstract Bone densitometry has great potential to improve our understanding of bone development. However, densitometric data in children rarely are interpreted in light of the biological processes they reflect. To strengthen the link between bone densitometry and the physiology of bone development, we review the literature on physiological mechanisms and structural changes determining bone mineral density (BMD). BMD (defined as mass of mineral per unit volume) is analyzed in three levels: in bone material (BMDmaterial), in a bone's trabecular and cortical tissue compartments (BMDcompartment), and in the entire bone (BMDtotal). BMDmaterial of the femoral midshaft cortex decreases after birth to a nadir in the first year of life and thereafter increases. In iliac trabecular bone, BMDmaterial also increases from infancy to adulthood, reflecting the decrease in bone turnover. BMDmaterial cannot be determined with current noninvasive techniques because of insufficient spatial resolution. BMDcompartment of the femoral midshaft cortex decreases in the first months after birth followed by a rapid increase during the next 2 years and slower changes thereafter, reflecting changes in both relative bone volume and BMDmaterial. Trabecular BMDcompartment increases in vertebral bodies but not at the distal radius. Quantitative computed tomography (QCT) allows for the determination of both trabecular and cortical BMDcompartment, whereas projectional techniques such as dual-energy X-ray absorptiometry (DXA) can be used only to assess cortical BMDcompartment of long bone diaphyses. BMDtotal of long bones decreases by about 30% in the first months after birth, reflecting a redistribution of bone tissue from the endocortical to the periosteal surface. In children of school age and in adolescents, changes in BMDtotal are site-specific. There is a marked rise in BMDtotal at locations where relative cortical area increases (metacarpal bones, phalanges, and forearm), but little change at the femoral neck and midshaft. BMDtotal can be measured by QCT at any site of the skeleton, regardless of bone shape. DXA allows the estimation of BMDtotal at skeletal sites, which have an approximately circular cross-section. The system presented here may help to interpret densitometric results in growing subjects on a physiological basis. [source] More economic 25 mg 13C-urea breath test can be effective in detecting primary Helicobacter pylori infection in childrenJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2007Yao-Jong Yang Abstract Background and Aim:, The high cost of the 13C-urea breath test (UBT) limits its wide application for both epidemiological and clinical studies for diagnosing Helicobacter pylori infection. This study examined if a lower-dose UBT, applying 1 mg/kg of bodyweight (maximum 25 mg, UBT25), could introduce cost savings while preserving high diagnostic yields for primary H. pylori infection. Methods:, Children aged less than 16 years were recruited after obtaining consent. Those children with administration of antibiotics or proton pump inhibitors within 1 month of the tests were excluded. Positive tests for both the UBT with 50 mg urea (UBT50) and the H. pylori stool antigen (HpSA) were qualifying criteria for H. pylori infection. Negative results for both indicated non-infection. The UBT25 was conducted 1 week after the UBT50. The cut-off points for the UBT25 ranging from 2, to 5, were examined for their sensitivity, specificity and accuracy rates. Results:, A total of 153 children were recruited (55% male; mean age 9.1 ± 3.5 years). Both the UBT50 and HpSA test were positive in 18 (13.1%) and negative in 119 children, respectively. The sensitivity and specificity of the UBT25 were optimally achieved at 88.9% (95% confidence interval [CI]: 71.4,100) and 95.0% (95% CI: 91.1,99.9), judged with a cut-off point at 3.5,. The diagnostic accuracy was significantly higher for children older than 7 years than for those younger than 7 years (98%vs 85%, P = 0.009). Conclusion:, Lower-dose UBT titration by bodyweight can cut costs while maintaining a highly reliable method to screen primary H. pylori infection in children older than 7 years, which is generally beyond school age. [source] Self-assessment of relationships with peers in children with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2001A. Zic Abstract Interaction with peers is important for the development of children, but children with special needs may feel rejected by their peers. The present study examines self-assessment of relationships with peers by children with intellectual disability (ID; n = 20) and children from the general population (n = 20). All participants attended a regular primary school and were aged between 7 and 10.5 years; both sexes were represented in the samples. The Behavior Rating Profile was applied. The results of the children with ID on the ,Student Rating Scale: Peers' did not show statistically significant differences from the results of children from general population, with both groups responding similarly to the self-perception scale. However, the sociometric results obtained from their peers clearly show that children with ID are not accepted by their classmates. Peers frequently and more often refuse to study, sit together in class or socialize after classes with children with ID than is the case for children without ID. Despite the high frequency of rejection, it is concluded that children with ID of younger primary school age have average confidence in their own abilities and in the success of their relationships with their peers. Further education among the children who reject them could have a negative impact on their self-esteem. [source] Chronic lung disease of prematurity and respiratory outcome at eight years of ageJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2007Karthikeyan Kulasekaran Aim: The study aimed to determine the respiratory outcome of children who had chronic lung disease of prematurity (CLD) compared with a preterm control group of children at school age. Methods: Fifty-two preterm infants with CLD born between 26 and 33 weeks gestation were assessed regarding respiratory illness with 47 having lung function testing. Information regarding respiratory illness was obtained from 52 children in the birthweight-matched control group of whom 45 had lung function testing. The results were compared between the CLD and control groups. Results: There was no difference in respiratory symptomatology between CLD groups and control preterm infants. On lung function testing, a significantly lower mean forced expiratory flow at 25,75% of vital capacity was identified compared with the preterm controls (P = 0.024). This significant difference did not persist after bronchodilator therapy. There was no evidence of increased air trapping or bronchial hyper-reactivity in the CLD children compared with the controls. Conclusion: Lung function in CLD children is largely normal in comparison with preterm controls, apart from some evidence of reversible small airway obstruction. Respiratory symptomatology is not increased in chronic disease children in comparison with control preterm children. [source] Intensity of Aggression in Childhood as a Predictor of Different Forms of Adult Aggression: A Two-Country (Finland and the United States) AnalysisJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 1 2009Katja Kokko This study examined the prediction of different forms of adult aggression in 2 countries from child and adolescent aggression. It was based on 2 longitudinal projects: the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS; N=196 boys and 173 girls) conducted in Finland and the Columbia County Longitudinal Study (CCLS; N=436 boys and 420 girls) conducted in the United States. The same peer-nominated items for aggression were used in both studies at age 8; comparable measures of aggression were also available in adolescence (age 14 in the JYLS/19 in the CCLS) and adulthood (ages 36/30 and 42/48). Results showed that in both countries and in both genders, aggression in school age was linked significantly to physical aggression and lack of self-control of anger in adulthood but not to verbal aggression. This differential predictability of aggression over 40 years suggests that individual differences in physical aggression are more determined by lasting individual differences (including emotional reactivity) than are individual differences in verbal aggression. [source] Improving Dean's writing: or, what shall we tell the children?LITERACY, Issue 2 2004Graham Frater Abstract In this paper Graham Frater finds early signs of a revival of explicit instruction in English grammar to pupils of compulsory school age in England; this is accompanied by an expectation that such teaching might play an important part in closing the ,writing gap'. He suggests that, strengthened by the National Literacy Strategy, this early re-awakening invokes again some of the debates that accompanied the construction of the National Curriculum. Rooted in a case study of a text by a low-achieving Y7 writer, and in two surveys of effective practice with writing (covering Key Stages 2,4), this paper argues that purposeful text-level teaching, reading in particular, and the creation of real readerships offer more secure ways of promoting progress in writing. [source] Swimming pool attendance and hay fever rates later in lifeALLERGY, Issue 11 2006Y. Kohlhammer Background:, Exposure to chlorination by-products through swimming pool attendance showed adverse health effects on children. The aim of our study was to assess whether pool attendance in childhood would be related to higher rates of allergic diseases in adulthood, with special regard to hay fever. Methods:, 2606 adults aged 35,74 years provided retrospectively collected information on swimming pool attendance and medical history, including data on atopic diseases. Information was assessed by a combination of a personal interview and a self-administered questionnaire. Logistic regression models were applied to study associations between hay fever and swimming pool attendance, adjusted for potentially relevant confounders, such as age, gender, region, education and smoking. Results:, Higher rates of hay fever could be seen when frequently exposed at school age (aOR: 1.74, 95% CI: 1.09,2.77), frequently exposed during the past 12 months (aOR: 1.32, 95% CI: 0.92,1.89) and ever exposed (aOR: 1.65, 95% CI: 0.98,2.78). Strongest associations were found for the youngest subjects and were dose-related to the extent of current and school-age pool attendance. Conclusions:, Impaired integrity of the lung epithelial by exposure to chlorination by-products might facilitate a closer contact to allergens and therefore could result in higher rates of hay fever. [source] Messages from the German Multicentre Allergy StudyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2002Renate Nickel Several birth cohort studies have been initiated during the past two decades to study environmental and genetic risk factors for atopic dermatitis, asthma and allergic rhinitis. This article summarizes results from the German Multicentre Allergy Study (MAS), which has followed children (initially 1314) from birth (in 1990) to the present time. The effects of immunizations, allergen exposure, early sensitization patterns as well as upper airway infections on the subsequent development of asthma and atopy at school age are described. Furthermore, candidate gene studies of atopic dermatitis and increased total serum IgE levels on chromosomes 5q, 12q and 17q in MAS-children and their parents are outlined. [source] Hepatitis A seroprevalence and demographics in Turkish children in AnkaraPEDIATRICS INTERNATIONAL, Issue 1 2009Rukiye U. Sac Abstract Background:, Hepatitis A virus (HAV) is the most common cause of hepatitis in childhood and an important public health problem. The objective of the present study was to determine the seroprevalence of hepatitis A and patient demographics in children between 1 and 15 years old who were admitted to a pediatric outpatient clinic in Ankara, Turkey. Methods:, Hepatitis IgM and G antibodies were determined in the sera of children who attended the outpatient clinic. Informed consent was obtained from all subjects or their parents. Results:, The mean age of the children (n = 335) was 7.9 ± 2.1 years; 47.5% of them were girls. The overall anti-HAV IgG prevalence in children aged 1,15 years was 47.2%. The positivity of hepatitis A IgM was highest in the 6,10 years age group (22.7%; P < 0.001). HAV IgG was highest in the 11,15 years age group (69.4%; P < 0.001). A total of 95.6% of the children had social insurance, 49.3% were living in poverty. The socioeconomic level of 82.4% of subjects was low. The history of hepatitis in their families was 6.9%. Conclusions:, Hepatitis A is intermediate endemic in Ankara and children must be vaccinated before school age, in addition to health education and improved sanitation. [source] Intussusception in children of school agePEDIATRICS INTERNATIONAL, Issue 1 2007TARO IKEDA Abstract Background: There are only a few reports discussing the characteristics of intussusception developing in school-age children. The characteristics of these cases are discussed, with reference to previous literature. Methods: The present study included eight cases of intussusception in school-age children among 143 intussusception patients treated on an inpatient basis at Nihon University Itabashi Hospital, during the 11 year period from 1993 to 2003. The remaining 135 patients were assigned to the infant group as controls. The clinical characteristics of intussusception in school-age children were compared with those of the condition developing in infants. Results: The eight children of school age with intussusception ranged in age from 8 to 15 years (mean, 11.6 years), and consisted of five boys and three girls. The major symptom was abdominal pain, occurring in 100% (8/8). Bloody stools and vomiting were reported in two patients each (25%) from this group. The triad of abdominal pain, bloody stools and vomiting was recognized in only one child (12.5%) of this group. Two children (25.0%) had a palpable abdominal mass, and one child (12.5%) complained of diarrhea. None of the school-age children with intussusception had any antecedent infection; five, two and one patients had the ileo-colic type, ileo-ileo-colic type and ileo-ileal type of intussusception, respectively. Four underwent enema reduction and four underwent surgical reduction. One of the eight children (12.5%) had underlying organic abnormality; in the remaining children the condition was labeled idiopathic. One child developed recurrences. Conclusions: In school-age children intussusception is generally believed to be commonly secondary to underlying organic abnormality, but in the present study only one of eight school-age children had underlying organic abnormality; in the remaining children, the condition was labeled idiopathic. The major symptom in school-age intussusception was abdominal pain. Therefore this may need to be differentiated from appendicitis in children of school age. It is considered that abdominal ultrasonography (USG) is a simple and useful method for making the diagnosis of intussusception, and that diagnostic USG should be conducted in all school-age children presenting with acute abdominal pain. [source] Mesothelioma in a worker who spun chrysotile asbestos at home during childhoodAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2009Eiji Yano MD Abstract Background Malignant mesothelioma has a long latency period and more commonly found in those exposed to amphibole than chrysotile asbestos. Method A 35 years old asbestos worker in an asbestos textile plant in Chongqing, China, developed mesothelioma after only 4 years of employment. He was born and bred in a company residence of an asbestos plant and manually spun asbestos thread during school age. In the plant, not amphibole but only chrysotile has been used. Results Diagnosis of malignant mesothelioma was confirmed by comprehensive approaches including gross appearance, histology, histochemistry, and immunocytochemistry. In the lung and tumor tissues, huge number of tremolite with exceptional chrysotile was observed despite the reverse proportion in the work environment. Discussion Residential exposure and home spinning of asbestos seemed contributed to the early development of mesothelioma in this subject. Although only chrysotile was used and contamination of tremolite was low in the work environment, chrysotile seemed to be cleared leaving tremolite remain in the tissue. Conclusion Chrysotile with little contamination of tremolite can lead to early development of malignant mesothelioma when heavily exposed from childhood at a company residence with household exposure. There can be several mechanisms for tremolite to remain in the lung tissue, far exceeding chrysotile in number. Am. J. Ind. Med. 52:282,287, 2009. © 2009 Wiley-Liss, Inc. [source] Comorbidity in attention deficit,hyperactivity disorderPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Takashi Ishii Abstract Attention deficit,hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age , 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51,84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD. [source] Assessment of child problem behaviors by multiple informants: a longitudinal study from preschool to school entryTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 10 2007David C.R. Kerr Background:, Children's early problem behavior that manifests in multiple contexts is often more serious and stable. The concurrent and predictive validity of ratings of externalizing and internalizing by four informants was examined at preschool and early school age in an at-risk sample. Methods:, Two hundred forty children were assessed by mothers and fathers (Child Behavior Checklist (CBCL)), and teachers and laboratory examiners (Teacher Report Form (TRF)) at ages 3 and 5 years. Results:, All informants' ratings of externalizing converged on a common factor at ages 3 and 5 that showed strong stability over time (, = .80). All informants' age 3 externalizing ratings significantly predicted the problem factor at age 5; mothers', fathers', and teachers' ratings were independently predictive. Ratings of internalizing (except by examiners at age 3) also converged at both ages; the problem factor showed medium stability (, = .39) over time. Only fathers' ratings of age 3 internalizing predicted the age 5 problem factor. Conclusions:, Findings support the value of multi-informant assessment, uphold calls to include fathers in childhood research, and suggest that examiners provide valid, though non-unique assessment data. Examiner contributions may prove useful in many research contexts. [source] Minimum local analgesic concentration of ropivacaine for intra-operative caudal analgesia in pre-school and school age childrenANAESTHESIA, Issue 10 2010X. M. Deng Summary We compared the minimum local analgesia concentration of ropivacaine for intra-operative caudal analgesia in pre-school and school age children. Fifty-one boys, undergoing hypospadius repair surgery, were stratified into pre-school or school age groups. After induction of anaesthesia, caudal block was performed with ropivacaine 1 ml.kg,1 of the desired concentration. The first child in each group received ropivacaine 0.125%, and subsequent concentrations were determined by the analgesic response of the previous patient using Dixon's up-and-down method. Under general anaesthesia with 0.7 minimum alveolar concentration of sevoflurane, the minimum local analgesia concentration of ropivacaine for intra-operative caudal block was 34% greater in school age than in pre-school age boys (0.143% (95% CI 0.132,0.157%) vs 0.107% (95% CI 0.089,0.122%), respectively; p < 0.001). This study indicates that a higher concentration of ropivacaine is needed for school age than pre-school age children to provide intra-operative caudal analgesia when combined with general anaesthesia. [source] Erythropoietin improves neurodevelopmental outcome of extremely preterm infantsANNALS OF NEUROLOGY, Issue 5 2010Achim-Peter Neubauer MD Objective Erythropoietin has been reported to possess neuroprotective properties in animal studies. No previous studies have investigated the neurodevelopmental outcome of extremely low birth weight (ELBW) infants treated with recombinant human erythropoietin (rEpo) and evaluated it at school age. Methods Of 200 ELBW infants treated from 1993 to 1998, 171 (86%) survived, and 148 (87%) were followed up to the age of 10 to 13 years. The neurodevelopmental and school outcome of the ELBW infants receiving rEpo treatment for stimulation of erythropoiesis in the first weeks of life (n = 89) was compared to that of untreated children (n = 57). To test for a neuroprotective effect of erythropoietin therapy, analyses of variance (ANOVAs) were conducted with erythropoietin treatment and intraventricular hemorrhage (IVH) as independent variables and Hamburg-Wechsler Intelligence Test for Children-III (HAWIK-III) intelligence quotient (IQ) scores as dependent variables. Results The rEpo group scored significantly better than untreated children in the overall developmental assessment (55% vs 39% normally developed, p < 0.05) as well as in the psychological examination (mean composite HAWIK-III IQ score, 90.8 vs 81.3, p < 0.005). The results of ANOVAs show that these differences were ascribable to children with IVH. Whereas those children with IVH treated with rEpo scored significantly better than untreated children (52% vs 6% normally developed, composite HAWIK-III IQ score, 90.3 vs 67.0), treated and untreated children without IVH did not differ in their outcome. The treatment and control groups were comparable in perinatal parameters relevant to prognosis. Interpretation The results of our observational study confirm the hypothesis of a neuroprotective effect of rEpo in ELBW infants with IVH. This offers a promising preventative therapeutic option for the treatment of these high-risk infants. ANN NEUROL 2010;67:657,666 [source] The natural history of daytime urinary incontinence in children: a large British cohortACTA PAEDIATRICA, Issue 7 2010LV Swithinbank Abstract Aim:, Few studies have looked at the prevalence of daytime incontinence in a longitudinal cohort of children. This study set out to determine the prevalence of daytime incontinence and relationships between daytime incontinence and bedwetting, faecal incontinence and urgency in a large cohort of British children. Methods:, Parents of children taking part in the Avon Longitudinal Study of Parents and Children (ALSPAC) were asked questions concerning the child's daytime wetting, bedwetting and faecal incontinence at different time points, 4.5, 5.5, 6.5, 7.5 and 9.5 years. The difference between the sexes for these different conditions was compared. Results and limitations:, Data were available for 10 819 of the 13 973 children who entered the study. The prevalence of any daytime incontinence declined from 15.5% at 4.5 years to 4.9% at 9.5 years, and was mainly described as infrequent. Daytime incontinence was more common in girls than boys and frequent (DSM-IV) incontinence was more commonly related to urgency, bedwetting and faecal incontinence than infrequent incontinence. Conclusions:, Daytime incontinence is relatively common among children of primary school age and frequent incontinence more commonly coexists with other conditions, such as bedwetting and urgency. This study suggests the need for treatment to focus on children with frequent incontinence. [source] Childhood cardiac function after twin-to-twin transfusion syndrome , a 10-year follow upACTA PAEDIATRICA, Issue 9 2009CP Halvorsen Abstract Aim:, To perform a 10-year follow up of cardiac structure and function after twin-to-twin transfusion syndrome (TTTS) , a severe foetal circulatory complication associated with myocardial hypertrophy in the recipient twin. Methods:, Cardiac dimensions, systolic and diastolic function as assessed by echocardiography including flow and tissue Doppler velocimetry in 22 healthy survivors of TTTS with a mean age of 9.6 (7.2,11.8) years. Results:, The donor and recipient twin did not show any differences in end-diastolic ventricular size, interventricular septum thickness, diameter of right ventricular outflow tract, cardiac valves, coronary arteries or in systolic blood flow velocities. However, compared with the donors, the recipients had significantly lower E/A ratios because of lower E-waves in both mitral (,0.15 ± 0.10, p < 0.01) and tricuspid (,0.09 ± 0.07, p < 0.01) valves, indicating reduced early diastolic ventricular fillings compared with donors. Conclusion:, At school age, twins surviving TTTS had a cardiac structure and function within normal range. There were no differences in heart structure or systolic ventricular function between twins but, compared with the donor twin, we found a reduced early diastolic function in the recipient. [source] Coverage of recommended vaccines in children at 7,8 years of age in Flanders, BelgiumACTA PAEDIATRICA, Issue 8 2009Heidi Theeten Abstract Aim:, Evaluation of the coverage of primary diphtheria-tetanus-pertussis (DTP), poliomyelitis, hepatitis B (HBV) and measles-mumps-rubella (MMR) vaccine doses recommended before the age of 18 months in 7-year-old school children in Flanders, Belgium. Meningococcal serogroup C and DT-polio vaccines offered respectively as catch-up and booster vaccinations were also evaluated. Methods:, Parents of 792 children born in Flanders in 1997 and selected by cluster sampling were interviewed at home in 2005. Vaccination data since infancy were collected retrospectively from vaccination documents and school health records. Results:, Coverage rates were 88.0% for the first dose of MMR, and 72.0%, 84.2% and 91.4% for the recommended HBV, DTP and poliomyelitis primary vaccine doses, respectively. These rates included catch-up of missed infant MMR (4.9%) and HBV (6.4%) vaccinations. In addition, 88.3% of the target group received the DT-polio booster dose recommended at 6 years of age and 83.1% a meningococcal C vaccine dose. Preventive public health services as well as private physicians were involved to a varying extent. A lower socioeconomic status of the family was associated with a higher risk of nonvaccination. Conclusion:, Vaccinators in Flanders reach children relatively well during infancy and at school age, but catch-up of missed infant vaccine doses, especially MMR, should be optimized. [source] Middle-School-Age Outcomes in Children with Very Low BirthweightCHILD DEVELOPMENT, Issue 6 2000H. Gerry Taylor Most previous studies of children with birthweight <750 g have focused on early childhood sequelae. To evaluate later outcomes, a regional sample of 60 <750-g birthweight children was compared at middle school age (M= 11 years) to 55 children with birthweight 750 , 1,499 g and 49 term controls. The groups were matched on age, gender, and demographic variables at the time of an early-school-age assessment (mean age 7 years). The <750-g birthweight group fared less well at middle school age than the term group on measures of cognitive function, achievement, behavior, and academic performance. In many instances, outcomes were less favorable for the <750-g children than for the 750 to 1,499-g group. Children in the <750-g group who were free of neurosensory disorders and global cognitive impairment performed more poorly on several tests than their term counterparts. Group differences in this subsample on tests of motor skills, math, and the ability to copy and recall a complex drawing remained significant even after controlling for IQ. Disparities between the <750-g and term groups increased with age for some measures. Despite favorable outcomes for many children in the <750-g group, this population is at risk for long-term developmental problems. [source] Learning from mothers: how myths, policies and practices affect the detection of subtle developmental problems in childrenCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2007J. Williams Abstract Background Recent research has revealed increasing concerns over the number of children entering school with unidentified developmental problems, even though there are ostensibly comprehensive health services available for mothers and their children in the pre-school years. Recognizing that early detection and early intervention reduce the likelihood of long-term health and educational problems, it is important to understand why so many children are not detected with developmental problems in their pre-school years. Methods This doctoral study utilized the knowledge and experience of mothers to draw attention to reasons why children with subtle developmental problems are not identified until school age. A qualitative methodology utilized a synthesis of interpretive biography and literary folkloristics as a method of collecting, reading and interpreting personal stories. Three literary theories, arising, respectively, from the tenets of semiotics, neoMarxism and post-structuralism, were used to critically deconstruct the mothers' stories. Results The findings highlight a number of factors that influence the interaction between mothers, health professionals and members of the community, and how these interactions impact on the early detection of children's developmental problems. The findings illustrate the influence of societal myths on how mothers and health professionals view their roles, and on how they think about and respond to the child's problem. They also confirm the value placed on professional knowledge and the role it plays in communications between mothers and health professionals. Finally, they draw attention to how competing arguments about diagnosis and labelling delay identification and access to intervention programmes for children. Conclusion Health professionals working with mothers and young children should be aware of how their values, beliefs and communication styles affect their professional practice, especially when interacting with mothers who raise concerns about their children. State policies that limit access to early intervention programmes should also be reconsidered so that young children are not excluded from assistance. [source] Determinants of endotoxin levels in living environments of farmers' children and their peers from rural areasCLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2004M. Waser Summary Background Lower frequencies of asthma and hayfever have been observed in children with contact to livestock. At school age, the amount of endotoxin measured in the dust of children's mattresses is inversely related to the occurrence of atopic asthma, hayfever and atopic sensitization both in children from farming and non-farming households. Objective The aim of the present study was to investigate which home and lifestyle characteristics of farm and non-farm families contribute to endotoxin levels measured in different indoor home environments. Methods In the framework of the Allergy and Endotoxin (ALEX) Study, endotoxin was measured in dust samples from the living room floor and the child's mattress of 319 farmers' families and 493 non-farming families, and in settled dust from stables. Endotoxin content of all dust samples was determined by a kinetic Limulus assay (Limulus - Amebocyte -Lysate test). Information about the child's activities on farms, home characteristics and cleaning behaviours was obtained from parental questionnaires. Results Endotoxin levels in stables did not predict the amount of endotoxin measured in floors or mattresses. However, a dose-dependent association between the child's activity on the farm and indoor home endotoxin levels was observed, both in farm and non-farm children. In non-farm children pet keeping and the frequency of floor cleaning were additionally associated with endotoxin levels, whereas in farm children parental farm activities, study area, time since last cleaning, the mattress type as well as younger age of the children contributed to increased microbial exposure. Conclusion These results demonstrate that regular contact to farm animals increases indoor home endotoxin concentrations, both in farm and non-farm children, and might thus explain the protective effect of contact to livestock on atopic outcomes. To assess children's individual exposure to a microbial environment, measures of mattress dust exposure are needed as stable endotoxin concentrations were not associated with indoor home levels. [source] | ||||||||||||||||||||||||||||||||||