Assessment of the nutritional status of children with special needs in Alexandria: I. Nutrient intake and food consumption

The present study was undertaken to evaluate the nutritional status of children with special needs in Alexandria city, on the basis of nutrient intake and food consumption. Socio-demographic characteristics and dietary data were determined in a sample of 231 disabled children chosen randomly from five specialized day care centers. Results showed that the age of the sample ranged from less than 7 to 24 years with a mean age of 12.6 +/- 4.7 years. Mental retardation represents the highest proportion of subjects followed by Down's syndrome and then Autism Male subjects were found to consume higher nutrients than females at all ages except age under seven years. The intake of both gender was less than the recommended for energy, calcium, vitamin A, niacin and zinc. While the intake of protein and vitamin C was more than the RDA Iron intake was below the recommended for females at all ages and within the acceptable level for male. The results also showed that there is a relationship between nutrient intake and disability type. Down syndrome children were found to consume more nutrients than mentally retarded and autistic subjects.     

Siblings off a child with autism, with mental retardation and with a normal development

A total of 60 children between 8 and 15 years of age participated in this project, 20 of whom had a sibling with autism, 20 a sibling with mental retardation and 20a non-disabled sibling. The children were questioned about their sibling relationship and their experiences of stress. The children with a sibling with autism also completed a questionnaire on their knowledge of the autistic syndrome. Analyses revealed that the three groups were basically similar in their ratings of the frequency of stressors involving their siblings. There was a trend for children with a disabled brother or sister to rate their relationship with the sibling more positively. Correlational analyses revealed an association between both stressor frequency and appraisal and the evaluation of the relationship with the brother or sister. Siblings of children with autism had a fair understanding of the autistic syndrome, in this group, there was also an association between the children's knowledge of the autistic disorder and the quality of the sibling relationship.     

自闭症对复杂声音的感知:孩子反常的听觉皮层处理

目标作者先前已经描述过,自闭症成人在听到语言类似的声音时,左边语言相关的颞区域表现出比正常成人少的活化作用。这里,他们研究这种反常的皮层处理是否也出现在基本自闭症的孩子中。方法区域性大脑血流是通过术前用药后的正电子放射的X线断层摄影术测量的,对象是11个自闭症孩子和6个不自闭但智力迟钝的孩子,在他们休息时或当他们听语言类似的声音时进行测量。结果与自闭症成人的研究一样,这两组人的直接比较显示出,自闭症小孩左边的语言相关区域的活化作用明显比智力迟钝小孩的少。结论他们第一次在自闭症孩子中进行活化作用研究,研究所成还证实了早先在成年人中获得的成果。在自闭症孩子和成人中观察到的反常听觉皮层处理将关系到对声音的行为反应不足和自闭症的语言损伤特性。     

中国21县(市)3～6岁儿童贫血与体格发育的关系研究

目的探讨学龄前儿童贫血与体格发育之间的关系。方法数据来源于北京大学生育健康研究所2000年对河北、江苏和浙江3省21个县市3～6岁儿童所作的随访研究和相关围产保健监测资料。按儿童血红蛋白水平分为正常组、轻度贫血组、中重度贫血组,分别比较各组的身高、体重、BMI、年龄别身高Z评分、年龄别体重Z评分,以及生长迟缓率和体重低下率。结果各年龄段贫血儿童的身高、体重均值显著低于正常组。3～、4～、5～、6～7岁各年龄组轻度贫血男童比正常男童平均身高分别小0.65、0.69、0.94、1.42cm,平均体重分别少0.22、0.18、0.38、0.63kg;而各年龄组轻度贫血女童比正常女童平均身高分别低0.93、0.74、0.88、1.71cm,平均体重分别少0.29、0.22、0.35、0.78kg,以上差异均有显著性(P<0.05)。调整儿童出生体重、城乡地区、母亲身高、母亲初次孕检BMI、母亲文化程度、母亲职业后,轻度贫血儿童发生生长迟缓的危险是非贫血儿童的1.37倍(OR=1.37),而发生体重低下的危险是非贫血儿童的1.32倍(OR=1.32)。结论儿童贫血与体格发育密切相关,应在促进儿童生长发育的同时防治儿童贫血。     

四川省病残儿先天性疾病性别、城乡顺位差异及年龄趋势分析

目的 了解四川省病残儿先天性疾病性别、城乡顺位差异及年龄趋势,为探讨疾病重点防治策略提供科学依据。方法 基于国际疾病分类编码体系,对四川省2004-2015年鉴定的18 897例先天性病残儿对应的21 059个鉴定诊断进行疾病编码,分析性别、城乡顺位差异及年龄趋势。结果 先天性心脏病在女性（30.85%）病残儿中构成比高于男性（19.08%）,脑先天性畸形、肌肉骨骼先天性变形构成比在男性（7.24%和4.76%）中高于女性（5.94%和3.92%）。脊柱及胸廓先天性畸形构成比随年龄增长而升高,先天性心脏病、脑先天性畸形、唐氏综合征则随年龄增长而降低（均有P<0.05）。唐氏综合征、先天性晶状体畸形在城镇组中构成比更高,肌肉骨骼先天性变形、上肢短小缺陷、唇腭裂在农村组中构成比更高。结论 四川省病残儿先天性疾病在性别、城乡顺位构成和年龄趋势上存在差异,应据此制订切实有效的重点防治策略,合理管控先天性病残儿家庭再生育风险,降低疾病发生率和致残率。     

Hepatitis B virus infection in an institution for the mentally retarded

A cross-sectional survey on the prevalence of hepatitis B serologic markers and hepatitis B virus DNA was performed in a population of 493 mentally handicapped males. Special interest was focused on age-related variables such as age at entry into the institution and on duration of residency. Furthermore, the differences with regard to the prevalence of hepatitis B markers found in Down's syndrome residents and other mentally retarded persons were analyzed. In a longitudinal study, the impact of the presence of hepatitis B virus DNA in serum was studied. Overall, 62.1 per cent of residents had serologic evidence of infection with hepatitis B virus, while 16.7 per cent of those residents with markers of infection were positive for hepatitis B surface antigen (HBsAg). Hepatitis B virus DNA was found in 24 per cent of HBsAg carriers (all positive for hepatitis B e antigen (HBeAg). In residents whose age at entry was less than 15 years, those with Down's syndrome were more often carriers of HBsAg than other mentally retarded residents. In addition, Down's syndrome residents more often had serum hepatitis B virus DNA compared with residents with other forms of mental retardation. A young age at entry was recognized as an important factor with regard to the prevalence of hepatitis B markers. From the longitudinal studies, it appeared that loss of hepatitis B virus DNA from serum indicated imminent loss of HBeAg and normalization of alanine aminotransferase values. Knowledge of the hepatitis B virus DNA status of HBsAg carriers in these institutions may therefore provide a valuable tool in attempts to reduce the transmission of this infection.     

不同发育障碍儿童家庭的依恋特点

【目的】 探索不同发育障碍儿童家庭的依恋特点。 【方法】 采用一般家庭情况问卷及亲密关系经历量表(ECR,中文版)分别对69例孤独症患儿(孤独症组)、18例Asperger综合征患儿(Asperger综合征组)、51例精神发育迟滞患儿(精神发育迟滞组)及69名正常儿童(正常对照组)的父亲和母亲进行问卷调查,分析不同发育障碍儿童家庭的父亲和母亲的依恋特点。 【结果】 组间父亲依恋回避、母亲依恋焦虑和母亲回避维度差异无统计学意义(P均＞0.05);父亲依恋焦虑维度差异有统计学意义(F=5.432,P＜0.01)。两两比较发现,父亲依恋焦虑维度评分孤独症及精神发育迟滞组明显高于正常对照组及Asperger综合征组(P＜0.05~0.01);正常对照组与Asperger综合征组间差异无统计学意义(P＞0.05)。 【结论】 不同发育障碍患儿家庭中,母亲依恋特征与正常儿童的母亲相同,但孤独症及精神发育迟滞患儿的父亲依恋焦虑维度增高,可能会影响其抚育患儿的方式。     

Autism spectrum disorders and low body weight: Is there really a systematic association?

OBJECTIVE: To examine the relationship between autism spectrum disorders and low body weight. METHOD: The effect of maladaptive social and communicative behavior as well as stereotyped features on the normative body mass index (BMI) was analyzed in 103 subjects with autism or Asperger syndrome. Statistics were controlled for medication, neurological signs, overactivity, and general intelligence. RESULTS: Twenty-eight percent of the male individuals had a BMI in the fifth percentile or below. Except for hyperactive behavior, none of the predictors showed a significant association with BMI. None of the subjects met diagnostic criteria for anorexia nervosa. DISCUSSION: Although low body weight is often present in male subjects with autism or Asperger syndrome, results indicate that this link is inconsistent and partly mediated by hyperactivity. The co-occurrence of autism spectrum disorders and anorexia nervosa is probably due to chance.     

Cognitive-perceptual treatment of exceptional children*

SUMMARY Adopting the notion that cognitive operations consist of multiple stages of information-processing, this treatment is designed to specify the locus and nature of the child's deficits in information processing and to compensate for these deficits. Our own clinical and empirical observations, as well as the findings of others, have convinced us that this treatment programme can be applied to exceptional children of many different diagnoses, including emotionally disturbed, learning disabled, autistic, and mentally retarded. A case study involving a seven-year-old autistic child is presented to illustrate the technique, process, and effectiveness of the treatment programme.     

Perceptions of stigma: the parents of autistic children

This paper reports the findings of a qualitative study of courtesy stigma among 32 parents of autistic children. The results indicate that autism has uniquely stigmatising aspects because of the extremely disruptive nature of autistic symptoms, the normal physical appearance of autistic children, and the lack of public knowledge and understanding regarding the nature of autism. Most parents perceived themselves to be stigmatised by their child's disorder. There was a strong tendency for mothers to feel more stigmatised than fathers. Parents with more severely disabled children and children who were under the age of twelve were also somewhat more likely to perceive themselves to be stigmatised.     

Body mass index as a measure of body fatness: age- and sex-specific prediction formulas

In 1229 subjects, 521 males and 708 females, with a wide range in body mass index (BMI; 13.9-40.9 kg/m2), and an age range of 7-83 years, body composition was determined by densitometry and anthropometry. The relationship between densitometrically-determined body fat percentage (BF%) and BMI, taking age and sex (males = 1, females = 0) into account, was analysed. For children aged 15 years and younger, the relationship differed from that in adults, due to the height-related increase in BMI in children. In children the BF% could be predicted by the formula BF% = 1.51 x BMI-0.70 x age - 3.6 x sex + 1.4 (R2 0.38, SE of estimate (SEE) 4.4% BF%). In adults the prediction formula was: BF% = 1.20 x BMI + 0.23 x age - 10.8 x sex - 5.4 (R2 0.79, SEE = 4.1% BF%). Internal and external cross-validation of the prediction formulas showed that they gave valid estimates of body fat in males and females at all ages. In obese subjects however, the prediction formulas slightly overestimated the BF%. The prediction error is comparable to the prediction error obtained with other methods of estimating BF%, such as skinfold thickness measurements or bioelectrical impedance.     

Sixty years of autism

The concept of autism has been broadened the last few years from 'early infantile autism' to 'an autistic spectrum'. Autism and related contact disorders are grouped together under 'pervasive developmental disorders' or 'autistic spectrum disorders'. The autistic disorder, Asperger's syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), Rett's disorder and the childhood disintegrative disorder all belong to this group. People with an autistic spectrum disorder have severe difficulties in the integration of perceived stimuli into a meaningful entity. More than two-thirds of the people with the autistic disorder (classical autism) are also mentally retarded. Although autism can still only be diagnosed at the behavioural level, there is considerable consensus regarding an underlying organic aetiology. Autism is clearly a multifactorial condition. Autism cannot be cured, but adequate intervention can significantly improve the quality of life of people with this disorder. Diagnosis and intervention are highly interrelated. In the intervention, a distinction is made between family-oriented and child-oriented strategies. Augmentative communication plays a key role in the treatment. People with autism need a lot of structure, clarity and predictability, also when they have become adults.     

The prevalence of serological markers,hepatitis B virus DNA and elevated serum amino transferase values in institutionalized mentally handicapped males and females: An epidemiological study of HBV infection in residents with down's syndrome or other forms of mental deficiency

Conventional HBV serological markers, as well as serum alanine amino transferase and hepatitis B virus DNA (HBV DNA) were studied in a population of 667 institutionalized mentally handicapped males and females and in 676 staff members. The role of Down's syndrome (DS), sex and age-related factors with respect to the prevalence of these markers was analyzed.A young age at admission was found as one of the important factors in the development of the chronic HBsAg carrier state in females.The well-known higher prevalence of HBsAg carriership in DS patients appeared to be restricted to males.Markers indicative of viral replication, HBsAg and $BV DNA, were also more prevalent in male than in female DS residents, or OMR residents.These findings indicate that the phase of active viral replication is prolonged in male HBsAg carriers with DS. However, only 66.7 per cent of HBV DNA-positive and 26.2 per cent of HBsAg-positive residents had abnormal serum alanine amino transferase (ALT) values. In addition, more than 50 per cent of residents with elevated serum alanine amino transferase values were negative for HBV serological markers. We conclude that male DS residents are the main source of HBV infection in institutions for the mentally handicapped and that determination of ALT values is not very useful in identifying those HBsAg carriers capable of transmission the infection.Abbreviations ALT alanine amino transferase - dGTP deoxy-cytidine triphosphate - DNA deoxy-ribonucleic acid - DS Down's syndrome - dpm disintegrations per minute - HBV hepatitis B virus - OMR other mentally retarded - ³²p radioactive phosphorus     

Practice guidelines for diagnosis of vision disorders in mentally handicapped persons. National Organization for Quality Assurance in Hospitals]

Visual impairment is more frequent among people with intellectual disability than among the general population. Because the diagnosis often fails to be made in this group screening is justified. Timely recognition may have consequences for prevention and treatment. Therefore, a consensus statement has been developed by the Dutch associations of physicians for intellectual disability, general practitioners, ophthalmologists, paediatricians, youth health physicians and orthoptists. Specialized ophthalmological assessment of all young children with retarded development is recommended, as well as assessment of visual function at the ages of 3, 6, 12 and 18 years and every 5 years from the age of 45. In adults with Down's syndrome, an additional assessment at the age of 30 is recommended for detection of age-related cataract and (increased) refractive errors. Most people can be assessed by the general practitioner, using normal methods. Diagnostic methods applicable in insufficiently co-operative people have been recommended. Low-threshold regional expert centres for diagnosis in children and adults who are difficult to assess and for specialized guidance would be advisable.     

Autism and the school nurse

Until recently, treatment for children with autism involved housing them in hospitals for the developmentally disabled. Today, more states are returning children with autism to their home communities, and more parents are choosing or are being required to keep their children with autism in their homes. Laws were developed to ensure that children with autism receive some form of education, often through the local school system. School nurses, who may not have experience working with children with autism, may feel uncertain about how to provide support for the child with autism. Approximately 300,000 persons in the United States have autism or display autistic behaviors. About one-third are under age 21. People with autism come from all socioeconomic classes. Males are four times more likely to be affected by autism than females. People with autism can be expected to live a normal lifespan.     

Assessment of the mean daily dietary intake of acrylamide in alexandria

Acrylamide is a toxic and potentially cancer causing chemical formed in thermally treated starchy foods. The objective of the present study is to estimate the mean daily dietary intake of acrylamide in Alexandria governorate. A total of 822 subjects (417 males and 405 females) were randomly selected, from different places such as clubs, schools, university, nursery schools, homes and companies, from different socio-demographic sectors of the Alexandria population. The age of the subjects ranged from less than four to more than fifty years old. Subjects were divided into seven age groups. A twenty four hours recall was used to record types and quantities of the food stuffs taken through three consecutive days including the week end. Samples of consumed starchy foods - presumed to contain high levels of acrylamide were collected and analyzed for acrylamide. Thirteen food items were analyzed for acrylamide. The highest acrylamide contents were recorded in chips potato and Fried potatoes (French fries) (1500 +/- 645 and 540 +/- 213 microg/kg respectively). Cakes were the lowest in mean acrylamide contents (12 +/- 12 microg/kg). The highest mean daily dietary intake of acrylamide (3.82 microg/kg body weight) was for the age group from 3 - < 6 years old subjects, while the lowest acrylamide intake (0.49 microg/kg body weight) was that of the age group above 50 years old. The overall estimated mean daily dietary intake of acrylamide was 1.75 microg/kg body weight. No significant differences between males and females were found among various studied age groups regarding the mean daily dietary intake of acrylamide. Chips potato represents the major source of dietary acrylamide (46%). The second most contributing agent in the mean daily dietary intake of acrylamide for studied Alexandria population was fried potato (19%). Bread contributes to 17 % of the mean daily dietary acrylamide intake. In conclusion, the fried and deep fried starchy foods consumed by the studied Alexandria population contain high levels of acrylamide. The majority of the estimated mean dietary daily intake of acrylamide is from fried potato products. Controlling the intake, especially in young children can thus reduce the high acrylamide intake.     

Relationship of dietary habits pattern and body build of parents to child obesity]

Patterns of eating habits were analyzed to elucidate its relationship to the temporal change of body build from childhood through school age in subjects of the Toyama study. Survey questionnaires at the time of entrance to elementary school were used. Subjects were 6,452 (males 3,293, and females 3,159). Subjects were classified into 6 clusters among the males, 8 clusters among females based on the results of cluster analysis of eating habits. The cluster in males that preferred egg, milk, dairy products, fats, fish and shellfish, soybeans, fruits, green yellow vegetables indicated more frequent subjects whose BMI were less that 14. The cluster in girls that preferred fats indicated more frequent subjects whose BMI were more or equal to 18. The ANOVA showed significant relation of parental body build on their children. Even after grouping by parental body build, the cluster based on patterns of eating habits showed different frequencies of obese children. Preference for intake of milk indicated less frequent obese children among the similar parental body build for boys, while preference for intake of fats indicated more frequent obese children among a similar parental body build for girls. In conclusion, the obesity of a school child has a close relationship to parent's body build. However, the temporal changes of obesity were seen among eating habits clusters even if body builds of their parents are the same. It was shown that patterns of eating habit are important in school children's obesity development.     

Current concept of autism]

Childhood autism, the most characteristic subgroup of the broader PDD (pervasive developmental disorders) category, is the consequence of genetic or typically prenatal, organic factors causing cerebral damage. The resulting mental handicap lasts for a lifetime. It is characterized by a behavioural syndrome, that becomes recognizable between the 2.-3. year. The core of the syndrome is a deviant and/or retarded development of cognitive capacities and skills necessary for social relations, communication, fantasy and symbolic thinking. Almost all autistic people (95%) would not reach independence as adults, and most of them (75%) is mentally retarded as well. According to our calculations about 16,000 people are affected in Hungary, in a more or less serious degree, 2000 children among them. Their condition would require intensive, early and long lasting intervention: conditioning, training, education, and special social services. Today we do not possess the necessary organisational background, nor the professional training, and knowledge. For the early diagnosis, proper care and services the competence of child- and general psychiatrists, also of family doctors is indispensable. The author summarizes the most important available informations on the field first of all for those, who work in the general medical services.     

Health care use by Medicare's disabled enrollees.

Three million persons under age 65 are entitled to Medicare because of disability. This study examines their Medicare use and mortality. Disabled enrollees had higher health care use and mortality than comparison groups of Medicare's aged enrollees or of the general population under age 65. One type of disabled enrollee, adults disabled as children (over one-half of whom are mentally retarded) show lower use rates than the other types of enrollees--workers and widows. High mortality of the disabled during the 2-year waiting period for Medicare suggests the need to investigate how they pay for care during this period.     

Mean body weight, height, and body mass index, United States 1960-2002

This report presents trends in national estimates of mean weight, height, and body mass index (BMI) from the National Health Examination and the National Health and Nutrition Examination Surveys between 1960 and 2002. The tables included in this report present data for adults by sex, race/ethnicity, and age group and for children by sex and year of age. Mean weight and BMI have increased for both sexes, all race/ethnic groups, and all ages. Among adults, mean weight increased more than 24 pounds. Although not as dramatically, mean height has also increased for most ages and for both males and females.