先天性梅毒患儿生长发育与神经心理发育随访研究

目的:探讨经正规驱梅治疗后的先天性梅毒儿生长发育和神经心理发育与正常儿是否存在差异及孕母正规治疗后的先天性梅毒儿与孕母未经正规治疗的先天性梅毒儿之间生长发育和神经心理发育是否存在差异。方法;孕母经过正规驱梅治疗的先天性梅毒患儿25例及孕母未经过正规驱梅治疗的先天性梅毒患儿25例作为试验组,同期在医院儿童保健科体检随访的健康婴儿25例作为对照组,进行系统追踪随访,分别在儿童3、6、9、12、18及24个月时进行生长发育(身高、体重、头围)及神经心理发育(0～6岁小儿神经心理发育诊断量表)评估。结果:先天性梅毒患儿身高增长及神经心理发育均低于正常儿,差异有统计学意义(P<0.05);孕母未经过正规驱梅治疗的先天性梅毒患儿身高低于孕母经过正规驱梅治疗的先天性梅毒患儿,差异有统计学意义(P<0.05)。结论:经正规治疗后的先天性梅毒影响儿童生长发育及神经心理发育。     

The effect of the motor regimen on the state of the blood circulation in 6-year-old children in kindergarten

Six-year old children attending day-care centers' groups with different motor regimens (a regular group and experimental classes where children spend 2.5-3.5 hours a day at the desk) were examined at the beginning (September) and at the end (May) of a school year for the following parameters: arterial blood pressure, pulse and breathing rate, as well as a step of regulation of the cardiac rhythm and spontaneous motor activity (determined with the help of coherent optics equipment according to ECG and actogram recordings). It has been found out that children from the experimental class have the bloodcirculation regulation status which is worse than that in children following a regular regimen. The authors suppose that it might be due to the reduction of physical activity.     

Disparities in regular source of dental care among mothers of medicaid-enrolled preschool children

For mothers of Medicaid children aged 3 to 6 years, we examined whether mothers' characteristics and local supply of dentists and public dental clinics are associated with having a regular source of dental care. Disproportionate stratified sampling by racial/ethnic group selected 11,305 children aged 3 to 6 in Medicaid in Washington State. Mothers (n=4,373) completed a mixed-mode survey that was combined with dental supply measures. Results reveal 38% of mothers had a regular dental place and 27% had a regular dentist. Dental insurance, greater education, income, length of residence, and better mental health were associated with having a regular place or dentist for Black, Hispanic, and White mothers, along with increased supply of private dentists and safety net clinics for White and Hispanic mothers. Mothers lacking a regular source of dental care may increase oral health disparities disfavoring their children.     

Snack consumption and waste by preschool children served "cute" versus regular snacks

OBJECTIVE: To determine if preschool children would eat and waste different amounts of food when served snacks in a regular versus a "cute" form. DESIGN: Preschool children were served 6 snacks in a cute form and the same snacks in a regular form using the same food components during 24 snack sessions. Children served as their own controls. SUBJECTS/SETTING: Thirty-nine children ages 36 to 60 months (20 girls, 19 boys) in a university child development laboratory. MAIN OUTCOME MEASURES: Snack portions eaten and wasted and time for eating. ANALYSIS: Data were analyzed using a 2 3 6 factorial analysis of variance, with snack form (cute or regular) and snack components as the 2 factors. RESULTS: There was no significant difference in children's snack consumption or waste between cute and regular versions of snacks. It took children an average of 2 minutes longer to eat the cute snacks. CONCLUSIONS AND IMPLICATIONS: There is no apparent advantage to serving cute snacks in terms of increased consumption or decreased waste. Further research should be conducted on children's mealtime behaviors when served cute foods to learn more about children's responses to the overall appearance of their food.     

The parent-provider relationship: Does race/ethnicity concordance or discordance influence parent reports of the receipt of high quality basic pediatric preventive services?

Recent research among adults suggests that having a provider of the same race/ethnicity may enhance the quality of health care above and beyond just having any regular source of care. It is not known whether such relationships exist in pediatric care. The purpose of this study is to identify the distribution and methods by which families have a race/ethnicity concordant provider of well-child care and examine whether differences exist in the receipt of basic preventive services (BPS) and familycentered care (FCC) among those with concordant, discordant, and no regular providers. Analyses are stratified by geography to assess whether urban versus nonurban setting moderates these differences. This study uses publicly available data from the 2000 National Survey of Early Childbood Health (NSECH), a nationally representative, cross-sectional telephone survey of parents of children ages 4–35 months (n=1,996). African Americans and Latinos were more likely than whites to lack a regular provider of well-child care (60.9% and 65.7% vs. 50.6%) and less likely to have a concordant provider (9.8% and 5.7% vs. 38.5%) (P<.0011). African Americans with a regular provider were about three times more likely to establish a concordant relationship in urban versus nonurban settings (32.4% vs. 12.5%, P<.011), No statistically significant differences in BPS or FCC were found by concordance versus discordance for any group, a finding that held regardless of geographic setting. White children with no regular provider received better BPS than those with a discordant provider (e.g., excellent BPS of 37.2% vs. 27.1%, P<..05), but children with no regular provider were more likely than those with either concordant or discordant providers to have lower FCC in one (Latinos, whites) or three domains (African Americans). Despite racial/ethnic differences in the likelihood of having a concordant regular provider of well-child care, no disparities were found in BPS or FCC associated with discordance, even after stratification by urban/nonurban setting. Lacking a regular provider was associated with lower FCC versus having either a concordant or discordant provider, suggesting that efforts to improve these aspects of well-child care might focus less on linking children with a race/ethnicity concordant provider and more on social, cultural, and linguistic factors that impact having any regular provider.     

Obesity or diet? Levels and determinants of phthalate body burden – A case study on Portuguese children

In this study we analyzed one of the most comprehensive sets of 21 urinary phthalate metabolites representing exposure to 11 parent phthalates (DEP, DMP, DiBP, DnBP, BBzP, DEHP, DiNP, DiDP, DCHP, DnPeP, DnOP) in first morning urine samples of 112 Portuguese children (4–18 years) sampled in 2014/15. The study population consisted of two groups: group 1 with normal weight/underweight children (N?=?43) following their regular diet and group 2 with obese/overweight children (N?=?69) following a healthy diet (with nutritional counselling). Most of the metabolites were above the limits quantification (81–100%) except for MCHP, MnPEP and MnOP. Metabolite levels were generally comparable to other recent child and general populations sampled worldwide, confirming the steady decline in exposures to most phthalates. Compared to Portuguese children sampled in 2011/2012, median urinary metabolite levels decreased by approximately 50% for DEHP, DnBP, DiBP and BBzP. Risk assessments for individual phthalates and the sum of the anti-androgenic phthalates did not indicate to attributable health risks, also at the upper percentiles of exposure. In the healthy diet group the median concentration of the DEHP metabolites was significant lower, while all phthalate metabolites except MEP tended to be lower compared to the regular diet group. Multiple log-linear regression analyses revealed significantly lower daily intakes (DIs) for all phthalates in the healthy diet group compared to the regular diet group (geometric mean ratios (gMR) between 0.510–0.618; p?≤?0.05), except for DEP (gMR: 0.811; p?=?0.273). The same analyses with the continuous variable body mass index instead of the diet groups also showed effects on the DIs (gMRs between 0.926–0.951; p?≤?0.05), however much smaller than the effects of the diet. The results indicate that obese children following a healthy diet composed of fresh and less packaged/processed food can considerably reduce their intake for most phthalates and can have lower phthalate intakes than regular weight/regular diet children.     

Patterns of cigarette smoking among Bristol schoolchildren: implications for educational intervention

A questionnaire on smoking behaviour and related issues wasadministered to 10 579 11- to 16- year-old children from 10co-educational secondary schools randomly selected from theBristol conurbation. The results show that children start experimentingwith cigarettes at a very early age and that over half reporttrying a cigarette before 11 years of age. The most dramaticincrease in regular smoking occurs at about age 14 for bothboys and girls, although the level of regular smoking reportedis consistently higher among girls than boys at ages 13–15years. By age 16 this sex difference disappears, with 27% ofteenagers reporting regular cigarette smoking. The vast majorityof regular smoking report some perceived dependence of cigarettesin terms of craving cigarettes at least occasionally (79%) andbelieving it would be difficult for them to give up smoking(67%). The implications of these results for health educationprogrammes are discussed and a two-tier approach is suggested.     

Actualité sur les déterminants de l’activité physique habituelle (APH) de l’enfant : mise à jour et implications pour les options de prise en charge et de prévention du surpoids/obésité infantile

With the steady rise in the prevalence of overweight/obesity and its comorbidities in the pediatric population, it seems necessary to watch and stimulate the engagement of a majority of children in a regular physical activity. To do this, it seems crucial to know and handle properly the determinants or influences of the habitual physical activity (HPA) of children, especially when it is about overweight/obesity children. This article is an update and a review of existing data on the determinants of HPA with reference to overweight/obesity in childhood. Current data suggest that self-efficacy and physical competence are key motivators and solid anchor points for the initiation and engagement of children in a regular physical activity. In particular, for overweight/obese children, intervention strategies should first concentrate on improving these psychosocial dimensions around which other physiological components (capacity factors) and environmental (reinforcement factors) could revolve. These strategies should involve a multidisciplinary professional team (epidemiologists, actiphysists, teachers, physicians, psychologists, urban planners, local councillors) not only pursuing the same objective but with sufficiently varied skills to be effective at their respective levels.     

Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic

The novel coronavirus-19 (COVID-19) pandemic has considerably impacted children’s lives. The aim of this study was to determine whether the pandemic affected mealtime regularity among preschool children and whether maintaining regular mealtimes or changes in mealtime regularity during the pandemic were related to dietary balance, including chronological relationships. This online cross-sectional survey involving individuals registered with a company that provides meals to children aged 2−6 years was conducted in February 2021. Using a 40-point scale, a healthy diet score (HDS) was developed to evaluate children’s dietary balance. The participants were divided into four groups based on their responses, and multiple regression analyses were performed with the HDS as the dependent variable. Maintaining regular mealtimes was associated with practices such as waking and going to bed earlier, less snacking, and eating breakfast every day. Even after adjusting for basic attributes, lifestyle habits, household circumstances, and other factors, regular mealtimes were still positively correlated with the HDS. These findings indicate that maintaining regular mealtimes is associated with higher HDS scores and better lifestyle habits. Furthermore, as the changed HDS was higher in the group whose mealtimes became regular during the pandemic, adopting regular mealtimes may lead to a more balanced diet.     

Health Services for Special Needs Children in Pennsylvania Schools

ABSTRACT: School health programs traditionally have involved health services, health instruction, and a safe school environment. Likewise, school health services have been provided by nurses, physicians, and appropriate administrative personnel. In the 1990s, increased integration of primary care services through school-based clinics expanded traditional activities of school health programs. Consequently, more chronically ill children, particularly technology dependent children, have entered the regular school setting, requiring that schools be prepared to manage these chronically ill students who come to school with new morbidities and technological dependencies. This statewide survey examined the number and kind of special needs children in the regular school setting in Pennsylvania, as well as the personnel, programs, policies, and resources available to support these children. ( J Sch Health. 1994;64(6):258–260 )     

广州市残疾儿童卫生服务利用现状及相关因素的调查分析

目的 了解广州市残疾儿童的卫生服务利用现状并探讨其影响因素,为有关部门改善残疾儿童卫生服务利用提供依据。方法 采用研究者自行设计的“残疾儿童卫生服务利用调查表”对广州市残疾人康复中心及4所特殊学校的残疾儿童家长进行问卷调查。结果 共回收有效问卷511份。1)残疾儿童的两周就诊率为25.2%,影响因素为儿童年龄、就读方式、家长健康状况及家庭接受最低生活保障救助情况(P<0.05);2)残疾儿童的年住院率为17.2%,影响因素为儿童年龄、残疾等级、家长了解早期干预情况(P＜0.05);3)疫苗全程接种率为61.1%,定期体检率为21.5%,影响因素为儿童就读方式及家庭接受最低生活保障救助情况(P<0.05);4)残疾儿童康复利用率为58.9%,影响因素为儿童年龄、残疾类型、独生子女、就读方式及家长了解早期干预情况等(P＜0.05),随访复查率为19.2%。结论 残疾儿童卫生服务利用相对不足,卫生服务可及性与利用服务的主动性有待改善;相关部门应建立合理、有效的卫生服务保障体系,优化卫生资源可及性;同时加强残疾儿童的预防保健及早期干预,提高家长利用服务的主动性,以促进残疾儿童健康成长。     

广州市残疾儿童卫生服务利用现状及相关因素的调查分析

目的 了解广州市残疾儿童的卫生服务利用现状并探讨其影响因素,为有关部门改善残疾儿童卫生服务利用提供依据。方法 采用研究者自行设计的“残疾儿童卫生服务利用调查表”对广州市残疾人康复中心及4所特殊学校的残疾儿童家长进行问卷调查。结果 共回收有效问卷511份。1)残疾儿童的两周就诊率为25.2%,影响因素为儿童年龄、就读方式、家长健康状况及家庭接受最低生活保障救助情况(P<0.05);2)残疾儿童的年住院率为17.2%,影响因素为儿童年龄、残疾等级、家长了解早期干预情况(P＜0.05);3)疫苗全程接种率为61.1%,定期体检率为21.5%,影响因素为儿童就读方式及家庭接受最低生活保障救助情况(P<0.05);4)残疾儿童康复利用率为58.9%,影响因素为儿童年龄、残疾类型、独生子女、就读方式及家长了解早期干预情况等(P＜0.05),随访复查率为19.2%。结论 残疾儿童卫生服务利用相对不足,卫生服务可及性与利用服务的主动性有待改善;相关部门应建立合理、有效的卫生服务保障体系,优化卫生资源可及性;同时加强残疾儿童的预防保健及早期干预,提高家长利用服务的主动性,以促进残疾儿童健康成长。     

Lead powder use for skin care and elevated blood lead level among children in a Chinese rural area

To investigate the association between lead powder use, as folk skin care, and blood lead level (BLL) in children, we studied 222 children up to 14-years old living in a Chinese rural area and administered a face to face interview with their parents to collect information on lead powder use and other potential exposure. We measured children's BLL at baseline and 2 years later after an intervention. The children were divided into three categories according to their use of lead powder: regular use, irregular use and never use. We applied multivariate linear regression to determine the association between lead powder use and elevated BLL. The average BLL of all children was 18?μg/dl; 56% of them had BLL of 10?μg/dl or higher. Lead powder use was significantly associated with elevated BLL. After adjusting for potential confounders the BLL of regular and irregular users was higher than non-users by 3.11?μg/dl and 1.47?μg/dl, respectively. Duration of lead powder use was positively associated with BLL, but the time since last use was inversely associated. A significant BLL reduction was observed 2 years later, and the greatest reduction (21?μg/dl) was seen in the youngest group of regular users. This study showed that traditional use of lead powder for a skin care purpose was a major contributor to elevated BLL in these children.     

Health fitness training responses of normotensive and elevated normotensive children

Abstract The purpose of this study was to compare health fitness profiles of normotensive (blood pressure < 108/76) and elevated normotensive (blood pressure ≥ 108/76) children and to evaluate the health fitness training responses of children with higher and lower blood pressures to a regular program of exercise over an eight month period. The subjects were 386 fourth grade students (lower blood pressures = 305; higher blood pressures = 81). They were measured for height and weight and evaluated before and after an exercise intervention program for flexibility, muscular endurance, cardiovascular endurance, and body fat levels. The results show that children with higher blood pressures were fatter and had lower cardiovascular fitness levels before and after the intervention. They had health fitness profiles similar to hypertensive adults. Their rate of health fitness improvement, with training, was similar to children with lower blood pressures. Therefore, elevated normotensive children have an increased risk of cardiovascular disease but can change their risk profile with regular exercise.     

A Randomized Effectiveness Trial of Brief Parent Training in Primary Care Settings

Brief Parent Training (BPT) is a short-term intervention (3?C5 sessions) delivered by regular staff in municipal child and family services. BPT is based on social interaction learning theory and Parent Management Training, the Oregon model (PMTO) and promotes parenting skills in families with children who either are at an early stage of problem behavior development or have developed conduct problems. This study examined the effectiveness of BPT compared to regular services in primary care settings at post assessment. Participants were 216 children (3?C12?years) and their parents who were randomly assigned to BPT or the comparison group. Data were collected from parents and teachers. Significant intervention effects emerged for caregiver assessments of parenting practices, child conduct problems, and social competence. The results suggested that BPT had beneficial effects for families, although the generalization of the effects to school was limited.     

High risk of hookworm infection among wastewater farmers in Pakistan

The health risks of wastewater use in agriculture were investigated in the city of Faisalabad, Pakistan, by means of a cross-sectional study. The study showed an increased risk of intestinal nematode infection and hookworm infection, in particular, in wastewater farmers (OR = 31.4, 95% CI 4.1-243) and their children (OR = 5.7, 95% CI 2.1-16) when compared with farming households using regular (non-wastewater) irrigation water. Textile labourers living in the same village as the wastewater farmers showed a lower risk of hookworm infection than wastewater farmers but an increased risk compared with farming households using regular irrigation water. Many urban and peri-urban farmers make a living by using untreated wastewater in the production of fresh produce for the urban market. Banning the use of untreated wastewater would deprive these farmers of their livelihood and affect food supply for the urban population. If treatment of wastewater is not a feasible option, the promotion of footwear and improved hygiene, the construction of toilets, in combination with regular anthelminthic treatment, would be suitable alternatives to safeguard the health of wastewater farmers and their children.     

Characteristics of patients with a regular source of care

This study was designed to describe patient characteristics associated with having a regular source of care among all patients who received care from large urban clinics in Manitoba over a three-year period (N = 298,222). Using administrative data, patients were classified as having a regular source of care if they made 75% or more of their total ambulatory visits to the same clinic. Overall, 44.2% of patients had a regular source of care. A logistic regression showed that children and adults aged 45 and older were more likely to have a regular source of care than patients aged 18-44. Moreover, patients with a regular source of care tended to live in more affluent neighbourhoods and were healthier than individuals with no regular source of care. Systemic changes might be needed to enhance continuity of care (e.g., mechanisms to enhance access) among vulnerable segments of the population like the poor.     

Relationship between children's dental needs and dental care utilization: United States, 1988-1994

OBJECTIVES: This study describes the relationship between dental needs and dental care utilization among children. METHODS: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to analyze dental care needs and dental care utilization. RESULTS: Younger children with perceived needs (needs perceived by the child or responsible adult) were more likely to be episodic users of dental care than children without perceived needs. Younger children with normative needs (defined by the presence of untreated caries diagnosed by a dentist) were less likely to be regular users. Older children with perceived or normative needs were more likely to be episodic users and less likely to have had a previous-year visit than children with no needs. CONCLUSIONS: Despite their presence, dental needs do not drive dental care use among children, and children's dental care utilization is inadequate.     

Social adjustment of children with a severe craniofacial anomaly (Apert syndrome)

Objective Children with a severe craniofacial anomaly are at risk for emotional and behavioural problems. Do children with Apert syndrome present with a special psychological profile? Method Parent reports (Child Behaviour Checklist) were obtained from 25 children with Apert syndrome. Results Fourteen children were characterized by clinically significant social problems, 10 by attentional problems, nine by social withdrawal. Total CBCL‐scores were in the clinical range for eight children. Conclusion Information on psychosocial state should be included in regular check‐ups of children with a severe craniofacial anomaly in order to identify children who are in need of psychological interventions.     

Unfriendly shores: how immigrant children fare in the U.S. health system

The proliferation of poor immigrant children in the United States raises concern about their high uninsurance rates and access to care. We examined the joint effects of health insurance status and place of birth on use of health services by children of the working poor. Of foreign-born children, 52 percent were uninsured and 66 percent had a regular care source, compared with 20 percent and 92 percent, respectively, of native-born children. Foreign-born uninsured children were less likely than their native-born peers were to have a regular care source or to have sought care. Health insurance and immigration policies must act in concert to increase health care access for foreign-born children.