A Challenging Job: Physical and Sexual Violence Towards Group Workers in Youth Residential Care

Background

Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about sexual harassment in addition to physical victimization of social workers in youth residential or group care.

Objective

We investigated the prevalence of physical and sexual victimization of youth care workers in residential care and tested whether characteristics of the group care workers and the type of care facility influenced this prevalence.

Methods

One hundred seventy-eight participants reported whether they had experienced verbal threat, physical threat, physical violence, verbal sexual harassment, and physical sexual harassment by one or more of the youth they worked with in a 1-year period.

Results

Eighty-one percent of the group workers experienced violence. Most incidents were verbal threats, but about half of the participants experienced physical violence. Youth care workers from secure care were most at risk for experiencing physical and verbal violence and workers from juvenile detention facilities were most at risk for experiencing sexual harassment. Rates of violence were increased for participants working with children with a mild intellectual disability. Gender of the youth care workers was not related to the rate of victimization, but age was: younger group workers reported more incidents than older group workers.

Conclusions

The high levels of violence in residential youth care indicate that residential care is not the best workplace for professionals nor the best rearing setting for youth. Alternative care settings, such as treatment in a family-type environment, should be explored.     

The Berkeley Puppet Interview: A Screening Instrument for Measuring Psychopathology in Young Children

Background

While child self-reports of psychopathology are increasingly accepted, little standardized instruments are utilized for these practices. The Berkeley Puppet Interview (BPI) is an age-appropriate instrument for self-reports of problem behavior by young children.

Objective

Psychometric properties of the Dutch version of the BPI will be reported, specifically, test–retest reliability, intra-class correlations, congruent and concurrent validity.

Methods

In a sample of 300 children (M _age = 7.04 years, SD = 1.15), the BPI was administered twice, with a 1-year interval. Parents and teachers filled out questionnaires about their children’s problem behavior.

Results

Findings from the analyses indicate that the BPI subscales have sufficient test–retest reliability and can be reliably coded. Furthermore, findings suggest adequate congruent validity. More support for concurrent validity is found among externalizing problems in comparison to internalizing problems.

Conclusions

With regard to the present study, the BPI seems to have adequate psychometric properties. As such, the BPI enables interviewing young children about their psychopathology-related symptoms in a standardized way. The BPI could be applied in clinical practice as a complement to the diagnostic cycle, allowing children’s self-reports to play an increasingly important role.     

Skin cancer preventative behaviors in state park workers: a pilot study

Objectives

Considering the potential for occupational sun exposure among state park workers, the purpose of this pilot study was to identify skin cancer knowledge, health beliefs, self-efficacy, and sun protection behaviors (SPBs) among state park employees.

Methods

The current study used a cross-sectional survey research design with state park workers in a Southern state. Of the 94 possible employees who could have participated in the study, 87 completed the survey.

Results

Assessment of the participants’ skin cancer knowledge demonstrated an average correct response rate of 68.8 %. While the vast majority (87.4 %) believed that skin cancer is a serious disease, a minority (42.5 %) believed they would develop skin cancer sometime during their lifetime, and even fewer (35.6 %) believed their risk was higher than average. Collectively, workers reported low levels of SPBs. The most commonly reported barriers to sun protection were “inconvenient,” “too hot to wear,” and “forget to protect.” Half of the participants (50.6 %) were highly confident in their ability to wear long pants while in the sun. About the same proportion of participants was highly confident they could wear a wide-brimmed hat (21.8 %) and sunscreen (20.7 %).

Conclusions

Based on available evidence, a need exists to develop individual and worksite programs and interventions to increase skin cancer prevention behaviors among this occupational group. This data could serve as a baseline to monitor and evaluate the efficacy of these interventions.     

Is Early Center-Based Child Care Associated with Tantrums and Unmanageable Behavior Over Time Up to School Entry?

Background

Existing research suggests that there is a relationship between greater exposure to center-based child care and child behavioral problems though the mechanism for the impact is unclear. However the measure used to document child care has usually been average hours, which may be particularly unreliable in the early months when fewer children are in center care. In addition individual trajectories for behavior difficulties have not been studied.

Objective

The purpose of the current study was to examine whether the extent of exposure to center-based child care before 2 years predicted the trajectory of children’s difficult behavior (i.e., tantrums and unmanageable behavior) from 30 to 51 months controlling for child and maternal characteristics.

Method

Data were drawn from UK-based families, children and child care study (n = 1201). Individual growth models were fitted to test the relation between early center-based child care experiences and subsequent difficult behavior.

Results

Children with more exposure to center-based care before two had less difficult behavior at 30 months, but more increase over time. Initial levels were predicted by higher difficult temperament and lower verbal ability. Higher difficult temperament and lower family socio-economic status predicted its change over time.

Conclusion

Findings suggest that early exposure to center-based care before 2 years old is a risk factor for subsequent behavior problems especially when children have a longer period of exposure. A possible explanatory process is that child coping strategies to manage frustration are less well developed in a group context, especially when they lag behind in expressive language.     

Canadian Children and Youth in Care: The Cost of Fetal Alcohol Spectrum Disorder

Background

A high prevalence of prenatal alcohol exposure has been reported among children in care and thus, the risk of fetal alcohol spectrum disorder (FASD) in this population is high.

Objective

The purpose of the current study was to estimate the number of children (0–18 years) in care with FASD and to determine the associated cost by age group, gender, and province/territory in Canada in 2011.

Methods

The prevalence of children in care by province/territory was obtained from the Canadian Child Welfare Research Portal, and the number of children in care with FASD for each province/territory was estimated from available epidemiological studies. In order to calculate the total cost per province/territory, the cost per individual per day, by age group, was applied to the respective number of children in care with FASD.

Results

The estimated number of children in care with FASD ranged from 2,225 to 7,620, with an annual cost of care ranging from $57.9 to $198.3 million Canadian dollars (CND). The highest overall cost ($29.5 to $101.1 million CND) was for 11–15 year-olds.

Conclusion

The study findings can be used to demonstrate the substantial economic burden that FASD places on the child welfare system. Attention towards the needs of this population and prevention efforts to reduce FASD incidence in Canada, and other countries are urgently needed.     

Deliberate Self-harm Among Children in Tertiary Care Residential Treatment: Prevalence and Correlates

Background

Few studies have examined deliberate self-harm (DSH) among children in residential treatment in Canada. Most of the existing studies examined adolescent students or children from pediatric emergency departments.

Objectives

The objectives of this study were to examine the prevalence of DSH among children in tertiary care residential treatment and the factors associated with DSH.

Methods

Data on 284 children aged 5–17 years (M = 11.54 years, SD = 2.56) with mental health problems in tertiary care residential treatment were analyzed. Binary logistic regression was performed to examine the likelihood of engaging in DSH.

Results

About 35 % of children engaged in DSH. Suicidal talk emerged as the strongest factor to be associated with DSH. Children who used alcohol or drugs were also more likely to engage in DSH than those who did not use alcohol or drugs. Furthermore, symptoms of conduct problems were associated with the likelihood of engaging in DSH.

Conclusions

Identifying children at risk for engaging in DSH and suicidal behavior is of critical importance to mental health care providers. These factors could assist in identifying children who might require more specialized treatment related to self-harm during their stay in residential treatment.     

The validity of the Satisfaction with Life Scale in adolescents and a comparison with single-item life satisfaction measures: a preliminary study

Purpose

The validity of the life satisfaction measures commonly used among adults has been rarely examined in adolescent samples. The present research had two main goals: (1) to evaluate the structural validity of the Satisfaction with Life Scale (SWLS) among adolescents and to test measurement invariance across gender; (2) to compare the criterion and convergent validity of the SWLS and single-item life satisfaction measures among adolescents.

Methods

Three samples of Serbian adolescents were recruited for the present research. Study 1 (N = 481, M _age = 17.01 years) examined the structure of the SWLS via confirmatory factor analysis (CFA) and evaluated measurement invariance of the SWLS across gender by a multi-group CFA. Study 2 (N = 283, M _age = 17.34 years) and Study 3 (N = 220, M _age = 16.73 years) compared the convergent validity of the SWLS and single-item life satisfaction measures.

Results

The results of Study 1 supported the original one-factor model of the SWLS among adolescents and provided evidence for strong measurement invariance of the SWLS across gender. The findings of Study 2 and Study 3 showed that the SWLS and single-item measures were equally valid and strongly associated (r = .734 in Study 2 and r = .668 in Study 3). No substantial differences in correlations with school success and well-being indicators were found between the SWLS and single-item measures.

Conclusions

Our findings support the use of the SWLS among adolescents and indicate that single-item life satisfaction measures perform as well as the SWLS in adolescent samples.

     

Parental Decision Making About Technology and Quality in Child Care Programs

Background

This study investigated parental decision making about non-parental child care programs based on the technological and quality components of the program, both child-focused and parent-focused. Child-focused variables related to children’s access to technology such as computers, educational television programming, and the internet. Parent-focused variables related to parental access to observe the program via the internet, and methods of communication by teachers, as well as traditional indicators of quality such as experience and education of the caregivers and type of curriculum offered.

Objective

The study investigated which of these variables were most influential to parents’ decision-making processes when choosing programs based on hypothetical scenarios. The study sought to examine which variables emerged as most important to parents, and whether these technological variables were more important than traditional indicators of quality, such as staff education level.

Methods

A sample of 82 parents of children between the ages of 1 and 6 years (M = 3.6) completed a questionnaire gathering demographic information, as well as information about their perceptions of their children’s media usage. The questionnaire also included hypothetical scenarios created using the SPSS ORTHOPLAN procedure to examine technology related variables (both child-focused and parent-focused) and traditional quality indicators that emerged as most influential to the decision-making process when choosing a child care program.

Results

Using conjoint analysis, the results revealed that the child-focused technology variables that emerged as most influential to parents’ decision making were educational software usage, television usage, and internet availability. In regard to parent-focused variables, conjoint analyses revealed that experience of the caregivers, type of curriculum offered, and education level of the caregivers were more influential to the decision making process than the ability to observe the program via the internet or method of communication used by the provider.

Conclusions

The results provide additional support for the importance of well-trained and experienced staff in child care programs, as well as for a developmentally appropriate curriculum. These findings suggest that administrators interested in marketing early child care programs should continue to focus on these traditional indicators of quality, rather than on improving parental access to the program via technology.     

Preliminary Study of Resilience-Based Group Therapy for Improving the Functioning of Anxious Children

Background

There is a lack of research examining the feasibility of group psychotherapy interventions for anxious children in private clinical service settings. Furthermore, no research to date has examined the effectiveness of resilience-based interventions for helping children with anxiety disorders.

Objective

The present study aims to examine the effectiveness of a resilience-based cognitive behavioral therapy (CBT) group psychotherapy, the Resilience Builder Program^® (RBP), for improving the social, emotional, and family functioning of anxious children in a private clinical setting.

Methods

Participants consisted of 22 children with an anxiety disorder aged 7–12 (81.8 % generalized anxiety disorder; M age = 9.93; 63 % male) enrolled at a private psychotherapy practice in RBP, a 12-week manualized group treatment that targets social competence using resilience skills (i.e., affect and behavior regulation, flexibility/adaptability, social problem-solving, proactive orientation)

Results

Following the completion of RBP, results showed that parents and teachers reported significant decreases in problem behavior. In addition, parents reported significant decreases in depressive symptoms and improved family functioning domains of problem behaviors and communication. Teachers reported reduced internalizing symptoms, somatic problems, and socially odd behaviors, as well as improvements in communication skills and resilience. Moreover, children reported significant improvement in their positive and negative emotions, as well as their emotional control.

Conclusions

Findings from the present study suggest preliminary support for the effectiveness of RBP for improving anxious children’s social, emotional, and family functioning.     

Stigma related to sex work among men who engage in transactional sex with men in Ho Chi Minh City,Vietnam

Objectives

Male sex workers (MSW) in Vietnam face high levels of stigma related to sex work, which may be associated with depression and increased vulnerability to HIV.

Methods

In 2010, 300 MSW completed a behavioral and psychosocial survey. Multivariable models assessed factors associated with sex work-related stigma and the association between stigma and depression.

Results

Factors associated with increased stigma included having disclosed sexual orientation to healthcare workers (b 1.75, 95 % CI 0.69–2.80), meeting clients in the street/park (b 1.42, 95 % CI 0.32–2.52), and having been forced to have sex without a condom (b 2.36, 95 % CI 1.27–3.45). Factors associated with decreased stigma included meeting clients via the telephone or internet (b ?1.26, 95 % CI ?2.39 to ?0.12) and receiving financial support from family or friends (b ?1.31, 95 % CI ?2.46 to ?0.17). Stigma was significantly associated with increased odds of depression (AOR 1.07, 95 % CI 1.01–1.15).

Conclusions

Addressing stigma and depression in HIV prevention interventions is crucial for tailoring these programs to MSWs’ needs, and may result in decreased HIV spread.     

The Incredible Years Basic Parent Training for Portuguese Preschoolers with AD/HD Behaviors: Does it Make a Difference?

Background

Evidence-based psychosocial interventions such as parent training programs are strongly recommended as first-line treatment for preschool-age children with or at-risk of attention deficit/hyperactivity disorder (AD/HD).

Objective

Evaluate the effectiveness of the Incredible Years Basic Parent Training (IY) in hyperactive and inattentive behaviors of Portuguese preschoolers.

Methods

One hundred children, between three and six years-old, with AD/HD behaviors, who were part of a larger randomized controlled trial in which participants were allocated to either an intervention or control group. In this subsample analysis, there were 52 participants in the intervention condition (IYC) and 48 in the waiting-list control condition (WLC). Multi-informants and multi-measures of child and parenting behaviors were taken before and after the 14-week intervention.

Results

Medium-to-large intervention effects were found in primary caregivers’ reported measures of children’s AD/HD behaviors and on self-reported parenting practices. Independent observations indicated significant short-term effects on positive parenting and coaching. Primary caregivers had a high attendance rate and reported high satisfaction with the program. Additionally, 43 % of children in the IYC clinically improved in the primary AD/HD outcome measure, compared with 11 % in the WLC.

Conclusions

Preliminary results suggest that IY parent training seems to be an effective tool, making the difference in the behavior of Portuguese preschoolers with early signs of AD/HD and their mothers.     

The impact of influenza-like illness in young children on their parents: a quality of life survey

Background

Influenza-like illness can cause excess paediatric morbidity and burden on parents.

Objectives

We determined the quality of life (QoL) impact of children’s influenza-like illness (ILI) on their parents.

Methods

We conducted a prospective cohort study in childcare centres and a general practice in Sydney, Australia. Using PAR-ENT-QoL, we measured QoL of parents of children aged 6 months–3 years before the 2010 influenza season, then again for parents of children with ILI (ILI group) using SF-12v2 Acute Form and PAR-ENT-QoL, and contemporaneously for parents of aged-matched children without ILI (non-ILI group).

Results

Of 381 children enrolled from 90 childcare centres, 105 developed ILI. PAR-ENT-QoL scores of the ILI group were significantly lower in the post-ILI follow-up interviews than at baseline (60.99 vs. 79.77, p < 0.001), and those of non-ILI group at follow-up interviews (60.99 vs. 84.05, p < 0.001). SF-12v2 scores of the ILI group were also significantly lower than those of non-ILI group: physical component summary (50.66 vs. 53.16, p = 0.011) and mental component summary (45.67 vs. 53.66, p < 0.001). Two factors were significantly associated with parental QoL: total time spent caring child during ILI and whether the child had severe ILI or not. Correlations between PAR-ENT-QoL and SF-12v2 scores were satisfactory.

Conclusions

Parents had significantly lower QoL while their child had ILI, compared with before ILI and with parents of children without ILI. The public health impact of ILI in children on the QoL in families is far from negligible. QoL measurement can complement economic evaluation of ILI disease burden and provide a more complete picture of impact.     

Effectiveness of a tailor-made weight loss intervention in primary care

Introduction

Weight loss interventions have been studied extensively, but methodological limitations negatively affecting applicability in everyday clinical practice are a very common problem in these studies. Despite the fact that obesity is treated mostly in a primary care setting, studies that investigate weight loss interventions in a primary care setting are scarce. Our objective was to assess the effectiveness of a tailor-made weight loss intervention in achieving a clinically significant weight loss in overweight (BMI ≥ 27 kg/m²) women aged 50–60 years in a primary care setting.

Methods

As part of a randomized controlled trial on the effects of a tailor-made weight loss intervention and oral glucosamine sulphate on the incidence of osteoarthritis of the knee in 407 overweight women aged 50–60 years, we analysed the effectiveness of the weight loss intervention in achieving clinically relevant weight loss.

Results

At baseline, the mean body weight for all participants was 88.7 ± 13.2 kg, and the mean BMI was 32.4 ± 4.3 kg/m². The percentage of participants that lost ≥5 kg or 5 % of their baseline body weight was 14.8 versus 6.3 % (p = 0.012) at 6 months for the intervention group and the control group, respectively. At 12 months, this was 18.7 versus 14.9 % (p = 0.027). Mean weight gain at 6 months was ?0.9 versus 0.9 kg (p < 0.001) for the intervention group and the control group, respectively. At 12 months, this was ?0.6 versus 0.6 kg (p = 0.01). At 30 months of follow-up, no significant differences were found between both groups.

Conclusions

This weight loss intervention, which, at short notice, is easily applicable in everyday clinical practice, is effective in achieving clinically significant weight loss in overweight women aged 50–60 over a 12-month period. Long-term weight loss maintenance, however, occurred only marginally. Magnitude of the effect is comparable to that achieved in many other more intensive weight loss interventions.     

Examining the Influence of Antenatal Care Visits and Skilled Delivery on Neonatal Deaths in Ghana

Background

Many Sub-Saharan African countries may not achieve the Millennium Development goal of reducing child mortality by 2015 partly due to the stalled reduction in neonatal deaths, which constitute about 60 % of infant deaths. Although many studies have emphasized the importance of accessible maternal healthcare as a means of reducing maternal and child mortality, very few of these studies have explored the affordability and accessibility concerns of maternal healthcare on neonatal mortality.

Objective

This study bridges this research gap as it aims to investigate whether the number of antenatal visits and skilled delivery are associated with the risk of neonatal deaths in Ghana.

Methods

Using individual level data of women in their reproductive years from the 2008 Demographic and Health Survey, the study employs an instrumental variable strategy to deal with the potential endogeneity of antenatal care visits.

Results

Estimates from the instrumental variable estimation show that antenatal care visits reduce the risk of neonatal death by about 2 %, while older women have an approximately 0.2 % higher risk of losing their neonates than do younger women.

Conclusion

Findings suggest that women who attend antenatal visits have a significantly lower probability of losing their babies in the first month of life. Further, results show that women’s age significantly affects the risk of losing their babies in the neonatal stage. However, the study finds no significant effect of skilled delivery and education on neonatal mortality.     

Ten years incidence of natural rubber latex sensitization and symptoms in a prospective cohort of health care workers using non-powdered latex gloves 2000–2009

Objectives

To assess the incidence of sensitization and gloves-related symptoms in 10-year follow-up in a group of health care workers (9,660 person-years) using non-powdered latex gloves from 2000 to 2009 and to examine related factors.

Materials and methods

We studied 2,053 health care workers in Trieste Hospitals by means of skin prick test for latex extract, patch tests and medical examinations. We report the incidence of latex sensitization among workers using non-powdered latex gloves.

Results

The incidence of latex sensitization, rhinitis, asthma, urticaria, irritant and allergic contact dermatitis were 1.0; 0.12; 0.21; 0.72; 2.39 and 2.50 cases per 1,000 person-years, respectively. Respiratory symptoms and urticaria were positively related with latex sensitization (OR = 8.0; 95 % CL 1.27–48.6), with common allergic respiratory symptoms (OR = 4.19; 95 % CL 1.04–16.8) and with familial atopy (OR = 4.47; 95 % CL 1.1–17.9).

Conclusion

The incidence of latex sensitization and latex-related symptoms were very low but subjects with allergic symptoms related to common allergens are at higher risk. The use of non-latex gloves is suggested for them.     

Prevalence of respiratory symptoms and disorders among rice mill workers in India

Objectives

Lung function tests have become an integral part of assessment of pulmonary disease. Diseases of the respiratory system induced by occupational dusts are influenced by the duration of exposure. The aim of the study is to investigate the impairment of lung function and prevalence of respiratory symptoms among the rice mill workers.

Methods

A total of 120 rice mill workers from three districts of Karnataka were included in this study. Fifty urban dwellers from the same socio-economic level were selected as controls. The study included clinical examination, assessment of respiratory symptoms, pulmonary function test, measurement of peak expiratory flow rate, absolute eosinophil count, ESR estimation, total IgE estimation and radiographic test.

Results

The present study has shown that the rice mill workers complained of several types of respiratory disorders like phlegm (40.8 %), dyspnea (44.2 %), chest tightness (26.7 %), cough (21.7 %), and nose irritation (27.5 %). Rice mill workers exposed to dust presented significantly (p < 0.05) lower levels of FVC (3.44 ± 0.11), FEV₁ (2.73 ± 0.15) and PEFR (304.95 ± 28.79) than the controls. The rice mill workers are having significantly higher absolute eosinophil counts, total IgE and ESR than control groups. The hematological findings suggest that the harmful effects may be linked to both non-specific irritation and allergic responses to rice husk dust among rice mill workers.

Conclusion

Dust exposure in the working environment affects the lung function values and increased the respiratory symptoms among the rice mill workers.     

Effects of the Caregiver Interaction Profile Training on Caregiver–Child Interactions in Dutch Child Care Centers: A Randomized Controlled Trial

Background

Previous studies underscore the need to improve caregiver–child interactions in early child care centers.

Objective

In this study we used a randomized controlled trial to examine whether a 5-week video feedback training can improve six key interactive skills of caregivers in early child care centers: Sensitive responsiveness, respect for autonomy, structuring and limit setting, verbal communication, developmental stimulation, and fostering positive peer interactions.

Method

A total of 139 caregivers from 68 early child care groups for 0- to 4-year-old children in Dutch child care centers participated in this RCT, 69 in the intervention condition and 70 in the control condition. Caregiver interactive skills during everyday interactions with the children were rated from videotape using the Caregiver Interaction Profile (CIP) scales at pretest, posttest, and follow-up 3 months after the posttest.

Results

Results at posttest indicate a significant positive training effect on all six caregiver interactive skills. Effect sizes of the CIP training range between d = 0.35 and d = 0.79. Three months after the posttest, caregivers in the intervention group still scored significantly higher on sensitive responsiveness, respect for autonomy, verbal communication, and fostering positive peer interactions than caregivers in the control group with effect sizes ranging between d = 0.47 and d = 0.70.

Conclusions

This study shows that the quality of caregiver–child interactions can be improved for all six important caregiver skills, with a relatively short training program. Possible ways to further improve the training and to implement it in practice and education are discussed.

     

Effectiveness and Cost of a Personalized Reminder Intervention to Improve Adherence to Glaucoma Care

Background

Glaucoma is the leading cause of irreversible blindness in the USA. Glaucomatous vision loss is preventable with proper eye care, including appointment adherence. Therefore, interventions that improve appointment adherence can reduce the number of patients with more severe glaucoma.

Objectives

The primary study aim was to determine the efficacy and cost-effectiveness of a multifaceted personal reminder intervention, which included a customized letter and personal telephone outreach, in improving appointment adherence of patients with glaucoma. A secondary study aim was to identify patient characteristics that were associated with non-adherence.

Methods

This prospective, randomized, controlled study included a cost-effectiveness analysis completed using a decision analytic model. The subjects included 256 patients with glaucoma. Study measures included appointment adherence and incremental cost effectiveness ratios.

Results

Patients in the intervention group were more likely to adhere to appointments (82.31 vs. 69.05 %; RR 1.23; 95 % CI 1.04–1.37, p < 0.012) than patients in the usual care group. Patients in the intervention group were 23 % more likely to adhere to appointments (RR 1.23; 95 % CI 1.08–1.41, p < 0.0021) than patients in the usual care group, when adjusting for age, secondary insurance, primary open angle glaucoma diagnosis, number of previous visits at Wills Eye Hospital, and follow-up recommendation using Poisson regression. Per-patient cost of the program was US$11.32, and cost per follow-up attended within the adherence window was US$73.56.

Conclusions

A low cost reminder intervention consisting of a personalized letter and telephone outreach significantly improved appointment adherence of patients with glaucoma.

     

Children Treated for Nocturnal Enuresis: Characteristics and Trends Over a 15-Year Period

Background

Nocturnal Enuresis (NE) is one of the most prevalent childhood disorders and has significant negative psychosocial impact on the child and family.

Objective

To assess the characteristics of children with NE and trends over a 15-year period.

Methods

The study included 18,677 children [11,205 (60 %) boys and 7,472 (40 %) girls] referred to a network of clinics specializing in treatment of voiding problems (Age range: 4–12 years; Mean age = 7.06) between the years 1995–2009. We analyzed socio-demographic characteristics and trends over time using a standard questionnaire administered in the clinics.

Results

Over the course of the 15-year period, children were referred to treatment at a younger age (Mean age 1st period = 7.52, Mean age 2nd period = 7.12, Mean age 3rd period = 6.71) and the likelihood of referrals of younger children (4–5 years) increased (1st period = 24.5 %; 2nd period = 33.6 %; and 3rd period = 41.9 %). More children were referred during winter than summer or transition seasons. The higher prevalence of boys was maintained across this period. In addition, girls had 34 % higher chance to suffer from primary NE compared to boys and had 12 % higher chance to suffer from NE only compared to boys. Birth order and children’s age predicted NE type (primary/secondary) and in addition to family size also predicted enuresis pattern (NE only/combined NE and Diurnal Enuresis).

Conclusions

The findings of this largest study on children referred for NE treatment provides a wider understanding of important associated factors to this phenomenon.