The causal relation between human papillomavirus and cervical cancer

The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.     

A prospective test of the hopelessness theory of depression in children.

Providing a developmental extension of the cognitive theories of depression, researchers and theorists have suggested that during early to middle childhood, attributional styles may mediate rather than moderate the association between negative life events and the development of depression. Within the context of the hopelessness theory of depression, we tested this hypothesis in a 6-month longitudinal study of 4th- and 5th-grade children. Using path analysis, we found support for the mediating role of attributional styles among both 4th and 5th graders. Supporting recent refinements in the hopelessness theory, the best fitting mediation model was one in which depressive symptoms exhibited reciprocal relations with the other variables. Specifically, attributional styles partially mediated the link between verbal victimization and residual change in depressive symptoms. In addition, initial depressive symptoms predicted negative changes in children's attributional styles and increases in verbal victimization across the follow-up. Contrary to our hypothesis, we also found support for the moderating role of attributional styles, although this was significant only among 5th graders.     

女性工作动机 归因方式与婚姻质量关系研究

本研究以天津市已婚女性为研究对象,采用归因风格、工作动机及婚姻质量评价量表进行调查,研究结果为:①区域变量对女性的婚姻质量、努力归因、内归因、生存动机、关系动机、责任动机差异有统计学意义。区域的差异更可能体现出文化差异,即中国传统文化与市区现代的、时尚的及多元文化的差异。②归因方式单独对婚姻质量的解释仅为10.4%的变异量,工作动机对婚姻满意度的单独解释了55.4%的变异量,而归因风格、工作动机的十二个因子可以解释婚姻质量的56.8%的变异量,从归因风格、工作动机与婚姻质量的回归分析看:生存动机、关系动机、责任动机及努力归因对婚姻质量具有显著的预测力。     

A Mendelian randomization study of the causal association between anxiety phenotypes and schizophrenia

Schizophrenia shows a genetic correlation with both anxiety disorder and neuroticism, a trait strongly associated with anxiety. However, genetic correlations do not discern causality from genetic confounding. We therefore aimed to investigate whether anxiety‐related phenotypes lie on the causal pathway to schizophrenia using Mendelian randomization (MR). Four MR methods, each with different assumptions regarding instrument validity, were used to investigate casual associations of anxiety and neuroticism related phenotypes on schizophrenia, and vice versa: inverse variance weighted (IVW), weighted median, weighted mode, and, when appropriate, MR Egger regression. MR provided evidence of a causal effect of neuroticism on schizophrenia (IVW odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.12–1.59), but only weak evidence of a causal effect of anxiety on schizophrenia (IVW OR: 1.10, 95% CI: 1.01–1.19). There was also evidence of a causal association from schizophrenia liability to anxiety disorder (IVW OR: 1.28, 95% CI: 1.18–1.39) and worry (IVW beta: 0.05, 95% CI: 0.03–0.07), but effect estimates from schizophrenia to neuroticism were inconsistent in the main analysis. The evidence of neuroticism increasing schizophrenia risk provided by our results supports future efforts to evaluate neuroticism‐ or anxiety‐based therapies to prevent onset of psychotic disorders.     

Verbal victimization and changes in hopelessness among elementary school children

Hopelessness is a known risk factor for a number of negative outcomes including suicide attempts and deaths. However, little is known about how hopelessness may develop. The goal of this study was to examine the impact of verbal victimization on changes in children's levels of hopelessness. Participants were 448 fourth- and fifth-grade children who were assessed twice, 6 months apart. As hypothesized, reports of verbal victimization occurring during the follow-up period predicted residual change in children's levels of hopelessness. This relation was maintained even after statistically controlling for children's depressive symptoms. Together, these findings suggest that verbal victimization is associated with a greater risk for developing hopelessness in elementary school children, an effect that appears at least partially independent of concurrent depressive symptoms.     

A causal link between lymphopenia and autoimmunity

It is well recognized that the composition of the mature T cell population is subject to strict homeostatic control. The TCR repertoire and relative proportions of various T cell subsets are established in the thymus, and continue to be shaped and regulated in the periphery. As the thymic function declines, peripheral homeostatic mechanisms assume increasing importance. Indeed, loss of thymic function does not lead to progressive decline of T cell numbers because peripheral mechanisms ensure that the size of the T cell population is maintained due to proliferation of residual cells. However, our current understanding of the basic mechanisms of 'homeostatic' or lymphopenia-induced proliferation suggests that this drive to maintain population size may be accompanied by loss of TCR diversity and emergence of auto-reactive effector T cells. This prediction is supported by experimental and clinical evidence. This consideration is important because lymphopenia is seen commonly in clinical practice as a consequence of viral infections, or medical treatment of cancer, autoimmunity, and graft rejection. Lymphopenia may be a simple link between viral infections and autoimmunity, and may be one reason for common failure of very potent, but non-specific, immunosuppressive drugs in current clinical use.     

Cosleeping and its correlates in Saudi school-aged children

Background: There are cross-cultural variations in sleep habits among children. No previous study has assessed the prevalence of cosleeping in school-aged children in Middle Eastern countries.Purpose: To assess the prevalence of, and the factors associated with, cosleeping in Saudi school-aged children.Methods: Questionnaires were distributed according to a specified sampling procedure, and parents were asked to rate each item that described their child’s behavior within the previous 6 months. Cosleeping was defined as all-night sharing of a bed or room with a parent. Results: Data were analyzed for 977 children (50.5% boys) with a mean age of 9.5 ± 1.9 years and a range from 5 to 12 years. Cosleeping with parents was reported by 26% (95% CI: 23.2–28.7%) of the sample. According to a multivariate logistic regression model, a child’s school level, enuresis, and nightmares were the only predictors of cosleeping.Conclusion: This study demonstrated that cosleeping is more common among Saudi school-aged children than has been reported for other countries. When assessing children’s sleep, the practitioner should give special consideration to the child’s needs, and his/her family’s cultural background.     

Levels of hopelessness in children and adolescents: a developmental perspective

We investigated hopelessness at 3 age levels (8-, 12-, and 17-year-olds) in 210 children and adolescents from a community sample derived from public school listings of 4,810 children in a midwestern college town. The sample included 105 boys and 105 girls, and there were 70 subjects in each age group. The major finding was that children with high hopelessness scores are at greater risk not only for suicide and depression as revealed by the Child Assessment Schedule and the Birleson Depression Scale but also for overall psychopathology. This study suggests that hopelessness does not increase from preadolescence to adolescence in a general population.     

Examining the causal model of depression: the relation between depressogenic schemata and depression

This study examines the causal relation between depressogenic schemata and depression. Three structural equation models were tested two times among 149 students during five months: (1) one-way causal relation from depressogenic schemata to depression, (2) one-way causal relation from depression to depressogenic schemata, (3) reciprocal relation between depressogenic schemata and depression. Results showed the third model is the most adequate among three models. It is possible that depressogenic schemata influences depression and depression also has some effects on depressogenic schemata. As a result of reviewing previous studies, it is thought that there is a continuity is between clinical and non-clinical groups. Therefore, the findings of this study is useful in understanding the clinical image of depression.     

The structure of the causal attribution belief network of patients with obesity

Objectives. Causal attributions form a significant part of how people understand and represent illness. The present study explored the structure of causal attributions in obesity using network analysis and examined the specific properties of this network in terms of extent, patterning, and direction. Design. Cross‐sectional study. Methods. Seventy‐two obese individuals (22 male, 50 female) completed a questionnaire, which asked them to rate the strength of all causal relationships between nine possible causes of obesity. Inductive eliminative analysis (IEA) was used to produce the networks and multidimensional scaling (MDS) determined the spatial structure of the network. Results. A high percentage (70.4%) of participants endorsed the resultant network. Analysis revealed a two‐dimensional solution, with the MDS statistics of low level of stress (.05) and a dispersion accounted for (DAF) of .95 indicating a good fit between the data and the solution. The results indicated traumatic events, family problems, and addictive personality were perceived as distal causes of over‐eating and comfort eating, while more passive behaviours, less physical activity, over‐eating, and comfort eating were perceived as proximal causes of obesity. Family history did not contribute to the network. Conclusions. Obese individuals appeared to hold a highly consensual and complex representation of their illness. From a multidisciplinary treatment perspective, this understanding would seem valuable in relation to achieving behaviour change.     

Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000

Little is known about the prevalence of atopic dermatitis and food allergy outside North America and Europe. We evaluated the prevalence of atopic dermatitis and food allergy with the comparison of prevalence between 1995 and 2000 in Korea and evaluated the correlation of prevalence between atopic dermatitis and food allergy. A cross-sectional questionnaire survey was conducted on random samples of schoolchildren 6 to 14 yr at two time points, 1995 and 2000 throughout Korea. The last twelve months prevalence of atopic dermatitis in Korean school-aged children was increased from 1995 to 2000. The twelve-month prevalence of atopic dermatitis and food allergy were higher in Seoul than in any other provincial cities in 1995, but the prevalence of both diseases in Seoul and Provincial Centers became to be similar in 2000. The rate responded to food allergy of children with atopic dermatitis (9.5%) was lower than that of the western countries (60%). And our data demonstrated paternal and maternal allergy history is very significantly correlated to developing atopic dermatitis in their offspring. The further objective evaluations are required to confirm these outcomes because the environmental and risk factors may be different among the countries according to their living cultures.     

Sleep disturbance and daytime symptoms in wheezing school-aged children

The aim of the study was to investigate whether wheezing is associated with disturbed sleep and increased daytime symptoms in school-aged children. A random sample of 1234 children, aged 6-14 years, participated in a respiratory health study in the region of Antwerp. The International Study of Asthma and Allergies in Childhood questionnaire and a separate sleep questionnaire were completed. In the children who wheezed in the last 12 months, sleep quality was more frequently disturbed due to nocturnal awakenings and restless sleep compared with children who did not wheeze. Daytime sleepiness and tiredness were more common in wheezing than in non-wheezing children. After adjusting for possible confounders a positive association was found between wheeze and: difficulties falling asleep [odds ratio (OR) = 2.0], restless sleep (OR = 5.0), daytime sleepiness (OR = 3.8) and daytime tiredness (OR = 5.1). Chronic cough (OR = 2.4), snoring (OR = 2.0), chronic rhinitis (OR = 2.6) and eczema (OR = 3.3) were associated with disturbed sleep. Chronic cough (OR = 2.5) and rhinitis (OR = 4.1) were related to daytime tiredness. Chronic rhinitis was an important risk factor for snoring (OR = 1.9). In wheezing school-aged children, decreased quality of sleep and increased daytime tiredness and sleepiness were more often reported. Upper airway symptoms were related to the sleep disturbances.     

Symptom profile and asthma control in school-aged children.

BACKGROUND: Children with poorly controlled asthma are at high risk of airway remodeling, sleep disruption, school absenteeism, and limited participation in activities. OBJECTIVE: To determine asthma prevalence and characterize disease severity and burden in school-aged children. METHOD: A case-finding study was conducted via a multiple-choice questionnaire and asthma algorithm. Items used for analysis include physician diagnosis of asthma, symptom severity, and health care utilization. The chi2 test was used to determine the significance of differences among cases. Logistic regression was used to evaluate the association of patient factors and asthma indicators. RESULTS: Of the 5,417 children surveyed, 1,341 (25%) were classified as being at risk of asthma. Of these asthma cases, 55% were positive by diagnosis and algorithm (active), 10% were positive per algorithm alone (suspected), and 35% were positive per diagnosis alone (nonactive). Only 14% of all asthma cases reported experiencing no respiratory symptoms (< 1% active, 2% suspected, and 40% nonactive) compared with 75% of noncases. Also, 75% of noncases reported never missing school compared with 19%, 33%, and 54% of active, suspected, and nonactive asthma cases. African American race, Medicaid enrollment, and male sex were independent predictors of asthma risk. Similarly, African American race, Medicaid enrollment, age, and persistent asthma were independent predictors of emergency department use among asthma cases. DISCUSSION: Prevalence of active symptoms suggestive of poor asthma control was extremely high among urban, minority children enrolled in Arkansas' largest public school district. Poor asthma control greatly affects quality of life, including school attendance and performance. Interventions should raise expectations and emphasize the importance of achieving asthma control.     

Nutrition education improves knowledge and BMI-for-age in Ghanaian school-aged children

BackgroundAdequate nutrition is required for growth and development in children. This study tested the effectiveness of nutrition education on knowledge and BMI-for-age (BFA) of school-aged children in the Kumasi Metropolis.MethodsChildren, aged 9–13 years old were recruited from ten randomly selected primary schools in the Metropolis. The schools were randomly allocated into 3 groups: nutrition education (3 schools), physical activity (PA) education (3 schools), both interventions (2 schools), or control (2 schools). Following a baseline nutrition and PA knowledge and status assessment in 433 children, twice-monthly nutrition and PA education and demonstrations were carried out for 6 months, followed by a post-intervention assessment.ResultsPA and nutrition knowledge improved in all groups (P<0.001); the highest improvement was among those who received both interventions (31.0%), followed by the nutrition education group (29.8%), and the least, the control group (19.1%). Overall, BFA improved by +0.36, from baseline (-0.26) to end of the intervention (+0.10, P<0.001). Within the groups, the nutrition group (+0.65, P<.001) had the highest improvement, then, both the intervention group (+0.27, P<0.001), the PA group (+0.23, P<0.001) and lastly, the control group (+0.18, P=0.001).ConclusionNutrition education could improve knowledge and BMI-for-age in school-aged children in Ghana.     

Analysis of word clustering in verbal fluency of school-aged children

The use of clustering strategies in semantic and phonological fluency was tested in children in third (age 8-9) and fifth (age 10-11) grades. To analyze the development of clustering strategies in the fluency task, the latency to the first word and intervals between clustered and non-clustered words were recorded. Semantic fluency was greater than phonological fluency in both age groups. Children in fifth grade had greater semantic and phonological fluency than children in the third grade, concomitant with an increase in number of clusters, but not in cluster size. The greater facility of the children with semantic fluency was confirmed by a shorter latency to the first word, and significantly shorter intervals between clustered words compared to non-clustered words. Girls had shorter latencies to the first word and made more phonological clusters in the semantic task than boys. The increase in cluster number and concomitant increase in fluency in older children might be related to the development of cognitive flexibility. These data suggest that measurement of clustering strategies in the verbal fluency task can be used to assess executive function deficits in children with acquired or developmental neurological impairment or attention deficits.     

Components and developmental differences of executive functioning for school-aged children

This study examined the developmental differences, components, and underlying factor structure of executive functioning (EF) in school-aged children by utilizing subtests from Test of Everyday Attention for Children and some additional EF tests. The developmental differences identified across age groups between 7 to 14 years for a sample of 185 children support a multistage interpretation of EF development. Structural equation modeling was used to test models with three first-order EF components which included shifting, working memory/updating, and inhibition. Results indicated that the first-order full, three-factor model was the best model among all the alternative first-order and second-order models.     

Symptoms of depression and anxiety in children: specificity of the hopelessness theory.

The common etiology hypothesis proposes that depression and anxiety commonly co-occur because they share etiological factors. This study examined the specificity of the hopelessness theory in the development of depressive and anxious symptoms in children. Students in Grades 3 through 6 (N = 418, 47% boys) completed measures assessing inferential styles about causes, consequences, and the self, depressive symptoms, and anxious symptoms. Six weeks later, children completed measures of depressive symptoms, anxious symptoms, and hassles. All 3 inferential styles interacted with hassles to predict increases in depressive symptoms, although this relation only held for children with low levels of initial symptoms. Inferential styles about consequences and the self also predicted increases in anxious symptoms. Consistent with the common etiology hypothesis, after controlling for the association between depressive and anxious symptoms, the effects of inferential styles about consequences and the self persisted.