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1.
《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1494-1499
Aim
From birth to old age, males generally have poorer disease outcomes compared to females. Preterm infants display a marked gender disparity in disease outcomes, and the underlying mechanisms are not well delineated. Our aim was to review the literature on clinical outcomes between preterm infants of different genders and discuss the potential mechanisms underlying the differences observed.Methods
A literature review was undertaken for experimental and clinical research related to gender differences in preterm outcomes.Results
Preterm male infants appear to have consistently worse outcomes compared to females, and the aetiology of these differences, while mostly undetermined, is likely multifactorial.Conclusion
The male disadvantage in preterm outcomes is likely multifactorial with hormonal, genetic and immunological differences likely playing key roles. Gender is an important variable in preterm outcome and should be considered when designing clinical and experimental research.2.
Ursula Kiechl‐Kohlendorfer Elisabeth Ralser Ulrike Pupp Peglow Nicola Pehboeck‐Walser Barbara Fussenegger 《Acta paediatrica (Oslo, Norway : 1992)》2013,102(1):66-71
Aim
To unravel risk predictors for impaired numerical skills at 5 years of age in a population‐based cohort of very preterm infants.Methods
Between January 2003 and August 2006, we prospectively enrolled all infants born in Tyrol with <32 weeks of gestation. A total of 161 of 223 preterm infants (participation rate 72.2%) had a detailed examination at 5 years of age including cognitive assessment (Hannover‐Wechsler Intelligence Test for preschool children, third edition (HAWIVA‐III) or Snijders‐Oomen Nonverbal Intelligence Test (SON‐R)). In 135 children, numerical abilities were assessed with the dyscalculia test TEDI‐MATH. The association between pre‐ and postnatal factors and impaired numerical skills was analyzed by means of logistic regression analysis.Results
Dyscalculia test showed delayed numerical skills (TEDI‐MATH Sum T‐score <40) in 27 of 135 children tested (20.0%). In half of the children tested, delayed numerical abilities were related to lower IQ scores. Smoking in pregnancy, intracerebral haemorrhage and chronic lung disease were predictive of delayed numerical skills at 5 years of age in the multivariate analysis.Conclusion
This study identified risk predictors for impaired numerical skills in preterm infants. Our data support the role of both pre‐ and perinatal factors in the evolution of mathematical deficits.3.
Observation study showed that the continuity of skin‐to‐skin contact with low‐birthweight infants in Uganda was suboptimal
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1541-1547
Aim
Kangaroo mother care (KMC) is a safe and effective method of reducing neonatal mortality in resource‐limited settings, but there has been a lack of data on the duration of skin‐to‐skin contact (SSC) in busy, low‐resource newborn units. Previous studies of intermittent KMC suggest the duration of SSC ranged from 10 minutes to 17 hours per day.Methods
This was an observational study of newborn infants born weighing less than 2000 g, which collected quantitative data on SSC over the first week after birth. The study took place in July 2016 in the newborn unit of a low‐resource facility in Uganda.Results
The mean daily duration of SSC over the first week after birth was three hours. This differed significantly from the World Health Organization recommendation of at least 20 hours of SSC per day. SSC was provided by mothers most of the time (73.5%), but other family members also took part, especially on the day of birth.Conclusion
Our study found a disappointingly low daily duration of SSC in this Ugandan newborn unit. However, advocacy and community education of SSC may help to decrease the stigma of KMC, improve overall acceptance and reduce the age at SSC initiation.4.
Perspectives on periviability counselling and decision‐making differed between neonatologists in the United States and the Netherlands
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(10):1710-1715
Aim
American guidelines suggest that neonatal resuscitation be considered at 23 weeks of gestation, one week earlier than in the Netherlands, but how counselling practices differ at the threshold of viability is unknown. This pilot study compared prenatal periviability counselling in the two countries.Methods
In 2013, a cross‐sectional survey was sent to 121 Dutch neonatologists as part of a nationwide evaluation of prenatal counselling. In this pilot study, the same survey was sent to a convenience sample of 31 American neonatologists in 2014. The results were used to compare the organisation, content and decision‐making processes in prenatal counselling at 24 weeks of gestation between the two countries.Results
The survey was completed by 17 (55%) American and 77 (64%) Dutch neonatologists. American neonatologists preferred to meet with parents more frequently, for longer periods of time, and to discuss more intensive care topics, including long‐term complications, than Dutch neonatologists. Neonatologists from both countries preferred shared decision‐making when deciding whether to initiate intensive care.Conclusion
Neonatologists in the United States and the Netherlands differed in their approach to prenatal counselling at 24 weeks of gestation. Cross‐cultural differences may play a role.5.
Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology
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Atsushi Kawaguchi Angela Bates Bonita E. Lee Steven Drews Daniel Garros 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(3):504-510
Aim
To describe the epidemiology of critically ill children admitted to a paediatric intensive care unit (PICU) with acute respiratory disease. The association with intubation was analysed for the three most prevalent viruses and in those with and without viral co‐infection.Methods
Patients admitted to the PICU (2004–2014) with acute respiratory disease were included. Analyses were performed utilising each respiratory viral infection or multiple viral infections as an exposure.Results
There were 1766 admissions with acute respiratory disease of which 1372 had respiratory virus testing and 748 had one or more viruses detected. The risk of intubation before or during the PICU stay was higher if parainfluenza virus was detected compared to respiratory syncytial virus (RSV) (OR: 2.20; 95% CI: 1.06–4.56). Sixty‐three admissions had two or more viruses detected, and the combination of RSV and Rhinovirus/enterovirus was the most common. No significant difference was observed in the risk of intubation between patients with multiple and single viral infections.Conclusion
Higher risk of intubation was found in patients with parainfluenza as compared to RSV. The risk of intubation comparing parainfluenza virus to other viruses and for patients with multiple versus single virus needs to be further studied.6.
Thomas Rossor Ingran Lingam Abdel Douiri Ravindra Bhat Anne Greenough 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1535-1540
Aim
To determine whether a pH probe or multichannel intraluminal impedance (MII) more frequently detected gastro‐oesophageal reflux and test the hypothesis that acid reflux was associated with lower baseline impedance.Methods
A prospective study of infants in whom reflux was suspected and evaluated using combined pH and multichannel impedance. Studies were considered abnormal if the acid index was >10% or there were >79MII reflux events in 24 hours. The acid index was the percentage of total study time with a pHResults
Forty‐two infants [median gestational age 31 (range 23–42) weeks] were assessed. Only nine infants (21%) had abnormal studies, seven detected by pH monitoring, one by MII monitoring and one by both techniques (p = 0.04). After correcting for gestational age and post‐natal age, baseline impedance remained negatively correlated with the acid index (r = ?0.34, p = 0.038) and the maximum ACT (r = ?0.44, p = 0.006).Conclusion
Clinical suspicion of reflux was frequently incorrect, and reflux was more frequently detected by a pH probe. The inverse relationship of acid reflux to baseline impedance suggests that mucosal disruption may result from acid reflux in this population.7.
Nutritional therapy complications in children with ultra‐short bowel syndrome include growth deficiency but not cholestasis
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Katarzyna Olszewska Janusz Ksiazyk Dariusz Kozlowski Magdalena Pajdowska Malgorzata Janusz Maciej Jaworski 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(6):1088-1093
Aim
Children with ultra‐short bowel syndrome (USBS) have not been extensively studied to date because the condition is rare. The aim of the study was to assess the nutritional status of children with USBS receiving home parenteral nutrition, using citrulline serum concentration and cholestasis.Methods
We studied 17 patients with USBS, with a median age of 6.6 years and median duration of parenteral nutrition of 6.6 years. The study was carried out at The Children's Memorial Health Institute, Warsaw, from January 2014 to January 2015.Results
The median standard deviation score (SDS) was ?1.2 for body mass according to chronological age, ?1.72 according to height and ?0.59 according to height for age. Patients requiring seven days per week parenteral nutrition had a citrulline concentration below 10 μmol/L. Decreased bone‐mineral density was observed in 87% of the patients. Low values of 25‐hydroxyvitamin D were found in 53% of the children. None of the patients had elevated conjugated bilirubin levels above 34.2 μmol/L.Conclusion
Children with USBS were growth deficient according to their chronological age, with frequent abnormal bone mineralisation and vitamin D deficiency. Children requiring parenteral nutrition seven days a week had citrulline concentrations below 10 μmol/L. Cholestasis was not seen.8.
9.
Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1512-1520
Aim
Regurgitation, infantile colic and functional constipation are common functional gastrointestinal disorders (FGIDs) during infancy. Our aim was to carry out a concise review of the literature, evaluate the impact of these common FGIDs on infants and their families, and provide an overview of national and international guidelines and peer‐reviewed expert recommendations on their management.Methods
National and international guidelines and peer‐reviewed expert recommendations on the management of regurgitation, infantile colic and functional constipation were examined and summarised.Results
Regurgitation, infantile colic and functional constipation cause frequent parental concerns, lead to heavy personal and economic costs for families and impose a financial burden on public healthcare systems. Guidelines emphasise that the first‐line management of these common FGIDs should focus on parental education, reassurance and nutritional advice. Nutritional advice should stress the benefits of continuing breastfeeding, while special infant formulas may be considered for non‐breastfed infants with common FGIDs. Drug treatment is seldom required, with the exception of functional constipation.Conclusion
By providing complete and updated parental education, reassurance and nutritional advice, healthcare professionals can optimise the management of FGIDs and related symptoms and reduce the inappropriate use of medication or dietary interventions.10.
Minna Honkila Marjo Renko Irma Ikäheimo Tytti Pokka Matti Uhari Terhi Tapiainen 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(5):774-779
Aim
Our aim was to study prospectively the aetiology of neonatal conjunctivitis in a population‐based setting.Methods
Altogether 173 neonates with clinical conjunctivitis aged on average 20 (SD 10) days were recruited from child welfare clinics in Oulu, Finland, in 2010–2015. Conjunctival specimens were collected from 167 neonates for multiplex polymerase chain reaction to detect 16 respiratory viruses, from 163 for polymerase chain reaction to detect Chlamydia trachomatis and Neisseria gonorrhoeae and from 160 for bacterial culture studies. The cases were followed up until the age of 18 months.Results
Viral conjunctivitis was diagnosed in 8/167 (4.8%; 95% CI 2.1–9.2%), chlamydial or gonococcal conjunctivitis in 0/163 cases (0%; 95% CI 0–2.2%) and other bacterial conjunctivitis in 58/160 (36%; 95% CI 29–44%). Rhinovirus was found at the ocular site in 4/167 (2.4%) neonates, adenovirus in 3/167 (1.8%) and bocavirus in 1/167 (0.6%). The most commonly isolated bacteria included Staphylococcus aureus (16%), Moraxella catarrhalis (9.4%) and Streptococcus pneumoniae (3.1%). None of these pathogens was associated with the 4/173 (2.3%) cases later operated on for persistent nasolacrimal duct obstruction.Conclusion
Chlamydia trachomatis was a rare pathogen in neonatal conjunctivitis in a population‐based setting, but respiratory viruses were detected more frequently than indicated earlier.11.
Review shows that Icelandic society is taking firmer steps to tackle the diverse forms of child abuse and neglect that its children are exposed to
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1500-1511
Aim
This review examined and summarised the research published on child abuse in Iceland, which was mainly in the country's native language, to make the findings more accessible to English speakers. It specifically focused on child rearing and the physical, emotional and sexual abuse, neglect and intrafamilial conflicts suffered by children at the hands of their parents and other carers.Method
The review drew on published research, books and reports and compared the findings with Nordic research and global estimates of child abuse.Results
Qualitative and quantitative research revealed that the prevalence of different forms of child abuse, child neglect and intra‐familial conflicts in Iceland was similar to, or higher than, global and Nordic estimates. Younger respondents reported less physical abuse than older respondents, but higher levels of emotional abuse. Legislation, greater awareness, public debates and research on child abuse in Iceland have contributed to the growing recognition of the negative consequences of child abuse and strengthened support for prevention strategies.Conclusion
Icelandic children have reportedly experienced diverse forms of child abuse and neglect from their parents and other carers. Diverse initiatives have been put in place that underline the urgent need to tackle such behaviour.12.
Karin Persson Inger
hlund Lisbeth Nordstrm Anna Winberg Eva Rnmark Christina E West 《Acta paediatrica (Oslo, Norway : 1992)》2013,102(6):644-649
Aim
At the extremes of latitude, UVB intensity is insufficient for adequate vitamin D synthesis in winter. Fatty fish, vitamin D enriched milk, margarine and eggs are main dietary sources of vitamin D. Their elimination may increase the risk of vitamin D deficiency. The aim was to assess vitamin D status in food‐allergic adolescents eliminating milk, egg and/or fish compared with adolescents on normal diets.Methods
In winter, vitamin D intake was assessed by a food frequency questionnaire in 20 food‐allergic adolescents and 42 controls in the population‐based Obstructive Lung Disease In Northern Sweden (OLIN) cohort studies. Vitamin D supplementation was queried. Serum 25‐hydroxyvitamin D [S‐25(OH)D] and S‐parathormone (S‐PTH) levels were determined.Results
Mean (SD) dietary vitamin D intake was 7.9 (3.6) μg/day in allergic adolescents and 7.8 (3.4) in controls (p > 0.05). Mean (SD) S‐25(OH)D levels in supplement consumers were 44 (18) nmol/L compared with 35 (10) in non‐consumers (p = 0.03). S‐25(OH)D and S‐PTH levels were similar in food‐allergic adolescents and controls (p > 0.05). Eighty‐two percentage had deficient S‐25(OH)D levels <50 nmol/L, and none reached levels >75 nmol/L.Conclusion
Vitamin D deficiency was as common in food‐allergic adolescents as in controls although the vitamin D intake met national recommendations. Large‐scale studies on the prevalence of vitamin D deficiency in this region are needed.13.
Aim
To determine the occurrence and risk factors of sudden unexpected postnatal collapse (SUPC) in presumably healthy newborn infants.Methods
All live‐born infants during a 30‐month period, in five major delivery wards in Stockholm, were screened, and possible cases of SUPC thoroughly investigated. Infants were ≥35 weeks of gestation, had an Apgar score >8 at 10 min and collapsed within 24 h after birth. Maternal, infant, event characteristics and outcome data were collected.Results
Twenty‐six cases of SUPC were found among 68 364 live‐born infants, an incidence of 38/100 000 live births. Sixteen of these cases of SUPC required resuscitation with ventilation >1 min, and 14 of these remained unexplained (21/100 000). Fifteen of the 26 children were found in a prone position, during skin‐to‐skin contact, 18 were primipara, and 13 occurred during unsupervised breastfeeding at <2 h of age. Three cases occurred during smart cellular phone use by the mother. Five developed hypoxic–ischaemic encephalopathy (HIE) grade 2, and 4 underwent hypothermia treatment. Twenty‐five infants had a favourable neurological outcome.Conclusion
SUPC in apparent healthy babies is associated with initial, unsupervised breastfeeding, prone position, primiparity and distractions. Guidelines outlining the appropriate monitoring of newborns and safe early skin‐to‐skin contact should be implemented.14.
Katharina Bibl Peter Gröpel Angelika Berger Georg M. Schmölzer Monika Olischar Michael Wagner 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(9):1831-1837
Aim
Our aim was to examine the relationship between rescuers' anthropometric data and chest compression quality during paediatric resuscitation training.Methods
This study focused on 224 medical students (53% women) who performed 2 minutes of paediatric resuscitation at the Medical University of Vienna, Austria: 116 on a baby manikin and 108 on an adolescent manikin. Skill Reporter software measured chest compression quality by recording compression depth, frequency, hand position and complete recoil. The participants' height, weight and body mass index (BMI) were recorded.Results
Participants with a lower BMI achieved higher total chest compression scores on both the baby and adolescent manikins than participants with a higher BMI. The latter were more likely to exceed the correct compression depth and not achieve complete chest recoil in the adolescent manikin. When it came to the baby manikin, the female participants achieved better chest recoil and the males achieved a higher number of compressions at the correct rate. Males also achieved better chest recoil with the adolescent manikins. Being tall only correlated with incomplete recoil in the adolescent manikin.Conclusion
The results indicate that anthropometric variables were associated with chest compression quality in paediatric patients and should be considered by future education programmes.15.
Objective
To study the quality of life of Chinese pediatric patients with retinoblastoma (RB) after enucleation and the influencing factors.Methods
A questionnaire survey was performed on 71 cases of pediatric patients with RB after enucleation and 80 cases of healthy children, using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL? 4.0).Results
The social dimension scores, school dimension scores, and total scores for the PedsQL? 4.0 among the pediatric patients with RB were statistically significantly lower than those of healthy children. The influencing factors were unilateral/bilateral affected eyes, diagnosis age, and ocular prosthesis satisfaction.Conclusion
Early discovery, timely treatment, increased eye salvage rate, and cosmetic effects of ocular prosthesis were key factors for increasing the quality of life of pediatric patients with RB. Attention should be paid to the health, social, and school development of pediatric patients with RB.16.
Possible effect of maternal safe food preparation behavior on child malnutrition in Benin,Africa
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Chikako Nagahori Yoshihide Kinjo Assogba Joseph Vodounon Maroufou Jules Alao Geneviève Padonou Batossi Benjamin Hounkpatin Eve Amoule Houenassi Taro Yamauchi 《Pediatrics international》2018,60(9):875-881
Background
In many developing countries, faulty complementary feeding practises and frequently contaminated foods are contributing factors to child malnutrition. The aims of this study were to evaluate the nutrition status of, and clarify the maternal safe food preparation behaviors associated with malnutrition in, children aged <5 years in Cotonou, Benin.Methods
This study targeted 300 mother–child pairs visiting the University Hospital of Mother and Child Cotonou Lagoon. Mothers were interviewed using a structured questionnaire. Child height/length and weight measurements were determined and Z ‐scores were calculated using the 2006 World Health Organization Child Growth Standards. Children with Z ‐score < ?2 were considered to have stunting or be underweight. On logistic regression analysis, significant variables on bivariate analysis, the associations of which were clarified in previous studies, were established as independent variables. Approximately 80% of the children who participated in this study were aged < 1 year. Being underweight was analyzed as a dependent variable.Results
Regarding nutrition status, 11.0% of the children had stunting and 14.7% were underweight. On logistic regression analysis, underweight was correlated significantly with birthweight. As a remarkable point, food refrigeration was statistically significant. Food refrigeration can possibly be regarded as a maternal safe food preparation behavior.Conclusions
Maternal safe food preparation behaviors can prevent child malnutrition, even after considering biological and socioeconomic factors.17.
Treatment of Langerhans cell histiocytosis with a modified risk‐adapted protocol—experience from a tertiary cancer institute in India
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Gaurav Narula Nirmalaya D. Pradhan Brijesh Arora Sripad D. Banavali 《Pediatric blood & cancer》2018,65(8)
Background
Involvement of risk‐organs (RO+) in Langerhans cell histiocytosis (LCH) and inadequate early response identifies patients at high risk for relapse and mortality requiring intensive salvage therapy including stem cell transplant, adding cost and toxicity. To mitigate this, we used a standard induction, augmented with metronomic etoposide, and prolonged maintenance—similarly augmented for RO+, and retrospectively analyzed its impact.Procedure
LCH patients from 2009 through 2014 were included. Patients received standard vinblastine and prednisolone therapy weekly till week 25 for RO+. Single site (SS) and multisystem (MS) without risk organ involvement (RO?) received 3‐weekly pulses from week 13 till week 25. Maintenance was 3‐weekly vinblastine and 5‐day prednisolone pulses, daily 6‐mercaptopurine (60 mg/m2) and weekly methotrexate (15 mg/m2) for 18 and 9 months for RO+ and MSRO?, respectively. RO+ also received oral etoposide (50 mg/m2) for 21 of every 28‐day cycle for the first year.Results
Fifty consecutive patients were analyzed. Median age was 36 months (4–189 months). SS, MSRO?, and RO+ were 29 (58%), 12 (24%), and nine (18%), respectively. Four were lost to follow‐up and excluded from further evaluation. On response evaluation at week 6, 24 (52%) had no active disease (NAD), 17 (37%) had AD‐better (where AD is active disease), and one (2%) had AD‐worse. In RO+, eight (66.6%) had AD‐better and three (25%) had NAD. Forty‐five patients had NAD by week 12. Three patients relapsed. With median follow‐up of 39 months (8–84), 5‐year event free survival was 85.6% (RO? and SS), and 100% for RO+. One patient's death in remission from unrelated causes resulted in overall survival of 97%.Conclusions
RO+LCH receiving oral etoposide augmented induction and maintenance had early and durable responses. Prolonging maintenance lowered reactivation rates in RO+ and RO?LCH, resulting in excellent survival.18.
Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children
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Daniel McAullay Kimberley McAuley Ross Bailie Veronica Mathews Peter Jacoby Karen Gardner Beverly Sibthorpe Natalie Strobel Karen Edmond 《Journal of paediatrics and child health》2018,54(2):132-140
Aim
To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children.Methods
Data were collected from 59 Australian primary health‐care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6‐year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age‐relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues.Results
During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44–4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22–1.54). Improvement in anticipatory guidance, treatment and follow‐up of medical conditions was almost universal.Conclusion
We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow‐ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing.19.
Hidenori Moriyama Toru Fuchimukai Naoki Kondo John I Takayama 《Pediatrics international》2018,60(3):282-286
Background
Rikuzentakata was one of the cities most devastated by the Great East Japan Earthquake on 11 March 2011. Many buildings were swept away or destroyed and affected families were placed into temporary housing. The aim of this study was to determine the impact of long‐term temporary housing on the body mass index (BMI ) of elementary school children living in Rikuzentakata City.Methods
A retrospective cohort study of was carried out of students attending 1st–3rd grade in 2010, and 4th–6th grade in 2013, in eight elementary schools in Rikuzentakata City. Height and weight were measured annually. We compared changes in BMI between children in temporary housing and those in permanent housing. Separately, parents of students attending one of the elementary schools were surveyed in 2013.Results
Of 526 children in the present study, 32% were living in temporary housing. The prevalence of obesity climbed from 5.3% in 2010 to 7.8% in 2013 in the temporary housing group, and from 7.6% to 7.8% in the permanent housing group. BMI z‐score in the temporary housing group increased by 0.102 points between 2010 and 2013 (P < 0.02). Children in temporary housing spent more time reading comic books and their walking commute time had decreased by 2 min compared with before the disaster.Conclusion
Obesity prevalence and BMI z‐score increased in children in temporary housing compared with permanent housing. A more sedentary lifestyle may explain this trend. It is important for policy makers and health‐care providers to recognize potential consequences of long‐term residence in temporary housing.20.
Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease, 2017
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Mitsuru Muto Hiroshi Matsufuji Takeshi Tomomasa Masaki Nio Hiroshi Tamai Masanori Tamura Haruhiko Sago Akira Toki Shunsuke Nosaka Tatsuo Kuroda Masahiro Yoshida Atsushi Nakajima Hiroyuki Kobayashi Hideki Sou Kouji Masumoto Yoshio Watanabe Yutaka Kanamori Yoshinori Hamada Atsuyuki Yamataka Naoki Shimojima Akio Kubota Kosuke Ushijima Ken Haruma Shin Fukudo Yuko Araki Takahiro Kudo Satoshi Obata Wataru Sumita Toshihiko Watanabe Suguru Fukahori Yoshimitsu Fujii Yoshiyuki Yamada Keisuke Jimbo Fujimi Kawai Tomoya Fukuoka Shinsuke Onuma Toshio Morizane Satoshi Ieiri Genshiro Esumi Takahiro Jimbo Tomoko Yamasaki 《Pediatrics international》2018,60(5):400-410