Influence of reporting effects on the association between maternal depression and child autism spectrum disorder behaviors

Background: Maximizing measurement accuracy is an important aim in child development assessment and research. Parents are essential informants in the diagnostic process, and past research suggests that certain parental characteristics may influence how they report information about their children. This has not been studied in autism spectrum disorders (ASD) to date. We aimed, therefore, to investigate the possible effect that maternal depression might have on a mother’s reports of her child’s ASD behaviors. Using structural equation modeling, we disaggregated shared from unique variation in the association between latent variable measures of maternal depression and ASD behaviors. Methods: Data were obtained from a study of preschoolers aged 2–4 newly diagnosed with ASD (n = 214). Information from a parent questionnaire, a semi‐structured parent interview, and a semi‐structured observational assessment was used to develop a latent variable measure of child ASD behaviors. Mothers reported on their own depression symptoms. We first modeled the covariance between maternal depression and child ASD behavior. Then, to quantify unique variation, we added covariance terms between maternal depression and the residual variation associated with the individual measures of child ASD behaviors. Results: The model demonstrated excellent fit to the underlying data. Maternal self‐report of depression symptoms exhibited a significant association with the unique variance of the questionnaire report but not with the latent variable measure of child ASD behavior. A gradient pattern of association was demonstrated between maternal depression and the unique variance of the ASD measures: most strongly for the maternal questionnaire report, more weakly for the maternal semi‐structured interview, and to a trivial extent for the observational interview. Conclusions: Parental depression may influence reporting of ASD behaviors in preschoolers. Shared method effects may also contribute to bias. This finding highlights the importance of obtaining multimethod reports of child ASD symptoms.     

Seasonal variation in the association between household food insecurity and child undernutrition in Bangladesh: Mediating role of child dietary diversity

Household food insecurity (HFI) and child dietary diversity (CDD) are variable across seasons. We examined seasonal variation in HFI and child undernutrition association and tested how CDD mediates this association. We analyzed data for 26,353 children aged 6–59 months drawn from nationally representative cross-sectional Food Security and Nutrition Surveillance Project data collected during 2012–2014 in Bangladesh across three seasons annually: Post-Aman harvest (January–April); Monsoon (May–August); and Post-Aus harvest (September–December). Multivariable logistic regression analysis adjusted for individual, maternal, household and geographical characteristics reveals that children of food-insecure households were more likely than food-secure households to be stunted (adjusted odds ratio, AOR: 1.12; 95% confidence interval, CI: 1.02–1.23; p < 0.05), wasted (AOR: 1.21; 95% CI: 1.05–1.39; p < 0.01) and underweight (AOR: 1.16; 95% CI: 1.04–1.3; p < 0.01). CDD mediated 6.1% of the total effect of HFI on underweight. These findings varied across seasons. HFI was associated with greater odds of underweight during Monsoon (AOR: 1.32; 95% CI: 1.08–1.62; p < 0.01) and Post-Aus (AOR: 1.21; 95% CI: 1.06–1.37; p < 0.01) while wasting during Post-Aus (AOR: 1.65; 95% CI: 1.35–2.01; p < 0.001). CDD largely mediated the total effect of HFI on underweight during the Post-Aman in 2012–2014 (23.2%). CDD largely mediated the total effect of HFI on wasting (39.7%) during Post-Aman season in 2014 and on underweight (13.7%) during the same season in 2012. These findings demonstrate that HFI is seasonally associated with child undernutrition and mediated by CDD as well in Bangladesh and seasonality and diversity should be considered while designing appropriate population-level food-based interventions to resolve child undernutrition.     

Increasing the hospitalization of asthma in children not in adults – from a national survey in Taiwan 1996–2002

Prevalence of asthma has risen gradually in past 30 yr in Taiwan, but less is known about the trend of asthma hospitalization and different hospitalization patterns between children and adult groups in the Chinese population. The implementation of National Health Insurance (NHI) in Taiwan was in 1995, and it covered health care for >96% of the population. Using NHI data from 1996 to 2002, we investigated the admission rate, length of stay, cost and the readmission rate of hospitalization with primary diagnosis of asthma in this period. We also compare the difference between the children group (<18 yr old) and adult group (≥18 yr old). The average incidence of hospitalization in the age group below 18 was 105.0 cases per 100,000 children, and was 116.7 per 100,000 population in the adult group during that period. It increased by 6.5% annually in the children group, though it was 0.1% annually in the adult group. The hospitalization days were 3.6 ± 2.4 days in the children group, and were 8.2 ± 8.9 days of those age ≥18 (p < 0.0001). The hospitalization cost was $288.7 ± $292.9 and $717.5 ± $1409.4, respectively (p < 0.0001). Autumn was the most frequent admission season in the children group, but the winter season was the most common in the adult group. The average readmission rate in this period was 20.4%. It was 13.0% in the children group, and was 22.6% in the adult group (p < 0.0001). The general hospitalization rate of asthma in the children group was lower than the adult group. It increased significantly in the children group from 1996 to 2002, but the admission cost rose prominently in the adult group during the same period. The hospitalization days, admission cost, and readmission rate were also significantly lower in the children group.     

Pneumonia in the first 2 years of life,and asthma in preschool‐age children

Background: The relationship between viral bronchiolitis in early infancy and subsequent wheezing and asthma has been well established. The aim of the present cross‐sectional study was to test the hypothesis that pneumonia severe enough to require hospitalization during the first 2 years of life could also be associated with asthma or asthma‐like symptoms in pre‐school children. Methods: Structured interviews were conducted with parents of children who were classified as exposed (n= 36) or non‐exposed (n= 84), based on whether they were hospitalized with radiologically confirmed pneumonia during the first 2 years of life. The main outcomes were ever physician‐diagnosed asthma, asthma‐like symptoms and use of anti‐asthmatic medications during the last 2 months and during the last 12 months. Results: The prevalence of ever physician‐diagnosed asthma was higher in the exposed group compared with the non‐exposed group (41.6% vs 22.6%, P= 0.01), with an adjusted prevalence ratio of 2.03 (95% confidence interval: 1.10–3.62). The exposed group had a trend toward a higher prevalence of asthma‐like symptoms and use of anti‐asthmatic medications during the last 2 months and during the last 12 months. Conclusions: Radiologically confirmed pneumonia in the first 2 years of life may be associated with asthma or asthma‐like symptoms in pre‐school children.     

The associations between women's empowerment measures,child growth and dietary diversity: Findings from an analysis of demographic and health surveys of seven countries in Eastern Africa

Evidence on the efficacy of women''s empowerment to improve child growth and minimum dietary diversity (MDD) in the Eastern Africa (EA) region is limited. This cross‐sectional study used recent Demographic and Health Survey data of mother–child dyads from seven countries in EA to examine the associations between women''s empowerment measures, child growth and MDD. Length‐for‐age z‐scores, weight‐for‐length z‐scores and weight‐for‐age z‐scores were used to categorize growth indicators of 6–23 months old children. Multivariable logistic regression was used to identify significant associations. Among all countries, 32%–59% of children experienced growth failure. Children meeting MDD were 18%–45%. Women having self‐esteem were associated with lower odds of stunting (adjusted odds ratio [AOR] = 0.62 in Rwanda), wasting (AOR = 0.38 in Uganda), underweight (AORs = 0.60 and 0.57 in Tanzania and Uganda, respectively) and growth failure (AOR = 0.64 in Rwanda). Having health decision control in Burundi was associated with lower odds of stunting (AOR = 0.49) and child growth failure (AOR = 0.52) and higher odds of meeting MDD (AOR = 2.50). Having Legal empowerment among women increased the odds of stunting (AOR = 1.79 in Burundi), underweight (AOR = 1.77 in Uganda) and growth failure (AOR = 1.87 in Burundi). Economic empowerment showed mixed associations with child growth and MDD among some countries. Women''s self‐esteem and health decision control were associated with better child growth and MDD for some countries in EA. Nutrition‐sensitive interventions aimed at improving child growth and MDD should consider local contexts when addressing women''s empowerment.     

哮喘预测指数对婴幼儿哮喘临床应用及评价

哮喘是儿童时期最常见的慢性疾病,也是临床儿科医生难以在婴幼儿期作出明确诊断的疾病之一。40%～50%的儿童在3岁前出现过至少1次喘息和呼吸困难等哮喘样症状[1],但是仅有约30%的反复喘息学龄前儿童到6岁时仍有哮喘症状[2]。事实上,发生喘息的幼龄儿童中约半数仅发生过1次喘息[3]。另一方面,约80%儿童持续哮喘患者的喘息症状出现在6岁以前,50%以上的喘息症状发生在3岁以前[4]。幼龄儿童喘息的疾病负担远高于年长儿,与学龄儿童相比,小于3岁儿童的哮喘控制情况较差,这部分患     

婴幼儿期病毒感染与儿童期哮喘的关系研究进展

呼吸道病毒感染是小年龄患儿喘息最为常见的诱因,也是慢性哮喘患儿出现急性加重的主要诱发因素.关于呼吸道病毒感染引发气道炎症反应的机制尚不完全明确,目前有研究提出用表观遗传学机制来解释病毒感染与哮喘的关系.该文就婴幼儿期呼吸道病毒感染在儿童时期哮喘发生发展中作用的研究进展作一综述.     

Bronchial asthma and the short-term quality of life: follow-up study of childhood bronchial asthma in Hungary

The aim of our study is to determine and describe the current short-term health-related quality of life of recent adult patients who had bronchial asthma in childhood. Our objective was to investigate if symptom control in bronchial asthma could be in conflict with general quality of life. We made a follow-up study of 152 patients (105 male, 47 female) over the age of 30 (31-55 yr) who were allergic asthmatics in childhood. The patients' current symptoms and short-term quality of life were evaluated by a questionnaire. The patients developed asthmatic symptoms by age 4.4 (0.5-13) years on the average. Now 60% (91 persons) have no symptoms. They became symptom-free between 3 and 41 yr of age (mean = 14.2 +/- 8.2). Amongst the currently asthmatic patients (58 patients, 38%), 34 patients (22%) belong to the Global Initiative for Asthma (GINA) I, nine patients (6%) to the GINA II, five patients (3.3%) to the GINA III, and five patients (3.3%) to the GINA IV classification. Five patients (3.3%) did not specify their own symptoms. Three persons (2%) did not answer this question. Symptomatic patients reached 5.28 on the Juniper Asthma Quality of Life Questionnaire, while their asymptomatic peers scored statistically higher with 6.8 on the scale. Amongst the symptomatic patients, the most limited areas were: 'bothered by heavy breathing', 'had to avoid a situation or environment because of dust', 'experienced difficulty breathing out as a result of asthma', 'experienced asthma symptoms as a result of the weather or air pollution outside'. They were least 'concerned about medication', 'frustrated as a result of their asthma', they were least limited in 'going outside because of the weather or air pollution'. The most problematic areas for the symptom-free patients were 'had to avoid a situation or environment because of dust', 'had to avoid a situation or environment because of cigarette smoke', 'experiencing asthma symptoms as a result of being exposed to dust and the 'need to clear throat'. It seems that having no asthma symptoms is not equal to having a good quality of life for asthmatic patients. Moreover, symptom control in bronchial asthma is in conflict with quality of life, as many prophylactic measures to prevent exposure to allergens also restrict the patient's life.     

儿童哮喘与1岁以内使用抗菌药物的关系的Meta分析

目的评估生后1年内使用抗菌药物与儿童哮喘的关系。方法检索中国知网数据库、中国维普科技期刊数据库、万方数据库、Pub Med、EBSCO等中英文数据库关于儿童哮喘与其1岁以内使用抗菌药物的关系的前瞻性队列研究,采用Stata12.0软件,通过Meta分析方法探讨二者之间的关系。结果选取文献质量评分高并且调整了下呼吸道感染因素的效应值进行合并,共纳入8项研究。Meta分析结果显示,1岁以内抗菌药物的使用增加了儿童哮喘的风险(OR=1.14,95%CI:1.10~1.17,P0.05);1年内使用抗菌药物4次与使用0~1次相比哮喘风险增加(OR=1.28,95%CI:1.19~1.38,P0.05);高风险儿童(至少有1位直系亲属曾患有哮喘)使用抗菌药物罹患哮喘的风险与其他儿童相比增加(OR=1.47,95%CI:1.20~1.81,P0.05)。结论生后1年内使用抗菌药物增加儿童哮喘的风险;高风险儿童使用抗菌药物增加哮喘的风险;抗菌药物使用次数增加与哮喘风险增加有关,但具体的剂量关系有待进一步研究。     

Timing of infection and development of wheeze,eczema, and atopic sensitization during the first 2 yr of life: The KOALA Birth Cohort Study

Mommers M, Thijs C, Stelma F, Penders J, Reimerink J, van Ree R, Koopmans M. Timing of infection and development of wheeze, eczema, and atopic sensitization during the first 2 yr of life: The KOALA Birth Cohort Study.
Pediatr Allergy Immunol 2010: 21: 983–989.
© 2010 The John Wiley & Sons A/S To investigate if infections in pregnancy and very early in life present a risk for wheezing, eczema, or atopic sensitization in later infancy. A total of 2319 children enrolled before birth in the KOALA Birth Cohort Study were followed during their first 2 yr of life using repeated questionnaires. Information was obtained on common colds, fever, and diarrhea with fever as well as on wheeze and eczema at ages 3 and 7 months and 1 and 2 yr, respectively. Blood samples were collected from 786 children at age 2 yr for specific immunoglobulin E analyses. Children with a common cold [adjusted odds ratio (aOR) 2.03 95% CI 1.21–3.41] or fever episode (aOR 1.81 95% CI 1.10–2.96) in the first 3 months of life had a higher risk of new onset wheeze in the second year of life compared to children who had not. For children with diarrhea with fever in the first 3 months of life, the aOR for new onset wheeze in the second year of life was 3.94 (95% CI 1.36–11.40) compared to children without diarrhea. Infections becoming clinically manifest during the first 3 months of life may be a general marker for a wheezy phenotype.     

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??Objective??To observe the clinical efficacy of Huaiqihuang in the treatment of children with bronchial asthma and its effects on the level of cytokines Th1??Th2 and PON1. Methods??A total of 180 children with bronchial asthma admitted between June 2014 and June 2015 in the Fourth Hospital of Baotou were randomized into the observation group??96 cases of GINA regimen treatment combined with Huaiqihuang??and the GINA regimen treatment group??84 cases????healthy children were enrolled as control group??50 cases??. Times of respiratory tract infection occurrence, asthmatic attacks, application of emergency medicine, hospitalization due to asthmatic and the levels of IL-4??IL-12??IL-13??INF-γ and PON1 were observed before and after treatment. Results??There were significant differences about the times of upper respiratory tract infections, bronchitis and pneumonia, asthma attacks, application of emergency medicine and hospitalization due to asthmatic??P??0.05??. There were significant differences about the changes of IL-4, IL-12, IL-13, INF-γ and PON1 before and after treatment??P??0.01??. Conclusion??The treatment of bronchial asthma in children with Huaiqihuang granule can reduce the incidence of respiratory infections and the number of asthmatic attacks and improve clinical effect. The Huaiqihuang granule alleviating asthma symptoms may by decreasing the levels of Th2 cytokines??IL-4??IL-13??and also by increasing the levels of Th1 cytokines??IL-12, IFN-γ??and PON1.