Separation anxiety disorder (SAD) is one of the most commonly occurring pediatric anxiety disorders. Children with SAD are characterized by excessive anxiety of separation from the primary attachment figure. These children exhibit fear of separation from their parents and display behaviors such as clinging, excessive crying, and tantrums. Children with SAD are found to have significant brain changes. SAD can co-occur with other conditions such as autism spectrum disorders, and attention deficit hyperactivity disorder. Past studies have identified not only cognitive deficits in children diagnosed with SAD, but also speech and language deficits, which vary depending on comorbidities. A team-centered approach is essential in the assessment and treatment of children diagnosed with SAD.
{"title":"Speech and language deficits in separation anxiety disorder","authors":"Roha M. Thomas, R. Kaipa","doi":"10.12715/APR.2016.3.7","DOIUrl":"https://doi.org/10.12715/APR.2016.3.7","url":null,"abstract":"Separation anxiety disorder (SAD) is one of the most commonly occurring pediatric anxiety disorders. Children with SAD are characterized by excessive anxiety of separation from the primary attachment figure. These children exhibit fear of separation from their parents and display behaviors such as clinging, excessive crying, and tantrums. Children with SAD are found to have significant brain changes. SAD can co-occur with other conditions such as autism spectrum disorders, and attention deficit hyperactivity disorder. Past studies have identified not only cognitive deficits in children diagnosed with SAD, but also speech and language deficits, which vary depending on comorbidities. A team-centered approach is essential in the assessment and treatment of children diagnosed with SAD.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Herskind, M. Willerslev-Olsen, A. Ritterb, Rosenbaum, L. Greve, JakobLorentzen, J. Nielsen
Background: Reduced muscle growth may be involved in the development of contractures in children with cerebral palsy (CP). Here, we report data from a pilot study of intensive gait training in CP toddlers. Methods: Five children with CP aged 8-30 months performed activity-based gait training for one hour/day, five days/week for three consecutive months. Included children were diagnosed with spastic CP, had a Gross Motor Function Classification System (GMFCS) score of I–II, and were not epileptic. All children wore pedometers during training. Before and after the training period, kinematic and qualitative gait analysis, clinical and objective evaluation of spasticity, Gross Motor Function Measure-66 (GMFM-66), and ultrasound of the affected medial gastrocnemius (MG) muscle were performed. Two children were also tested before and after three months of receiving only standard care (SC). Results: On average 1410 steps/session were logged during 63 days of training. More steps were achieved at home than at a central facility. During training, MG muscle volume increased significantly, while it decreased for SC children. Gait improved qualitatively in all children, and GMFM-66 score improved in four of the five children. Similar improvements were seen among the SC children. Two children had pathologically increased muscle stiffness prior to training, which was reduced during training. Reflex stiffness was unchanged in all five children. Conclusions: This pilot study suggests that intensive gait training may increase muscle volume, improve walking skills and reduce passive muscle stiffness in toddlers with CP.
{"title":"Intensive gait training in toddlers with cerebral palsy: A pilot study","authors":"A. Herskind, M. Willerslev-Olsen, A. Ritterb, Rosenbaum, L. Greve, JakobLorentzen, J. Nielsen","doi":"10.12715/apr.2016.3.8","DOIUrl":"https://doi.org/10.12715/apr.2016.3.8","url":null,"abstract":"Background: Reduced muscle growth may be involved in the development of contractures in children with cerebral palsy (CP). Here, we report data from a pilot study of intensive gait training in CP toddlers. Methods: Five children with CP aged 8-30 months performed activity-based gait training for one hour/day, five days/week for three consecutive months. Included children were diagnosed with spastic CP, had a Gross Motor Function Classification System (GMFCS) score of I–II, and were not epileptic. All children wore pedometers during training. Before and after the training period, kinematic and qualitative gait analysis, clinical and objective evaluation of spasticity, Gross Motor Function Measure-66 (GMFM-66), and ultrasound of the affected medial gastrocnemius (MG) muscle were performed. Two children were also tested before and after three months of receiving only standard care (SC). Results: On average 1410 steps/session were logged during 63 days of training. More steps were achieved at home than at a central facility. During training, MG muscle volume increased significantly, while it decreased for SC children. Gait improved qualitatively in all children, and GMFM-66 score improved in four of the five children. Similar improvements were seen among the SC children. Two children had pathologically increased muscle stiffness prior to training, which was reduced during training. Reflex stiffness was unchanged in all five children. Conclusions: This pilot study suggests that intensive gait training may increase muscle volume, improve walking skills and reduce passive muscle stiffness in toddlers with CP.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66240009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Excessive television viewing has been associated with obesity and greater food intake but research has rarely focused on young children. This study aimed to determine relationships between home television access, dinnertime food consumption and obesity among children aged 3–5 years. Methods: Caregivers of children (n=72) reported: 1) children’s bedroom television access; 2) number of televisions in the home; 3) frequency of child eating dinner in front of the television; 4) presence of television viewable from dining areas; and a three-day dietary recall of child’s dinner food intake. Total kilocalories (kcal), fruit and vegetable servings, and body mass index percentiles (BMI%ile) were calculated. Results: Children were 3.7±0.7 years old, 43% male, 47% white, 26% overweight or obese, and mean BMI%iles were 68.6±28.8. At dinner, children consumed 426±146 kcals, 0.12±0.25 fruit, 0.59±0.59 vegetable, and 0.69±0.58 combined fruit and vegetable. Children without bedroom television’s consumed more vegetables (0.80±0.67 vs. 0.39±0.41; t=3.091, p=0.003) and combined fruit and vegetables (0.90±0.66 vs. 0.5±0.44; t=2.963, p=0.004). Children with ≥3 televisions in the home had higher BMI%iles than those with ≤2 televisions (68.8±27.3 vs. 54.3±29.3; F=4.629, p=0.035). Neither frequency of dining while watching television nor presence of television viewable from dining areas were associated with the BMI%ile. Conclusions: Greater television access in the home, including bedroom televisions and the overall number of televisions, is associated with lower fruit and vegetable intake and higher BMI%ile among young children. This study supports recommendations that children should not have bedroom television access and could help inform future childhood obesity prevention and intervention strategies.
背景:过度看电视与肥胖和更多的食物摄入有关，但研究很少关注幼儿。这项研究旨在确定3-5岁儿童的家庭电视收看、晚餐食物消费和肥胖之间的关系。方法:儿童照顾者(n=72)报告:1)儿童卧室电视接入情况;2)家里电视机的数量;3)孩子在电视机前吃饭的频率;4)从用餐区可以看到电视;并对儿童的晚餐食物摄入量进行为期三天的饮食召回。计算了总千卡(kcal)、水果和蔬菜摄入量以及体重指数百分位数(BMI%ile)。结果:患儿年龄3.7±0.7岁，男性43%，白人47%，超重或肥胖26%，平均BMI%iles为68.6±28.8。晚餐时，儿童摄入426±146千卡，水果0.12±0.25千卡，蔬菜0.59±0.59千卡，水果和蔬菜混合摄入0.69±0.58千卡。无卧室电视的儿童食用蔬菜较多(0.80±0.67 vs. 0.39±0.41);T =3.091, p=0.003)和混合水果和蔬菜(0.90±0.66 vs. 0.5±0.44;t = 2.963, p = 0.004)。家中电视机≥3台的儿童BMI%iles高于家中电视机≤2台的儿童(68.8±27.3 vs. 54.3±29.3;F = 4.629, p = 0.035)。看电视时吃饭的频率和从用餐区看电视都与BMI指数无关。结论:家里有更多的电视，包括卧室的电视和电视机的总数量，与幼儿水果和蔬菜的摄入量较低和较高的BMI%ile有关。这项研究支持了儿童不应该在卧室看电视的建议，并有助于为未来的儿童肥胖预防和干预策略提供信息。
{"title":"Television access, dinnertime food consumption and obesity amongyoung children in Oklahoma","authors":"A. H. Rasbold, S. Sisson, K. Lora, C. M. Mitchell","doi":"10.12715/apr.2016.3.3","DOIUrl":"https://doi.org/10.12715/apr.2016.3.3","url":null,"abstract":"Background: Excessive television viewing has been associated with obesity and greater food intake but research has rarely focused on young children. This study aimed to determine relationships between home television access, dinnertime food consumption and obesity among children aged 3–5 years. Methods: Caregivers of children (n=72) reported: 1) children’s bedroom television access; 2) number of televisions in the home; 3) frequency of child eating dinner in front of the television; 4) presence of television viewable from dining areas; and a three-day dietary recall of child’s dinner food intake. Total kilocalories (kcal), fruit and vegetable servings, and body mass index percentiles (BMI%ile) were calculated. Results: Children were 3.7±0.7 years old, 43% male, 47% white, 26% overweight or obese, and mean BMI%iles were 68.6±28.8. At dinner, children consumed 426±146 kcals, 0.12±0.25 fruit, 0.59±0.59 vegetable, and 0.69±0.58 combined fruit and vegetable. Children without bedroom television’s consumed more vegetables (0.80±0.67 vs. 0.39±0.41; t=3.091, p=0.003) and combined fruit and vegetables (0.90±0.66 vs. 0.5±0.44; t=2.963, p=0.004). Children with ≥3 televisions in the home had higher BMI%iles than those with ≤2 televisions (68.8±27.3 vs. 54.3±29.3; F=4.629, p=0.035). Neither frequency of dining while watching television nor presence of television viewable from dining areas were associated with the BMI%ile. Conclusions: Greater television access in the home, including bedroom televisions and the overall number of televisions, is associated with lower fruit and vegetable intake and higher BMI%ile among young children. This study supports recommendations that children should not have bedroom television access and could help inform future childhood obesity prevention and intervention strategies.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Islam, T. Ahmed, J. Peerson, M. Mollah, MakhdumaKhatun, K. Dewey, K. Brown
Background: Appropriate feeding of infants and young children is necessary to prevent growth faltering and optimize health during the first two years of life. There is little information on the effects of dietary energy density and feeding frequency of complementary foods on food consumption during individual meals and the amount of caregiver time expended in child feeding. Methods: During nine separate, randomly ordered dietary periods lasting 3-6 days each, we measured selfdetermined intakes of semi-solid cereal porridges by 18 healthy, breastfed children 8-11 months of age. The infants were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during three, four, or five meals/day. Complementary food intake was measured by weighing the feeding bowl before and after every meal. Results: Children consumed greater amounts of complementary foods per meal when they received diets with lower energy density and fewer meals per day. Greater time was expended per meal when fewer meals were offered. The time expended per meal did not vary with dietary energy density, but the children ate more and faster for the lower energy density diets. Conclusions: We conclude that the energy density and feeding frequency of complementary foods affect meal-specific food intake. Meal frequency also influences the duration of individual meals, but energy density does not. These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy, and convey information on factors that affect the amount of time that caregivers must devote to child feeding.
{"title":"Energy density and feeding frequency of complementary foods affectsmeal-specific food consumption and meal duration by healthy, breast fedBangladeshi children","authors":"M. Islam, T. Ahmed, J. Peerson, M. Mollah, MakhdumaKhatun, K. Dewey, K. Brown","doi":"10.12715/apr.2016.3.4","DOIUrl":"https://doi.org/10.12715/apr.2016.3.4","url":null,"abstract":"Background: Appropriate feeding of infants and young children is necessary to prevent growth faltering and optimize health during the first two years of life. There is little information on the effects of dietary energy density and feeding frequency of complementary foods on food consumption during individual meals and the amount of caregiver time expended in child feeding. Methods: During nine separate, randomly ordered dietary periods lasting 3-6 days each, we measured selfdetermined intakes of semi-solid cereal porridges by 18 healthy, breastfed children 8-11 months of age. The infants were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during three, four, or five meals/day. Complementary food intake was measured by weighing the feeding bowl before and after every meal. Results: Children consumed greater amounts of complementary foods per meal when they received diets with lower energy density and fewer meals per day. Greater time was expended per meal when fewer meals were offered. The time expended per meal did not vary with dietary energy density, but the children ate more and faster for the lower energy density diets. Conclusions: We conclude that the energy density and feeding frequency of complementary foods affect meal-specific food intake. Meal frequency also influences the duration of individual meals, but energy density does not. These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy, and convey information on factors that affect the amount of time that caregivers must devote to child feeding.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66239718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Friends are important role models for the formation of social norms and behaviour comparisons, particularly in children. This study examined the similarities between pre-adolescent children’s own eating behaviours with the eating behaviours of those in their friendship group. It also evaluated whether symptoms of anxiety and depression were related to eating behaviours in this age group. Methods: Three hundred and forty three children (mean age 8.75 years) completed questionnaires designed to measure dietary restraint, emotional eating and external eating, as well as general and social anxiety, and symptoms of depression. Children also provided details about their friendship groups. Results: Pre-adolescents’ dietary restraint was positively predicted by the dietary restraint of members of their friendship groups, and their individual levels of anxiety and depression. The levels of general anxiety exhibited by pre-adolescents predicted emotional and external eating behaviours. Younger children were significantly more likely to report higher levels of emotional and external eating than older children, and boys were more likely to report more external eating behaviours than girls. Conclusions: These results suggest that greater dieting behaviours in pre-adolescents are related to their friends’ reports of greater dieting behaviours. In contrast, greater levels of eating governed by emotions, and eating in response to external hunger cues, are related to greater symptoms of anxiety in pre-adolescent children. Such findings underline the importance of friends’ social influences on dieting behaviours in this age group and highlight the value of targeting healthy eating and eating disorder prevention interventions at pre-adolescents.
{"title":"Social and individual influences on eating in preadolescents: the role of friends’ eating behaviours and individual anxiety and depression","authors":"L. Houldcroft, E. Haycraft, C. Farrow","doi":"10.12715/APR.2015.2.22","DOIUrl":"https://doi.org/10.12715/APR.2015.2.22","url":null,"abstract":"Background: Friends are important role models for the formation of social norms and behaviour comparisons, particularly in children. This study examined the similarities between pre-adolescent children’s own eating behaviours with the eating behaviours of those in their friendship group. It also evaluated whether symptoms of anxiety and depression were related to eating behaviours in this age group. Methods: Three hundred and forty three children (mean age 8.75 years) completed questionnaires designed to measure dietary restraint, emotional eating and external eating, as well as general and social anxiety, and symptoms of depression. Children also provided details about their friendship groups. Results: Pre-adolescents’ dietary restraint was positively predicted by the dietary restraint of members of their friendship groups, and their individual levels of anxiety and depression. The levels of general anxiety exhibited by pre-adolescents predicted emotional and external eating behaviours. Younger children were significantly more likely to report higher levels of emotional and external eating than older children, and boys were more likely to report more external eating behaviours than girls. Conclusions: These results suggest that greater dieting behaviours in pre-adolescents are related to their friends’ reports of greater dieting behaviours. In contrast, greater levels of eating governed by emotions, and eating in response to external hunger cues, are related to greater symptoms of anxiety in pre-adolescent children. Such findings underline the importance of friends’ social influences on dieting behaviours in this age group and highlight the value of targeting healthy eating and eating disorder prevention interventions at pre-adolescents.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66238634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Leslie, A. Magarey, Tim Olds, J. Ratcliffe, Michelle Jones, L. Cobiac
Background: The Obesity Prevention and Lifestyle (OPAL) intervention program targets families and communities to improve children’s eating and physical activity patterns. We outline the quantitative evaluation design and recruitment results for baseline data collection. Methods: A longitudinal quasi-experimental design, with baseline data collection and five-year follow-up. Participants targeted are children, parents, and school principals/directors from primary, secondary/R-12 schools, pre-schools, childcare and out-of-school-hours-care (OSHC) centers in 20 selected communities across South Australia (SA), and one in the Northern Territory (NT). A total of 277 (262 SA, 15 NT) schools participated; 4860 9-11 year olds and 1164 12-16 year olds completed a questionnaire. Anthropometric measures were taken from 5531 students; 6552 parents, 276 pre/school/childcare directors, 139 OSHC directors and 237 principals completed questionnaires. Data include measurements of child participants’ weight/height/waist circumference; paper-based/online surveys of informants in early childhood, primary/secondary school and community settings; and secondary growth check data for 4-5 year old children. Serial cross-sectional analyses will compare intervention to matched comparison communities. Results: Overall school response rate was 50%. Student response rates were 20-22% and 11-13% (questionnaires and measurements respectively); 14-21% of parents, 49-55% of directors, and 26-44% of principals completed and returned questionnaires. Changes to child weight status; eating practices; sleep, physical activity/sedentary behaviors; physical environments; community capacity; and economic evaluation (Quality Adjusted Life year gain) will examine program effectiveness. Conclusions: As the most significant program of its kind in Australia, OPAL will contribute to obesity prevention efforts on an international scale.
{"title":"Community-based obesity prevention in Australia: Background, methods and recruitment outcomes for the evaluation of the effectiveness of OPAL (Obesity Prevention and Lifestyle)","authors":"E. Leslie, A. Magarey, Tim Olds, J. Ratcliffe, Michelle Jones, L. Cobiac","doi":"10.12715/apr.2015.2.23","DOIUrl":"https://doi.org/10.12715/apr.2015.2.23","url":null,"abstract":"Background: The Obesity Prevention and Lifestyle (OPAL) intervention program targets families and communities to improve children’s eating and physical activity patterns. We outline the quantitative evaluation design and recruitment results for baseline data collection. Methods: A longitudinal quasi-experimental design, with baseline data collection and five-year follow-up. Participants targeted are children, parents, and school principals/directors from primary, secondary/R-12 schools, pre-schools, childcare and out-of-school-hours-care (OSHC) centers in 20 selected communities across South Australia (SA), and one in the Northern Territory (NT). A total of 277 (262 SA, 15 NT) schools participated; 4860 9-11 year olds and 1164 12-16 year olds completed a questionnaire. Anthropometric measures were taken from 5531 students; 6552 parents, 276 pre/school/childcare directors, 139 OSHC directors and 237 principals completed questionnaires. Data include measurements of child participants’ weight/height/waist circumference; paper-based/online surveys of informants in early childhood, primary/secondary school and community settings; and secondary growth check data for 4-5 year old children. Serial cross-sectional analyses will compare intervention to matched comparison communities. Results: Overall school response rate was 50%. Student response rates were 20-22% and 11-13% (questionnaires and measurements respectively); 14-21% of parents, 49-55% of directors, and 26-44% of principals completed and returned questionnaires. Changes to child weight status; eating practices; sleep, physical activity/sedentary behaviors; physical environments; community capacity; and economic evaluation (Quality Adjusted Life year gain) will examine program effectiveness. Conclusions: As the most significant program of its kind in Australia, OPAL will contribute to obesity prevention efforts on an international scale.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66238762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malnutrition is a major problem in many developing countries, including Bangladesh. Chronic malnutrition is a major cause of mortality and morbidity among children under the age of five years. Although Bangladesh has made remarkable progress in reducing mortality in the under-fives, chronic stunting remains a formidable challenge for the country. Based on an analysis of available secondary data, this paper illustrates the current status of chronic stunting in Bangladesh. Data on selected relevant indicators such as gender, urban/rural residence, level of mother’s education, and income by wealth quintiles were extracted from the Bangladesh Health and Demography Surveys from 2004, 2007, and 2011. The data clearly suggest a strong relationship between selected socio-economic variables and stunting among children under the age of five. In rural areas, stunting prevalence rate was found to be more than six times higher than in urban areas. Income inequality was also a significant predictor of stunting. Children from the lowest wealth quintile are twice as likely to be stunted as children from the highest wealth quintile (54% of children under five in the lowest quintile compared to 27% of their counterparts in the highest wealth quintile). Similarly, the level of mother’s education is strongly related to stunting: the higher the level of mothers’ education, the lower the prevalence rate of stunting among children under five. Since wealth or income is a strong predictor of place of residence (urban/rural) as well as mothers’ level of education, it can be generally concluded that inequity is the primary determinant of stunting among children under five. Bangladesh must forcefully address inequity in order to tackle the overwhelming prevalence of stunting among children under five. Despite making impressive gains to improve major health and development indicators at the macro level, Bangladesh has so far failed to adequately address the underlying issue of inequity
{"title":"Chronic stunting among under-5 children in Bangladesh: A situation analysis","authors":"A. Islam, T. Biswas","doi":"10.12715/apr.2015.2.18","DOIUrl":"https://doi.org/10.12715/apr.2015.2.18","url":null,"abstract":"Malnutrition is a major problem in many developing countries, including Bangladesh. Chronic malnutrition is a major cause of mortality and morbidity among children under the age of five years. Although Bangladesh has made remarkable progress in reducing mortality in the under-fives, chronic stunting remains a formidable challenge for the country. Based on an analysis of available secondary data, this paper illustrates the current status of chronic stunting in Bangladesh. Data on selected relevant indicators such as gender, urban/rural residence, level of mother’s education, and income by wealth quintiles were extracted from the Bangladesh Health and Demography Surveys from 2004, 2007, and 2011. The data clearly suggest a strong relationship between selected socio-economic variables and stunting among children under the age of five. In rural areas, stunting prevalence rate was found to be more than six times higher than in urban areas. Income inequality was also a significant predictor of stunting. Children from the lowest wealth quintile are twice as likely to be stunted as children from the highest wealth quintile (54% of children under five in the lowest quintile compared to 27% of their counterparts in the highest wealth quintile). Similarly, the level of mother’s education is strongly related to stunting: the higher the level of mothers’ education, the lower the prevalence rate of stunting among children under five. Since wealth or income is a strong predictor of place of residence (urban/rural) as well as mothers’ level of education, it can be generally concluded that inequity is the primary determinant of stunting among children under five. Bangladesh must forcefully address inequity in order to tackle the overwhelming prevalence of stunting among children under five. Despite making impressive gains to improve major health and development indicators at the macro level, Bangladesh has so far failed to adequately address the underlying issue of inequity","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66238671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Everts, M. Wapp, B. Ritter, W. Perrig, M. Steinlin
Background: Little research has been conducted to assess the effect of using memory training with schoolaged children who were born very preterm. This study aimed to determine whether two types of memory training approaches resulted in an improvement of trained functions and/or a generalization of the training effect to non-trained cognitive domains. Methods: Sixty-eight children born very preterm (7-12 years) were randomly allocated to a group undertaking memory strategy training (n=23), working memory training (n=22), or a waiting control group (n=23). Neuropsychological assessment was performed before and immediately after the training or waiting period, and at a six-month follow-up. Results: In both training groups, significant improvement of different memory domains occurred immediately after training (near transfer). Improvement of non-trained arithmetic performance was observed after strategy training (far transfer). At a six-month follow-up assessment, children in both training groups demonstrated better working memory, and their parents rated their memory functions to be better than controls. Performance level before the training was negatively associated with the training gain. Conclusions: These results highlight the importance of cognitive interventions, in particular the teaching of memory strategies, in very preterm-born children at early school age to strengthen cognitive performance and prevent problems at school.
{"title":"Effects of two different memory training approaches in very preterm-born children","authors":"R. Everts, M. Wapp, B. Ritter, W. Perrig, M. Steinlin","doi":"10.12715/APR.2015.2.13","DOIUrl":"https://doi.org/10.12715/APR.2015.2.13","url":null,"abstract":"Background: Little research has been conducted to assess the effect of using memory training with schoolaged children who were born very preterm. This study aimed to determine whether two types of memory training approaches resulted in an improvement of trained functions and/or a generalization of the training effect to non-trained cognitive domains. Methods: Sixty-eight children born very preterm (7-12 years) were randomly allocated to a group undertaking memory strategy training (n=23), working memory training (n=22), or a waiting control group (n=23). Neuropsychological assessment was performed before and immediately after the training or waiting period, and at a six-month follow-up. Results: In both training groups, significant improvement of different memory domains occurred immediately after training (near transfer). Improvement of non-trained arithmetic performance was observed after strategy training (far transfer). At a six-month follow-up assessment, children in both training groups demonstrated better working memory, and their parents rated their memory functions to be better than controls. Performance level before the training was negatively associated with the training gain. Conclusions: These results highlight the importance of cognitive interventions, in particular the teaching of memory strategies, in very preterm-born children at early school age to strengthen cognitive performance and prevent problems at school.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66237993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ludmila N Bakhireva, Jean R Lowe, Hilda L Gutierrez, Julia M Stephen
Background: While intervention is the leading factor in reducing long-term disabilities in children with fetal alcohol spectrum disorder (FASD), early identification of children affected by prenatal alcohol exposure (PAE) remains challenging. Deficits in higher-order cognitive domains (e.g. executive function) might be more specific to FASD than global neurodevelopmental tests, yet these functions are not developed in very young children. Measures of early sensorimotor development may provide early indications of atypical brain development during the first two years of life.
Methods: This paper describes the novel methodology of the Ethanol, Neurodevelopment, Infant and Child Health (ENRICH) prospective cohort study of 120 maternal-infant pairs with a goal to identify early indices of functional brain impairment associated with PAE. The cohort is established by recruiting women early in pregnancy and classifying them into one of three study groups: patients on opioid-maintenance therapy who consume alcohol during pregnancy (Group 1), patients on opioid-maintenance therapy who abstain from alcohol during pregnancy (Group 2), and healthy controls (Group 3). After the initial prenatal assessment (Visit 1), patients are followed to Visit 2 occurring at delivery, and two comprehensive assessments of children at six (Visit 3) and 20 months (Visit 4) of age. ENRICH recruitment started in November 2013 and 87 women were recruited during the first year. During Year 1, the biospecimen (maternal whole blood, serum, urine, dry blood spots of a newborn) collection rate was 100% at Visit 1, and 97.6% for those who completed Visit 2.
Discussion: The tiered screening approach, evaluation of confounders, neurocognitive and magneto-/electro-encephalography (MEG/EEG) outcomes, and ethical considerations are discussed.
{"title":"Ethanol, Neurodevelopment, Infant and Child Health (ENRICH) prospective cohort: Study design considerations.","authors":"Ludmila N Bakhireva, Jean R Lowe, Hilda L Gutierrez, Julia M Stephen","doi":"10.12715/apr.2015.2.10","DOIUrl":"https://doi.org/10.12715/apr.2015.2.10","url":null,"abstract":"<p><strong>Background: </strong>While intervention is the leading factor in reducing long-term disabilities in children with fetal alcohol spectrum disorder (FASD), early identification of children affected by prenatal alcohol exposure (PAE) remains challenging. Deficits in higher-order cognitive domains (e.g. executive function) might be more specific to FASD than global neurodevelopmental tests, yet these functions are not developed in very young children. Measures of early sensorimotor development may provide early indications of atypical brain development during the first two years of life.</p><p><strong>Methods: </strong>This paper describes the novel methodology of the Ethanol, Neurodevelopment, Infant and Child Health (ENRICH) prospective cohort study of 120 maternal-infant pairs with a goal to identify early indices of functional brain impairment associated with PAE. The cohort is established by recruiting women early in pregnancy and classifying them into one of three study groups: patients on opioid-maintenance therapy who consume alcohol during pregnancy (Group 1), patients on opioid-maintenance therapy who abstain from alcohol during pregnancy (Group 2), and healthy controls (Group 3). After the initial prenatal assessment (Visit 1), patients are followed to Visit 2 occurring at delivery, and two comprehensive assessments of children at six (Visit 3) and 20 months (Visit 4) of age. ENRICH recruitment started in November 2013 and 87 women were recruited during the first year. During Year 1, the biospecimen (maternal whole blood, serum, urine, dry blood spots of a newborn) collection rate was 100% at Visit 1, and 97.6% for those who completed Visit 2.</p><p><strong>Discussion: </strong>The tiered screening approach, evaluation of confounders, neurocognitive and magneto-/electro-encephalography (MEG/EEG) outcomes, and ethical considerations are discussed.</p>","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Pereira, V. D. R. M. França, K. G. Sousa, Marcelo Fern, E. D. Costa
Background: In Brazil, where there are difficulties in accessing health services, the increasing number of comorbidities in preterm survivors diagnosed with bronchopulmonary dysplasia (BPD) necessitate the creation of a tool to effectively evaluate aspects of visual function in a short time. The objective of this study was to develop a simple protocol to evaluate the oculomotor system in newborns with BPD. Methods: Our study compared two groups of preterm-born infants: those who were oxygen-dependent for longer than 28 days were included in the BPD group (BG), while babies given oxygen for a maximum of 10 days were included in the premature group (PG). Exclusion criteria were: babies under mechanical ventilation and/or vasoactive drugs, those with intracranial hemorrhage, retinopathy of prematurity, motor and/or neurological malformation. Assessments were performed while the baby was comfortably seated and evaluated four eye movement types: saccadic movements (SAC), smooth pursuit (SP), vestibulo-ocular reflex (VOR), and optokinetic nystagmus (OKN). Results: Fifty-two infants were evaluated and of these, 22 were included in the BPD group and 30 in the premature group. Birth weight, gestational age and Apgar score at one and five minutes did not differ significantly between the two groups. Infants with BPD demonstrated the absence of three of the four eye movements types; according to a Chi-square test, this was statistically significant when compared with the premature group. Conclusions: The protocol considered in this study was sufficient to evaluate the oculomotor system in newborns diagnosed with BPD. Ocular motility in these infants was found to be impaired when compared to babies without a BPD diagnosis.
{"title":"Early assessment of oculomotor behavior in infants withbronchopulmonarydysplasia: A transversal study","authors":"S. Pereira, V. D. R. M. França, K. G. Sousa, Marcelo Fern, E. D. Costa","doi":"10.12715/apr.2015.2.16","DOIUrl":"https://doi.org/10.12715/apr.2015.2.16","url":null,"abstract":"Background: In Brazil, where there are difficulties in accessing health services, the increasing number of comorbidities in preterm survivors diagnosed with bronchopulmonary dysplasia (BPD) necessitate the creation of a tool to effectively evaluate aspects of visual function in a short time. The objective of this study was to develop a simple protocol to evaluate the oculomotor system in newborns with BPD. Methods: Our study compared two groups of preterm-born infants: those who were oxygen-dependent for longer than 28 days were included in the BPD group (BG), while babies given oxygen for a maximum of 10 days were included in the premature group (PG). Exclusion criteria were: babies under mechanical ventilation and/or vasoactive drugs, those with intracranial hemorrhage, retinopathy of prematurity, motor and/or neurological malformation. Assessments were performed while the baby was comfortably seated and evaluated four eye movement types: saccadic movements (SAC), smooth pursuit (SP), vestibulo-ocular reflex (VOR), and optokinetic nystagmus (OKN). Results: Fifty-two infants were evaluated and of these, 22 were included in the BPD group and 30 in the premature group. Birth weight, gestational age and Apgar score at one and five minutes did not differ significantly between the two groups. Infants with BPD demonstrated the absence of three of the four eye movements types; according to a Chi-square test, this was statistically significant when compared with the premature group. Conclusions: The protocol considered in this study was sufficient to evaluate the oculomotor system in newborns diagnosed with BPD. Ocular motility in these infants was found to be impaired when compared to babies without a BPD diagnosis.","PeriodicalId":72104,"journal":{"name":"Advances in pediatric research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66238128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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