Child health

Our objective was to understand the racial and ethnic variation in parental strain for non-Latino White, African American, and Latino parents of children with ADHD and other comorbid diagnoses. We selected 5,397 children with a current diagnosis of ADHD from the 2007 National Survey of Child Health (NSCH) and identified comorbid conditions that could cause additional parental strain. Multivariate regression analyses of parental strain, from ADHD plus comorbid physical and mental health conditions, varied by race and ethnicity in our sample. Additionally we found variables such as mother's mental health, family structure and social support to play significant roles in parental strain. These findings indicate a need for greater understanding of the family mechanisms in place that affect parental strain for these varying populations of families. Interventions to reduce parental strain also need to be tailored to the specific needs of racially and ethnically diverse parents of children with ADHD.

Indonesia consist of many island inhabited by many ethnic groups with different social economic condition. As in other parts of the world, anemia is still one of the major health problem in Indonesia The reported anemia prevalence differs in each area and age groups, ranging from 5.4% in well nourished preschool children to 56.3% in primary school children; and 19% to 62.5% in pregnant women. The causes of anemia mostly reported were nutritional like iron deficiency, abnormal hemoglobin besides other conditions. In Cipto Mangunkusumo Hospital as the national referral hospital in Indonesia, in the adults groups, the cause of anemia reported were 14% with iron deficiency, 54% aplastic, 16% hemolytic and 16% other causes. Whereas in the child health department the cause were 29% nutritional deficiency, 31% thalassemia, 10% aplastic, 4% hemolytic and 26% other causes. Thalassemia is quite often reported in Indonesia. In 1955 Lie-Injo first reported the HbE as the most frequently found abnormality among many ethnic groups in Indonesia, ranging from 2.5% to 13.2%. In later studies the prevalence reported varies very much. It was reported as 9.5% in newborns, 22% in pregnant women, and 15.95% to 60% in athletes. The carrier frequency in some areas was between 6-10%, while the pattern of mutation varied widely within each region. Hemophilia cases in Indonesia is still not diagnosed adequately, only 530 cases were reported. The problems were lack of diagnostic laboratories and awareness. As many as 56.9% of the hemophilia patients who received cryoprecipitate were reported positive with HCV antibody. Hematological malignancy is now also became an increasing problem in Indonesia, in child health department the prevalence of leukemia was 57%, and lymphoma 13% among other malignancies. In National Cancer hospital, the prevalence leukemia as diagnosed using morphology -and tlowcytometry, were 51.4% AML, 19.7% B-ALL, 14.6% T-ALL, 4.5% preB-ALL, with 9.8% cases with co expression, and 30% other malignancies. Due to geographical situation, economic condition and lack of diagnostic laboratory facility many abnormalities were unable to be diagnosed properly.

Objective: To assess from a societal perspective the incremental cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children. The intervention was modelled on the LEAP (live, eat and play) trial, a randomised controlled trial conducted by the Centre for Community Child Health, Melbourne, Australia in 2002. This study was undertaken as part of the assessing cost-effectiveness (ACE) in obesity project which evaluated, using consistent methods, 13 interventions targeting unhealthy weight gain in children and adolescents. Method: A logic pathway was used to model the effects of the intervention compared to no intervention on body mass index (BMI) and health outcomes (disability-adjusted life years-DALYs). Disease costs and health benefits were tracked until the cohort of eligible children reached the age of 100 years or death. Simulation-modelling techniques were used to present a 95% uncertainty interval around the cost-effectiveness ratio. The intervention was also assessed against a series of filters ('equity', 'strength of evidence', 'acceptability', 'feasibility', sustainability' and 'side-effects') to incorporate additional factors that impact on resource allocation decisions. Results: The intervention, as modelled, reached 9685 children aged 5-9 years with a BMI z-score of !3.0, and cost $AUD6.3M (or $AUD4.8M excluding time costs). It resulted in an incremental saving of 2300 BMI units which translated to 511 DALYs. The cost-offsets stemming from the intervention totalled $AUD3.6M, resulting in a net cost per DALY saved of $AUD4670 (dominated; $0.1M) (dominated means intervention costs more for less effect). Conclusion: Compared to a 'no intervention' control group, the intervention was costeffective under current assumptions, although the uncertainty intervals were wide. A key question related to the long-term sustainability of the small incremental weight loss reported, based on the 9-month follow-up results for LEAP. ß

Background: The International Knee Documentation Committee (IKDC) Subjective Knee Form is a knee-specific measure of symptoms, function, and sports activity. A modified IKDC Subjective Knee Form (pedi-IKDC) has been developed for use in children and adolescents. The purpose of this study was to determine the psychometric characteristics of the pedi-IKDC in children and adolescents with knee disorders.

Have you ever • Disagreed with colleagues over a proposed course of treatment for a child? • Considered ways to ‘bump’ a child up on a waiting list to speed up their assessment? • Wondered how to deal with a family that repeatedly fails to keep clinical appointments?

From the Foreword: “This is a must-have book for everyone who works in the fi eld of clinical childhood disability. There is something for all clinicians, therapists, nurses, and doctors whether in training or established in clinical practice for many years. This book ‘works’ because it is full of real stories of the situations we will all recognise from our own practice, written and edited by internationally renowned and respected clinicians and others with direct experience, who share their ‘workings out’ of the ethical issues discussed.” Dr Karen Horridge, Chair, British Academy of Childhood Disability

Published by Mac Keith Press 2016

Objectives-Self-versus proxy-perspectives may produce different results that are important for clinical decision-making and for assessing outcomes in research studies. We examined differences in child versus parent-report of the child's health-related quality of life (HRQOL) in a large prospective, community-based study of newly diagnosed childhood epilepsy that included children with epilepsy (case) and sibling controls.

Issue addressed: Children’s fruit and vegetable (FV) consumption in Australia is below levels recommended for optimal growth, development and health.

Methods: ‘Kids in the Kitchen’ is a classroom-based program that engages students in preparing FV. Impact evaluation was conducted with students from Grade 1 (around 6 years old) and Grade 5 (around 11 years old) who participated in the program. A questionnaire was used to collect pre- and post-program data on knowledge, attitudes and consumption of FV, FV preparation skills and environmental supports for FV consumption. A skill audit was also conducted for Grade 1 students.

Results: Study participants (n = 118) included 70 Grade 1 and 48 Grade 5 students. There was an increase in the median number of fruits correctly identified (from 14 to 16), tried (from 14 to 16) and liked (from 10.5 to 12; P = 0.0001 for all changes). The median number of vegetables correctly identified increased from 10 to 12 (P = 0.0001), but there was no change in the number of vegetables tried or liked. The proportion of participants who rated their skills in using a knife to prepare FV as ‘not really that good’ decreased by 15%, from 42% to 27% (P = 0.04). Grade 1 participants’ skills in cutting, grating and peeling improved (P = 0.0001 for all changes).

Conclusions: If children are involved in the preparation of FV, they are more likely to correctly identify them, try them, like them and eat them.

So what?: Primary schools have the potential to contribute to children’s nutrition through hands-on food preparation activities.

Key words: children, food preparation, fruit, health promotion, school, skills, vegetable.

Food insecurity, the lack of consistent access to sufficient quality and quantity of food, affects an estimated 800 million people around the world. Although household food insecurity is generally associated with poor child nutrition and health in the USA, we know less about household food insecurity and child health in developing countries. Particularly lacking is research assessing how associations between household food insecurity and children's health outcomes may differ by child age and among children beyond age 5 years in low-income settings. We use data from a population-based sample of households with children ages 3–11 years (N = 431) in León, Nicaragua to consider how household food insecurity is associated with three measures of child health: illness, anaemia and low height-forage. Our results provide new evidence that even mild household food insecurity is detrimental to children's health; and that child age conditions the associations between household food insecurity and child health. We find that food insecurity is especially harmful to health during early childhood, but continues to have significant associations with health into middle childhood (up to ages 7–8 years). We discuss the potential implications of these results for future child health research and policies in low-income countries.

Hunger, with its adverse consequences for children, continues to be an important national problem. Previous studies that document the deleterious effects of hunger among children cannot distinguish child from family hunger and do not take into account some critical environmental, maternal, and child variables that may influence child outcomes. This study examines the independent contribution of child hunger on children's physical and mental health and academic functioning, when controlling for a range of environmental, maternal, and child factors that have also been associated with poor outcomes among children. With the use of standardized tools, comprehensive demographic, psychosocial, and health data were collected in Worcester, Massachusetts, from homeless and low-income housed mothers and their children (180 preschool-aged children and 228 school-aged children). Mothers and children were part of a larger unmatched case-control study of homelessness among female-headed households. Hunger was measured by a set of 7 dichotomous items, each asking the mother whether she has or her children have experienced a particular aspect of hunger during the past year--1 concerns food insecurity for the entire family, 2 concern adult hunger, and 4 involve child hunger. The items, taken from the Childhood Hunger Identification Project measure, are summed to classify the family and divided into 3 categories: no hunger, adult or moderate child hunger, or severe child hunger (indicating multiple signs of child hunger). Outcome measures included children's chronic health condition count using questions adapted from the National Health Interview Survey, Child Health Supplement, and internalizing behavior problems and anxiety/depression, measured by the Child Behavior Checklist. Additional covariates included demographic variables (ie, age, gender, ethnicity, housing status, number of moves, family size, income), low birth weight, child life events (ie, care and protection order, out of home placement, abuse, severe life events count), developmental problems (ie, developmental delay, learning disability, emotional problems), and mother's distress and psychiatric illness. Multivariate regression analyses examined the effect of child hunger on physical and mental health outcomes. The average family size for both preschoolers and school-aged children was 3; about one third of both groups were white and 40% Puerto Rican. The average income of families was approximately $11 000. Among the school-aged children, on average 10 years old, 50% experienced moderate child hunger and 16% severe child hunger. Compared with those with no hunger, school-aged children with severe hunger were more likely to be homeless (56% vs 29%), have low birth weights (23% vs 6%), and have more stressful life events (9 vs 6) when compared with those with no hunger. School-aged children with severe hunger scores had parent-reported anxiety scores that were more than double the scores for children with no hunger and significantly higher chronic illness counts (3.4 vs 1.8) and internalizing behavior problems when compared with children with no hunger. There was no relationship between hunger and academic achievement. Among preschool-aged children, who averaged 4 years of age, 51% experienced moderate child hunger and 8% severe child hunger. For preschoolers, compared with children with no hunger, severe hunger was associated with homelessness (75% vs 48%), more traumatic life events (8.5 vs 6), low birth weight (23% vs 6%), and higher levels of chronic illness and internalizing behavior problems. Mothers of both preschoolers and school-aged children who reported severe hunger were more likely to have a lifetime diagnosis of posttraumatic stress disorder. For school-aged children, severe hunger was a significant predictor of chronic illness after controlling for housing status, mother's distress, low birth weight, and child live events. For preschoolers, moderate hunger was a significant predictor of health conditions while controlling for potenns while controlling for potential explanatory factors. For both preschoolers and school-aged children, severe child hunger was associated with higher levels of internalizing behavior problems. After controlling for housing status,…

Infant mortality rate (IMR) is an important indicator of progress toward health equity and socioeconomic development. Despite progress, the US is ranked 45th among 192 countries in IMR, with non-Hispanic black IMR 2.2 times that of non-Hispanic white rates, and higher than average IMR in Native American populations. The Preconception Peer Educators (PPE) program of the U.S. DHHS Office of Minority Health Resource Center (OMHRC) aims to raise awareness about IMR disparities in African Americans, and to promote preconception health behaviors among women of childbearing age and sexually active men. Building upon this program, this report focuses on lessons learned from a capacity-building and participatory planning pilot program designed and implemented in 4 US cities by Health Equity Initiative in collaboration with the OMHRC to encourage multisectoral partnerships, and engage local leaders and organizations in participatory planning and infant mortality prevention.

Reference:  Schiavo, Renata; Estrada-Portales, Isabel; Hoeppner, Elena; Ormaza, Denisse; and Ramesh, Radhika (2016) "Building Community-Campus Partnerships to Prevent Infant Mortality: Lessons Learned from Building Capacity in Four US Cities," Journal of Health Disparities Research and Practice: Vol. 9: Iss. 3, Article 5.
Available at: http://digitalscholarship.unlv.edu/jhdrp/vol9/iss3/5

To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. Methods: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to HFAK and control groups, interviewed mothers at baseline, and followed families until children were 2 years old (85% follow-up). Child outcomes included health care use, development and behavior. Parent outcomes included knowledge of infant development, parenting attitudes, quality of the home environment, and parent-child interaction. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure knowledge, perceived effectiveness and perceived training adequacy. Results: There was no overall impact on child health, but HFAK group children had more favorable developmental and behavioral outcomes. HFAK and control mothers had similar parenting outcomes except that HFAK mothers had greater parenting self-efficacy (35.1 vs. 34.6 based on the Teti Self-Efficacy Scale, p < .05). Fewer HFAK families had a poor home environment for learning (20% vs. 31%, p < .001). HFAK families were more likely to use center-based parenting services (48% vs. 39%, p < .05). The impact was greater for families with lower baseline risk (Family Stress Checklist scores < 45). There was little evidence of efficacy for families with a higher dose of service.

‫في‬ ‫بصحتهم‬ ‫املرتبطة‬ ‫األطفال‬ ‫حياة‬ ‫نوعية‬ ‫تقييم‬ ‫هو‬ ‫هدفنا‬ :‫األهداف‬ ‫يعانون‬ ‫الذين‬ ‫أولئك‬ ‫باستثناء‬ ،‫السعودية‬ ‫العربية‬ ‫اململكة‬-‫بجدة‬ ‫املجتمع‬ .‫معروفة‬ ‫مزمنة‬ ‫أمراض‬ ‫من‬ ‫التي‬ ،‫املستعرضة‬ ‫الدراسة‬ ‫هذه‬ ‫في‬ ‫جدة‬ ‫في‬ ‫مدارس‬ 4 ‫شاركت‬ :‫املنهجية‬ ‫األطفال‬ ‫آباء‬ ‫استطالع‬ ‫مت‬ ‫حيث‬ .‫9102م‬ ‫فبراير‬ ‫إلى‬ ‫8102م‬ ‫فبراير‬ ‫من‬ ‫أجريت‬ ‫التي‬ ‫العربية‬ ‫النسخة‬ ‫باستخدام‬ ‫ا‬ ً ‫عام‬ 14 ‫إلى‬ 5 ‫بني‬ ‫أعمارهم‬ ‫تتراوح‬ ‫الذين‬ CHQ-PF(‫الوالدين‬ ‫منوذج‬-‫الطفل‬ ‫صحة‬ ‫استبيان‬ ‫من‬ ‫منها‬ ‫التحقق‬ ‫مت‬ ‫عشر‬ ‫وأحد‬ ‫ا‬ ً ‫مقياس‬ 15 ‫على‬ ‫ا‬ ً ‫مقسوم‬ ‫ا‬ ً ‫عنصر‬ 50 ‫من‬ ‫يتألف‬ ‫وهو‬ .)50 ‫قيمتها‬ ‫عن‬ ‫التعبير‬ ‫ومت‬ ‫العنصر‬ ‫أحادية‬ ‫نطاقات‬ ‫وأربع‬ ‫العناصر‬ ‫متعدد‬ ‫ا‬ ً ‫مقياس‬ ‫نوعية‬ ‫أفضلية‬ ‫إلى‬ ‫يشير‬ ‫الدرجات‬ ‫ارتفاع‬ ‫أن‬ ‫حيث‬ ،)0-100(‫كالتالي‬ .‫ومقارنتها‬ ‫العناصر‬ ‫هذه‬ ‫حتليل‬ ‫مت‬ ‫وقد‬ .‫بالصحة‬ ‫املرتبطة‬ ‫احلياة‬ ‫النقاط‬ ‫متوسطات‬ ‫كانت‬ .‫االستبيان‬ ‫على‬ ً ‫طفال‬ 498 ‫آباء‬ ‫أجاب‬ :‫النتائج‬ ‫من‬ ‫ثمان‬ ‫في‬)80 ‫من‬ ‫(أعلى‬ ‫ا‬ ً ‫نسبي‬ ‫مرتفعة‬ CHQ-PF50 ‫الفرعية‬ ‫في‬ ‫ا‬ ً ‫نسبي‬ ‫منخفضة‬ ‫درجات‬ ‫لوحظت‬ ‫بينما‬ ،‫عشر‬ ‫ـخمسة‬ ‫ال‬ ‫املجاالت‬ ‫العقلية‬ ‫والصحة‬)73.70(‫والسلوك‬)70.01(‫للصحة‬ ‫العام‬ ‫اإلدراك‬ = ‫الفرق‬ ‫(متوسط‬ ‫السلوك‬ ‫في‬ ‫أقل‬ ‫درجة‬ ‫األوالد‬ ‫سجل‬ .)75.65(‫اإلدراك‬ ،)-4.81(‫العقلية‬ ‫الصحة‬ ،)-4.47(‫العاملي‬ ‫السلوك‬ ،)-5.80 ‫األنشطة‬ ،)-5.11(‫العاطفي‬-‫األبوي‬ ‫التأثير‬ ،)-2.59(‫للصحة‬ ‫العام‬ ‫األوالد‬ ‫أظهر‬ ‫كما‬ .)-2.19(‫العائلي‬ ‫والتماسك‬ ،)-1.77(‫العائلية‬ ‫العاملي‬ ‫والسلوك‬ ‫العقلية‬ ‫والصحة‬ ‫العامة‬ ‫الصحة‬ ‫في‬ ‫أقل‬ ‫درجات‬ ‫املراهقون‬ .‫الوالدين‬ ‫وتأثير‬ ‫حياة‬ ‫لنوعية‬ ‫عام‬ ‫بشكل‬ ‫مرضية‬ ‫درجات‬ ‫الدراسة‬ ‫هذه‬ ‫أظهرت‬ :‫اخلالصة‬ ‫يتعلق‬ ‫فيما‬ ‫التحذيرات‬ ‫بعض‬ ‫مع‬ ،‫بصحتهم‬ ‫املرتبطة‬ ‫السعوديني‬ ‫األطفال‬ ‫فإن‬ ‫كذلك‬ .‫واملراهقني‬ ‫األوالد‬ ‫في‬ ‫وخاصة‬ ‫العقلية‬ ‫والصحة‬ ‫بالسلوك‬ ‫األبعاد‬ ‫ببعض‬ ‫يتعلق‬ ‫فيما‬ ‫خاصة‬ ‫فيها‬ ‫مشكوك‬ CHQ-PF50 ‫موثوقية‬ .‫املراهقني‬ ‫ولألطفال‬ Objectives: To assess the health-related quality of life (HRQOL) of children from a community in Jeddah, Saudi Arabia, excluding those with known chronic illnesses.

To: 1) review the historical contexts and current profiles of father involvement in African American families; 2) identify barriers to, and supports of, involvement; 3) evaluate the effectiveness of father involvement programs; and 4) recommend directions for future research, programs, and public policies. Review of observational and interventional studies on father involvement. Several historical developments (slavery, declining employment for Black men and increasing workforce participation for Black women, and welfare policies that favored single mothers) led to father absence from African American families. Today, more than two thirds of Black infants are born to unmarried mothers. Even if unmarried fathers are actively involved initially, their involvement over time declines. We identified multiple barriers to, and supports of, father involvement at multiple levels. These levels include intrapersonal (eg, human capital, attitudes and beliefs about parenting), interpersonal (eg,...