Average Age Of Parents Research Articles

Problems of organization of medical and social care for children with bronchopulmonary dysplasia.

Background: Bronchopulmonary dysplasia is a controversial disease of premature infants, manifested by shortness of breath, recurrent pneumonia and bronchitis. In Kazakhstan, as well as throughout the world, in recent years, bronchial dysplasia is increasingly common in children. However, the problems of bronchopulmonary dysplasia in Kazakhstan are not fully understood. This study will focus on monitoring the medical and social care provided to children with bronchopulmonary dysplasia and their families in Almaty. Methods: The study involved 34 children with bronchopulmonary dysplasia and their families and 64 children without bronchopulmonary dysplasia and their families. The research was carried out using a specially developed questionnaire. Results: The average age of parents of children with BPD was higher than in the control group. It turned out that 52.9% of fathers and 5.9% of mothers of sick children smoke. Families with two or three children were more common (p=0.011). The share of families with disabled children was 17.6%. Despite this, the monthly income of families is low. The main reason for bad family relations is the child's illness (29.4%). After the birth of a child, only 29.4% of mothers worked in a profession, while the majority of mothers were engaged in household chores (64.7%). 47.1% of fathers had a job; 5.9% were unemployed. It turned out that the parents have good potential to rehabilitate the sick child, but they cannot get all the necessary medical services in the clinic. It turned out that only 17.6% of clinics have pulmonologists, despite the fact that sick children need regular follow-up by a pulmonologist. Conclusion: The data obtained made it possible to identify the necessary medical and social problems for children with BPD. It is clear that such children and their families need government support. Keywords: Bronchopulmonary dysplasia, Premature birth, Medical and social care, Family.

Paternal age in rhesus macaques is positively associated with germline mutation accumulation but not with measures of offspring sociability.

Mutation is the ultimate source of all genetic novelty and the cause of heritable genetic disorders. Mutational burden has been linked to complex disease, including neurodevelopmental disorders such as schizophrenia and autism. The rate of mutation is a fundamental genomic parameter and direct estimates of this parameter have been enabled by accurate comparisons of whole-genome sequences between parents and offspring. Studies in humans have revealed that the paternal age at conception explains most of the variation in mutation rate: Each additional year of paternal age in humans leads to approximately 1.5 additional inherited mutations. Here, we present an estimate of the de novo mutation rate in the rhesus macaque (Macaca mulatta) using whole-genome sequence data from 32 individuals in four large pedigrees. We estimated an average mutation rate of 0.58 × 10−8 per base pair per generation (at an average parental age of 7.5 yr), much lower than found in direct estimates from great apes. As in humans, older macaque fathers transmit more mutations to their offspring, increasing the per generation mutation rate by 4.27 × 10−10 per base pair per year. We found that the rate of mutation accumulation after puberty is similar between macaques and humans, but that a smaller number of mutations accumulate before puberty in macaques. We additionally investigated the role of paternal age on offspring sociability, a proxy for normal neurodevelopment, by studying 203 male macaques in large social groups.

Potential conflict between the rights of the child and parental expectations in traditional child-rearing patterns: Resolving the tension

This paper aimed to ascertain whether the rights of the child conflict with traditional child-rearing patterns in rural and urban Ghana among 60 participants. Qualitative exploratory study was undertaken using semi-structured interviews with parents of children who both were and were not involved in child labour (10), and stakeholders, including government officials and NGO representatives (10); focus groups (30); and participant observation techniques (10) in order to gather the needed data. Participants were purposively sampled across rural areas (Ankaase, Anwiankwanta and Kensere), and urban areas (Jamestown, Korle Gonno and Chorkor) in Ghana. The average age of parents interviewed was 31 years. Interviews were recorded and transcribed, and a framework approach was used as the main data analysis method. The discussion shows that inconsistencies between parental expectations in traditional child-rearing patterns and participation rights as expressed in Article 3 (1) of the United Nations Convention on the Rights of the Child (UNCRC) are reconcilable and provides a genuine prospect for reform.

An empirical estimate of the generation time of mouse lemurs.

The generation time of organisms drives the rate of change in populations and across evolutionary times. In long-lived species, generation time should also account for overlapping generations, and the average age of parents has been proposed as a best approximation under these conditions. This study uses this definition to estimate the generation time of a widely studied small primate, Microcebus murinus, based on parentage data generated for a free-living population over a 6-year period in northwestern Madagascar. The average age of parents was calculated separately for mothers and fathers of three different offspring cohorts that differed in the degree of demographic uncertainty. In addition, adult survival rates were calculated for males and females based on long-term capture data from the same population to estimate the possible upper limits of generation time. Adult survival was low with only 44% of adult females and 38% of adult males being recaptured at the beginning of their second breeding season. The average age of mothers was 1.56-1.91 years, pointing toward a 2-year female generation time due to the high proportion of 1-year old mothers in all three cohorts. Female generation time estimates were fairly stable across the three offspring cohorts. In contrast, the average age of fathers differed by more than 1 year from the first to the third offspring cohort (1.71-2.83 years) pointing toward a 3-year generation time, but also suggesting a higher degree of demographic uncertainty in the early years of the study. For future modeling purposes, we, therefore, propose to use the average, 2.5 years, of male and female values as new estimate for the generation time of mouse lemurs.

Mutation accumulation is still potentially problematic, despite declining paternal age: a comment on Arslan et al. (2017).

Arslan et al . [1] found that paternal age negatively predicts offspring survival and reproductive success in four Western populations (three ‘historical’ and one ‘modern’, i.e. from the twentieth century) even after implementing controls for relevant covariates. The authors believe that this finding indicates that ‘purifying selection is still effective’ in at least one modernized population, and conclude that they ‘do not predict that contemporary reproductive timing will lead to unprecedented or unbearable de novo mutation loads and concomitant changes in the prevalence of genetic disorders' (p. 8), especially in light of the observation that average parental age has decreased over time, diminishing the number of deleterious de novo mutations added to the genomes of each new generation. We contend that negative selection acting on the relative fitness costs of mutations may be insufficient to prevent mutation accumulation in modernized populations and that the possibility of problematic increases in mutation load ought to be reconsidered. Simulations indicate that considerably less reproductive failure (possibly as little as 20% per generation [2]) is needed to remove variants from populations under the assumption of selection based on relative fitness differentials (i.e. where the fitness costs of a given variant are estimated relative to the fitness of other genomes with different mutation loads) compared to absolute fitness differentials (i.e. where the fitness costs are estimated relative to a hypothetical mutation-free genome). On the assumption of absolute fitness differentials and given observed human de novo mutation rates, 88% of individuals must fail to reproduce, and an average fertility rate of 16 babies per woman in the reproducing fraction is required to purify a population of deleterious variants. This yields the mutation load paradox , or the incongruity between the high reproductive failure rate apparently required for population purification and the low …

Comparison of Health Care Expenditure Patterns between Various Income Deciles: Iran Urban Households (2009–2014)

Abstract This study estimates and compares healthcare expenditure patterns of different income deciles of urban households by ordinary least square (OLS) method. Data is obtained from houshold survey data and includes healthcare expenditure, family income, the education level of parents, number of children and the average age of parents during 2009-2014. The purpose is to identify the effectiveness of each variable on healthcare expenditure between different income deciles. Moreover, it will be examined that if there is any significant difference between effects of variables on healthcare expenditure in different income deciles. The results indicate that the pattern of healthcare expenditure varies between different income deciles. The first and second deciles show a similar pattern and the level of education of parents doesn’t have any significant effect on the healthcare expenditure. In these deciles, a percent increase in family income, increases the healthcare expenditure less than 1 percent. In addition, other variables except than the education level have a positive effect on the healthcare expenditure. On the other hand, almost the same pattern is observed in other income deciles as well. Thus, family income, the average age of parents and number of children demonstrated a positive effect on healthcare expenditure and the education level of parents showed a negative effect. This finding seems to be related to the preventive effects of education. What’s more is that in the ninth and tenth deciles, a percent increase in family income, leads to more than 1 percent increase in healthcare expenditure. Therefore, the most prominent suggestion to healthcare authorities is to improve the level of awareness of family. And also, this instruction can be categorize base on the average age of parents. This could be done through government agencies or insurance authorities.

Parents Perceptions and Practices as Regards Adolescents Adolescents Sex Education in the Home Environment in the City of Come, Benin in 2015

Introduction: Adolescence is a period of life during which physiological and anatomical changes which influence the individual’s personality occur. Objective: To study parents’ perceptions and practices as regards adolescents’ sex education in the home environment in 2015. Methodology: It was an analytical and descriptive cross-sectional study with a prospective data collection from 6 to 13 October 2015 from households of the city of Come in Benin. It was a random sampling in accordance with the two-stage cluster sampling technique. Results: In total, 576 fathers or mothers were involved in the survey. The average age of parents was 44 years ±13 years old with extremes of 23 and 90 years. On the whole, for 90.8% of the surveyed parents, adolescents’ sex education was necessary, and this opinion was more especially expressed by christian parents. Furthermore, 55.0% of the surveyed parents agreed that it was their duty to provide their children with sex education. The female sex (0.021), university education (0.038), permissive parenting style (0.09), christian religion (0.026), the very practicing (0.022) took part in the adolescents’ sex education. Among the subjects covered, women mostly tend to discuss themes related to pregnancy-contraception-the adolescent’s desire (p=0.005), personal experiences (p<0.001) with adolescents rather than men. Conclusion: Parents’ involvement remains a necessity in adolescents’ sex education

Estimation of genetic parameters for growth-related traits and evaluating the results of a 27-year selection program in Baluchi sheep

The aim of the present study was to estimate (co) variance components and genetic parameters for growth traits of Baluchi sheep as well as to study the response of Baluchi sheep to selection for yearling live weight. Data and pedigree information used in this study were collected at the Abbasabad Sheep Breeding Station from 1983 to 2011. Studied traits were birth weight (BW), 3-month weight (W3), 6-month weight (W6), 9-month weight (W9) and yearling weight (W12). Six different animal models were fitted, including or ignoring maternal effects. Estimates of breeding values were obtained by the best linear unbiased prediction (BLUP) method. Genetic trends of studied traits were estimated by regressing mean of breeding values on birth year. On the four gametic pathways, generation intervals were estimated as the average age of parents at the birth of their progeny. The estimates of direct heritability (h2) for traits studied were low and ranged between 0.03 (W6) and 0.15 (W12). Maternal genetic and environmental effects were significant on traits studied. Maternal heritability m2) was 0.09 at birth but decreased gradually and reached 0.02 at yearling age. Likewise, maternal permanent environment variance as a proportion of phenotypic variance (c2) decreased from 0.13 at birth to 0.05 at yearling age. Phenotypic correlations between various traits were positive and increased with older pairs of ages. The corresponding direct genetic correlations were all positive, with a tendency for higher estimates between pairs of older ages. Genetic changes over the experiment were −0.13kg, 0.192kg, 0.082kg, 0.147kg and 0.459kg for BW, WW, W6, W9 and W12, respectively. Annual genetic gain for BW, WW, W6, W9 and W12 were, respectively, ≈0.00g, 7g, 4g, 7g and 14g per year. The average generation interval was 3.50 years. The lower generation interval was observed on the ram side compared with the dam side (3.35 year vs. 3.81 year), indicating faster generation turnover for sires than for dams. Overall, results showed a moderate genetic improvement in growth traits of Baluchi sheep. In addition, because of significant maternal effects on growth-related traits of Baluchi sheep, to have an accurate genetic evaluation, these effects need to be considered in any breeding program aimed at improving growth traits of this breed.

Population structure and genealogical analysis of the Brazilian Crioula Horse

A genealogical analysis of Crioula horses registered by the Brazilian Association of Crioula Horse Breeders was performed. The state of Rio Grande do Sul is the largest producer of animals with 89.85 percent of registered animals, of which 45.29 percent were males and 54.71 percent females. The inbreeding coefficient was calculated at 0.88 percent and the average relatedness was 0.65 percent in the total population (animals born in Brazil and imported). Inbreeding increased over the generations. An increase was seen in the average genetic conservation index in animals born after the year 1927 (0) until 2010 (8.67 percent). The average generation interval was 10.3 years and the average age of parents when offspring born were 10.5 years, falling in recent years. The effective population size of founders was 95.19 animals, the number of ancestors contributing to this population was 5086 where 56 ancestors explained 50 percent of the genetic diversity of the breed. Inbreeding is under control in the Crioula horse. The increase in registrations reflects the increased interest from farmers in this breed.

Generation length for mammals

Generation length (GL) is defined as the average age of parents of the current cohort, reflecting the turnover rate of breeding individuals in a population. GL is a fundamental piece of information for population ecology as well as for measuring species threat status (e.g. in the IUCN Red List). Here we present a dataset including GL records for all extant mammal species (n=5427). We first reviewed all data on GL published in the IUCN Red List database. We then calculated a value for species with available reproductive parameters (reproductive life span and age at first reproduction). We assigned to missing-data species a mean GL value from congeneric or confamilial species (depending on data availability). Finally, for a few remaining species, we assigned mean GL values from species with similar body mass and belonging to the same order. Our work provides the first attempt to complete a database of GL for mammals; it will be an essential reference point for all conservation-related studies that need pragmatic information on species GL, such as population dynamics and applications of the IUCN Red List assessment.

Ano imperforado. Enfoque clínico-epidemiológico

Introduction. Ano-rectal malformations are among the most common defects in clinical practice. Unfortunately we do not know how many new cases occur each year in our country. The aim of this study is to show a clinical-epidemiological aspect of the problem. Material and methods. It is a retrospective study over a period of three years in which we studied 72 charts. We analyzed universal variables such as sex, age, prenatal control, birth weight etc. There were 42 (58.3%) males, and 30 females (41.8%). Their age ranged from one to eight days, the mean birth weight was 2,827 grams, the average age of parents was 23.4 and 25.3 years. Results. Fourty two (58.3%) patients required colostomy; only 17 had an associated malformation. There were three deaths. Conclusions. Anorectal malformations are severe and common defects. We propose that a national registry should be mandatory.

Pedigree analysis of an ostrich breeding flock

Pedigree records, maintained from 1978 to 2005 at the Oudtshoorn Research Farm, South Africa, of 40 074 birds of a pair-breeding ostrich flock were used to estimate the effective number of founders (fe), the effective number of ancestors (fa), the effective population size and the effective genome equivalents (fg) under random mating, to assess the genetic variability present in the population. The average level of completeness of the pedigrees was high (99.3%) in the first generation, and the average level of inbreeding (F), calculated from the pedigrees, was 0.51%. The reference population was defined as the 39 784 birds hatched from 1990 to 2005. The estimated measures of variability were fg = 47.3, fe = 59 and fa = 58, with an fe/fa ratio of 1.02. The numbers of ancestors responsible for 100%, 50% and 20% of the genes in the reference population were 254, 21 and 6, respectively. The largest individual contribution to the population hatched from 1990 to 2005 was from a male that was responsible for 4.85% of the genetic variability. The generation interval for the four selection pathways – calculated as the average age of parents when offspring that were kept for reproduction were born – were sire to son (7.74 ± 4.92), sire to daughter (7.77 ± 5.13), dam to son (7.50 ± 4.29) and dam to daughter (7.90 ± 4.92). The average generation interval of the reference population was 7.72 ± 4.79 years. The linear regressions of mean annual individual rate of inbreeding on year of birth for the two distinct periods 1995–2002 and 2003–2005 were 0.08% and -0.07% per year, respectively. The estimate of effective population size (Ne), computed via the increase in the individual rate of inbreeding, was 112.7. Estimates of Ne using the alternative methods of tracing the numbers of generations were 73.6, 177.4 and 95.3 for complete, maximum and equivalent complete generations. The results of this study indicated that the population under study was at an acceptable level of genetic variability. Keywords: Effective number of founders and ancestors, effective population size, level and rate of inbreeding.

The relationship between gender and age of first concern in toddlers with autism spectrum disorders

The age at which parents first developed concerns over their child's development was examined in 965 toddlers with autism spectrum disorders (ASD) and atypical development to examine the potential role of gender. A two-way analysis of covariance was conducted with gender and diagnosis entered as independent variables, age at assessment entered as a covariate, and age of parents’ first concerns entered as the dependent variable. The average age of parents’ first concerns was significantly younger for females when compared to males. Additionally, the age of parents’ first concerns was significantly younger for toddlers with ASD when compared to toddlers with atypical development. No significant interaction was found. Possible explanations for the results and their implications are discussed.

Anterior encephaloceles in children of Assamese tea workers

Anterior encephaloceles are rare congenital malformations. Most of the cases in the literature are reported from Southeast Asia. In India it is seen more frequently among manual laborers in the tea gardens of Assam. A brief background of the patients, clinical presentation, operative treatment, and outcome are discussed, with a review of the relevant literature. The causes and pathogenesis of anterior encephaloceles are discussed. The authors' surgical approach to repair of the defect, postoperative complications, and results are described. Twenty-eight patients (mean age 38 months, range 1 month-12 years) with anterior encephaloceles who presented between 1998 and 2007 are included in the study. Patients were assessed for physical and psychological growth and development; any associated anomalies were noted. A detailed history of the patient's family, including the prenatal history, was obtained. Lesions were classified with the help of neuroimaging studies (skull x-ray, CT, ultrasonography, and MR imaging studies) and confirmed at surgery. Sixteen patients had nasofrontal, 9 had nasoethmoidal, and 3 had nasoorbital encephaloceles, and 12 patients had associated hydrocephalus. The modes of presentation were nasofrontal swelling, watering from the eyes, CSF leakage, fever, and vomiting. Parents of all the patients were ethnic tea garden workers. The average parental age at the time of marriage was 24 years for men and 18 years for women. Consanguinity was present in 6 patients. Alcohol consumption and tobacco chewing were a common practice in both parents. A total of 42 surgical procedures were done in 16 patients, one of whom died of postoperative meningitis. The mean follow-up duration was 38 months (1-92 months). Anterior encephaloceles are rare in Western countries and other states in India, but this defect is more commonly seen among the ethnic tea garden workers in Assam. Transcranial repair is the treatment of choice. Unlike encephaloceles in other locations, anterior encephaloceles have a better clinical outcome after surgery.

Short-term selection for yearling weight in a small-experimental Iranian Afshari sheep flock

A selection experiment was initiated in 2000 in an Afshari sheep flock at the department of animal breeding and genetics of the University of Zanjan, Iran. The aim was to evaluate the response of Afshari sheep to selection for yearling live weight. Here, we evaluate the results of this breeding program obtained between 2000 and 2005. Traits studied were birth weight (BW), weaning weight (WW), yearling weight (YW), average daily gain from birth to weaning (WWDG) and average daily gain from weaning to yearling age (YWDG). Mixed model methodology based on a multi-trait animal model was employed to estimate (co)variance components and corresponding genetic parameters. Estimates of breeding values were obtained by the best linear unbiased prediction (BLUP) method. Generation intervals on the four genetic pathways were estimated as the average age of parents at the birth of their progeny kept for reproduction. The heritability estimates were 0.34, 0.27, 0.14, 0.20 and 0.01 for BW, WW, YW, WWDG and YWDG, respectively. Estimates of genetic correlations among traits studied were positive, and ranged from low (0.07, YW/WWDG) to high (0.76, YW/YWDG). Genetic improvements over the experiment based on estimated breeding values were 0.104, 0.824, 1.247, 0.005 and ≈0.00 kg for BW, WW, YW, WWDG and YWDG, respectively. Annual genetic gain for YW was relatively high, 0.311 kg yr-1, which demonstrated the effectiveness of the implemented breeding program. Correlated responses in BW, WW, WWDG and YWDG were 0.021, 0.167, 0.001 and ≈0.00 kg yr-1, respectively. Estimates of heritabilities and observed genetic trends indicated that selective breeding can lead to significant genetic improvement in Afshari sheep. The average generation interval was estimated to be 3.35 yr. The shorter generation interval was observed on the sire side compared with the dam side (3.30 yr vs. 3.78 yr), indicating faster generation turnover for sires than for dams. Key words: Sheep, animal model, genetic trend, generation interval, heritability

De novo SCN1A mutations in Dravet syndrome and related epileptic encephalopathies are largely of paternal origin

BackgroundDravet syndrome is a severe infantile epileptic encephalopathy caused in approximately 80% of cases by mutations in the voltage gated sodium channel subunit gene SCN1A. The majority of these mutations...

Contrasting Effects of Maternal and Paternal Age on Offspring Intelligence

Both maternal and paternal ages are increasing in the developed world. The average age of mothers at time of childbirth has increased from 26.4 years in 1974 to 29.3 years in 2002, while the average age of fathers has increased from 29.2 years in 1980 to 32.1 years in 2002 [1]. This increase in the average parental age is most likely due to the societal trend for couples to delay starting a family for career or financial reasons. The concept of the female “biological clock” (the effect of increasing maternal age on reducing fertility) is well known and is a source of anxiety for many women [2]. In contrast, the consequences of increasing paternal age on fertility and other adverse reproductive outcomes are rarely discussed [3].

Understanding and retention of the informed consent process among parents in rural northern Ghana

BackgroundThe individual informed consent model remains critical to the ethical conduct and regulation of research involving human beings. Parental informed consent process in a rural setting of northern Ghana was studied to describe comprehension and retention among parents as part of the evaluation of the existing informed consent process.MethodsThe study involved 270 female parents who gave consent for their children to participate in a prospective cohort study that evaluated immune correlates of protection against childhood malaria in northern Ghana. A semi-structured interview with questions based on the informed consent themes was administered. Parents were interviewed on their comprehension and retention of the process and also on ways to improve upon the existing process.ResultsThe average parental age was 33.3 years (range 18–62), married women constituted a majority (91.9%), Christians (71.9%), farmers (62.2%) and those with no formal education (53.7%). Only 3% had ever taken part in a research and 54% had at least one relation ever participate in a research. About 90% of parents knew their children were involved in a research study that was not related to medical care, and 66% said the study procedures were thoroughly explained to them. Approximately, 70% recalled the study involved direct benefits compared with 20% for direct risks. The majority (95%) understood study participation was completely voluntary but only 21% recalled they could withdraw from the study without giving reasons. Younger parents had more consistent comprehension than older ones. Maternal reasons for allowing their children to take part in the research were free medical care (36.5%), better medical care (18.8%), general benefits (29.4%), contribution to research in the area (8.8%) and benefit to the community (1.8%). Parental suggestions for improving the consent process included devoting more time for explanations (46.9%), use of the local languages (15.9%) and obtaining consent at home (10.3%).ConclusionSignificant but varied comprehension of the informed consent process exists among parents who participate in research activities in northern Ghana and it appears the existing practices are fairly effective in informing research participants in the study area.

Prediction of genetic contributions and generation intervals in populations with overlapping generations under selection.

A method to predict long-term genetic contributions of ancestors to future generations is studied in detail for a population with overlapping generations under mass or sib index selection. An existing method provides insight into the mechanisms determining the flow of genes through selected populations, and takes account of selection by modeling the long-term genetic contribution as a linear regression on breeding value. Total genetic contributions of age classes are modeled using a modified gene flow approach and long-term predictions are obtained assuming equilibrium genetic parameters. Generation interval was defined as the time in which genetic contributions sum to unity, which is equal to the turnover time of genes. Accurate predictions of long-term genetic contributions of individual animals, as well as total contributions of age classes were obtained. Due to selection, offspring of young parents had an above-average breeding value. Long-term genetic contributions of youngest age classes were therefore higher than expected from the age class distribution of parents, and generation interval was shorter than the average age of parents at birth of their offspring. Due to an increased selective advantage of offspring of young parents, generation interval decreased with increasing heritability and selection intensity. The method was compared to conventional gene flow and showed more accurate predictions of long-term genetic contributions.

Advising Parents to Stop Smoking: Pediatricians' and Parents' Attitudes

Pediatricians are in a unique position to address the issues of smoking cessation with parents. Vermont pediatricians and parents of their patients were surveyed to assess attitudes about giving and receiving smoking cessation advice. A questionnaire was mailed to all pediatricians in Vermont, and 72 valid responses were received, for a response rate of 91%. Forty percent of pediatricians routinely took a smoking history from parents and 11% recorded this information in the child's chart. Most pediatricians (94%) reported advising at least 60% of smoking parents to quit, and they spent an average of 4.4 minutes doing this. Barriers to giving advice were lack of time (42%), feeling that parents did not expect advice (25%), and feeling ill at ease giving the advice (25%). Only 8.5% of pediatricians had received training in how to give smoking cessation advice, but 87% were willing to learn methods to give advice briefly. Six hundred seventy-six parents from randomly selected pediatric practices were interviewed. The average parental age was 32, and 84% were women; 49% had never smoked, 30% were former smokers, and 21% were current smokers. Current smokers were less likely to agree with statements about the adverse effects of passive smoke on children. Most parents (56%) felt that pediatricians should give quit-smoking advice to parents, and 52% of smoking parents reported that they would welcome advice. Only 30% of current smokers said advice would bother them somewhat, and 15% had more negative reactions. Parents and pediatricians agreed on the best opportunities to give quit-smoking advice.(ABSTRACT TRUNCATED AT 250 WORDS)