Length In Children Research Articles

Estimation Body Height according to Tibia Length in Children with Cerebral Palsy Aged 6-12 Years in Bandung, Indonesia

Background and Objective. Children with Cerebral Palsy (CP) have a risk of contracture or hypotonia causing difficulty in measuring their standardized height hence it requires height estimation based on the tibial length as an alternative measurement. Estimation body height formula is not available yet in Indonesia. We aim to determine the estimation body height according to tibia length in children with cerebral palsy aged 6-12 years in Bandung, Indonesia. Methods. The subjects are children 6-12 years old with CP who attended Special School, Growth and Development Clinic, Neuropediatric, and Medical Rehabilitation Outpatient Department at Hasan Sadikin General Hospital in Bandung, Indonesia between March until May 2019. This research performed a cross-sectional study. The height, body length, and tibia length of subjects who met the inclusion criteria were measured concomitantly. Data analysis was performed using linear regression. Results. We found 68 CP patients who met the inclusion criterion. Patients could be measured using the standard method are 36 children which then analyzed statistically. There were 36 subjects consisting of 22 boys (61,1%) and 14 girls (38,9%). The new calculation formula for body height estimation based on the tibia length in CP children aged 6-12 years is = 32,01 + 2,90 * tibia length (Standard error of the estimate ±1,85). Conclusion. Measurement of tibia length is important in determining the height estimation in children with CP so growth could still be monitored in the patients. There is a new calculation formula that we can use for height estimation based on the tibial length in children with CP aged 6-12 years.

Which modifiable prenatal factors mediate the relation between socio-economic position and a child's weight and length at birth?

Although several studies have shown a positive association between socio-economic position and size at birth, not enough is known about the modifiable factors that may be involved. We aimed to investigate whether maternal prepregnancy body mass index (BMI), smoking, diet, and depression during pregnancy mediate the positive association between maternal education and birth size. Weight and length z-scores specific for gestational age and sex were calculated for 1,500 children from the EDEN mother-child cohort. A mediation analysis of the associations between maternal education and birth size was conducted with a counterfactual method, adjusted for recruitment centre, parity, maternal height, and age. In the comparison of children of mothers with low versus intermediate education levels, maternal smoking during pregnancy explained 52% of the total effect of education on birth weight. Similar findings were observed with birth length z-score (37%). The comparison of children of mothers with high versus intermediate education levels yielded a non-significant total effect, which masked opposite mediating effects by maternal BMI and smoking during pregnancy on both birth weight and length. Prepregnancy BMI and maternal smoking during pregnancy mediate the positive association between maternal education and birth weight and length z-scores. These mediators, however, act in opposite directions, thereby masking the extent to which healthy prenatal growth is socially differentiated.

Impact of Long-Term Hippotherapy on the Walking Ability of Children With Cerebral Palsy and Quality of Life of Their Caregivers.

Background: Cerebral palsy (CP) is a permanent motor disorder that occurs at birth or during early infancy. Despite advances in fetal and maternal medicine, the incidence of CP remains high. Hippotherapy has gradually been recognized as an excellent rehabilitation tool for children with CP. However, a scientific basis for how it achieves long-term functional improvements or provides additional benefits to patients' caregivers remains unknown.Objectives: We performed a prospective trial to determine how hippotherapy affects the gross motor and gait functions in children with CP and how it may also impact the quality of life (QOL) of patients' caregivers.Methods: In total, 24 children with CP (11 boys, 13 girls; age: 4–14 years; Gross Motor Function Classification System [GMFCS] II-III) underwent a program (30 min/day, once a week) of hippotherapy or day-care recreation (control) over a 1-year intervention and a 3-month follow-up period. Assessment measures used for the children were gait parameters for a 5-m walk test, Gross Motor Function Measure (GMFM)-66, and GMFM dimension-E (GMFM-E). The QOL of the caregivers was estimated using a brief version of the World Health Organization Quality Of Life (WHOQOL-BREF) self-assessment questionnaire.Results: In addition to better GMFM-66 and GMFM-E scores, hippotherapy was associated with increased cadence, step length, and mean acceleration; stabilized horizontal/vertical displacement of patients; and better relationship between the psychological status and QOL of the caregivers than those seen in the control group (p < 0.05). Additionally, the initially improved children's step length and their caregivers' psychological QOL domain (particularly in the “positive feeling” facet) tended to be preserved up to the 3-month follow-up.Conclusion: These data suggest that compared with common day-care recreational activities, a 1-year program of once-weekly hippotherapy can improve not only the walking ability of children with CP but also the psychological health and QOL of their caregivers.Clinical Trial Registration:: www.umin.ac.jp/ctr/, identifier: UMIN000022986

A Model to Predict Postoperative Axial Length in Children Undergoing Bilateral Cataract Surgery With Primary Intraocular Lens Implantation

To develop a model for predicting postoperative globe axial length (AL) in children undergoing bilateral cataract surgery with primary intraocular lens (IOL) implantation in children older than 2 years. Retrospective case series. Children were included only if AL data were available for both eyes before surgery and at least 1 year after surgery. We analyzed variables that could influence globe axial growth and developed a multivariable generalized estimating equation regression model to predict postoperative AL. Sixty-four children were included. The median age at surgery and at follow-up was 5.1 and 12.5 years, respectively. AL measurements were obtained in both eyes during 242 visits. The median AL before and at last follow-up was 22.2 and 23.1mm, respectively. Beta value for the final model to predict postoperative AL is as below: intercept (1.93), preoperative AL (0.91), age at cataract surgery (-0.07), age at follow-up (0.14), and interaction between age at surgery and age at follow-up (-0.005). Using this model, for a hypothetical patient operated at 2.5 years of age with a 20.5mm AL would be estimated to have a 22.8mm AL at 18 years of age. IOL power selection is a major challenge of pediatric cataract surgery attributable to unpredictable future eye growth. This model theoretically could be used to predict individual future adult size AL for each child undergoing cataract surgery, helping the surgeon to customize the selection of an IOL power at implantation and also to help the parents understand what to expect.

Reading to babies: Exploring the beginnings of literacy

In this study, the researchers explored the impact of reading aloud on language acquisition for 12 infants and toddlers (6–22 months old) attending a preschool located in South Florida. The research team included university professors, a preschool director and two preschool teachers. A teacher assistant read a selected picture book to each child individually for 10 weeks using scripts with prompts to assess receptive and expressive language. In addition to the book scripts, data collection included parent surveys, observation, developmental checklists, videotaping and field notes. Researchers measured each child's length of engaged time and level of engagement individually and as a whole group. Results indicate that participants demonstrated book preferences in terms of engagement, with the toddlers showing interest in books on familiar topics. Effective read-aloud strategies and techniques for young children are shared to promote the love of literacy.

Factors affecting parents' satisfaction with pediatric wards.

To explore the relationship of parental satisfaction with sociodemographic variables and to identify the possible determinants in pediatric and surgical wards of two public pediatric hospitals in Greece. The validated Swedish Pyramid Questionnaire that measures parental satisfaction with the quality of care was used. A convenience sample of 352 parents (response rate: 88%) was collected from two major pediatric public hospitals in Athens, Greece, from February to April, 2016. The satisfaction questions focused on eight domains: information on illness, information on routines, accessibility, medical treatment, care processes, staff attitudes, parental participation, and the staff work environment. The parents of the hospitalized children were highly satisfied with the behavior of the healthcare providers and the medical and nursing care that was provided, but they were less satisfied with accessibility in the hospital. The marital status and child's length of stay in the hospital seemed to affect the most dimensions of parental satisfaction, with the married parents whose child's length of stay was short expressing higher levels of satisfaction. Healthcare providers' approaches should be modified for parental satisfaction to be improved and parents' sociodemographics while providing health care. Nurses should enhance the quality of nursing care.

Paternity Leave and Parental Relationships: Variations by Gender and Mothers' Work Statuses.

This study examines the associations between paternity leave and parents' reports of relationship satisfaction and relationship conflict, and whether the associations vary by parent gender and mothers' work statuses. Paternity leave research in the U.S. has focused on implications for father involvement, but paternity leave may also help to strengthen parental relationships by promoting a more equitable division of domestic labor. Given gender gaps in childcare, the association between paternity leave and parental relationship outcomes may also vary by gender and mothers' work statuses. The sample consists of 4,700 couples (i.e., parent dyads) from the Early Childhood Longitudinal Study, Birth Cohort. Multilevel models are used to assess the associations between paternity leave and both relationship satisfaction and conflict, and whether these associations vary by gender and mothers' work statuses. Paternity leave-taking is positively associated with parents' reports of relationship satisfaction, but length of paternity leave is only positively associated with mothers' reports of relationship satisfaction. Also, among mothers who worked prior to the child's birth, paternity leave-taking and length of leave are negatively associated with their reports of relationship conflict. In contrast, among mothers who did not work in paid labor pre-birth, paternity leave is positively associated with mothers' reports of relationship conflict. Paternity leave may have implications for parental relationships (and especially mothers' perceptions of their relationships with fathers).

Feasibility of Dual Energy X-Ray Absorptiometry Based Images for Measurement of Height, Sitting Height, and Leg Length in Children

BackgroundInterpretation of pediatric bone mineral density by dual energy absorptiometry (DXA) requires adjustment for height (Ht). This is often not easily obtainable in nonambulant subjects. AimsTo investigate the feasibility of using DXA images to evaluate measurements of Ht, sitting height (SH), and leg length (LL). MethodologyA total of 2 observers performed measurements of Ht, SH, and LL on 3 separate occasion using DXA digital images in 125 children. Intraclass correlation and relative technical error of measurement (rTEM) were performed to assess reliability of repeated measurements. In 25 children, Ht and SH were measured in clinic on the same day and Bland-Altman analysis was performed to compare DXA measured Ht, SH, LL with clinic measurements for these 25 children. ResultsIntraclass correlation for DXA based Ht, SH, and LL measurements ranged from 0.996 to 0.998 (p < 0.0001). rTEM of Ht, SH, and LL for observer 1 was 0.0016%, 0.002%, and 0.0034%, respectively. rTEM of Ht, SH, and LL between observer 1 and 2 was 0.0047%, 0.0049%, and 0.0087%, respectively. Mean difference between clinic and DXA measurements from Bland-Altman plots were +0.57 cm (95% confidence interval [CI] −0.54 to +1.68) for Ht, +1.33cm (−1.60 to +4.24) for SH, and −0.76cm (−3.88 to +2.37) for LL. ConclusionsOur study demonstrated for the first time that Ht, SH, and LL in children can be measured very precisely using DXA images. Ht can be measured accurately. We believe this may be a convenient method to obtain Ht measurements to allow size adjustment of DXA bone mineral density in immobile children with chronic conditions.

Maternal breast and body symmetry in pregnancy and offspring condition.

Fluctuating asymmetry (FA) is hypothesized to reflect the level of an individual's developmental instability, and therefore genetic quality. As a potential signal of biological condition, female body (including breast) symmetry was shown to be perceived as more attractive in mate choice context. If symmetry reflects a woman's genetic quality, it is possible that FA, similarly to other maternal anthropometric cues of biological condition (e.g., body height or waist-to-hip ratio), may be also related to her offspring condition. To test this, breast and body asymmetry was measured in 93 pregnant women in the 1st, 2nd, and 3rd pregnancy trimester. Child's birth weight, length, chest and head circumference, information on the Apgar score, congenital malformations, and birth complications was taken from hospital records. The relationships between offspring birth characteristics and maternal breast FA and body FA were analyzed separately, controlled for a child's sex and maternal weight in pregnancy. Breast asymmetry was not a predictor of a child's neonatal condition assessed from morphological parameters at birth. Asymmetry of maternal non-ornamental body characteristcs, commonly used to assess body FA, correlated negatively with a child's weight, head and chest circumference at birth. A composite asymmetry index of eight body traits, non-sexually selected characteristics, seems to be a better predictor of a woman's ability to invest in fetus during pregnancy than breast asymmetry, sexual ornamentation that is perceived as a signal of a woman's attractiveness and biological condition.

Gestational weight gain and optimal ranges in Chinese mothers giving singleton and full-term births in 2013

Objective: To analyze the status of gestational weight gain (GWG) among Chinese mothers who gave singleton and full-term births, and to look at optimal GWG ranges. Methods: In 2013, using the multi-stage stratified and population proportional cluster sampling method, we investigated 8 323 mother-child pairs at their 0-24 months postpartum from 55 counties (cities/districts) of 30 provinces (except Tibet) in mainland China. Questionnaire was used to collect data on body weight before pregnancy and delivery, diseases during gestation, hemorrhage or not at postpartum, child birth weight and length, and other information about pregnant outcomes. We measured mother's body weight and height, and child's body weight and length. Based on 'Chinese Adult Body Weight Standard', we divided mothers into four groups according to their body weight before pregnancy: low weight (BMI<18.5 kg/m(2)), normal weight (BMI 18.5-23.9 kg/m(2)), overweight (BMI 24.0-27.9 kg/m(2)) and obesity (BMI≥28.0 kg/m(2)). The status of GWG was assessed by IOM optimal GWG guidelines. Chinese optimal GWG ranges were calculated according to the association of GWG with pregnant outcomes and anthropometry of mothers and children, and according to P25-P75 of GWG among mothers who had good pregnant outcomes and good anthropometry, and whose children had good anthropometry. The status of GWG was assessed by the new optimal ranges. Results: P50 (P25-P75) of GWG among the 8 323 mothers was 15.0 (10.0-19.0) kg. According to the proposed optimal GWG ranges of IOM, the proportions of inadequate, optimal and excessive GWG accounted for 27.2% (2 263 mothers), 36.2% (3 016 mothers) and 36.6% (3 044 mothers). The optimal GWG ranges for low weight, normal weight, overweight and obesity were 11.5-18.0, 10.0-15.0, 8.0-14.0 and 5.0-11.5 kg. Based on these optimal GWG ranges established in this study, the rates of inadequate, optimal and excessive GWG were 15.7% (1 303 mothers), 45.0% (3 744 mothers) and 39.3% (3 276 mothers), and these rates were significantly different from that defined by the IOM standards (χ2=345.36, P<0.001). Conclusion: The median of GWG among Chinese mothers is 15.0 kg, which is at a relatively higher level. This study suggests the optimal GWG ranges for Chinese women who give singleton and full-term babies, which appears lower than IOM's.

Dynamic prediction in functional concurrent regression with an application to child growth.

In many studies, it is of interest to predict the future trajectory of subjects based on their historical data, referred to as dynamic prediction. Mixed effects models have traditionally been used for dynamic prediction. However, the commonly used random intercept and slope model is often not sufficiently flexible for modeling subject‐specific trajectories. In addition, there may be useful exposures/predictors of interest that are measured concurrently with the outcome, complicating dynamic prediction. To address these problems, we propose a dynamic functional concurrent regression model to handle the case where both the functional response and the functional predictors are irregularly measured. Currently, such a model cannot be fit by existing software. We apply the model to dynamically predict children's length conditional on prior length, weight, and baseline covariates. Inference on model parameters and subject‐specific trajectories is conducted using the mixed effects representation of the proposed model. An extensive simulation study shows that the dynamic functional regression model provides more accurate estimation and inference than existing methods. Methods are supported by fast, flexible, open source software that uses heavily tested smoothing techniques.

Effect of participatory women's groups and counselling through home visits on children's linear growth in rural eastern India (CARING trial): a cluster-randomised controlled trial.

SummaryBackgroundAround 30% of the world's stunted children live in India. The Government of India has proposed a new cadre of community-based workers to improve nutrition in 200 districts. We aimed to find out the effect of such a worker carrying out home visits and participatory group meetings on children's linear growth.MethodsWe did a cluster-randomised controlled trial in two adjoining districts of Jharkhand and Odisha, India. 120 clusters (around 1000 people each) were randomly allocated to intervention or control using a lottery. Randomisation took place in July, 2013, and was stratified by district and number of hamlets per cluster (0, 1–2, or ≥3), resulting in six strata. In each intervention cluster, a worker carried out one home visit in the third trimester of pregnancy, monthly visits to children younger than 2 years to support feeding, hygiene, care, and stimulation, as well as monthly women's group meetings to promote individual and community action for nutrition. Participants were pregnant women identified and recruited in the study clusters and their children. We excluded stillbirths and neonatal deaths, infants whose mothers died, those with congenital abnormalities, multiple births, and mother and infant pairs who migrated out of the study area permanently during the trial period. Data collectors visited each woman in pregnancy, within 72 h of her baby's birth, and at 3, 6, 9, 12, and 18 months after birth. The primary outcome was children's length-for-age Z score at 18 months of age. Analyses were by intention to treat. Due to the nature of the intervention, participants and the intervention team were not masked to allocation. Data collectors and the data manager were masked to allocation. The trial is registered as ISCRTN (51505201) and with the Clinical Trials Registry of India (number 2014/06/004664).ResultsBetween Oct 1, 2013, and Dec 31, 2015, we recruited 5781 pregnant women. 3001 infants were born to pregnant women recruited between Oct 1, 2013, and Feb 10, 2015, and were therefore eligible for follow-up (1460 assigned to intervention; 1541 assigned to control). Three groups of children could not be included in the final analysis: 147 migrated out of the study area (67 in intervention clusters; 80 in control clusters), 77 died after the neonatal period and before 18 months (31 in intervention clusters; 46 in control clusters), and seven had implausible length-for-age Z scores (<–5 SD; one in intervention cluster; six in control clusters). We measured 1253 (92%) of 1362 eligible children at 18 months in intervention clusters, and 1308 (92%) of 1415 eligible children in control clusters. Mean length-for-age Z score at 18 months was −2·31 (SD 1·12) in intervention clusters and −2·40 (SD 1·10) in control clusters (adjusted difference 0·107, 95% CI −0·011 to 0·226, p=0·08). The intervention did not significantly affect exclusive breastfeeding, timely introduction of complementary foods, morbidity, appropriate home care or care-seeking during childhood illnesses. In intervention clusters, more pregnant women and children attained minimum dietary diversity (adjusted odds ratio [aOR] for women 1·39, 95% CI 1·03–1·90; for children 1·47, 1·07–2·02), more mothers washed their hands before feeding children (5·23, 2·61–10·5), fewer children were underweight at 18 months (0·81, 0·66–0·99), and fewer infants died (0·63, 0·39–1·00).InterpretationIntroduction of a new worker in areas with a high burden of undernutrition in rural eastern India did not significantly increase children's length. However, certain secondary outcomes such as self-reported dietary diversity and handwashing, as well as infant survival were improved. The interventions tested in this trial can be further optimised for use at scale, but substantial improvements in growth will require investment in nutrition-sensitive interventions, including clean water, sanitation, family planning, girls' education, and social safety nets.FundingUK Medical Research Council, Wellcome Trust, UK Department for International Development (DFID).

Effects of maternal omega-3 fatty acids supplementation during pregnancy/lactation on body composition of the offspring: A systematic review and meta-analysis

The effect of maternal omega-3 fatty acids intake on the body composition of the offspring is unclear. The aim of this study was to conduct a systematic review and meta-analysis to confirm the effects of omega-3 fatty acids supplementation during pregnancy and/or lactation on body weight, body length, body mass index (BMI), waist circumference, fat mass and sum of skinfold thicknesses of offspring. Human intervention studies were selected by a systematic search of PubMed, Web of Science, the Cochrane Library and references of related reviews and studies. Randomized controlled trials of maternal omega-3 fatty acids intake during pregnancy or lactation for offspring's growth were included. The data were analyzed with RevMan 5.3 and Stata 12.0. Effect sizes were presented as weighted mean differences (WMD) or standardized mean difference (SMD) with 95% confidence intervals (95% CI). Twenty-six studies comprising 10,970 participants were included. Significant increases were found in birth weight (WMD=42.55g, 95% CI: 21.25, 63.85) and waist circumference (WMD=0.35cm, 95% CI: 0.04, 0.67) in the omega-3 fatty acids group. There were no effects on birth length (WMD=0.09cm, 95% CI:-0.03, 0.21), postnatal length (WMD=0.13cm, 95% CI:-0.11, 0.36), postnatal weight (WMD=0.04kg, 95% CI:-0.07, 0.14), BMI (WMD=0.09, 95% CI:-0.05, 0.23), the sum of skinfold thicknesses (WMD=0.45mm, 95% CI:-0.30, 1.20), fat mass (WMD=0.05kg, 95% CI:-0.01, 0.11) and the percentage of body fat (WMD=0.04%, 95% CI:-0.38, 0.46). This meta-analysis showed that maternal omega-3 fatty acids supplementation can increase offspring's birth weight and postnatal waist circumference. However, it did not appear to influence children's birth length, postnatal weight/length, BMI, sum of skinfold thicknesses, fat mass and the percentage of body fat during postnatal period. Larger, well-designed studies are recommended to confirm this conclusion.

Associations between Maternal Behaviors at 1 Year and Child Language at 2 Years in a Cohort of Women Experiencing Adversity

Variations in parenting have been suggested as contributing to a higher prevalence of language difficulties in children experiencing economic, environmental, and social adversity. Within these cohorts, the contribution of responsive and intrusive parenting to child language has been investigated; specific responsive and intrusive behaviors encapsulated within these parenting styles have yet to be fully examined. Additionally, the role of the mother–child dynamic in moderating mother–child associations has also not been explored. This study aimed to augment current research by identifying specific responsive and intrusive maternal behaviors associated with child language in a cohort experiencing adversity, as well as exploring the role of the fluency and connectedness of mother–child conversation in moderating associations (n = 249). Specific behaviors and the fluency and connectedness of the mother–child interaction were coded from free‐play videos at child age 12 months. Child language measures were derived from transcripts of free play at 24 months. Linear regression models were used to examine maternal–child associations. The moderating role of fluency and connectedness was then explored. Maternal imitations were positively associated with the child's total words; successful redirectives were negatively associated with the child's mean length of turn. Both associations were moderated by the fluency and connectedness of the interaction.

Sleep Duration and Telomere Length in Children

To test the association between sleep duration and telomere length in a pediatric population. We analyzed cross-sectional data for 1567 children from the age 9 study wave of the Fragile Families and Child Wellbeing Study, a population-based birth cohort of children born between 1998 and 2000 in large American cities (population >200 000). We measured telomere length using quantitative polymerase chain reaction, and children's typical nightly sleep duration was reported by their primary caregivers. Using linear regression, we estimated the association between sleep duration and telomere length both in unadjusted models and adjusting for a number of covariates. We found that children with shorter sleep durations have shorter telomeres than children with longer sleep durations. Each hour less of nightly sleep duration is associated with having telomeres that are 0.015 log-kilobases per chromosome shorter (P < .05). We found no difference in this association by race, sex, or socioeconomic status. We provide preliminary evidence that children with shorter sleep durations have shorter telomeres. This finding is consistent with a broader literature indicating that suboptimal sleep duration is a risk for increased physiological stress and impaired health. Future research should address the limitations of our study design by using longitudinal study designs and telomere measurements, measuring sleep duration via polysomnography or actigraphy, and assessing the intermediate biological mechanisms of the link between sleep and telomere dynamics.

Traffic-Related Air Pollution and Telomere Length in Children and Adolescents Living in Fresno, CA: A Pilot Study.

The main objective of this pilot study was to gather preliminary information about how telomere length (TL) varies in relation to exposure to polycyclic aromatic hydrocarbons (PAHs) in children living in a highly polluted city. We conducted a cross-sectional study of children living in Fresno, California (n = 14). Subjects with and without asthma were selected based on their annual average PAH level in the 12-months prior to their blood draw. We measured relative telomere length from peripheral blood mononuclear cells (PBMC). We found an inverse linear relationship between average PAH level and TL (R = 0.69), as well as between age and TL (R = 0.21). Asthmatics had shorter mean telomere length than non-asthmatics (TLasthmatic = 1.13, TLnon-asthmatic = 1.29). These preliminary findings suggest that exposure to ambient PAH may play a role in telomere shortening.Become familiar with previous evidence suggesting that telomere length may be a biomarker of air pollution-induced cytotoxicity.Summarize the new findings on the association between polycyclic aromatic hydrocarbon (PAH) exposure and telomere length in adolescents, including those with asthma.Discuss the implications for recommendations and policies to mitigate the health and respiratory effects of traffic-related air pollution.

The acquisition of tense morphology over time by English second language children with specific language impairment: Testing the cumulative effects hypothesis

ABSTRACTThe cumulative effects hypothesis (CEH) claims that bilingual development would be a challenge for children with specific language impairment (SLI). To date, research on second language (L2) children with SLI has been limited mainly to their early years of L2 exposure; however, examining the long-term outcomes of L2 children with SLI is essential for testing the CEH. Accordingly, the present study examined production and grammaticality judgments of English tense morphology from matched groups of L2 children with SLI and L2 children with typical development (TD) for 3 years, from ages 8 to 10 with 4–6 years of exposure to English. This study found that the longitudinal acquisition profile of the L2 children with SLI and TD was similar to the acquisition profile reported for monolinguals with SLI and TD. Furthermore, L2-SLI children's accuracy with tense morphology was similar to that of their monolingual age peers with SLI at the end of the study, and exceeded that of younger monolingual peers with SLI whose age matched the L2 children's length of exposure to English. These findings are not consistent with the CEH, but instead show that morphological acquisition parallel to monolinguals with SLI is possible for L2 children with SLI.

The effect of an educational pre-operative DVD on parents' and children's outcomes after a same-day surgery: a randomized controlled trial.

To examine the effect of a pre-operative DVD on parents' knowledge, participation and anxiety and on children's distress, pain, analgesic requirements and length of recovery after same-day surgery. Very few parents are adequately prepared to participate in their child's care during a same-day surgery. An educational DVD was developed to educate parents on how to actively support their child in the recovery room. Single-blind, post-test randomized controlled trial. Study is registered at ClinicalTrials.gov NCT02766452. Between September 2011-September 2012, 123 parent-child dyads where the child underwent an ENT or dental same-day surgery were recruited in a Canadian paediatric hospital. Dyads were randomly assigned to either the intervention (DVD and standard preparation) or control group (standard preparation). Parents and children were videotaped in the recovery room where parental participation and anxiety and children's distress were measured. Data on parents' knowledge, children's postoperative pain, analgesic requirements and length of recovery were measured. Independent and paired t-tests, chi square and repeated measures anova were used to analyse the data. Parents in the intervention group gained greater knowledge of and used more positive reinforcement and distraction and relaxation methods than those in the control group. Children's postoperative pain in the day-care surgery unit was significantly lower among the intervention group compared with the control group. A pre-operative DVD can increase parents' participation in the recovery room and decrease children's postoperative pain.

Traffic-Related Air Pollution and Telomere Length in Children and Adolescents Living in Fresno, CA

Traffic-Related Air Pollution and Telomere Length in Children and Adolescents Living in Fresno, CA

SU‐F‐T‐83: Infant Total Skin Electron Therapy Using Five Fields Technique

Purpose:We were presented with a 9 month old boy with Relapsed Acute Myeloid Leukemia (AML) involving the skin. The plan was to treat the entire skin using 6 MeV electrons with the infant under complete anesthesia. The purpose of this work is to commission the 6 MeV electron beam and to develop a technique that can be used to deliver total skin dose to infants with minimal patient immobilization.Methods:A baby mannequin phantom that mimics the child's length was used to determine the best technique to treat the infant. The 76 cm long phantom was placed on the floor. The phantom was placed in four unique immobilization devices to simulate four different treatment positions (anterior, posterior, left lateral and right lateral). Radiochromic films were used to determine beam profile in both axial and radial directions, and percent depth dose (PDD). Absolute calibration of the machine output at 214 cm distance was measured using an Exradin A11 parallel‐plate ion chamber. A 1.0 cm plexiglass scatter plate was inserted in the collimator. Mosfet dosimeters were used for dose verification for phantom and and patient.Results:At 214 cm source to surface distance (SSD) using gantry angle of + 20o from vertical beam flatness is + 10% in the radial direction over a region of 70 cm and + 4% in the axial direction over 60 cm. A five field arrangement was determined to optimally deliver the desired dose with &gt; 90% uniformity. The fifth field was used to boost the head vertex.Conclusion:It is possible to treat sedated infants with total skin dose using five positions. Four positions were enough to cover the body and the fifth position boosts the vertex of the head. All fractions can be reproduced accurately daily because of the patient's stable immobilization.