Burden Of Children Research Articles

Population-Based Assessment of Asthma Symptom Burden in Children

The Minneapolis and St. Paul Controlling Asthma in American Cities Project (CAACP) used a school-based symptom survey to inform community-based programming and provide an intermediate outcome measure of progress toward reducing the burden of asthma. In collaboration with the two school districts, the project mailed the Child Asthma Short Form, a validated health-related quality of life instrument to parents of children in grades K-8 every other school year from 2003 to 2007. The survey was mailed to a randomly selected sample in four languages (English, Spanish, Hmong, and Somali). The overall response rate was 47%, 41%, and 32% for years1, 3, and 5, respectively. Two out of three children for whom surveys were completed were children of minority populations; more than 50% were eligible for free or reduced-price meals. The changes in scores from the first round (2003-2004) to the third round (2007-2008) were statistically significant for daytime symptom burden (p < 0.05). Improvements were noted, but not statistically significant, for nighttime symptoms and functional limitations. Children of some racial/ethnic minority groups and children eligible for free or reduced-price meals had the highest symptom burden. Findings were used to guide CAACP's program development and delivery to populations in greatest need. CAACP's experience in Minneapolis and St. Paul demonstrates the feasibility of administering a symptom burden survey at low cost and in compliance with school system and institutional review board requirements to maintain confidentiality. The symptom-based survey may be a useful tool to track trends and changes in health disparities at a community and population level.

AAP Publications Reaffirmed and Retired

Policy Statement: Children, Adolescents, and Advertising [published correction appears in Pediatrics. 2007;119(2):424]. Pediatrics. 2006;118(6):2563–2569. Reaffirmed March 2010Policy Statement: Antimicrobial Prophylaxis in Pediatric Surgical Patients. Pediatrics. 1984;74(3):437–439. Retired May 1987Policy Statement: Haemophilus Influenzae Type b Conjugate Vaccines: Recommendations for Immunization with Recently and Previously Licensed Vaccines. Pediatrics. 1993;92(3):480–488. Retired May 1997Technical Report: Prevention of Pneumococcal Infections, Including the Use of Pneumococcal Conjugate and Polysaccharide Vaccines and Antibiotic Prophylaxis. Pediatrics. 2000;106(2):367–376. Retired January 2004Policy Statement: Prevention of Lyme Disease. Pediatrics. 2000;105(1):142–147. Retired October 2003Policy Statement: Prevention of Poliomyelitis: Recommendations for Use of Only Inactivated Poliovirus Vaccine for Routine Immunization. Pediatrics. 1999;104(6):1404–1406. Retired October 2003Policy Statement: Reduction of the Influenza Burden in Children. Pediatrics. 2002;110(6):1246–1252. Retired January 2009Policy Statement: Thimerosal in Vaccines: An Interim Report to Clinicians. Pediatrics. 1999;104(3):570–574. Retired January 2003Policy Statement: Revised Guidelines for Prevention of Early-onset Group B Streptococcal (GBS) Infection. Pediatrics. 1997;99(3):489–496. Retired October 2002Policy Statement: Joint Statement of the American Academy of Pediatrics (AAP) and the United States Public Health Service (USPHS). Pediatrics. 1999;104(3):568–569. Retired May 2002Policy Statement: Possible Association of Intussusception With Rotavirus Vaccination. Pediatrics. 1999;104(3):575. Retired January 2000Policy Statement: Ritual Genital Cutting of Female Minors. Pediatrics. 2010;125(5):1088–1093. Retired May 2010

Neurobehavioral Abnormalities May Correlate With Increased Seizure Burden in Children With Panayiotopoulos Syndrome

Prognostic factors for frequent seizure recurrences were studied in patients with Panayiotopoulos syndrome. The subjects were 79 children fulfilling the criteria of Panayiotopoulos syndrome who were monitored for longer than 2 years. Medical records and electroencephalograms were analyzed retrospectively. The total number of seizures in each patient at the final follow-up ranged from 1 to 22. The 79 patients were classified into three groups: typical Panayiotopoulos syndrome (seizure recurrence = 1-5 times, n = 45), borderline (6-9 times, n = 16), and atypical (>10 times, n = 18). Data analyzed included family history of seizure disorders, peri- and postnatal complications, previous seizure histories, age at epilepsy onset, clinical seizure manifestations, the frequency of status epilepticus, interictal electroencephalographic patterns, and the possible association of neurobehavioral disorders among the three groups. An association with pre-existing neurobehavioral disorders was significantly more frequent in the atypical than in the typical group (P < 0.05), but not significantly different between the typical and borderline or between the borderline and atypical patients (P> 0.05). In patients with Panayiotopoulos syndrome and pre-existing mild neurobehavioral disorders, seizures tend to be pharmacoresistant and to repeat more than 10 times. However, all patients experience seizure remission by 12 years of age, and should not be evaluated for surgery.

Wechselwirkung Krankheit Familie

Multiple sclerosis confronts patients, partners and their children with a wide array of challenges. In addition to physical symptoms, multiple sclerosis may result in cognitive dysfunction, depression or personality changes. Changes in family roles, loss of work, income and social status and caregiver burnout are common in these families. Thus multiple sclerosis represents a disease condition that has the potential to affect partner and children in a number of ways. Based on studies of 70 families and 110 of their offspring by means of semi-structured psychiatric interviews, questionnaires and psychological tests, we evaluated the coping process of the ill, the healthy parent and their children. We analysed disease variables, parental factors and family situations favouring the coping process of children or aggravating their burden, resulting in serious consequences for their psychosocial development. The results with respect to the coping of all family members show the mutual influences between the parental couple as well as between the parents and their children. The better patient or partner are able to cope with the disease, the higher are the values of the coping capacity of the partner and the patient respectively. Children's coping abilities are influenced by their parents' coping behaviour, and even stronger by the coping competence of the healthy parent. With regard to disease variables there are significant correlations between the severity of the disease, cognitive impairment and the degree of depression. Additional cognitive dysfunction of the patient is associated with depressive symptoms in his or her partner. Psychological distress affects not only the chronically ill patient but also the caregiver. A severe parental disease is considered as a potential risk factor for psychological trauma in children. If multiple psychosocial distress factors come together, the impact on the child's psychological development may be traumatising. Main factors aggravating children's burden and impeding their coping process are: parental depression, single parenthood and social isolation of the family, parental communication incapacity and unresolved traumatic experience in the parents' own past history. The latter may be associated with the parent's feelings of victimisation and a tendency to focus his or her life around the disease. Such an attitude interferes with his or her capacity to perceive and be available to the child's developmental and affective needs, leading eventually to her or his emotional or in rare cases physical abuse. In this context, social isolation may operate as a more or less important factor.

Antiviral Therapy for Influenza Infections

1. Karin Hillenbrand, MD 1. Brody School of Medicine East Carolina University Greenville, NC Influenza. American Academy of Pediatrics. In: Pickering LK, ed. 2000 Red Book: Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2003:382– 390 Reduction of the Influenza Burden in Children. Committee on Infectious Diseases. American Academy of Pediatrics. Pediatrics. 2002;110 :1246– 1252[OpenUrl][1][Abstract/FREE Full Text][2] Influenza Diagnosis and Treatment in Children: A Review of Studies on Clinically Useful Tests and Antiviral Treatment for Influenza. Ukeyi TM. Pediatr Infect Dis J. 2003;22 :164– 177[OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] Influenza infection results in significant morbidity each year for children in the United States. Although usually a self-limited illness, influenza may result in complications, including pneumonia, Reye syndrome, myositis, febrile seizures, and acute encephalopathy. Hospitalization, severe disease, and disease complications are more likely in children younger than 2 years of age and in those who have risk factors, including asthma or other chronic pulmonary disease, significant cardiac disease, immunocompromising conditions, chronic renal disease, hemoglobinopathies, and metabolic diseases, such as diabetes mellitus. The risk of influenza infection can be reduced significantly by annual administration of influenza vaccine, which is recommended for high-risk children and their contacts and for all children younger than 2 years of age. Although not a substitute for vaccination, antiviral agents are … [1]: {openurl}?query=rft.jtitle%253DPediatrics%26rft.stitle%253DPediatrics%26rft.issn%253D0031-4005%26rft.aulast%253DCommittee%2Bon%2BInfectious%2BDiseases%26rft.auinit1%253D%2B%26rft.volume%253D110%26rft.issue%253D6%26rft.spage%253D1246%26rft.epage%253D1252%26rft.atitle%253DReduction%2Bof%2Bthe%2BInfluenza%2BBurden%2Bin%2BChildren%26rft_id%253Dinfo%253Adoi%252F10.1542%252Fpeds.110.6.1246%26rft_id%253Dinfo%253Apmid%252F12456926%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=pediatrics&resid=110/6/1246&atom=%2Fpedsinreview%2F26%2F11%2F427.atom [3]: {openurl}?query=rft.jtitle%253DThe%2BPediatric%2Binfectious%2Bdisease%2Bjournal%26rft.stitle%253DPediatr%2BInfect%2BDis%2BJ%26rft.aulast%253DUyeki%26rft.auinit1%253DT.%2BM.%26rft.volume%253D22%26rft.issue%253D2%26rft.spage%253D164%26rft.epage%253D177%26rft.atitle%253DInfluenza%2Bdiagnosis%2Band%2Btreatment%2Bin%2Bchildren%253A%2Ba%2Breview%2Bof%2Bstudies%2Bon%2Bclinically%2Buseful%2Btests%2Band%2Bantiviral%2Btreatment%2Bfor%2Binfluenza.%26rft_id%253Dinfo%253Adoi%252F10.1097%2526454-200302000-00015%26rft_id%253Dinfo%253Apmid%252F12586981%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1097/00006454-200302000-00015&link_type=DOI [5]: /lookup/external-ref?access_num=12586981&link_type=MED&atom=%2Fpedsinreview%2F26%2F11%2F427.atom [6]: /lookup/external-ref?access_num=000181062700013&link_type=ISI

Technical report: Reduction of the influenza burden in children.

Epidemiologic studies have shown that children of all ages with certain chronic conditions, such as asthma, and otherwise healthy children younger than 24 months (6 through 23 months) are hospitalized for influenza and its complications at high rates similar to those experienced by the elderly. Annual influenza immunization is already recommended for all children 6 months and older with high-risk conditions. By contrast, influenza immunization has not been recommended for healthy young children. To protect children against the complications of influenza, increased efforts are needed to identify and recall high-risk children. In addition, immunization of children between 6 through 23 months of age and their close contacts is now encouraged to the extent feasible. Children younger than 6 months may be protected by immunization of their household contacts and out-of-home caregivers. The ultimate goal is universal immunization of children 6 to 24 months of age. Issues that need to be addressed before institution of routine immunization of healthy young children include education of physicians and parents about the morbidity caused by influenza, adequate vaccine supply, and appropriate reimbursement of practitioners for influenza immunization. This report contains a summary of the influenza virus, protective immunity, disease burden in children, diagnosis, vaccines, and antiviral agents.

Relieving parentified children's burdens in families with insecure attachment patterns.

In this article, I will explore how parentfication, in which children take on parental roles, develops within the context of insecure attachments. I argue that parentification is more prevalent than is generally supposed. Adaptive parentfication is differentiated from destructive parentification, which is associated with a range of childhood problems. In this article, attachment theory is placed within a family systems framework and family concepts are described, such as a secure family base and family scripts, which can help to understand parentification. The ways in which two attachment relationships--insecure/ambivalent and insecure/controlling--contribute to parentification processes are delineated. Transgenerational patterns are discussed. Family therapy can provide a preventive intervention aimed at reducing current parentification and interrupting transgenerational transmission. A central aim is to reduce the need for a parent to turn to a child for care. To this end, work can be done to resolve conflicts between parents, thus freeing them to provide sufficient mutual support to each other. Children need to be detriangulated from the parental relationship. Working with transgenerational patterns, including work with grandparents, is recommended. Therapy with a family with a preschool child illustrates these issues as well as the prevention of the establishment of destructive parentification.

Children's wishes, children's burdens

Abstract The authors are both practising family court welfare officers of more than ten years' standing, who draw on their experience of reporting to courts in contested private law applications for s.8 orders under the Children Act 1989. Taking the guiding principles of the Act as their starting-point they seek to locate the child's place within such proceedings. They discuss the concept of parental responsibility and give their views on the responsibilities of the court, court welfare officer and legal representative, as well as reflecting upon the rights and responsibilities of the child within those interrelationships. Proposing that ascertaining the wishes and feelings of the child is ‘no simple matter’, Cantwell and Scott make detailed reference to their own case material. They also link their commentary to some of the research findings in relation to children whose parents' separation is conflictual

Increased Lead Burden in Children of Battery Workers: Asymptomatic Exposure Resulting From Contaminated Work Clothing

Lead transmitted into the home via contaminated parental work clothing was the probable source of excessive lead exposure among 69% of 58 children whose mothers worked in a battery factory in Raleigh, North Carolina. Blood lead levels were highest in children less than 3 years old, and declined with age. All children were asymptomatic, and all had normal findings on physical examinations. Dust samples from the homes of children with the greatest lead burden demonstrated gross contamination of the home environment. Although maternal employment was short, young children spent a significant portion of their lives exposed to lead. Certain parental occupations can sufject children to considerable risk from lead exposure.

Our Children's Burden: Studies of Desegregation in Nine American Communities.

Our Children's Burden: Studies of Desegregation in Nine American Communities.

Our Children's Burden: Studies of Desegregation in Nine American Communities.

Our Children's Burden: Studies of Desegregation in Nine American Communities.

Raymond W. Mack, ed., Our Children's Burden; Studies of Desegregation in Nine American Communities.

Raymond W. Mack, ed., <i>Our Children's Burden; Studies of Desegregation in Nine American Communities.</i>

Review of Our Children's Burden: Studies of Desegregation in Nine American Communities.

Review of Our Children's Burden: Studies of Desegregation in Nine American Communities.