Measurements In Children Research Articles

Successful Virtual Delivery of a Group Childhood Healthy Weight Program.

Because of the COVID-19 pandemic, the Get Up & Go program, an established effective 10-week healthy weight program for children ages 6-14 years provided free to families, has offered the option of a synchronous virtual delivery. Pre- and postassessments include a parental questionnaire about child's health behaviors, and weight and height measurements of children. Over 3 cycles, 116 and 107 families registered for virtual and in-person delivery, respectively, with 70 (60.3%) and 84 (78.5%) attending ≥1 session (p = 0.003). More families in virtual delivery spoke Spanish (41.4% vs. 22.6%, p = 0.01), but children did not differ in age, gender, and severe obesity status, and baseline behavior scores and graduation rates were similar. Improvement from baseline in BMIp95 was -3.71 [standard deviation (SD) 5.26] for virtual delivery and -1.95 (3.69) (p = 0.06) for in-person. Behavior questionnaire improvement [+15.9 (12.9) vs. +14.2 (12.0), p = 0.51] did not differ. The virtual implementation demonstrated good effect and may be useful in nonpandemic environments.

Estimating the Effects of Soil Remediation on Children's Blood Lead near a Former Lead Smelter in Omaha, Nebraska, USA.

Background:Lead exposures from legacy sources threaten children’s health. Soil in Omaha, Nebraska, was contaminated by emissions from a lead smelter and refinery. The U.S. Environmental Protection Agency excavated and replaced contaminated soil at the Omaha Lead Superfund Site between 1999 and 2016.Objectives:The goal of this study was to assess the association of soil lead level (SLL) and soil remediation status with blood lead levels (BLLs) in children living near or on the site.Methods:We linked information on SLL at residential properties with children’s BLLs and assigned remediation status to children’s BLL measurements based on whether their measurements occurred during residence at remediated or unremediated properties. We examined the association of SLL and remediation status with elevated BLL (EBLL). We distinguished the roles of temporal trend and the intervention with time-by-intervention-status interaction contrasts. All analyses estimated odds ratios (ORs) with a generalized estimating equations approach to ensure robustness under the complex correlations among BLL measurements. All analyses controlled for relevant covariates including children’s characteristics.Results:EBLL () was associated with both residential SLL [e.g., ; 95% confidence interval (CI): 1.83, 2.19; vs. ] and neighborhood SLL [e.g., (95% CI: 1.62, 2.11; vs. )] before remediation but only with neighborhood SLL after remediation. The odds of EBLL were higher before remediation [OR 1.52 (95% CI: 1.34, 1.72)]. Similarly, EBLL was positively associated with preremediation status in our interaction analysis [interaction (95%CI: 1.02, 1.37)].Discussion:Residential and neighborhood SLLs were important predictors of EBLLs in children residing near or on this Superfund site. Neighborhood SLL remained a strong predictor following remediation. Our data analyses showed the benefit of soil remediation. Results from the interaction analyses should be interpreted cautiously due to imperfect correspondence of remediation times between remediation and comparison groups. https://doi.org/10.1289/EHP8657

Construct Validity of a Task-Oriented Unimanual Strength Measurement in Children with Unilateral Cerebral Palsy

Aim: Investigate aspects of construct validity of parameters “mean peak force” and “number of successful attempts” of the press button task using the Task-oriented Arm-hAnd Capacity (TAAC) in children with unilateral cerebral palsy (CP) by comparing them to outcomes of comparative measures using Consensus-based Standards for the selection of health Measurement INstruments guidelines. Methods: 118 children with unilateral CP (mean age 1 year 2 months, standard deviation 3 year 5 months) were included. Fourteen a priori hypotheses were formulated for each parameter of the TAAC. Strength and direction of the relationship between the TAAC and comparative measures were investigated by calculating Pearson correlation coefficients. Results: For the parameter “mean peak force” 8/14 (57%) hypotheses could be supported. For the parameter “number of successful attempts” 13/14 (93%) hypotheses could be supported. Conclusion: The hypothesized construct of the parameter “mean peak force” is only partially in line with our idea about the potential relationship of the compared constructs. The relationship needs to be reconsidered to some extent. The hypothesized construct of the parameter “number of successful attempts” is in line with our idea about the potential relationship of the compared constructs and can be considered to have good validity compared to the other measures. Thus, the construct of this parameter adds new and meaningful information as an outcome measure for functional strength measurements.

Interest of Procalcitonin Measurement in Children with Cerebral Malaria in Southern Benin

Introduction: Cerebral malaria is a major complication of the Plasmodium falciparum infection with a high case fatality rate. The objective of this study was to determine the relationship between cerebral malaria and high serum procalcitonin (PCT) level in children. Method: This was a prospective descriptive and analytical cohort study conducted over 12 months, on a series of PCT blood tests in children aged 6 months to 15 years old hospitalized for cerebral malaria in the pediatric wards of four hospitals in southern Benin. The cerebral malaria diagnosis was done based on WHO criteria. Blood samples for PCT measurement were collected on admission, 24 hours and 48 hours after the malaria therapy initiation. Student’s test, Pearson’s chi2 test, Fisher’s test and Kruskal-Wallis test were used where appropriate. For all comparisons the difference was significant when p was less than 5%. Results: Sixty-five children were included in the study with a sex ratio of 1.41. The age group of children under 5 years was the most represented, at 57%. PCT levels were high in 92.3% of children at admission, 90.8% at 24 hours and 84.6% at 48 hours. Forty-nine children had a positive clinical outcome while 16 died (24.6%). PCT levels were generally high over the three days of hospitalization, but higher at admission in case of death (p = 0.000). The association between PCT level and parasitemia at admission was significant (p = 0.04). Conclusion: In the view of the results, blood PCT level measured at admission could be predictive of the disease outcome in children with cerebral malaria.

Ophthalmic Anthropometry Versus Spectacle Frame Measurements

Purpose: Refractive errors among children are on the rise and more children are wearing spectacle correction. Selecting an appropriate frame that conforms to the child's developing facial features is vital for comfortable spectacle wear. This study aimed to analyze the relationship between the facial and frame measurements in spectacle-wearing children in southern India. Materials and Methods: This observational study included spectacle-wearing children aged 5–17 years. Participants were enrolled from the Paediatric Outpatient Department of a tertiary care hospital and across various schools in southern India. The facial and frame measurements such as pupillary distance, crest height (CH), bridge projection, apical radius, distance between rims at 10 mm and 15 mm, frontal angle (FA), splay angle, front to bend, head width, temple width (TW), angle of side and downward angle of drop were measured using Rees Fairbanks facial gauge, head and TW caliper and Association of British dispensing opticians frame rule. Results: Hundred and four children participated in the study. Statistically significant differences (P < 0.01, Wilcoxon signed-rank test) were observed between all facial and frame measurements such as CH, splay and FAs. Bland–Altman plots indicated large mean differences and wide limits of agreement between facial and frame measurements. Conclusion: Our study shows a large discrepancy between children's facial measurements and corresponding spectacle frame measurements. Many children were wearing reduced version of adult frames. This study highlights the need for dispensing age-appropriate spectacle frames for children. This may have implications for improved spectacle uptake and compliance.

Relationship between Maternal Mood Disorders and Dietary Intake of 3-Year-Olds.

Maternal depression affects parenting and children's early development, but its effect on dietary intake is unknown. While husbands' involvement in parenting and having friends to talk to may reduce childcare stress, this has not been thoroughly studied. In this study, mothers were stratified by the presence or absence of mood disorders, and the effects of support from their husbands and friends on the dietary intake of their 3-year-old children were examined. This cross-sectional analysis included 920 mother-child pairs examined at the National Center for Child Health and Development in Japan. Dietary intake was assessed using a brief dietary history questionnaire, and physical measurements were taken when the children were 3 years old. The Kessler Psychological Distress Scale was used to screen for maternal mood disorders, 3 years after delivery. The presence or absence of the husband's assistance with housework and childcare, mental support, and friends was obtained from a self-administered questionnaire when the child was 3 years old. Differences in the children's physical measurements, energy, and food intake with the presence or absence of support for subjects with or without mood disorders were compared. Mothers with support from husbands or friends had significantly fewer mood disorders. Support from friends and family did not affect the children's physical development and whether or not mothers had mood disorder symptoms. However, children's vegetable intake was higher if mothers were supported. Children of mothers with mood disorders had a significantly higher vegetable intake and fruit intake, depending on the support from friends (P=0.046, P=0.037); thus, such support may increase children's vegetable and fruit intake. The results of this study revealed the importance of supportive friends and family regarding childcare.

The Impact of Axial Eye Growth on Foveal Avascular Zone Measurements in Children.

SIGNIFICANCEFoveal avascular zone (FAZ) area is a frequently used biomarker in diseases impacting the retinal vasculature in pediatric populations. Variation in axial length between individuals results in differences in lateral image scale, which affect the accuracy of FAZ area measurements. Accordingly, changes in axial length over time within individual children would affect estimates of FAZ area change.PURPOSEThis study aimed to quantify how changes in axial length over time affect estimates of FAZ area change using optical coherence tomography angiography (OCT-A) images.METHODSTwenty pediatric participants (<18 years old) and 40 adult participants were imaged on Optovue's Avanti system (Fremont, CA) and had axial length measurements acquired at two time points. The FAZ was segmented twice using the OCT-A image at each time point. Foveal avascular zone area was estimated at both time points using the assumed/fixed axial length of the OCT-A device (unscaled) and using the participant's axial length (scaled). Changes in FAZ area over time were compared between the pediatric and adult groups using both unscaled and scaled data.RESULTSThe average ± standard deviation follow-up time was 3.35 ± 1.66 years for the pediatric group and 2.90 ± 1.65 years for the adult group. Using unscaled data, FAZ area seemed to decrease between visits in the pediatric group (P = .004), whereas the FAZ area increased between visits in the adult group (P = .003). When correctly scaled data were used, the FAZ area still increased between visits for the adult group (P < .001), although the FAZ area no longer showed a significant change between visits for the pediatric group (P = .37). When comparing the normalized FAZ area change across visits between unscaled and scaled data, a significant difference was found between the adult and pediatric groups (P < .001).CONCLUSIONSScaled data should be used when measuring FAZ area in pediatric populations, especially in longitudinal studies.

Comparison of Noninvasive Oscillometric and Intra-Arterial Blood Pressure Measurements in Children Admitted to the Pediatric Intensive Care Unit.

Intra-arterial blood pressure (IABP) measurement, although considered the gold standard in critically ill children, is associated with certain risks and lacks widespread availability. This study was conducted to determine the differences and agreements between oscillometric non-invasive blood pressure (NIBP) and invasive IABP measurements in children. Inclusion criteria consisted of children (from 1 month to 18 years) admitted to the pediatric intensive care unit (PICU) of a teaching hospital who required arterial catheter insertion for blood pressure (BP) monitoring. The comparison between IABP and NIBP was studied using paired t -test, Bland-Altman analysis, and Pearson's correlation coefficient. In total, 4,447 pairs of simultaneously recorded hourly NIBP and IABP measurements were collected from 65 children. Mean differences between IABP and NIBP were -3.6 ± 12.85, -4.7 ± 9.3, and -3.12 ± 9.30 mm Hg for systolic, diastolic, and mean arterial BP, respectively ( p < 0.001), with wide limits of agreement. NIBP significantly overestimated BP ( p < 0.001) in all three BP states (hypotensive, normotensive, and hypertensive), except systolic blood pressure (SBP) during hypertension where IABP was significantly higher. The difference in SBP was most pronounced during hypotension. The difference in SBP was significant in children <10 years ( p < 0.001), with the maximum difference being in infants. It was insignificant in adolescents ( p = 0.28) and underweight children ( p = 0.55). NIBP recorded significantly higher BP in all states of BP except SBP in the hypertensive state. SBP measured by NIBP tended to be the most reliable in adolescents and underweight children. NIBP was the most unreliable in infants, obese children, and during hypotension.

Agreement Between Automated and Clinically Reported Manual ROI-Based MR Elastography Liver Stiffness Measurements in Children and Young Adults.

MR elastography (MRE) typically requires manual ROI placement to generate liver shear stiffness measurements. Among 419 patients (primarily children and young adults), a computer-based automated MRE processing tool and clinically reported manual ROI-based measurements generated similar results (mean bias = 0.13 kPa). The intraclass correlation coefficient was 0.94 and was at least 0.90 across common indications in male and female patients and in patients with and without elevated liver fat fraction. Automated analysis may promote postprocessing standardization and decrease reporting variability.

Brain Volumetric Measurements in Children With Attention Deficit Hyperactivity Disorder: A Comparative Study Between Synthetic and Conventional Magnetic Resonance Imaging.

Objective: To investigate the profiles of brain volumetric measurements in children with attention deficit hyperactivity disorder (ADHD), and the consistency of these brain volumetric measurements derived from the synthetic and conventional T1 weighted MRI (SyMRI and cT1w MRI).Methods: Brain SyMRI and cT1w images were prospectively collected for 38 pediatric patients with ADHD and 38 healthy children (HC) with an age range of 6–14 years. The gray matter volume (GMV), white matter volume (WMV), cerebrospinal fluid (CSF), non-WM/GM/CSF (NoN), myelin, myelin fraction (MYF), brain parenchyma volume (BPV), and intracranial volume (ICV) were automatically estimated from SyMRI data, and the four matching measurements (GMV, WMV, BPV, ICV) were extracted from cT1w images. The group differences of brain volumetric measurements were performed, respectively, using analysis of covariance. Pearson correlation analysis and interclass correlation coefficient (ICC) were applied to evaluate the association between synthetic and cT1w MRI-derived measurements.Results: As for the brain volumetric measurements extracted from SyMRI, significantly decreased GMV, WMV, BPV, and increased NON volume (p < 0.05) were found in the ADHD group compared with HC; No group differences were found in ICV, CSF, myelin volume and MYF (p > 0.05). With regard to GMV, WMV, BPV, and ICV estimated from cT1w images, the group differences between ADHD and HC were consistent with the results estimated from SyMRI. And these four measurements showed noticeable correlation between the two approaches (r = 0.692, 0.643, 0.898, 0.789, respectively, p < 0.001; ICC values are 0.809, 0.782, 0.946, 0.873, respectively).Conclusion: Our study demonstrated a global brain development disability, but normal whole-brain myelination in children with ADHD. Moreover, our results demonstrated the high consistency of brain volumetric indices between synthetic and cT1w MRI in children, which indicates the high reliability of SyMRI in the child-brain volumetric analysis.

Use of Serial Weight and Length Measurements in Children from Birth to Two Years of Age to Predict Obesity at Five Years of Age

Childhood obesity is a major health concern. The associated health risks dramatically reduce lifespan and increase healthcare costs. The goal was to develop methodology to identify as early in life as possible whether or not a child would become obese at age five. This diagnostic tool would facilitate clinical monitoring to prevent and or minimize obesity. Obesity is measured by Body Mass Index (BMI), but an improved metric, the ratio of weight to height (or length) (WOH), is proposed from this re search for detecting early obesity. Results of this research demonstrate that WOH performs better than BMI for early detection of obesity in individuals using a longitudinal decision analysis (LDA), which is essentially an indi viduals type control chart analysis about a trend line. Utilizing LDA, the odds of obesity of a child at age five is indicated before the second birth day with 95% sensitivity and 97% specificity. Further, obesity at age five is indicated with 75% specificity before two months and with 84% specificity before three months of age. These results warrant expanding this study to larger cohorts of normal, overweight, and obese children at age five from different healthcare facilities to test the applicability of this novel diagnostic tool.

Relationship between Clinic and Ambulatory Blood Pressure Measurements in Children

Publisher: School of Statistics, Renmin University of China, Journal: Journal of Data Science, Title: Relationship between Clinic and Ambulatory Blood Pressure Measurements in Children, Authors: Dejian Lai, Tim S. Poffenbarger

Changes in Body Composition and Anthropomorphic Measurements in Children Participating in Swimming and Non-Swimming Activities.

Background. Physical activity is a well-known means of obesity prevention, but the relationship between exercise frequency and body composition in children has not been thoroughly investigated. Objective: The aim of this study was to compare the body composition of children aged 11–12 who regularly performed swimming and other sports as an organized extra-curricular physical activity for a 12-week period. Methods: The study included 46 students who attended swimming classes and 42 students who participated in training activities in other sports, including, but not limited to, football, basketball and athletics. Body height and body composition were measured using a Tanita BC 418 MA analyzer. The students individually reported their rate of perceived exertion during training using the Pictorial Children’s Effort Rating Table PCERT scale. Results: The weekly volume of training was substantially higher in the group of swimmers than in that playing other sports (12.3 h/week vs. 5.2 h/week, p < 0.01). After 12 weeks of training, body height and weight significantly increased in both groups (p < 0.001). However, the BMI value and adipose tissue content only increased in the group of non-swimmers. Swimmers perceived greater exertion during training than non-swimmers (7.1 vs. 5.8 on the PCERT scale, p < 0.01). Conclusions: In early pubescent children, engaging in vigorous exercise such as swimming for at least 10 h a week may restrain the growth of adipose tissue. However, the variety of exercises that are typical of team sports, if performed for no more than 5 h a week, may be insufficient to restrain adipose tissue growth.

The Variability and Determinants of Testosterone Measurements in Children: A Critical Review.

This critical review aimed to summarize: (1) the variability and determinants of testosterone (T) measurements; and (2) reference values for the variability and determinants of T measurements in children. As T is a representative androgen, it has been widely used to explain male vulnerability to child health and developmental problems. T measurements in children, however, have been challenging because of low levels, diurnal and episodic secretion patterns, limited quantity and quality of the samples, and inconsistent study findings. The search strategy used PubMed, CINAHL, Cochrane Library, Embase, Scopus, and Google Scholar. Studies published between 2008 through 2020 that examined factors influencing T measurement were included. The final 30 studies were selected using two appraisal forms. We extracted five categories of data from the reports. Variability and determinants of T measurement included assay methods, the source of samples, and child demographic and environmental characteristics. T levels were higher 1-3 months after birth and in males up to 1 year; fewer sex differences were found up to 10-12 years. Serum T levels measured by using liquid chromatography-mass spectrometry were most reliable because immunoassays overestimated the levels, especially in neonates. T levels were stable at different temperatures and durations of storage, although sample collection remained an ongoing challenge for researchers. Depending on the study aims and feasibility, mass-spectrometry, multi-methods, and multi-materials are the recent trends in T measurement. Immunoassays may be an option if the study aims for relative rather than absolute comparisons.

Use of Serial Weight and Length Measurements in Children from Birth to Two Years of Age to Predict Obesity at Five Years of Age

Use of Serial Weight and Length Measurements in Children from Birth to Two Years of Age to Predict Obesity at Five Years of Age

Reliability of Shear Wave Elastography and Ultrasound Measurement in Children with Unilateral Spastic Cerebral Palsy

In clinical practice, few data exist on the feasibility of performing reliable shear wave elastography (SWE) and ultrasonography (US) measurements in spastic muscles of children with cerebral palsy (CP). Ten children with unilateral CP took part in SWE and US assessment of the tibialis anterior and medialis gastrocnemius muscles during two sessions separated by a 1-wk interval. Intra- and inter-investigator reliability of shear modulus (µ) and muscle thickness (MT) measurements, at neutral and maximal dorsiflexion angles on both legs, was assessed by two investigators with different levels of experience. Reliability was assessed with the coefficient of variation (CV), standard error of measurement and intra-class correlation coefficient (ICC). Reliability of the µ measurement was insufficient, regardless of angle position (CV >10% and >20% for neutral and maximal dorsiflexion angles, respectively). The intra- and inter-investigator reliability of MT measurements was good (CV >10%, ICC >0.74) for both muscles in both legs. SWE measurements must be performed using a rigorous standardized protocol while MT should be considered an important parameter to monitor change in muscle morphology.

Reproducibility of Office and Out-of-Office Blood Pressure Measurements in Children: Implications for Clinical Practice and Research.

This study aimed to evaluate the reproducibility of office (OBP), ambulatory (ABP), and home blood pressure (HBP) measurements in children and adolescents, and their implications in diagnosing hypertension in clinical practice and in pediatric hypertension research. Apparently healthy children and adolescents referred for suspected hypertension were included. Measurements of 2-visit OBP, 7-day HBP, and 24-hour ABP were performed twice, 1 to 6 months apart. Reproducibility was quantified using the SD of differences between repeated measurements. The sample size of clinical trials comparing the efficacy of antihypertensive drugs using each method was calculated. Fifty-eight individuals were analyzed (mean age, 13.0±2.9 years, 60.3% boys). The reproducibility of 24-hour ABP (SD of differences 5.7/4.5 systolic/diastolic) and HBP (5.9/5.0 mm Hg) were comparable and superior to that of visit-2 OBP (9.2/7.8) and awake (6.7/5.5) or asleep ABP (7.6/6.1). As a consequence, a parallel-group comparative trial aiming to detect a difference in the effect of 2 drugs of 10 mm Hg systolic BP, would require 36 participants when using OBP measurements, 14 using 24-hour ABP, and 15 using HBP (102/34/42 respectively for detecting a 5 mm Hg difference in diastolic BP). For a crossover design trial, the corresponding sample sizes are 9/3/4 for systolic BP and 26/9/11 for diastolic, respectively. These data suggest that in children and adolescents 24-hour ABP and 7-day HBP have similar reproducibility, superior to OBP and daytime or asleep ABP. These findings have major implications in diagnosing hypertension in children in clinical practice and in designing clinical research trials in pediatric hypertension.

Temporal and Regional Trends in Ferritin Measurements in Children and Adolescents in Finland

Temporal and Regional Trends in Ferritin Measurements in Children and Adolescents in Finland

Correlation Between Invasive and Noninvasive Technique of Intracranial Pressure Measurement in Children With Traumatic Brain Injury: An Observational Study

Direct measurement of intracranial pressure (ICP) is an invasive technique with potential complications, which has prompted the development of alternative, noninvasive, methods of ICP assessment. The aim of this study was to determine the relationship between noninvasive ultrasound-based measurement of optic nerve sheath diameter (ONSD), transcranial Doppler-derived pulsatility index (PI), and invasive ICP measurements in children with traumatic brain injury (TBI). Children aged 1 to 18 years undergoing invasive ICP monitoring following TBI were included in the study. Noninvasive ONSD and PI measurements were compared with simultaneous invasive ICP. In all, 406 measurements of ONSD and PI were obtained in 18 patients. ONSD and PI correlated with ICP (r=0.76 and 0.79, respectively), combining ONSD and PI resulted in an even stronger correlation with ICP (r=0.99). Formulas were derived from mixed-effect models that best fitted the data for noninvasive ICP estimation. A combination of ONSD and PI had the highest ability to detect ICP >20 mm Hg (area under the receiver operating characteristic curve=0.99, 95% confidence interval: 0.99-1.00). Optimal cutoff values for the prediction of intracranial hypertension were 5.95 mm for ONSD (sensitivity, 92%; specificity, 76%) and 1.065 for PI (sensitivity, 92%; specificity, 87%). In children with TBI, a combination of ONSD and PI strongly correlates with invasive ICP and has potential to screen for intracranial hypertension noninvasively. ONSD and PI may be useful tools for assessing ICP where invasive monitoring is unavailable or contraindicated.

The Association Between High Body Mass Index and Technology Use Among Female Elementary School Students.

BackgroundOverweight and obesity among children are progressively turning into global issues. Numerous factors have been linked to the proliferation of pediatric obesity. However, there are still questions as to whether the corresponding proliferation in the use of technology could be linked to the increase in body mass index (BMI) among children. The aim of this study is to investigate the association between high BMI in female elementary school-age children and time spent using electronic devices.MethodsThis is a cross-sectional study that was conducted across three female elementary schools located in Jeddah between 2017 and 2018. All schools which are affiliated with the Ministry of National Guard in Jeddah were included. Demographic data, school performance, sleep routine, physical activity, parents' beliefs, and family demographic data were collected from the legal custodian of the children. The research group visited schools to obtain children's BMI measurements.ResultsThe number of participants who responded to the survey was 681. The results showed that the increase in BMI was non-significantly linked with the period spent using electronic devices, the use of electronic devices before sleep, nor the kind of device used. However, there was a significant association between high BMI and one type of electronic device: the television. There was a significant association between high BMI and the denial by parents that their children were obese. Furthermore, 50% of children were obese while 92.9% of overweight children's parents did not believe that there was a problem with the weight of their children.ConclusionThere is no significant association between screen time spent on electronic devices and high BMI among female elementary school-age children. However, lack of physical activity, fast food consumption, and genetic predispositions are still major contributing factors for childhood obesity and overweight. Nearly all parents of children who are overweight did not perceive their children as being overweight, which brings to the fore the subject of lack of awareness about childhood obesity among parents.