Population Of Schoolchildren Research Articles

Exhaled nitric oxide in school children: Searching for the lost variability

ObjectiveThe factors – including asthma and rhinoconjunctivitis – which influence FeNO values in a general population of school children have been studied in order to know to what extent the variability of those values can be explained. MethodsFeNO was measured in a population of 240 school children aged 6–12 years by means of a Niox-Mino™ device in a standardised way. Parents filled in an ISAAC-validated questionnaire of symptoms and environmental factors. Diagnoses were checked against clinical records. Height and weight were measured. A multivariate regression analysis including all variables in the questionnaire was performed, which was followed by two Xi stepwise tests in order to build a predictive model which included the main variables influencing FeNO values. ResultsAmong the 240 children, 10 suffered from asthma, 16 from rhinoconjunctivitis and 15 from both conditions. FeNO values (GM±GSD) in children with rhinoconjunctivitis (19.61±1.20ppb), with asthma (18.62±1.32ppb), and with both conditions (17.62±1.19ppb) tended to be significantly higher than control children (11.42±1.04ppb), p=0.0016, p=0.08 and p=0.01, respectively. The different predictive models were able to explain only 20–27% of FeNO variability. ConclusionsThe proportion of FeNO inter-individual variability which can be explained by individual (including suffering from asthma or rhinoconjunctivitis), family, and environmental factors is very low (20–27%). This could have implications on the usefulness of FeNO as a diagnostic tool in asthma.

Espesor medio intimal carotídeo en niños escolares y su relación con factores de riesgo cardiovascular

ObjetiveTo determine the relationship between cardiovascular risk factors and carotid intima-media thickness in a school children population of the city of Bogotá. MethodsCross-sectional descriptive study including all students at the selected schools of the convenience sample. The sample gathered 94 pupils (57 girls and 37 boys) of ages 13±1.54. Anthropometric measurements, blood pressure and ultrasound measurement of carotid intima-media thickness were conducted. Data analysis was carried out by means of descriptive statistics, in so far the univariate and bivariate analysis was made with frequency distribution and contingency tables for qualitative variables and descriptive measures of central tendency and variability for quantitative variables. ResultsOut of the total population, 34.79% showed excess weight according to the body mass index, 28.8% registered excess body fat, 46% had high blood pressure, of which 36.8% corresponded to early arterial hypertension and 9.2% to stage I hypertension. Average carotid intima-media thickness was 0.3163±0.040mm. A direct association was found between the carotid intima-media thickness and diastolic pressure (r=0.193). There is a direct lineal association between the percentage of body fat and diastolic pressure (r=0.283). ConclusionThe present study found a direct association between the carotid intima-media thickness and diastolic pressure. No statistically significant evidence was found to relate carotid intima-media thickness and obesity or excess body fat. It is very important to continue this type of study in Colombian population in order to prevent, from early stages in life, the occurrence of cerebro-cardiovascular risk factors.

Longitudinal Assessment of Blood Pressure in School-Aged Children: A 3-Year Follow-Up Study.

The purpose of this study was to assess the prevalence of abnormal blood pressure in a population of school children during a 3-year follow-up period and its relationship with obesity. Anthropometric and blood pressure data were collected from a population of Italian school children during three consecutive years. During each year blood pressure measurements were repeated three times, at intervals of 1 week. A total of 564 school-children [311 boys; mean (SD) age 8.8 ± 1.4 years] were recruited. During each year, systolic and diastolic blood pressure decreased from visit 1 to visit 3 (p < 0.001). This was associated with a decline in the percentage of prehypertension/hypertension from visit 1 to visit 3. An abnormal blood pressure value in at least one study visit was found in 8.8-17 % of children, whereas the prevalence of hypertension at all three study visits was between 5.2 and 7.8 %, and that of prehypertension at all three visits was between 2.8 and 3.8 %. High blood pressure was more frequent in obese children. In this population of school children the percentage of prehypertension/hypertension remarkably varied when based on one versus three annual assessments, thus emphasizing the importance of repeated measurement before making a diagnosis of abnormal blood pressure. Adiposity was confirmed to be a determinant of high blood pressure.

Socioeconomic status and health conditions associated with incidence of dental caries in Brazilian children

The purpose of this study was to assess the prevalence and severity of caries in primary and permanent dentition and to investigate the association between disease distribution and socio-demographic conditions, oral hygiene, and dietary habits of a population of schoolchildren in three districts of Belo Horizonte, Brazil, in 2012. This study involved 753 schoolchildren, aged 3–15 years, of two socio-economic levels: a low level, in a public school and kindergarten; and a high level, in a private school. The mean decayed, missing and filled deciduous infant teeth (dmft) values in children age 6 years and decayed, missing, and filled permanent adult teeth (DMFT) at 12 years were similar between children in the public school (dmft, 1.53; DMFT, 0.56) and the private school (dmft, 1.53; DMFT, 0.28). A low DMFT is associated with the habit of cleaning teeth after eating sweet foods, when the fathers were employed at the time of the child’s birth and if children started to brush their teeth earlier than 3 years of age. The data show that oral health monitoring of schoolchildren is a significant factor that can reduce dental caries, even in children from poor families. It is necessary to educate children to brush teeth before the 3 years of age, and to create prevention programs for children whose fathers are unemployed.

Black Like Who?: The Class of 2014 Considers Race in Dear White People

Modern educational institutions were associated with the separation of children from ordinary people and of the schoolhouse from the ordinary world, creating an educational subculture and a minority population of schoolchildren. Passage through this subculture became a universal shared experience. Higher education grew at the same time into an experience that separated those who went to college from those who did not, becoming a basis for the modern class system. Popular culture reflects this split as the college movie, a genre that addresses only part of the movie audience. As in other American institutions, there is also a split between the worlds of Black and White colleges. Only the mainstream White version of college appeared in movies until recently. The African-American-themed college movie was pioneered in School Daze. Dear White People followed that lead. The movie concerns a generation of Black college students whose perspectives rest on a familiarity with more than a half century of ideas about race in America.

The Eating Habits of School Children from the Longevity Blue Zone of Sardinia: a Positive Model

A healthy diet should balance caloric intake (quality calories) with a variety of foods poor in simple sugars, such as cereals and legumes, fruits and vegetables, nuts, low-fat dairy products, fish, meat, and eggs prepared with culinary skills and minimally processed. This paper investigates the eating habits of school children of Villagrande, Italy, a rural village characterized by the remarkable longevity of its inhabitants, and makes a comparison with a sample of school children of the same age from an urban setting in the island. A specific questionnaire was used to collect demographic data, meals structure and composition, frequency of food consumption, and characteristic of the usual diet. The frequency of healthy eating habits, according to the current standards, was superior in the rural compared to the urban setting. The consumption of vegetables was higher in rural than in urban students (≥ once a week, 94% vs 54%, p<0.01) whereas for fruit and legumes the percentages were comparable (≥ once a week, 97% vs 94% and 79% vs 71%, respectively). Cheese, which is a typical product of Sardinia and mostly homemade, was consumed more than once a week in 86% of rural compared to 73% of urban school children. Fish consumption was consistently higher in the rural compared to the urban area (more than once a week 81% vs 65% (p<0.001). Alcoholic beverages were consumed in small quantities in both cohorts surveyed, while soft drinks to a greater extent among urban school children. The overall nutrition pattern observed in the rural village could be considered the result of persistent traditional household influence and may prove useful to prevent early onset of obesity if extended to a broader school children population, although the implementation of such observations may be the biggest challenge.

Significant associations between hemostatic/fibrinolytic systems and accumulation of cardiovascular risk factors in Japanese elementary schoolchildren.

The aim of this study was to establish the reference values of hemostatic/fibrinolytic markers and investigate their relationship with physical constitution and cardiovascular risk factors in a normal schoolchildren population. This study comprised 148 healthy Japanese children aged 9-10 years (males 73; females 75). We performed laboratory tests including blood levels of leptin, high-sensitive C-reactive protein (hs-CRP), hemostatic and fibrinolytic markers [plasminogen activator inhibitor 1 (PAI-1), coagulation factor VII (FVII), coagulation factor X (FX), fibrinogen (Fbg), protein C, protein S], as well as common biochemical markers in the morning after an overnight fast. We investigated the mean, 10th, 50th and 90th percentile values of these markers. All parameters were compared between two groups, that is those with body mass index (BMI) 90th percentile or higher and BMI less than 90th percentile, and between subgroups based on the number of cardiovascular risk factors. Multiple-linear regression was used to assess associations between these hematological parameters and the components related to metabolic syndrome (MetS). Alanine aminotransferase (ALT), uric acid, leptin, hs-CRP, and all hemostatic/fibrinolytic markers (PAI-1, FVII, FX, Fbg, protein C, protein S) tested were significantly higher in the group with BMI 90th percentile or higher, and increased with accumulation of cardiovascular risk factors. Multiple-linear regression analysis showed that these values were associated with one or more components related to MetS. Reference values of hemostatic/fibrinolytic markers in Japanese schoolchildren were obtained. Many hemostatic/fibrinolytic markers showed significant association with BMI and accumulation of cardiovascular risk factors in normal Japanese schoolchildren.

Alanine transferase: An independent indicator of adiposity related comorbidity risk in youth.

Elevated levels of alanine aminotransferase (ALT) are associated with obesity and are often a consequence of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to assess the relationship between ALT and risk factors for adiposity-related co-morbidities in a diverse population of middle school children. We measured height, weight, body fatness (bioelectrical impedance), waist circumference, insulin sensitivity, phase 1 insulin release (acute insulin response following intravenous glucose), beta-cell function (acute insulin response corrected for insulin sensitivity), ALT, lipid profiles, and circulating concentrations of interleukin-6 (IL-6), C-reactive protein, adiponectin, and tumor necrosis factor-α (TNF-α) in a multi-ethnic/racial population of 106 middle school students (aged 11-14 years, 45 female) of varying body mass indexes (BMI). Alanine aminotransferase was significantly correlated with BMI, % body fat, fat mass, waist circumference, fasting insulin, insulin resistance, triglycerides, and was inversely correlated with high-density lipoprotein cholesterol in children, even though all values of ALT were "normal" (range of 4.0-33.0 U/L). ALT was significantly higher in males than females even when corrected for body fatness. Significant correlations with lipids and insulin resistance persisted even when adjusted for age, gender, and body fatness. Even within the normative range, ALT levels were significantly correlated with anthropomorphic and biochemical risk factors for adiposity-related co-morbidities in youth. Therefore, because ALT is correlated with dyslipidemia, insulin resistance, and central fat distribution, it might also serve as a marker of risk for adiposity-related co-morbidities beyond NAFLD.

Оценка порога вкусовой чувствительности к поваренной соли как одного из факторов риска артериальной гипертензии у школьников Тюмени

Aim. To study the prevalence of the taste sensitivity threshold for salt (TSTS) as one of the main risk factor for hypertension in Tyumen city schoolchildren. Material and methods. The single-period epidemiologic study conducted in the population of 7-17 y. o. schoolchildren from one of the districts of Tyumen (2004-2006), chosen by a random assignment method, with a quantity of 2640 persons (1308 boys, 1332 girls), with response rate 87,7%. In schoolchildren of 9-17 y. o. (880 boys, 936 girls), the TSTS measured using modified Henkin R et al. method (described by Konstantinov E. N. et al., 1983). Results. The prevalence of high level of TSTS in a population of schoolchildren was 14,8%, average TSTS had 75,8% of schoolchildren, in 9,5% of persons low TSTS was identified. Persons with high TSTS were met almost in 2 times often among boys compared with girls, and in 1,5 times among adolescents with simultaneously elevated systolic and diastolic blood pressure (BP), than among schoolchildren with normal BP levels (p<0,05).Adolescents 14-17 years of age with elevated diastolic blood pressure were observed higher tangible medium salt concentration. The relation between TSTS and the degree of increase in blood pressure in adolescent’s, from medium to strong, was revealed by paired correlation analysis. Conclusion. The results showed high prevalence of the high TSTS in Tyumen schoolchildren population, relation between TSTS and the severity of BP increase in youths.

Ocular higher-order aberrations in a school children population

PurposeThe primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children. MethodsA sample of 557 children aged 10–15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7±0.5 years), group II (12.4±0.5 years) and group III (14.5±0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4lux). Wavefront analysis was achieved for a 5mm pupil. Statistical analysis was carried out for the right eye only. ResultsThe average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076μm) and horizontal (0.018μm) coma, oblique trefoil (−0.055μm) and spherical aberration (0.018μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007μm (SE 0.005) in group I to 0.011μm (SE 0.004) in group II and 0.030μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations. ConclusionsDifferences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development.

Salivary carriage of Candida species in relation to dental caries in a population of Saudi Arabian primary school children

Abstract Aim Salivary Candida carriage patterns seem to significantly vary by geographical location. The aim of this study was to assess carriage of Candida species in saliva of primary school children in a Saudi population, and correlate it to their dental caries activity. Materials and methods A total of 270 children of both genders were recruited from six primary schools. Oral hygiene and dental caries were assessed using the simplified oral hygiene and dft/DMFT indices, respectively. Chromagar Candida medium was used to identify and quantify Candida species in unstimulated saliva samples. Results Seven percent of the subjects were caries free while 74% had high caries activity. Candida was detected in 63.3% of the children with a mean count of 1076 ± 1888 CFU/ml. Significantly higher carriage was observed in males (70% vs. 56%; P = 0.02). Candida albicans accounted for 69% of the isolates, while Candida tropicalis, Candida glabrata, Candida krusei and unidentified species represented 11.8%, 5.5%, 2.3% and 11.4%, respectively. Twenty-five percent of the carriers harbored 2 or more species. Four carrier clusters were identified as described previously. Carriage status showed the strongest association with both d and D scores (P 1000 CFU was only seen in caries active subjects. Conclusions Asymptomatic oral carriage of Candida at high counts seems to be common among children from Arabia. Further evidence is provided here for the potential use of Candida counts for prediction of caries risk.

Excess weight among children and adolescents in Switzerland--prevalence and correlates for the early 2010s.

To determine the prevalence of overweight and obesity, and some of their social correlates among children in Switzerland. Data from population and sample studies of school children of different grades from eleven Swiss towns and cantons, gathered in the framework of medical examinations at state schools in the school years 2010/11, 2011/12 or 2012/13, were used. Body mass index (BMI) was used to classify children as normal weight, overweight or obese. The term "excess weight" refers to children who are either obese or overweight. A total of 17.0% of the children and adolescents were affected by excess weight (including obesity), of which 3.9% were obese. Excess weight was more prevalent at higher school levels (highest level: 20.5%; middle level: 18.2%; basic level: 12.3%), among foreign nationals (basic level: 19.0%; middle level: 26.1%; highest level: 29.3%) as opposed to Swiss nationals (basic level: 11.4%; middle level: 15.2%; highest level: 19.8%) and among children whose parents had only attended compulsory school (basic level: 24.5%; middle level: 37.6%; highest level: 28.3%) as opposed to children whose parents had tertiary schooling (basic level: 8.4%; middle level: 10.6%; highest level: 14.3%). Differences with respect to sex and area of residence were rather small and disappeared in multivariate statistical analyses controlling for the effect of nationality and social background. Excess weight is widespread but not equally distributed among children in Switzerland. Strategies aimed at reducing the number of overweight children need to take into account social differences between different groups.

Factors associated with low adherence to a Mediterranean diet in healthy children in northern Spain

There is a tendency in Mediterranean countries to abandon the characteristic Mediterranean diet. This is especially apparent within younger populations. This could have negative consequences for health such as, cardiovascular diseases, obesity or metabolic syndrome. The aim of this study was to describe adherence to the Mediterranean diet within a population of school children and to examine the influence of different socio-demographic factors and lifestyle habits. The study was conducted on a representative sample of 321 school children aged 11–12 years from 31 schools in the city of Logroño (La Rioja). Socio-demographic variables, anthropometric variables, blood pressure, level of development, aerobic fitness, lifestyle, physical activity habits and adherence to the Mediterranean diet were recorded. High adherence to the Mediterranean diet was reported by 46.7% of school children, with low adherence being reported by 4.7% of them. Children attending state schools, immigrants and families from low-to-medium socio-economic strata reported significantly lower adherence to the Mediterranean diet (p = .039), but the results did not reveal any significant differences in terms of body composition. Correlations were found between adherence to the Mediterranean diet and other lifestyle habits, especially level of physical activity (r = .38) and screen time (r = −.18). Adherence to a Mediterranean diet differs according to the type of school attended by children, and the child's nationality and socio-economic status. Children who attended state schools, immigrants and those from families with a medium-to-low socio-economic status were less likely to follow healthy diets.

The secular trend in the prevalence of overweight and obesity in the population of primary school children from Ljubljana (Slovenia)

Abstract Background: The prevalence of overweight and obesity among children has increased dramatically in recent decades. The survey examined overweight and obesity in the population of boys and girls from Ljubljana, the capital of Slovenia, aged seven through fourteen from 1991 to 2011. Methods: An annually repeated cross-sectional study of data from the national SLOFIT monitoring system was used. The body mass index cut-off points of the International Obesity Task Force were used to identify the prevalence of overweight and obesity. Multinomial logistic regression was used for modelling the probability of overweight and obesity as a function of time (year of measurement), sex and age of subjects. Results: In 1991-2011 period, the odds for overweight and obesity among primary school children (n = 376,719) increased every year by 1.7% (95% CI: 1.6-1.9) and 3.7% (3.4-4%) respectively. Boys have 1.17 (95% CI: 1.15-1.20) times higher odds of becoming overweight and 1.39 (95% CI: 1.35-1.44) times higher odds of becoming obese than girls. In comparison to the reference group (age of 14), the highest odds for overweight were found at the ages of nine and ten (1.39; 95% CI: 1.34-1.44), while for the obesity the highest odds were at the age of eight (2.01; 95% CI: 1.86-2.16). Conclusion: From 1991 to 2011, overweight and obesity clearly became more prevalent in children from Ljubljana. This trend has been more obvious among boys than girls. In comparison to 14-year-old boys and girls, the highest odds for excessive weight were found below the age of 10.

Biomonitoring exposure assessment to contemporary pesticides in a school children population of Spain

The exposure to pesticides amongst school-aged children (6–11 years old) was assessed in this study. One hundred twenty-five volunteer children were selected from two public schools located in an agricultural and in an urban area of Valencia Region, Spain. Twenty pesticide metabolites were analyzed in children׳s urine as biomarkers of exposure to organophosphate (OP) insecticides, synthetic pyrethroid insecticides, and herbicides. These data were combined with a survey to evaluate the main predictors of pesticide exposure in the children׳s population. A total of 15 metabolites were present in the urine samples with detection frequencies (DF) ranging from 5% to 86%. The most frequently detected metabolites with DF>53%, were 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos), diethyl phosphate (DEP, generic metabolite of OP insecticides), 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY, metabolite of diazinon) and para-nitrophenol (PNP, metabolite of parathion and methyl parathion). The calculated geometric means ranged from 0.47 to 3.36µg/g creatinine, with TCPy and IMPY showing the higher mean concentrations. Statistical significant differences were found between exposure subgroups (Mann–Whitney test, p<0.05) for TCPy, DEP, and IMPY. Children living in the agricultural area had significantly higher concentrations of DEP than those living in the urban area. In contrast, children aged 6–8 years from the urban area, showed statistically higher IMPY levels than those from agricultural area. Higher levels of TCPy were also found in children with high consumption of vegetables and higher levels of DEP in children whose parents did not have university degree studies. The multivariable regression analysis showed that age, vegetable consumption, and residential use of pesticides were predictors of exposure for TCPy, and IMPY; whereas location and vegetable consumption were factors associated with DEP concentrations. Creatinine concentrations were the most important predictors of urinary TCPy and PNP metabolites.

Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account. A quantitative cross-sectional survey was conducted on 131 children aged 6 to 11 years and their mothers in the framework of the Demonstration Of A Study To Coordinate And Perform Human Biomonitoring On A European Scale (DEMOCOPHES) European project. Participants were selected from 1 urban and 1 rural area of Denmark, and equally distributed in age and gender. Data were collected through structured interviews with all children and self-report questionnaires for mothers regarding health, pain, and medicine use. After adjusting for several sociodemographic and health parameters, maternal use of OTC analgesics was significantly associated with self-medication with OTC analgesics, particularly PCM, in our population of schoolchildren, even when the child's pain was adjusted for (odds ratio 3.00, P = .008). A clear association between child pain and OTC analgesic use was not found. Additionally, maternal health (self-rated health, chronic pain, chronic disease, daily medicine intake) did not significantly influence child use of OTC analgesics. Maternal self-medication with OTC analgesics is associated with self-medication of OTC analgesics, predominantly PCM, among school-aged children, perhaps more than the child's pain. Maternal health seems of less importance. Information to parents about pain self-management is important to promote appropriate PCM use among schoolchildren.

Potencjalne możliwości wykorzystania interaktywnych gier ruchowych w korygowaniu wad postawy u dzieci

Strugarek Jan, Potencjalne mozliwości wykorzystania interaktywnych gier ruchowych w kory- gowaniu wad postawy u dzieci (The Potential of Using Exergames for Correcting Posture Problems of Children). Studia Edukacyjne nr 31, 2014, Poznan 2014, pp. 289-304. Adam Mickiewicz University Press. ISBN 978-83-232-2781-6. ISSN 1233-6688 In Poland we observe a large scale of posture deformations and consequent health implications in the population of school children. Therefore many pedagogical and medical societies are looking for ways and methods of preventing and reversing this negative trend. The purpose of this article is to present the potential of practical use of new posture correction interactive games among school children. Some of the newest equipment and ways of detecting and registering natural human movement have been presented. Teletransmision of data in real time makes it possible for a physio- therapist to supervise and modify the player's motor behavior. Creating visually attractive and involving forms of physical exercise might help encourage and inspire children to reject a sedentary lifestyle.

The relative roles played by structural and pragmatic language skills in relation to behaviour in a population of primary school children from socially disadvantaged backgrounds

Considerable evidence supports the association between language learning difficulties and behaviour in young children and this is likely to be particularly true of children raised in social disadvantage. Less is known about the way that different aspects of language, specifically pragmatics, interact with behaviour. This study examines the extent to which pragmatic language skills mediate the relationship between structural language skills and parent report of behaviour. It was carried out with 138 community ascertained monolingual English speaking primary school children raised in an area of marked social disadvantage. We found that pragmatic skills substantially mediate the relationship between language and behaviour in this group of children. Further analyses suggest that the mediational relationship holds for hyperactivity, peer related problems and overall impact score but not for emotional problems, conduct problems or pro-social behaviour. Pragmatic language skills underpin the relationship between language and behaviour in low SES (socio-economic status) children. This is specifically true for children exhibited signs of hyperactivity, peer problems and the perceived impact that these may have on the classroom teacher, parents and other children. These findings need to be replicated in both comparable and different populations but, if the relationship holds, it is likely to have considerable implications for the development of valid and effective interventions in this area. Furthermore they may lead to a more differentiated approach to behavioural difficulties.

Prevalence of Symptomatic Congenital Heart Disease in Tibetan School Children

The prevalence of congenital heart disease (CHD) in Tibet has not been fully investigated. The aim of this study was to illustrate and compare the prevalence of symptomatic CHD and its major subtypes in Tibetan children at different altitudes. A total of 5,790 children from regions at altitudes of 3,500 to 4,100 m (group L) and 4,548 children from 4,200 to 4,900 m (group H) were compared for CHD prevalence. Group H had greater prevalence of total CHD (12.09 vs 4.32 per 1,000, p <0.001), patent ductus arteriosus (PDA, 7.70 vs 1.38 per 1,000, p <0.001), and atrial septal defect (ASD, 3.52 vs 2.25 per 1,000, p = 0.23) than group L. The differences were more remarkable in women (CHD, 18.63 vs 4.88 per 1,000, p <0.001; PDA, 11.53 vs 1.74 per 1,000, p <0.001; ASD, 5.32 vs 2.79 per 1,000, p = 0.15). No significant difference was observed in the prevalence of ventricular septal defect between the 2 groups (0.44 vs 0.35 per 1,000, p >0.05). The most common cardiac defect was ASD (52.0%) in group L compared with PDA (63.6%) in group H. In group L, women had slightly and insignificantly greater prevalence of total CHD, PDA, and ASD than men. In contrast, the prevalence was almost threefold greater in women than men in group H. In conclusion, the CHD prevalence and composition differed significantly between populations of school children living above and below 4,200 m.

Daily stressors in school-age children: A multilevel approach.

This study uses hierarchical or multilevel modeling to identify variables that contribute to daily stressors in a population of schoolchildren. Four hierarchical levels with several predictive variables were considered: student (age, sex, social adaptation of the student, number of life events and chronic stressors experienced, and educational level of the father and mother), class (number of students per class), school (type of school), and province (number of inhabitants per province). Participants were 6,078 students from primary years 3-6 in the region of Andalusia (Spain). After conducting a multilevel regression analysis, the final fitted model was a random intercept and random slope model (at the school level) for the variable age, with the fixed factors being the variables social adaptation, life events and chronic stressors, and the educational level of the father and mother. This model yielded a specific profile of daily stressors in childhood: children with the highest levels of daily stressors are younger, present aggressive or inhibited behavior, have experienced more life events and chronic stressors, and have parents who did not complete their primary education. The results provide relevant information for the design of psychoeducational interventions in relation to children's daily stressors.