Proportion Of Older Children Research Articles

Factors influencing the length of stay (LOS) undergoing robot-assisted thoracoscopic lung surgery in the setting of enhanced recovery after surgery (ERAS) protocol for pediatric patients: a retrospective study.

A prolonged length of stay (LOS) after surgery may result in higher hospital costs and hospital-acquired complications. This study aims to identify the risk factors associated with a prolonged hospital stay after robot-assisted thoracoscopic lung surgery for pediatric patients in the context of enhanced recovery after surgery. The data for this retrospective study were collected from pediatric patients undergoing robot-assisted thoracoscopic lung surgery. Patients were divided into two subgroups based on median postoperative LOS (Group I: LOS > median 5 days and Group II: LOS ≤ median 5 days). Logistic regression analysis was used to identify the potential factors associated with increased LOS. This study included 241 patients, 71 (29.46%) with an LOS of >5 days. The proportion of older children was significantly higher in Group I than that in Group II (P=0.004). Patients in Group I were more likely to experience a longer duration of anesthesia and surgery (P<0.001). They also had significantly higher rates of pneumonia, pleural effusion, and liver function damage (P<0.05). Several factors were identified to be associated with an increased LOS after robot-assisted thoracoscopic lung surgery: age >6 years [odds ratio (OR) =3.214, 95% confidence interval (CI): 1.464-7.502, P=0.004], surgery duration >100 min (OR =2.138, 95% CI: 1.296-4.387, P=0.005), intra-albumin (OR =13.778, 95% CI: 1.470-129.116, P=0.022), and blood loss >5 mL (OR =2.184, 95% CI: 1.082-4.409, P=0.029). The results revealed that older age, longer surgery duration, use of intra-albumin, and more blood loss predict longer postoperative hospital stay in pediatric patients with congenital lung lesions after robot-assisted thoracoscopic lung surgery.

Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

ObjectiveTo assess the epidemiologic association between Kawasaki disease and common pediatric infectious diseases (PIDs) identified during the coronavirus disease 2019 (COVID-19) pandemic period to confirm whether the infection-triggered theory is a plausible hypothesis for the pathogenesis of Kawasaki disease.Study designA retrospective epidemiologic study was conducted using datasets obtained from Web-based surveillance of Kawasaki disease and PIDs in Japan. We compared weekly numbers of patients who developed Kawasaki disease and specific PIDs between 2020 and 2017-2019 and evaluated the association between the percent reduction in the number of patients with these diseases.ResultsA total of 868 patients developed Kawasaki disease in 2020. During the social distancing period in 2020, the number of patients with Kawasaki disease was approximately 35% lower than in 2017-2019. Time from the onset of Kawasaki disease until the first hospital visit did not differ significantly among the examined years. The proportion of older children with Kawasaki disease decreased more than that of infants with Kawasaki disease (age <1 year), resulting in a significant difference in the proportion of infant patients between 2020 and 2017-2019 (24% vs 19%; P < .01). The number of patients with incomplete Kawasaki disease was unchanged from that of previous years. The weekly percent reduction in patient numbers differed between Kawasaki disease and PIDs during 2020, with no strong correlation between the 2 diseases.ConclusionsOur data indicate that parents of patients with Kawasaki disease did not avoid hospital visits during the COVID-19 pandemic period. The findings indicate the possibility that triggering Kawasaki disease might be associated with presently unidentified respiratory pathogen(s) that potentially might be acquired from both within and outside the household.

Neurocognitive Lag in School-Aged Children Living With HIV in India and Its Relevance.

ObjectiveObjective assessment of neurocognitive lags in pediatric HIV patients and its correlation with various clinical, social and familial factors.MethodsNinety-eight school-aged children living with HIV (CLHIV) (age 7-18 years) attending regional pediatric HIV clinic were observed for neurocognitive lag using Raven’s Standard Progressive Matrices by the same trained instructor. Sociodemographic data, mode of transmission, clinical staging, CD4 count, highly active antiretroviral therapy (HAART) duration were recorded and analyzed in the well-performing group and under-performing group.Results29.6% of children had definitive neurocognitive lag. The proportion of older children (11-18 years) in the under-performing group was significantly high (P = 0.007). The mean CD4 counts were low in the under-performing group (P = 0.001). Other socioeconomic factors could not be specifically correlated with neurocognitive lag in either of the groups.ConclusionCLHIV has a significant neurocognitive lag, which is accentuated in the upper age group. Findings point toward declining intellectual gains with increasing age in CLHIV.

Effects of group membership and visual access on children’s selective trust in competitive and non-competitive contexts

Two experiments examined how informants' group membership (social cue) and visual access (epistemic cue) influence children's selective trust in information provided by different informants in both competitive and non-competitive contexts. Children (3- and 4-year-olds, N = 35; 6- and 7-year-olds, N = 33) were assigned to “membership” groups (blue or red), while an ingroup informant and an outgroup informant provided conflicting testimony about a hidden picture in a box. In the non-competitive context (Experiment 1), children in both age groups trusted the ingroup informant more when both informants had visual access (baseline) and when only the ingroup informant had visual access (consistent). In an inconsistent scenario where only the outgroup informant had visual access, both the younger and the older children’s trust in the ingroup informant decreased, with only the 6- to 7-year-olds being less likely than chance to choose the ingroup informant. In Experiment 2 where children were told that the two groups were competitive, the older children endorsed the ingroup informant more compared to their performance in Experiment 1. The proportion of older children who claimed the ingroup informant was more trustworthy increased in the inconsistent scenario. Results suggest that older children attached more weight to visual access in the non-competitive context but they showed some sensitivity to informants’ self-interests in the competitive context, whereas younger children did not show a clear preference for either of the two cues when making selective trust decisions.

Health Seeking Behavior after Fever Onset in a Malaria-Endemic Area of Malawi

Informal sources of care may lead to ineffective use of antimalarial drugs. A survey conducted in Malawi estimated the frequency of use of informal and formal services, medications, and household costs. A total of 508 household interviews were conducted. Treatment with an antimalarial was reported in 24% of young children accessing the informal sector and in 91% accessing formal services. Informal care was associated with shorter travel and waiting times, a lower proportion of carers or feverish adults missing work or studies and losing earnings, and a lower proportion of older children missing studies or work. Total out of pocket costs of fever episodes constitutes between 9% and 14% in young children and 18% in adults of their total available resources. Patients may perceive informal services to be associated with opportunity cost advantages; however, these may be associated with health risks of inadequate prescribing, particularly in young children.

Perseverant responding in children's picture naming*

Two groups of children were given pictures of animals to name as quickly as they could. The groups comprised 40 nursery aged children (mean age 3; 11) and 40 Year 2 children (mean age 6;9) attending primary school in London. The 30 animals were presented one by one, on cards, and any errors made by the children were noted. Consistent with a similar object naming study with adults (Vitkovitch, Kirby & Tyrrell, 1996) and a study with children (Gershkoff-Stowe, 2002), picture naming errors referred to earlier named objects. However, while adults showed below-chance interference from objects that had only just been named (Lag 1), children were most susceptible to interference from very recently named objects (see also Gershkoff-Stowe, 2002). Furthermore, the proportion of younger children making Lag 1 errors was higher than the proportion of older children making Lag 1 errors. The results are discussed in relation to the activation levels of lexical representations.

Oral health habits amongst children in the United Kingdom in 2003

The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys. This paper presents data on parental attitudes towards the care of children's teeth and gums, reported oral hygiene behaviours and clinical measures of hygiene and periodontal health in 2003 and highlights trends since previous surveys. A total of 10,381 children were examined in schools by trained and calibrated examiners. Four measures of hygiene and periodontal health were recorded as part of the clinical examination. In addition, 3,342 questionnaires were completed by parents of a sub-sample of these children. The questionnaire enabled information to be collected about reported oral health behaviours and parental attitudes. About three quarters of children across all age groups are reported to brush their teeth twice daily. A range of oral health products was reported as being used in addition to toothbrushes and toothpaste. There is a trend in parental preferences towards restoration of teeth rather than extractions and towards a better understanding of dental caries prevention. Although overall a higher proportion of children in this survey appeared to have gingival inflammation, plaque and calculus than 10 and 20 years ago, there was no change in the proportion of older children with gingivitis. Dental practitioners have a role to play in reinforcing these positive attitudes and encouraging appropriate and effective oral hygiene behaviours in their child patients.

New strategies to promote the adoption of older children out of foster care

The proportion of older children in foster care is increasing. In order to ensure that these children do not age out of foster care into a life of poverty, it is imperative that more is done to find these children permanent adoptive homes. There are many more potential adoptive homes available than is commonly thought and there maybe even more homes available due to the increased attention from public and private initiatives focusing on foster children that need adoptive families. In order for these efforts to be successful, the most important steps that need to be taken are those that will decrease the numerous inter-jurisdictional barriers to adoption. Next, adoption practitioners need to focus on finding homes for older children that have empirical data that show they are unlikely to result in adoption disruption. Lastly, both the federal government and state governments need to mobilize funds to create networks of post-adoption services that will provide adoptive families with the support that will enable them to succeed as life-long caregivers.

Nutrition, health and schoolchildren

SUMMARY 1 NUTRITIONAL REQUIREMENTS OF CHILDREN 1.1 Dietary reference values1.2 Fluid requirements1.3 Growth and development 2 THE NATIONAL DIET AND NUTRITION SURVEY OF YOUNG PEOPLE 2.1 Types of food eaten2.2 Energy intake2.3 Macronutrient intakes2.4 Micronutrient intakes and status2.5 Dietary supplements2.6 Vegetarians/vegans2.7 Regional and socio‐economic differences 3 PHYSICAL ACTIVITY PATTERNS IN CHILDREN 3.1 Physical activity patterns in the UK3.2 Health benefits and effecting change 4 HEALTH IMPLICATIONS OF CHILDREN's DIETS AND ACTIVITY PATTERNS 4.1 Prevalence and implications of childhood obesity4.2 Risk factors for cardiovascular health4.3 Bone development4.4 Cancer4.5 Iron deficiency anaemia4.6 Oral health4.7 Food allergies and intolerance4.8 Eating disorders and restrained eating 5 SOCIAL AND CULTURAL INFLUENCES 5.1 Impact of television advertising5.2 Other social influences5.3 Teenage pregnancy5.4 Smoking, alcohol and drug use 6 TEACHING ABOUT NUTRITION AND HEALTH IN SCHOOLS 6.1 The formal curriculum6.2 The ‘hidden’ curriculum 7 IMPROVING THE HEALTH AND NUTRITIONAL STATUS OF CHILDREN 7.1 UK initiatives in schools7.2 School lunches7.3 School initiatives in North America and elsewhere7.4 Non‐school initiatives7.5 Welfare programmes for mothers and young children 8 CONCLUSIONS REFERENCES LIST OF BRIEFING PAPERS Summary Over the last 50 years, there has been a change in the predominant concerns about the diets and health of school aged children. Historically, the focus has been on the provision of sufficient nutrients and energy in relation to current and future needs, but providing dietary balance and encouraging less sedentary lifestyles are now viewed as the main priorities.The government report, the National Diet and Nutrition Survey: Young People aged 4–18 years, which was published in 2000, provides comprehensive information on the dietary patterns, nutrient intakes, nutritional status and physical activity patterns of young people in Britain today. This survey, in common with a number of other recent reports and papers, has identified the public health implications of the diet and lifestyle of schoolchildren of all ages. With the exception of very young children (4–6 years old), between 40–69% of children in Britain are largely inactive, spending less than one hour a day participating in activities of moderate intensity. These findings are also consistent with a number of other recent reports concerning the increasing prevalence of overweight and obesity in children. This situation mirrors that in adults and is likely to have the same fundamental causes.Consistent with data from the National Food Survey, it appears that over recent years there has been a reduction in energy intake and fat intake as a percentage of energy, with a corresponding increase in the proportion of energy derived from protein and carbohydrate. The average fat intake of children is in line with recommendations for adults, although their average intake of saturated fatty acids still exceeds government targets for adults. Salt and sugar intakes were also high in many children.Again, like many adults, British children are typically eating less than half the recommended five portions of fruit and vegetables a day. One in five (4–18 year olds) ate no fruit at all during an average week.There is evidence of low micronutrient intakes or status in some sub groups, for example poor vitamin D status, particularly in a proportion of older children. There is also evidence of low status of some vitamins in children from low income households and low intakes of some minerals, particularly in the older children: zinc, calcium and magnesium in boys and girls; and iron, iodine and copper in the girls. In particular in girls, there was some evidence of poor iron status.Clearly, these issues are worthy of attention because poor eating and physical activity habits in childhood may increase the risk of health problems in later life. Diet during childhood is a factor to varying degrees in the development of a number of diseases, either in childhood itself or during adult life, such as obesity, iron deficiency anaemia, dental caries, coronary heart disease, hypertension, osteoporosis and cancer. There is some evidence to suggest that health traits present in childhood tend to track into adult life, including body weight, blood levels of cholesterol, other blood lipids and insulin, and blood pressure. The extent to which genetic and environmental factors influence the development of diseases in later life remains unclear, but adoption of sensible eating habits and an active lifestyle early in childhood are considered important health strategies.Improving the health and nutrition of children should remain a priority for the government, health professionals, the food industry and teachers alike. The Healthy Schools Programme, re‐introduction of minimum nutritional standards for school lunches, compulsory teaching of food and nutrition in the Science; Design and Technology; and Personal, Social and Health Education programmes of study, together with other government initiatives such as the Wired for Health website, the School Fruit Scheme and School Travel Plans (encouraging walking and cycling) will contribute towards empowering children with knowledge and opportunities to make informed choices for their future health.