Children's Scores Research Articles

Brain AVM compactness score in children with hereditary hemorrhagic telangiectasia.

The brain arteriovenous malformation (BAVM) nidus compactness score (CS), determined on angiography, predicts BAVM recurrence after surgical resection among children with sporadic BAVMs. We measured theangiographic CS for BAVMs among children with hereditary hemorrhagic telangiectasia (HHT) to determine CS characteristics in this population. A pediatric interventional neuroradiologist reviewed angiograms to determine the CS of BAVMs in children with HHT recruited to the BVMC. CS is based on overall nidus and perinidal anomalous vessel compactness. CS categories included 1 = diffuse nidus, 2 = intermediate nidus, and 3 = compact nidus. Forty-eight of 78 children (61.5%) with HHT and brain vascular malformations had a conventional angiogram; 47 (97.9%) angiograms were available. Fifty-four BAVMs were identified in 40 of these 47 children (85.1%). Of 54 BAVMs in children with HHT, CS was 1 in 7 (13%), 2 in 29 (53.7%), and 3 in 18 BAVMs (33.3%) compared with CS of 1 in six (26.1%), 2 in 15 (65.2%), and 3 in 2 BAVMs (8.7%) among 23 previously reported children with sporadic BAVMs, p = 0.045 (Fisher's exact). Seven children with HHT had intracranial hemorrhage: 4 had CS = 3, 1 had CS = 2, and 2 had CS = 1. A range of CSs exists across HHT BAVMs, suggesting it may be an angiographic measure of interest for future studies of BAVM recurrence and hemorrhage risk. Children with HHT may have more compact niduses compared to children with sporadic BAVMs. Additional research should determine whether CS affects hemorrhage risk or post-surgical recurrence risk in HHT-associated BAVMs, which could be used to direct BAVM treatment.

Exploring the Effects of Repetitive Transcranial Magnetic Stimulation on Comorbid Sleep Disorders in Preschool Children with Attention-Deficit Hyperactivity Disorder.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurological developmental disorders in children, and sleep disorders (SDs) are a common comorbidity in children with ADHD. There are currently no pharmacological treatment options for SD in children with ADHD of preschool age (4-6 years). Repetitive transcranial magnetic stimulation (rTMS) is a novel, non-invasive neuromodulation technique. This study explores the effectiveness of rTMS for comorbid SDs in preschool-aged children with ADHD. Thirty-five children of preschool age with ADHD and comorbid SDs were recruited for this study. The children were divided into a parent behavior management training (PBMT) group (n = 19) and a repetitive transcranial magnetic stimulation combined with parent behavior management training group (n = 16). Both groups underwent 8 weeks of treatment. The children's SD scores were assessed using the Chinese Children's Sleep Habits Questionnaire, were measured before the start, at the end, and 4 weeks after the end of the intervention, and were used to measure the effects. Within-group differences were compared using a repeated-measures analysis of variance, and between-group differences were compared using an independent samples t-test and Mann-Whitney U-test. Both the PBMT group and the rTMS combined with the PBMT group significantly improved the SDs of preschool-aged children with ADHD (P < .001), but the effect of the intervention was more pronounced in the rTMS combined with the PBMT group (P < .001) and lasted longer than the PBMT group (P = .004). Repetitive transcranial magnetic stimulation is a promising non-pharmacological therapy to improve SD in preschool-aged children with ADHD.

The impact of large-scale land acquisitions on child food insecurity in Africa

Food insecurity is a major concern in most African countries. Large-scale land acquisitions (LSLAs) frequently have a negative impact on local communities. In this paper, I examine the impact of LSLAs on the nutritional status of neighboring children. To this end, I use a difference-in-differences methodology applied to LSLAs in a large number of African countries at different times since the early 2000s. I analyze data from Demographic and Health Surveys combined with data from the Land Matrix Initiative, supplemented by my own research, ultimately covering 18,276 children living in the vicinity of 45 LSLAs. I show that LSLAs have had a significant negative impact on child nutrition in Africa over the past two decades. Specifically, the dietary diversity scores of children living close to LSLAs were reduced by 20 per cent after acquisition. The results are robust to various statistical tests. I find no changes in work status or household assets. While the impact of LSLAs may be positive for agricultural practices, it is negative for child food security. The analysis highlights the importance of supporting local communities following foreign agricultural investment.

Age of entry into early childhood education and care, literacy and reduction of educational inequality in Nordic countries

ABSTRACT An early start to good-quality early childhood education and care (ECEC) is considered beneficial, especially for disadvantaged children's development and educational outcomes. This assumption was tested using the latest two waves (2015 and 2018) of data from the Programme for International Student Assessment (PISA) in five countries using the Nordic model of early education and care: Denmark, Finland, Iceland, Norway, and Sweden. The article finds evidence of the overall positive association between the age of entry in ECEC and literacy at age 15 in all Nordic countries. However, the relationship is non-linear, and the highest benefits seem to occur following entry into ECEC from ages two to three. The link between family background and ECEC enrollment largely explains this association. We did not find that ECEC would generally compensate for low socioeconomic status (SES) in children’s achievement. However, the Matthew effect was observed in Norway, where an early ECEC start is more strongly associated with literacy scores for affluent children than disadvantaged children. These findings have limitations due to their correlational nature. Still, this article indicates that even in high-quality universal ECEC systems, early preschool education is not a panacea for lowering achievement gaps due to parental background.

Dental health status of children with diabetes in Riyadh, Saudi Arabia

ObjectiveThe impact of diabetes on oral diseases remains debatable. We aimed to determine the prevalence of dental caries, gingival health status and knowledge, and oral hygiene level and practice in children with type 1 diabetes mellitus in Riyadh, Saudi Arabia. MethodsThe teeth of Sixty children with diabetes (33 males and 27 females; age 11.3 ± 2.2 [7–14] years) were examined for dental caries following the modified World Health Organization criteria. Data on age, sex, medical history, gingival health status and knowledge, and oral hygiene level and practice were collected from parents. ResultsIn this study, 53 % of the children had dental caries with decayed, missing, and filled primary and permanent teeth scores of 5.6 ± 3.8 and 3.6 ± 3.2, respectively, with similar scores for male and female children. Children with and without caries had similar oral hygiene practices and oral health knowledge but differed in the rates of good or fair oral hygiene status (89.2 vs. 56.6 %; P = 0.024) and normal gingival health status or mild gingivitis (96.5 vs. 81.3 %; P = 0.010). ConclusionsWe found that the oral hygiene status and rate of gingivitis differed in children with type 1 diabetes mellitus with or without dental caries.

The impact of raising a child with a developmental or physical health condition in Ethiopia

ObjectiveRaising a child with a developmental disability or physical health condition can have a major impact on the lives of their families, especially in low-income countries. We explored the impact on such families in Ethiopia. Study designA total of 241 child-caregiver dyads were recruited from two public hospitals in Addis Ababa, Ethiopia. Of these, 139 children were diagnosed with a developmental disability (e.g. autism, intellectual disability) and 102 children with a physical health condition (e.g. malnutrition, severe HIV infection). The family quality of life was assessed using caregiver reports on the Pediatric Quality of Life Inventory™ (PedsQL-FIM™). The disability weight score, which is a Global Burden of Disease measure to quantify health loss, was estimated for each child. ResultsFamilies with a child with a developmental disability reported lower quality of life than families caring for a child with a physical health condition (p < .001). Mean disability weight scores in children with a developmental disability were higher than in children with a physical health condition (p < .001), indicating more severe health loss. Disability weight scores were negatively associated with the family quality of life in the whole group (B=−16.8, SE=7.5, p = .026), but not in the stratified analyses. ConclusionsCaring for a child with a developmental disability in Ethiopia is associated with a substantial reduction in the family quality of life. Scaling up support for these children in resource-limited contexts should be prioritized.

Growing through adversity: the relation of early childhood educator post-traumatic growth to young children's executive function.

Early childhood educators (ECEs) play a critical role in supporting the development of young children's executive functions (EF). EF, in turn, underpins lifelong resilience and well-being. Unfortunately, many ECEs report adverse childhood experiences (ACEs) that may compound high stress levels associated with an emotionally and physically demanding profession. ACEs have well-established negative implications for adult well-being and may dampen ECEs' capacities to engage in emotionally responsive interactions with children. However, many individuals who experience ACEs also report post-traumatic growth experiences that foster empathy, self-determination, and resilience. Such post-traumatic growth may equip teachers with skills to engage in responsive interactions with children that support children's EF. The aim of this study was to explore the relations of ECE ACEs and post-traumatic growth to the EF of children in their classrooms. Fifty-three female ECEs self-reported on their ACEs and post-traumatic growth. Parents of 157 children (53% male, 47% female, M age = 4.38 years) rated children's EF. In a set of linear mixed models that accounted for multiple demographic factors and ECE perceived workplace stressors, ECE ACEs were not significantly related to children's EF scores. However, controlling for ACEs, higher levels of ECE post-traumatic growth were associated with fewer parent-reported EF difficulties in children. ECEs may draw on the coping skills they have developed in times of adversity to model and promote healthy EF for children. Mental health supports to facilitate ECEs' processing of their own trauma may be a fruitful means to foster positive early childhood environments that nurture the well-being and resilience of future generations.

Relation between Polygenic Risk Score, Vitamin D Status and BMI-for-Age z Score in Chinese Preschool Children.

Both genetics and vitamin D deficiency are associated with childhood obesity. However, the role of vitamin D status between polygenic and childhood obesity has been unknown. The current study aimed to determine the relation between genetic factors, vitamin D status, and BMI-for-age z score (zBMI) in Chinese preschool children. A total of 1046 participants aged 3.7 to 6.6 years old from the Long-term Health Effects Assessment Project of Infants and Toddlers Nutritional Pack (LHEAPITNP) were included in this study. The polygenic risk score (PRS) was established based on 55 BMI-related single nucleotide polymorphisms (SNPs) derived from a published genome-wide association study (GWAS) for BMI. Serum 25(OH)D was used as an index of vitamin D status and measured with liquid chromatography-tandem mass spectrometry (LC/MS-MS) assay. The Wilcoxon test or Kruskal-Wallis test was used to compare the differences of variables between different groups and Spearman correlation analysis was used for analyzing the correlations between the PRS, 25(OH)D levels, and zBMI. The PRS showed a positive relation to zBMI (rs = 0.0953, p = 0.0022) and 25(OH)D showed a negative relation to zBMI (rs = -0.1082, p = 0.0005) in the full-adjustment model. In addition, the differences in zBMI at different vitamin D statuses in the low-risk PRS group and the intermediate-risk PRS group were both statistically significant (plow = 0.0308, pintermediate = 0.0121), the median zBMI was both higher at vitamin D insufficiency status. And the difference in zBMI between different genetic risk groups was also statistically significant at vitamin D sufficiency status (p = 0.0077). Furthermore, genetic risk showed a positive relation to zBMI at vitamin D sufficiency status, and the p for trend was 0.0028. Our findings suggested that vitamin D was related to zBMI negatively in Chinese preschoolers and maintaining adequate vitamin D levels may only contribute to lower the zBMI in preschoolers with low and intermediate genetic susceptibility.

The Relationship between Passive Smoking and Caries Experience in Children Aged 1-12 Years and Influencing Factors

Objective: The aim of this study was to evaluate the relationship between passive smoking by parents and dental caries in children aged 1-12 years and the factors affecting this relationship. Materials and Methods: The examination data of 900 children aged 1-12 years who were admitted to Zonguldak Bülent Ecevit University, Faculty of Dentistry, Department of Pediatric Dentistry between December 2020 and May 2021 for various reasons and underwent routine examinations and met the study criteria were retrospectively analyzed. Sociodemographic characteristics, passive smoking status and dmft/DMFT scores of the children were recorded. The relationship between passive smoking status and dmft/DMFT scores and the factors affecting this relationship were analyzed. Results: The results of A statistically significant correlation was found between passive smoking status and dmft/DMFT scores of children (p=0.000). At the same time, a significant relationship was found between passive smoking and income level (p0.05). Conclusion: Passive smoking is thought to be a risk factor in caries formation. Therefore, it is important to reduce exposure to passive smoking in order to protect both oral and dental health and general health of children

Neurobehavioral problems at age 2 years in children with prenatal opioid exposure.

To evaluate factors associated with borderline/clinical range Child Behavior Checklist (CBCL) scores in opioid-exposed children. Retrospective study of 94 children with prenatal opioid exposure evaluated with the CBCL at age 2 years. Twenty-eight children (30%) had borderline/clinical findings on the CBCL, with 27% scoring borderline/clinical for Externalizing Problems. In the multivariable model, lower Bayley-III motor scores and discharge home with mother with safety plan were associated with borderline/clinical Externalizing Problems. Medication treatment for neonatal opioid withdrawal syndrome (NOWS) was associated with normal Externalizing Problems scores. Treatment with clonidine or phenobarbital was associated with scores in the normal range in all broadband CBCL measures. Specific factors are associated with behavioral and emotional challenges measured by borderline/clinical CBCL scores among opioid-exposed children.

Utility of the Full Outline of UnResponsiveness score in children with altered sensorium: A single-center prospective observational study

Background: Recent studies on the Full Outline of UnResponsiveness (FOUR) score suggest that it can overcome the limitations of the Glasgow Coma Scale (GCS). Hence, this study was planned to predict the outcome of children with altered sensorium using the FOUR score and to compare it with the GCS score. Subjects and Methods: This was a single-center prospective observational study conducted in children in the age group of ≥2 months–12 years with altered sensorium included in this study. Admission GCS and FOUR scores were collected. Data were analyzed to compare the FOUR score to GCS in relation to outcome (survivors/nonsurvivors). Results: Out of 90 cases with altered sensorium, 12 expired (13.3%). The mean (standard deviation [SD]) of age (years) was 4.69 (3.72) and the maximum in the age group of 1–5 years (n = 42). The mean (SD), median (interquartile range), and range for GCS at admission for survivors versus nonsurvivors were 11.58 (1.62) versus 6.08 (1.08), 12 (11–13) versus 6 (5.75–7), and 7–17 versus 4–8, and for FOUR score, 13.51 (1.46) versus 8.67 (1.50), 13 (13–15) versus 8 (7.75–10), and 9–16 versus 7–11 were observed, P &lt; 0.001. Admission GCS score of ≤8 (12 out of 15) and FOUR score &lt;11 (10 out of 12) died, P &lt; 0.001. ROC curve analysis for mortality prediction, the area under the curve for GCS (cutoff of 8) was 0.992, and for the FOUR score (cutoff of 11), 0.989 was observed, P &lt; 0.001. Conclusions: Admission FOUR and GCS scores are comparable for the prediction of mortality in children with altered sensorium. The FOUR score of ≤11 strongly correlated with mortality.

Relationship between gut microbiome and neurodevelopment in early life

To compare the differences in gut microbiome composition between children with good neurodevelopment and those with delayed neurodevelopment, and to analyze the relationship between gut microbiome and the neurodevelopment status of infants in early life. The mothers were included at the Second West China Hospital from November 2020 to April 2021. Their infant stools were collected on day 0 and day 90 after birth, and the follow-up questionnaires at the corresponding time points were completed. Additionally, the Ages and Stages Questionnaires-Third Edition(ASQ-3) were completed by mothers at 12 months of age. The structure and diversity of gut microbiota were examined by 16S rRNA sequencing, and the relationship between gut microbiome and ASQ-3 questionnaire scores in early life was analyzed. According to the ASQ-3 scores, mothers and infants into neurodevelopment good group(G group, n=18) and neurodevelopmental delay group(D group, n=10). Compared with the D group, the relative abundance of the Firmicutes was significantly higher in the G group at day 0(P&lt;0.05), while the level of the Proteobacteria was lower(P&lt;0.05). At day 90 after birth, the relative abundance of the Actinobacteria, Bifidobacteriaceae and Enterococcaceae was significantly higher in the G group(P&lt;0.05). In addition, alpha diversity was not statistically different between the two groups. Spearman&apos;s correlation analysis showed that Clostridiaceae of the postnatal day 0 infants was positively correlated with the communication domain score, but negatively associated with gross motor domain score in children at 12 months of age, whereas the relative abundance of Proteobacteria and Enterobacteriaceae of children at postnatal day 90 was negatively associated with communication development, while the relative abundance of Erysipelatoclostridiaceae showed a negative correlation with gross motor domain scores. The structure of the gut microbiome in early life between neurodevelopment good and delayed infants, and were associated with the development of communication and gross motor domain in infants at 12 months of age, suggesting that gut microbiome in early life may be related to the level of neurodevelopment in infants.

Voice treatment of school-aged children with vocal nodules with ABCLOVE rehabilitation

BackgroundThis study was to explore the effectiveness of the ABCLOVE exercise on school-aged children with vocal nodules after the treatment of budesonide. MethodsEighty-six school-aged children with vocal nodules were divided into control and ABCLOVE therapy groups. Subjective voice assessment and dysphonia severity index (DSI) assessment were performed before and after the 3-month of therapy. ResultsA significant improvement was observed in the ABCLOVE therapy group as compared with the control group (p = 0.035). ABCLOVE therapy significantly reduced the hoarseness and roughness scores in school-aged children with vocal nodules. Additionally, a significant reduction in functional score, physical score, emotional score, and total pVHI score was observed in the ABCLOVE therapy group. Moreover, acoustic parameters including jitter (%) and shimmer (%) were significantly reduced, whereas MPT and DSI were increased in school-aged children with vocal nodules who received 3 months of ABCLOVE treatment. ConclusionABCLOVE therapy displayed effectiveness on school-aged children with vocal nodules after the treatment of budesonide.

Developing and assessing the measurement properties of an instrument to assess the impact of musculoskeletal pain in children aged 9 to 12—the pediatric musculoskeletal pain impact summary score

BackgroundDespite the high prevalence of musculoskeletal (MSK) pain in children, there is a lack of instruments to measure the impact of MSK pain on children's activity and participation. ObjectiveTo assess the reliability and construct validity of the Pediatric MSK Pain Impact summary score in school children (aged 9 to 12) with MSK pain. MethodsWe used a pragmatic approach in a reflective framework to assess internal consistency, structural validity, convergent validity, and discriminative validity in a sample of 615 children with MSK pain. ResultsThe confirmatory factor analysis results indicate that the summary score has limited internal consistency and construct validity. The estimated Cronbach's alpha was 0.63, and most goodness of fit indices met the recommended thresholds (SRMR = 0.030; GFI = 0.993, CFI = 0.955, RMSEA 0.073), although they were close to the lower bounds of the thresholds. The convergent validity showed appropriate correlation of the summary score with quality of life (r = -0.33), care-seeking (r = 0.45), and medication intake (r = 0.37). Discriminative validity showed that the instrument can discriminate between the impact of pain on children with frequent and infrequent (2.93; 95% CI: 2.36 - 3.50) MSK pain. ConclusionThe Pediatric MSK Pain Impact summary showed limited internal consistency and construct validity; however, it can discriminate between children with frequent and infrequent pain. The results are promising for clinical and research practices as it is a short and convenient tool to be used in school-aged children.

Wie bewährt sich die Kaufman Assessment Battery for Children-II in der klinischen Anwendungspraxis? Befunde bei 7- bis 12-jährigen Kindern / How Does the Kaufman Assessment Battery for Children-II Stand the Test of Clinical Practice? Findings in 7- To 12-Year-Old Children

How Does the Kaufman Assessment Battery for Children-II Stand the Test of Clinical Practice? Findings in 7- To 12-Year-Old Children Reliability and validity of the KABC-II were investigated in 646 children aged 7 to 12 years who had been assessed in four social pediatric centers and one pediatric clinic in Germany due to developmental, behavioral, or emotional disorders.The reliability of the global scales Fluid-Crystallized-Index (FCI) and Mental Processing Index (MPI) proved to be very high in all age groups, with values ≥ .96. Reliability values for the scales were above .85 for Sequential/ Gsm and Delayed Recall, and above .90 for the other scales. Relatively higher test scores were found for Learning/Glr in children with intellectual disability than in other scales. Findings for discriminative validity for clinical diagnostic groups and educational backgrounds were as expected, with the lowest intelligence scores for children with intellectual disabilities.The correlation between FCI and the full scale IQ of the SON-R 2.-7 was .73 in a longitudinal subsample. Divergent validity for behavioral variables was confirmed in a subsample by low and nonsignificant correlations with the CBCL/6-18R. With some limitations, psychometric data indicate the suitability of the KABC-II for individual clinical assessment.

The emergence of a coherent self-concept: A longitudinal study on the development of the moral self.

The moral self-concept (MSC) is an early indicator of how children view themselves as moral agents. It has been proposed that an important feature of an established self-concept (SC) is sufficient coherency in how one views oneself. Furthermore, the MSC is expected to develop into a multidimensional, hierarchical construct which is stable over time. Investigating these theoretical hypotheses, this study aims to take three aspects into account to get a deeper insight into when and how the MSC first emerges: emergence of coherency, stability, and a differentiated structure. Preschoolers were presented with a puppet-interview at two measurement points (T1: M = 4.21 years, T2: M = 5.43 years, N = 108-133; 51%-57% female, largely Caucasian). The interview comprises three moral (helping, sharing, comforting), a physical, and a verbal self-concept scale. To investigate whether children had an established SC and therefore answered coherently, we analyzed children's response patterns resulting in a coherency-score: The greater answers vary within scales, the lower children score. Coherency of the MSC rose significantly across preschool period: At age 5, children answered largely coherently. Coherency of children's MSC related to its stability, meaning that the MSC was mostly stable for children with high coherency at T1. Factor analysis confirmed a multidimensional structure of the MSC at age 5, but not at age 4. The results demonstrate that a coherent and differentiated MSC is acquired within the preschool period. This offers a new approach to investigate the emergence of the SC in early development by integrating the important aspect of coherency into the area of SC research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Does basketball training increase balance scores in children?

Background and Study Aim. Balance is a motor skill that enables children to perform physical activities fluently and regular physical activity is needed for the development of balance skills. In this context, the problem of which physical activity should be directed to the balance development of children arises. The study is aimed to determine the effect of basketball training on balance skills in children aged 7-10 years. Material and Methods. The participant group of the study consisted of 24 children aged 7-10 years with a mean age of 9.25±0.94 who did not regularly perform physical activity and lived in rural or non-rural areas. Participants living in non-rural areas were included in the exercise group (n=12) and participants living in rural areas were included in the control group (n=12). The exercise group received basketball training for 8 weeks, two days a week, while the control group did not receive any intervention. Before and after the training process, all participants were tested at Level 1 in TOGU Challenge Disc and software to determine static and dynamic balance levels. As a result of the balance test, participants' static balance score (SBS), dynamic balance score (DBS), general balance score (GBS) and dynamic balance sub-parameter scores as right and left dynamic balance score (RL-DBS), superior inferior dynamic balance score (SI-DBS), horizontal plane dynamic balance score (HP-DBS), vertical plane dynamic balance score (VP-DBS), clockwise (C-DBS) and opposite clockwise dynamic balance score (OC-DBS) were taken as percentage. Descriptive statistics, Skewness, Kurtosis and Kolmogorov-Smirnov values, paired sample t-test and independent sample t-test were used to analyse the data. Statistical significance level was determined as p&lt;0.05. Results. In the study, no difference was found between the exercise group and the control group in terms of pre-test results, which indicated that the participant groups showed homogeneous characteristics. In the exercise group, a significant increase was found in DBS, RL-DBS, SI-DBS, C-DBS, GBS levels after 8 weeks of basketball training. In the control group, there was a significant decrease in SBS and a significant increase in DBS, RL-DBS, SI-DBS, C-DBS and OC-DBS levels at the end of 8 weeks. Conclusions. As a result, regular basketball training provided an increase in dynamic balance level and general balance scores. Moreover, basketball training can slow the decrease in static balance that may occur as a result of growth spurts in children aged 7-10 years. Children targeted to develop balance skills can be directed to basketball training.

Association of preschool children behavior and emotional problems with the parenting behavior of both parents.

Parental behaviors are key in shaping children's psychological and behavioral development, crucial for early identification and prevention of mental health issues, reducing psychological trauma in childhood. To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children. From October 2017 to May 2018, 7 kindergartens in Ma'anshan City were selected to conduct a parent self-filled questionnaire - Health Development Survey of Preschool Children. Children's Strength and Difficulties Questionnaire (Parent Version) was applied to measures the children's behavioral and emotional performance. Parenting behavior was evaluated using the Parental Behavior Inventory. Binomial logistic regression model was used to analyze the association between the detection rate of preschool children's behavior and emotional problems and their parenting behaviors. High level of parental support/participation was negatively correlated with conduct problems, abnormal hyperactivity, abnormal total difficulty scores and abnormal prosocial behavior problems. High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children. High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms, abnormal conduct problems, abnormal hyperactivity, abnormal peer interaction, and abnormal total difficulty scores in children (all P < 0.05). Moreover, paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors (all P > 0.05), after calculating ratio of odds ratio values. Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children. Overall, the more supportive or involved the parents are, the fewer behavioral and emotional problems the children experience; conversely, the more hostile or controlling the parents are, the more behavioral and emotional problems the children face. Moreover, the impact of fathers' parenting behaviors on preschool children's behavior and emotions is no less significant than that of mothers' parenting behaviors.

Prenatal exposure to polybrominated diphenyl ether (PBDE) and child neurodevelopment: The role of breastfeeding duration

BackgroundPrenatal and early-life exposure to polybrominated diphenyl ethers (PBDEs) is associated with detrimental and irreversible neurodevelopmental health outcomes during childhood. Breastfeeding may be a child's largest sustained exposure to PBDE— potentially exacerbating their risk for adverse neurodevelopment outcomes. However, breastfeeding has also been associated with positive neurodevelopment. Our study investigates if breastfeeding mitigates or exacerbates the known adverse effects of prenatal exposure to PBDEs and child neurodevelopment. MethodsParticipants included 321 mother-infant dyads from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal birth cohort in California. PBDE concentrations were measured in maternal serum blood samples collected during pregnancy or at delivery. Using generalized estimated equations (GEE), we estimated associations of PBDE concentrations with children's attention, executive function, and cognitive scores assessed longitudinally between 7 and 12 years of age, stratified by duration of exclusive and complementary breastfeeding. ResultsWe observed that higher maternal prenatal PBDE concentrations were associated with poorer executive function among children who were complementary breastfed for a shorter duration compared to children breastfed for a longer duration; preservative errors (β for 10-fold increase in complementary breastfeeding <7 months = −6.6; 95 % Confidence Interval (CI): −11.4, −1.8; β ≥ 7 months = −5.1; 95 % CI: −10.2, 0.1) and global executive composition (β for 10-fold increase <7 months = 4.3; 95 % CI: 0.4, 8.2; β for 10-fold increase ≥7 months = 0.6; 95 % CI: −2.8, 3.9). ConclusionsProlonged breastfeeding does not exacerbate but may mitigate some previously observed negative associations of prenatal PBDE exposure and child neurodevelopment.

Clinically significant differences in self-reported pain scores in children with headaches.

Changes in pain scores that represent clinically significant differences in children with headaches are necessary for study design and interpretation of findings reported in studies. We aimed to determine changes in pain scores associated with a minimum clinically significant difference (MCSD), ideal clinically significant difference (ICSD), and patient-perceived adequate analgesia (PPAA) in this population. We performed a secondary analysis of two prospective studies of children with headaches presenting to an emergency department. Two serial assessments were performed in children aged 6-17 and 4-17 years who self-reported their pain intensity using the Verbal Numerical Rating Scale (VNRS) and Faces Pain Scale-Revised (FPS-R), respectively. Children qualitatively described any endorsed change in pain score; those who received an analgesic were asked if they wanted additional analgesics to decrease their pain intensity. We used receiver operating characteristic curve-based methodology to identify changes in pain scores associated with "a little less" (MCSD) and "much less" (ICSD) pain and patients declining additional analgesics because they experienced adequate analgesia after treatment (PPAA). We analyzed 105 children: 63.8% were female and the median (IQR) age was 13 (10-15) years. Ninety-eight children were analyzed for the VNRS and 101 were analyzed for the FPS-R. For the VNRS, raw change and percent reductions in pain scores associated with MCSD, ICSD, and PPAA were 2/10 and 25%, 4/10 and 56%, and 3/10 and 50%, respectively, and for the FPS-R, 2/10 and 25%, 4/10 and 67%, and 4/10 and 60%, respectively. The area under the curve (AUC) associated with a MCSD for both scales ranged from 94% to 98%; the AUC associated with an ICSD or PPAA for both scales ranged from 76% to 83%. We identified changes in pain score associated with patient-centered outcomes in children with headaches suitable for designing trials and assigning clinical significance to changes in pain scores reported in studies.