Swiss Children Research Articles

Cerebral sinus venous thrombosis in Swiss children

AIMo describe the characteristics of paediatric cerebral sinus venous thrombosis (CSVT) in Switzerland. data on clinical features, neuroimaging, risk factors, and treatment were collected for all children in Switzerland younger than 16 years of age who had CSVT between January 2000 and December 2008. A follow-up examination and a cognitive assessment were performed (mean follow-up period 26mo). Differences between neonates and children (patients older than 28d) were assessed and predictors of outcome were determined. twenty-one neonates (14 males, seven females; mean age 9d, SD 8d) and 44 children (30 males, 14 females; mean age 8y 7mo, SD 4y 5mo) were reported. The incidence of paediatric CSVT in Switzerland was 0.558 per 100000 per year. In neonates, the deep venous system was more often involved and parenchymal injuries were more common. The strongest predictor of poor outcome was neonatal age (odds ratio 17.8, 95% confidence interval 0.847-372.353). Most children showed global cognitive abilities within the normal range, but impairments in single cognitive subdomains were frequent. paediatric CSVT is rare. Its outcome is poor in neonates. Most children have good neurological outcomes, but some patients have individual neuropsychological impairments.

Winning Faces: Biologically Inspired Vision Algorithm Predicts Election Results

Todorov et al (2005) demonstrated that people could make competence judgments about faces with only 100 millisecond exposures that were predictive of electoral victories. Others have since shown that Swiss children can predict the outcome of French elections when they pick which face they would want to be the ‘captain of the boat’ in an adventure game. And, Indians and Americans can pick the winners of Mexican and Brazilian political contests just by looking at their faces. The automaticity, early development, and universality of this ability suggests it is likely instantiated in a basic cognitive process. We show that a computer model of the V1 region of the primate visual cortex that has performed very well in prior object recognition tasks can predict winners of elections based purely on candidate appearance and at a rate comparable to human subjects.

High prevalence of vitamin D deficiency in children and adolescents with type 1 diabetes

Vitamin D is important for bone health. An inadequate supply of vitamin D to the body is associated with a higher fracture risk in the elderly. Young adults with type 1 diabetes are reported to have a lower peak bone mass than healthy individuals, which could possibly lead to an increased fracture risk in the future. The prevalence of vitamin D deficiency in healthy young people is high. Thus, optimal supply of vitamin D may be of particular importance for bone health in children with type 1 diabetes. In this prospective cross-sectional study we measured serum 25-hydroxy-vitamin D, iPTH, total and ionised calcium, phosphate, and alkaline phosphatase in 129 Swiss children and adolescents with type 1 diabetes. Of the 129 subjects 78 (60.5%) were vitamin D deficient, defined as a 25-hydroxy-vitamin-D level below 50 nmol/L. During the winter this number rose to 84.1%. 25-hydroxy-vitamin-D levels showed marked seasonal fluctuations, whereas there was no correlation with diabetes control. Despite the high prevalence of vitamin D deficiency, we found a low prevalence of secondary hyperparathyroidism in vitamin D deficient diabetic children and adolescents. Prevalence of vitamin D deficiency in diabetic children and adolescents is high. Therefore, screening for vitamin D deficiency and supplementation in children with low vitamin D levels may be considered.

Immigrant children's peer acceptance and victimization in kindergarten: The role of local language competence

The study investigates peer acceptance and victimization of immigrant and Swiss children in kindergarten classes. Our first aim is to compare peer acceptance and victimization of Swiss and immigrant children. Secondly, we explore the role of their local language competences (LLCs). The sample was drawn from kindergartens in communities in the German-speaking part of Switzerland. A representative sample of 568 boys and 522 girls (mean age 5.8 years) took part in the research. Teachers completed questionnaires on children's victimization, bullying, and LLC. The nationality background of parents was indicated by teachers and parents. To assess peer acceptance, a peer nomination method was used. Immigrant children showed less acceptance by peers and were more often victimized than their Swiss peers. There was a significant interaction effect for LLC and national background of mothers, showing that LLC was positively associated with peer acceptance for children of an immigrant background but not for Swiss children. Furthermore, peer acceptance mediated the effect of national background of mothers on victimization. Results are discussed in terms of the need to improve immigrant children's LLC.

Die Entwicklung moralischer Emotionen bei Kindergartenkindern

We investigated the development of young children's moral emotions, i.e., sympathy and guilt, within a multi-informant longitudinal research design. One-hundred and seventy-five 6-year-old Swiss children participated at the first assessment (T1; re-assessed after one year; T2). Mothers and teachers participated as well. Sympathy was measured with self- and other reports and within children's play narratives. Guilt feelings were assessed by emotion attributions to protagonists and self-as-protagonist following different hypothetical moral transgressions. Mother-rated sympathy at T2 was positively related to guilt feelings at T2, whereas no relations between sympathy and guilt were found at T1. Sympathy ratings within informant were stable over a year. Guilt feelings to protagonists and self-as-protagonist were stable over a year as well. Guilt feelings predicted subsequent guilt feelings, whereas earlier sympathy did not predict guilt feelings. The results are discussed in regard to the differential development of moral emotions.

The surprisingly high proportion of Verb Second in causal adverbial clauses with wil ‘because’ in child Swiss German

Clauses introduced by wil ‘because’ are compatible with two verb-placement patterns: verb-final and Verb Second (V2), which are usually not interchangeable. The focus of this study is on the frequency of occurrence of the V2 pattern and its function in Swiss German, based on an analysis of the speech of two children whose acquisition of verb placement is unusual. Instead of using the verb-final pattern typical of embedded clauses, they extend verb movement from matrix clauses to embedded clauses, resulting in a verb-movement grammar before age 5. Only in clauses introduced by wil does verb movement result in genuine V2. Moreover, most of the children's wil-clauses produced before age 5 provide an answer to a question with warum ‘why’, a context in which Swiss-German adults predominantly use the verb-final pattern. An examination of the weil-clauses in two German corpora reveals that adults rarely use V2 in answer to a warum-question, but German children appear to overuse it in this context, although they have acquired the verb-final pattern, in contrast to the Swiss children. Thus the surprisingly high proportion of wil + V2 in the Swiss-German child data may not be a consequence of their verb-movement grammar, but rather the result of overextending V2 to a context in which adults generally use the verb-final pattern.

Estimation of percentage body fat in 6- to 13-year-old children by skinfold thickness, body mass index and waist circumference

We evaluated the accuracy of skinfold thicknesses, BMI and waist circumference for the prediction of percentage body fat (PBF) in a representative sample of 372 Swiss children aged 6-13 years. PBF was measured using dual-energy X-ray absorptiometry. On the basis of a preliminary bootstrap selection of predictors, seven regression models were evaluated. All models included sex, age and pubertal stage plus one of the following predictors: (1) log-transformed triceps skinfold (logTSF); (2) logTSF and waist circumference; (3) log-transformed sum of triceps and subscapular skinfolds (logSF2); (4) log-transformed sum of triceps, biceps, subscapular and supra-iliac skinfolds (logSF4); (5) BMI; (6) waist circumference; (7) BMI and waist circumference. The adjusted determination coefficient (R² adj) and the root mean squared error (RMSE; kg) were calculated for each model. LogSF4 (R² adj 0.85; RMSE 2.35) and logSF2 (R² adj 0.82; RMSE 2.54) were similarly accurate at predicting PBF and superior to logTSF (R² adj 0.75; RMSE 3.02), logTSF combined with waist circumference (R² adj 0.78; RMSE 2.85), BMI (R² adj 0.62; RMSE 3.73), waist circumference (R² adj 0.58; RMSE 3.89), and BMI combined with waist circumference (R² adj 0.63; RMSE 3.66) (P < 0.001 for all values of R² adj). The finding that logSF4 was only modestly superior to logSF2 and that logTSF was better than BMI and waist circumference at predicting PBF has important implications for paediatric epidemiological studies aimed at disentangling the effect of body fat on health outcomes.

Preference for formulations containing calcium and vitamin D 3 in childhood: A randomized-sequence, open-label trial

Background: Children who experience adverse reactions to cow's milk or who have diseases predisposing them to low bone mass are often prescribed a supplementation of calcium and vitamin D 3, but adherence can be poor. Age-specific preferences for different formulations may exist and at least partially explain poor compliance. Objective: The aim of this study was to compare the preference of Swiss children at risk for low bone mass for either a single-serving sachet or a suspension containing calcium and vitamin D 3. Methods: Two different commercial formulations containing calcium and vitamin D 3, either as a lemon-flavored single-serving sachet or as a banana-flavored commercial suspension, were tested for preference by means of a 5-point facial hedonic scale in children aged 4 to 7 and 8 to 11 years. A concealed random allocation procedure was used. The investigator asking about preference was blinded to the sequence. Results: A total of 40 Swiss children (13 boys and 7 girls aged 4–7 years; 11 boys and 9 girls aged 811 years) were assessed in this study. Low bone mass risks included adverse reactions to cow's milk (n = 25); cerebral palsy (4), juvenile idiopathic arthritis (4), cystic fibrosis (3), inflammatory bowel diseases (2), anorexia nervosa (1), and osteogenesis imperfecta (1). Two children (10%) aged 4 to 7 years were not able to express their preference. Twelve of the remaining 18 children (67%) aged 4 to 7 years preferred the suspension, 5 (28%) did not express a clear preference, and 1 (5%) preferred the sachet ( P < 0.002). In children aged 8 to 11 years, 15 (75%) preferred the sachet, 4 (20%) did not express a clear preference, and 1 (5%) preferred the suspension ( P < 0.001). The results were not significantly different between boys and girls or between children initially presented the suspension and those initially presented the sachet. Conclusions: In this small study, significantly more Swiss children aged 4 to 7 years who were prescribed a supplementation of calcium and vitamin D 3 preferred a banana-flavored suspension compared with those who preferred a lemon-flavored single-serving sachet. However, significantly more children aged 8 to 11 years prescribed the same supplementation preferred the single-serving sachet compared with the suspension.

Colorful Nature and Grey Misery: Science and Technology in an Environmental Context as Analyzed in Pictures Made by 11- to 13-Year-Old Swiss Students

Abstract We asked 408 eleven- to 13-year-old Swiss children to draw a picture of their choice about “the environment.” We were especially interested in how these children presented the role of science and technology in an environmental context. The qualitative content analysis of the pictures was complemented by the results of a survey that consisted of 15 environmental questions used in the Relevance of Science Education (ROSE) study. Our students showed a clear preference for an ecological, ecocentric stance. A colorful, untouched, idealized nature represented a normative threshold for a desirable situation. Technology was pictured as an instrument of human alienation from nature, creating a grey, hostile civilization dominated by science and technology. We conclude that science education has the delicate task of introducing students to more scientific, fact-oriented, pragmatic thinking without destroying their ecocentric, value-oriented views on environmental protection, thus fostering a constructive a...

Trend in active transportation to school among Swiss school children and its associated factors: three cross-sectional surveys 1994, 2000 and 2005

BackgroundGiving the rising trend in childhood obesity in many countries including Switzerland, strategies to increase physical activity such as promoting active school travel are important. Yet, little is known about time trends of active commuting in Swiss schoolchildren and factors associated with changes in walking and biking to school.MethodsBetween 1994 and 2005, information about mobility behaviour of children aged 6-14 years was collected within three Swiss population based national travel behaviour surveys. Mode of transport to school was reported for 4244 children. Weighted multivariate logistic regression analyses were used to assess active school travel time trends and their influencing factors.ResultsMore than 70% of Swiss children walked or biked to school. Nevertheless, the proportion of children biking to school decreased (p = 0.05, linear trend), predominately in urban areas, and motorized transportation increased since 1994 (p = 0.02). Distance to school did not change significantly over time but availability of bikes decreased (p < 0.001) and number of cars per household increased (p < 0.001). The association between survey year and bike use was significantly modified by living in an urban area (OR (95%CI): 1.0, 0.63 (0.44-0.90), 0.71 (0.49-1.03), respectively for 1994, 2000 and 2005) and by distance to school (OR (95%CI): 1.0, 0.65 (0.40-1.05), 0.50 (0.23-0.79) for the same years and for children who lived more than a mile away from school).ConclusionsPrograms to encourage safe biking and to limit car use as mode of transport to school are warranted to stop this trend.

Sense of Time in Children with Attention-Deficit/Hyperactivity Disorder (ADHD)

Parents of children with attention-deficit/hyperactivity disorder (ADHD) frequently report that their children have a poor sense of time. Several studies looking at the perception of time mentioned a form of temporal myopia. The present study investigates the sense of time in children with ADHD. Twenty-two French-speaking Swiss children with ADHD and 22 controls between the ages of 6 and 13 years were tested using a conventional time knowledge questionnaire and two Piagetian time conservation tasks. Parents were asked to complete the “It’s about time” questionnaire. Better performance was observed in matched control group children than in children with ADHD on a conventional time knowledge questionnaire. For children under 10 years of age, the two Piagetian time conservation tasks were able to differentiate children with and without ADHD. Parents of ADHD children reported more frequently that their children had time-related difficulties in daily activities. This study suggests that children with ADHD take longer to develop several time-related abilities.

Economic evaluation of varicella vaccination in Swiss children and adolescents

This study explores the effects of three different 2-dose varicella zoster virus (VZV) vaccination strategies in Switzerland. The EVITA model was used to assess clinical benefits and costs of strategies 1) vaccination of 11-15 year old adolescents with a negative or uncertain history for chickenpox, 2) universal vaccination of toddlers at age 1 to 2 years, and 3) strategy 2 plus catch-up vaccination of 11-15 year old susceptible adolescents. The cost-effectiveness analysis compares strategies 2 and 3 versus strategy 1 (current vaccination policy in Switzerland). Probabilities for clinical outcomes and medical resource utilization were derived from a real-world survey among Swiss pediatricians and general practitioners including 236 individuals with VZV infection, published information on varicella complications, and expert opinion. Costs of medical resource utilization represent official Swiss medical tariffs. The model predicts both universal childhood vaccination strategies to be more effective in reducing varicella disease burden compared to strategy 1. Economically, both universal childhood vaccination strategies with or without catch-up result in net savings from the societal perspective reflected by a benefit cost ratio (BCR) of 1.22 or 1.29, respectively. In contrast, the model predicts net costs from the payer perspective (BCR of 0.27 and 0.30, respectively). These economic findings are comparable to those reported from other similar evaluations. However, due to the recent recommendation for using a 2-dose varicella vaccination schedule, our economic results for Switzerland are somewhat less favorable than those for other country analyses in which a less expensive 1-dose vaccination regimen for toddlers has been studied.

Decrease in the prevalence of paediatric adiposity in Switzerland from 2002 to 2007

A national study in Switzerland in 2002 suggested nearly one in five schoolchildren was overweight. Since then, many programmes have been introduced in an attempt to control the problem. The aim of the present study was to determine the prevalence of childhood overweight in Switzerland five years later. In both studies a cross-sectional, three-stage, probability-proportional-to-size cluster sampling of schools throughout Switzerland was used to obtain a representative sample of approximately 2500 children aged 6-13 years. Height and weight were measured and BMI calculated. The BMI references from the Centers for Disease Control and Prevention were used to determine the prevalences of underweight (<5th percentile), overweight (>or=85th and <95th percentile) and obesity (>or=95th percentile). In 2007 the prevalences of underweight, overweight and obesity in boys were 3.5 %, 11.3 % and 5.4 %, respectively; in girls they were 2.6 %, 9.9 % and 3.2 %. Compared with 2002, there was a significant decrease in the prevalence of overweight in girls and of obesity in both genders. In contrast to 2002, where there were no differences, in 2007 the prevalence of paediatric obesity was significantly higher in communities with a population >100 000 compared with smaller communities (P < 0.05). In summary, over the past 5 years, the prevalence of adiposity has decreased in Swiss children. These findings suggest that increased awareness combined with mainly school-based programmes aimed at physical activity and healthy nutrition may have helped to control this public health problem. Future monitoring in Switzerland will determine if these findings are sustained.

Rohmilch-assoziierte Staphylococcus aureus Intoxikation bei Kindern

Four hours after the consumption of raw goat milk, three Swiss children came down with emesis and diarrhea in July 2008. First investigations showed that the milk originated from a goat suffering from clinical mastitis (Staphylococcus aureus). In the milk sample from the untreated left udder, Staphylococcus aureus counts reached 5.0 x 10(7) CFU ml(-1). By PCR, the gene for the staphylococcal enterotoxin D was found in isolated strains. The consumption of raw milk is rarely associated with Staphylococcus aureus intoxications. Due to the flora naturally present in raw milk, Staphylococcus aureus normally cannot multiply sufficiently. However, in the present case, high Staphylococcus aureus counts were already present in the milk due to the mastitis of the goat. This amount sufficed to cause a Staphylococcus aureus intoxication in the children.

Children's and adolescents' intuitive judgements about distributive justice: Integrating need, effort, and luck

This study investigated the principles that children and adolescents rely on when allocating a resource fairly. In a series of three experiments, 51 Swiss children (aged 7 and 9 years) and 309 German children (aged 6, 9, and 15 years) participated. A different situational context was presented in each experiment, where luck, need and effort of two protagonists were systematically varied. Primary-school children relied mainly on need when making distributive justice judgements. Effort became more prominent as the allocation principle in adolescence. Equality occurred rarely in all age groups. Integrational capacity and the ability to differentiate between the three situational contexts increased from childhood to adolescence. The data suggest the conclusion that the development of distributive justice decisions has both generalized and context-specific components.

Diet Determines Features of the Metabolic Syndrome in 6- to 14-Year-Old Children

Insulin resistance (IR) and hypertension are common in overweight children, and the adipocyte-derived hormones resistin, adiponectin, and leptin may modulate IR and blood pressure (BP). Few data exist in children on dietary determinants of IR, BP, or leptin, and no data exist on dietary determinants of resistin and adiponectin. Therefore, the objective of this study was to investigate dietary determinants of IR, BP, resistin, adiponectin, and leptin concentrations, as well as the interrelationship among these variables, in normal and overweight children. In 6- to 14-year-old Swiss children (n=79), nutritional intake was assessed using two 24-hour-recalls and a one-day dietary record. Body mass index (BMI), body fat percentage (BF%), waist/hip ratio (W/H ratio), BP, glucose, insulin, resistin, adiponectin, and leptin were determined. IR was calculated using the quantitative insulin sensitivity check index (QUICKI). BMI, BF%, and W/H ratio were significant predictors of leptin and insulin, QUICKI, and systolic BP, but not resistin or adiponectin. Of the overweight and obese children, 40% were diagnosed pre-hypertensive or hypertensive. Total energy, fat, saturated fat, and protein intakes were significant predictors of fasting insulin and QUICKI, and total fat, saturated fat, and monounsaturated fat intakes were significant predictors of systolic BP, independent of BMI standard deviation score (BMI-SDS) and age. There were no associations between these dietary factors and leptin, adiponectin, or resistin. In children, dietary macronutrient composition is a predictor of IR and systolic BP, but not resistin, adiponectin, or leptin concentrations. Resistin and adiponectin concentrations are not correlated with IR or BP in this age range.

Children in Regular and Special Needs Classes: Cognitive and Non-Cognitive Aspects

In the present study, systematic comparisons between Swiss children attending regular first grade classes and those enrolled in classes for children with special needs (so-called “Einführungsklassen”, in which the first grade curriculum is spread over two years) are reported. Different aspects of executive skills in the domain of short-term memory, attention, motor coordination, and achievement motivation are addressed. For most cognitive measures, children in special needs classes perform more poorly than children in regular classes. Deficits appeared to be pronounced in tasks of high complexity and with multiple demands, but there were no differences with respect to self-concept and school motivation. Follow-up analyses indicate that improvement in most of the tasks was minimal and that children in special needs classes do not catch up to their age-mates. The findings are discussed in terms of adequate placement of these children and the need for early and efficient prevention/intervention programs.

Children's Nurturance and Self‐Determination Rights: A Cross‐Cultural Perspective

Increasing awareness of children's developmental needs and rights has led to a global move toward giving children and adolescents a greater degree of autonomy in the decisions affecting their own lives. This article presents two studies examining the role of culture and religion in 12‐year‐old children's perceptions of their rights across three cultures. The first study showed that U.S. and Swiss children advocated for more self‐determination rights than Chinese‐Malaysian children; U.S. and Chinese‐Malaysian children advocated for more nurturance rights than Swiss children. Within the Chinese‐Malaysian sample, Buddhist children were more likely to advocate for self‐determination rights as compared to Christian children. Using a revised Children's Rights Interview (rCRI), the second study showed that on average U.S. and Chinese‐Malaysian children were more likely to advocate for self‐determination rights than nurturance rights. However, there were no significant differences between the two cultural groups in terms of the overall responses. The results of the studies are discussed in terms of the cultural orientation and constructivist frameworks.

Susceptibility of Escherichia coli strains isolated from outpatient children with community-acquired urinary tract infection in southern Switzerland

Background: Based on antimicrobial resistance patterns found in Swiss university hospitals, treatment with a third-generation cephalosporin is currently advised for Swiss children with urinary tract infection.Objective: The aim of this study was to prospectively assess the susceptibility of Escherichia coli strains isolated from children with symptomatic community-acquired urinary tract infection.Methods: The antimicrobial susceptibility of E coli strains causing symptomatic community-acquired urinary tract infections was assessed in outpatient children attending the emergency management unit at the Department of Pediatrics, Mendrisio and Bellinzona Hospitals, Switzerland. Strains from children receiving antimicrobial prophylaxis or prescribed antimicrobials in the previous 4 weeks were excluded. Clinical and Laboratory Standards Institute methods were used for culture and identification of pathogens. E coli susceptibility testing was performed using the disk diffusion technique.Results: Strains from 100 consecutive outpatient children (73 girls, 27 boys; aged 5 weeks-17 years [median, 33 months]; 100% white) were assessed. High rates of ampicillin and cotrimoxazole resistance (39 and 21 strains, respectively) and low rates of nitrofurantoin resistance (4 strains) were identified. No resistance was identified for coamoxiclav or third-generation cephalosporins.Conclusions: In these Swiss outpatient children with symptomatic community-acquired urinary tract infection, without antimicrobial prophylaxis or recent prescription of antimicrobials, uropathogenic E coli strains resistant in vitro to ampicillin and cotrimoxazole were common. However, in vitro resistance to nitrofurantoin, coamoxiclav, and third-generation cephalosporins was uncommon.

A Multicenter, Cross‐Sectional Study on the Prevalence and Risk Factors for Nasal Colonization withStaphylococcus aureusin Patients Admitted to Children’s Hospitals in Switzerland

The rate of nasal carriage of Staphylococcus aureus and associated risk factors were determined in a cross-sectional study involving Swiss children's hospitals. S. aureus was isolated in 562 of 1363 cases. In a stepwise multivariate analysis, the variables age, duration of antibiotic use, and hospitalization of a household member were independently associated with carriage of S. aureus.