Total Population Of Children Research Articles

Mental disorders in children and adolescents with type 1 diabetes before and during the COVID-19 pandemic: results from the DPV registry.

The COVID-19 pandemic affected the mental health of children and adolescents in the general population, yet its impact on those with chronic conditions is relatively unknown. This study aimed to compare the incidences of comorbid mental disorders and substance misuse in children and adolescents with type 1 diabetes before and during the pandemic. A total of 42,975 patients aged 6-18 years from the multicentre DPV (Diabetes Prospective Follow-up) registry were included. Multivariable regression models were applied to compare newly diagnosed comorbid mental disorders, adjusted for demographic and clinical variables, among them the number of medical visits, during the pre-pandemic period (09/2017-02/2020) and the COVID-19 pandemic period (03/2020-08/2022). Analysing both sexes together, there were no differences in the incidence rates of overall mental disorders between the pandemic and the pre-pandemic period. However, girls showed an increased incidence rate (odds ratio 1.2, CI 1.1-1.3) during the pandemic. Adolescent girls also displayed higher incidence rates of depression, eating disorders, and self-harm. Substance misuse declined overall during the pandemic (odds ratio 0.8, CI 0.7-0.9). During the COVID-19 pandemic, we found higher incidence rates of overall mental disorders in girls, but not in boys and not in the total study population of children and adolescents with type 1 diabetes. Adolescent girls displayed increased incidence rates of depression, eating disorders, and self-harm. Substance misuse declined substantially. Clinicians should be aware of the high-risk group of adolescent girls during times of increased strain.

Status of elevated blood pressure among Chinese children and adolescents aged 7-17 from 2016 to 2017 according to 4 different references

To describe and analysis the detection rate of high normal blood pressure and high blood pressure among Chinese children and adolescents aged 7-17 years from 2016 to 2017 according to the clinical practice guideline for screening and management of high blood pressure in Children and Adolescents published by the American Academy of Pediatrics(the AAP reference), the international blood pressure references among Children and Adolescents aged 6 to 17 years(the international reference), health industry standard of the People's Republic of China "Reference of screening for elevated blood pressure among children and adolescents aged 7 to 18 years(WS/T 610-2018)"(the industry reference) and updating blood pressure references for Chinese children aged 3 to 17 years(the guideline reference). Data was from the China Nutrition and Health Surveillance of Children and Lactating Women(2016-2017), in which the multistage stratified whole group random sampling method was used to draw participants from 275 surveillance sites in 31 provinces(autonomous regions and municipalities). In total, 67 231 participants were included according to the inclusion and exclusion criteria. Blood pressure was measured three times by trained staff using a validated oscillometric blood pressure monitor at the same point. The average blood pressure was calculated for the three measurements for SBP and DBP. To match the sampling design methodology, all values were weighted to represent the total population of Chinese children and adolescents 7-17 years of age considering sampling weights for each stratification based on the sixth population census data provided by the National Bureau of Statistics. The detection rate varied greatly under different references. The detection rate of high normal blood pressure was ranked from high to low according to the AAP reference(20.15%) > the guideline reference(17.29%) > the industry reference(13.14%) > the international reference(12.66%); the detection rate of high blood pressure in descending order is the guideline reference(24.31%) > the international reference(21.34%) > the AAP reference(20.59%) > the industry reference(19.96%). Although the consistency between the AAP references and international references and our national two references were medium to high, the difference in detection rate obtained by analysis was large. Considering the differences of demographic characteristics in the reference population, caution should be taken when applying foreign references to judge the blood pressure status of children and adolescents in China.

Sit-to-stand performance in children with cerebral palsy: a population-based cross-sectional study

BackgroundSit-to-stand (STS) is one of the most commonly performed functional movements in a child’s daily life that enables the child to perform functional activities such as independent transfer and to initiate walking and self-care. Children with cerebral palsy (CP) often have reduced STS ability. The aim of this study was to describe STS performance in a national based total population of children with CP and its association with age, sex, Gross Motor Function Classification System (GMFCS) level, and CP subtype.MethodsThis cross-sectional study included 4,250 children (2,503 boys, 1,747 girls) aged 1–18 years from the Swedish Cerebral Palsy Follow-Up Program (CPUP). STS performance was classified depending on the independence or need for support into “without support,” “with support,” or “unable.” “With support” included external support from, e.g., walls and furniture. Physical assistance from another person was classified as “unable” (dependent). Ordinal and binary logistic regression analyses were used to identify associations between STS and age, GMFCS level, and CP subtype.Results60% of the children performed STS without support, 14% performed STS with support, and 26% were unable or needed assistance from another person. STS performance was strongly associated with GMFCS level and differed with age and subtype (p < 0.001). For all GMFCS levels, STS performance was lowest at age 1–3 years. Most children with GMFCS level I (99%) or II (88%) performed STS without support at the age of 4–6 years. In children with GMFCS level III or IV, the prevalence of independent STS performance improved throughout childhood. CP subtype was not associated with STS performance across all GMFCS levels when adjusted for age.ConclusionsIndependent STS performance in children with CP is associated with GMFCS level and age. Children with CP acquire STS ability later than their peers normally do. The proportion of children with independent STS performance increased throughout childhood, also for children with GMFCS level III or IV. These findings suggest the importance of maintaining a focus on STS performance within physiotherapy strategies and interventions for children with CP, including those with higher GMFCS level.

Perceived discrimination among caregivers of children with disabilities in China: Unraveling the effects of social determinants

PurposeAlthough discrimination has gained increasing attention in research and practice intervention for family caregivers of children with disabilities, little is known about the social determinants that associate with the perceived discrimination among caregivers, especially in non-Western contexts. This study aims to examine the socio-familial and child-level determinants of perceived discrimination among family caregivers of children with disabilities in China. MethodThis study drew from a population-based cross-sectional survey in Shenzhen, China. Proportional quota sampling was conducted to get data from 2500 family caregivers of children with disabilities in rehabilitation service centers (response rate = 94.9%, n = 2373), accounting for 25% of the total population of children with disabilities receiving service in Shenzhen. Latent profile analysis was conducted to categorize three perceived discrimination groups among caregivers (i.e., severe perceived discrimination group, moderate perceived discrimination group, and low perceived discrimination group). The multinomial logistic regression models were conducted to test the association between these social determinants and perceived discrimination. ResultsMost caregivers (82.9%) reported moderate or severe levels of perceived discrimination. Caregivers of children with moderate and severe impairments and children with mental and multiple disabilities were more vulnerable to perceiving severe social discrimination. Socio-familial characteristics, particularly the intersectionality between gender and employment, influence caregivers’ perceived discrimination. ConclusionCaregivers of children with disabilities experience pervasive social discrimination in contemporary urban China. Our study demonstrates that the social construction of disablism and the affiliate discrimination against family caregivers of children with disabilities is complex and multidimensional and depends upon the children's disability and the caregivers' socio-demographic characteristics.

Establishment of the Norwegian hearing register for children.

The Norwegian Directorate of Health approved the Norwegian Hearing Register for Children in 2022. The main objective of the register is to improve the quality of treatment for children with permanent hearing loss, by measures, follow-ups and monitoring the quality and results of the health care system. Inclusion criteria are children who do not pass universal newborn hearing screening and/or children with permanent hearing loss <18 years of age. Hearing loss is defined as pure-tone audiometry threshold of (PTA4) > 20 dB in at least one ear. Data are registered at the Ear, Nose and Throat departments at inclusion and at follow-ups at the age of 3, 6, 10, and 15 years. The register collects information about the child within a holistic perspective. The key elements of the register are (a) data concerning newborn hearing screening; (b) data concerning hearing, medical information, hearing amplification and intervention (c) patient reported outcome measures registered by caregivers using three questionnaires; Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire and Parents' Evaluation of Aural/Oral Performance of Children. The register has established four quality indicators regarding newborn hearing screening and early intervention (a) the rate of false positive neonatal screens; (b) testing for congenital cytomegalovirus within 3 weeks of age for children who do not pass newborn hearing screening; (c) audiological evaluation to confirm the hearing status no later than 3 months of age and (d) initiated intervention within 3 months after confirmation of hearing status. The register will include the total population of hearing impaired children over long time periods. Thus, the register enables each hospital to monitor their quality indicator scores continuously and compare them with national levels in real time. This facilitates and accelerates identification of improvement areas in the hospitals and will be an important contributor for quality improvement in NHS, diagnostics and hearing intervention for children in Norway. In addition, data from the register will be a unique source for research, and study designs with a long follow-up time can be applied.

RELATION OF THE CHARACTERISTICS OF THE MAGNETIC RESONANCE PROFILE OF THE BRAIN IN CHILDREN WITH EPILEPSY ON THE SEASON OF THEIR BIRTH

Purpose of the study. Identifying common and distinctive features of the relationship between the season of children birth and the risk of developing epilepsy and without brain pathologies according to magnetic resonans imaging (MRI) data. Materials and methods of research. 94 children aged 4 to 14 years with a confirmed diagnosis of epilepsy were under observation. The children were divided into two groups: children with brain pathologies according to MRI data and children without brain pathologies according to MRI data. The entire population and the children in these groups are distributed according to their birth months. The proportions of children in each month and season were compared using pairwise tests. A statistically significant difference was considered at t≥1.96 (p≤0.05). Results. In the total population, the smallest and largest proportion of children were born in January and July, respectively (5.2±2.3 and 13.6±3.5%; t=1.98). In the group of children with epilepsy without brain pathology, according to MRI data, the smallest proportion of children were born in May (3.55±2.08%), and the largest in July (12.16±3.64%) and December (12.16±3.64%; t=2.03; p&lt;0.05). Conclusions. MRI can detect brain pathologies in 13.83±3.56% of children with epilepsy. The seasonality of the children birth with epilepsy with and without brain pathologies is different; it is more pronounced in children with epilepsy without brain pathologies according to MRI data.

The effect of cumulative childhood exposure to neighbourhood socioeconomic disadvantage on school performance—a register-based study on neighbourhoods, schools, and siblings

Abstract Several studies show that exposure to neighbourhood disadvantage predicts poorer educational outcomes among adolescents. Selective sorting into neighbourhoods, other unobserved childhood family characteristics, and failing to account for other relevant social contexts such as schools inhibit strong causal inference from the associations reported in previous studies. Based on longitudinal register data on the total population of Finnish children in major cities, we studied the extent to which variation in grade point average (GPA) was attributable to schools, neighbourhoods, and families. We also sought to determine whether exposure to neighbourhood disadvantage predicted GPA after accounting for non-random selection into neighbourhoods by comparing siblings with differential exposure to neighbourhoods. Overall, we observed no effect of neighbourhood disadvantage on GPA after accounting for observed and unobserved family characteristics in the general population. However, we did observe a non-negligible but not statistically significant effect of neighbourhood disadvantage among children of parents with only basic education. Family factors accounted for most of the variation in GPA, and only around 1 per cent of the variance was attributable to the neighbourhood. This weak relevance of the neighbourhood to educational outcomes may reflect the success of educational and other social policies limiting the emergence of neighbourhood effects.

Did the choice reform in Stockholm change social disparities in use of outpatient health services for children?

The aim of this study was to investigate whether the choice reforms in healthcare in Stockholm county in 2008 and 2013 changed the sociodemographic user patterns of outpatient healthcare services for children. The study used regional data on healthcare use linked to sociodemographic data from national registers in the total population of children 0-15 years in the Stockholm county. Change in use of healthcare services was analysed in multiple linear regression in a difference in differences approach of socio-economic indicators. The choice reform of 2013 increased children's overall use of specialised care by around 30% until 2017 while primary care use decreased by the same degree. The mean number of physician visits in specialised care for children with severe asthma increased from 3.9 to 5.2 per year. Overall, children in families with low maternal education, low disposable income and a non-Western background increased their use of specialised care more than children from families with a more privileged socio-economic situation. There was no indication that the choice reform in Stockholm county increased the social disparities in use of primary and specialised outpatient care for children, rather the opposite.

Social Inequities in Exposure to Traffic-Related Air and Noise Pollution at Public Schools in Texas.

Although children are particularly vulnerable to the adverse impacts of vehicular pollution and spend significant portions of their time at school, previous studies have not examined or compared school-level social inequities in exposure to both traffic-related air and noise pollution in the same study area. We addressed this gap through a case study in Texas-the second-largest US state based on total population and number of children. Vehicular pollution exposure was measured using: (1) outdoor concentrations of nitrogen dioxide (NO2), a widely used proxy for traffic-related air pollution; and (2) road noise estimates from the US Department of Transportation's National Transportation Noise Mapping Tool. These variables were linked to data on locations and sociodemographic characteristics of children enrolled in Texas public schools. We found children attending schools with the highest exposure to both NO2 and road noise (top 25%) were significantly more likely to be Black, Hispanic, and eligible for free/reduced lunches (socioeconomically deprived). Results from multivariable generalized estimating equations that control for spatial clustering and other relevant factors revealed that schools with greater NO2 exposure were significantly more likely to serve racial/ethnic minority and younger students, while schools with greater exposure to road noise were significantly more likely to serve socioeconomically deprived and older students. These findings underscore the urgent need to reduce both air pollution and noise exposure at school locations, especially in schools attended by higher proportions of socially disadvantaged children that are often additionally burdened with other challenges.

Hubungan Pengetahuan dan Perilaku Konsumsi Jajanan dengan Kejadian Diare pada Anak MDTA Al-Hamid di Kecamatan Medan Johor

In the selection of snacks there are influencing factors, namely external and internal factors. Food contaminated with pathogenic bacteria poses a risk of health problems such as digestive disorders namely diarrhea. This type of research is quantitative research. The sampling technique in this study was carried out using the total sampling method.The population in this study was MDTA Al-Hamid children totaling 30 respondents, which is the total population of children studying at MDTA Al-Hamid Medan Johor District. The results of this study are that there are 20 respondents (76, 9%) who have poor knowledge of snack consumption so that they experience diarrhea and there are 18 respondents (71,5%) who have poor behavior in consuming snacks so that they experience diarrhea. The conclusion of this study is that there is a relationship between knowledge and behavior of snack consumption with the incidence of diarrhea in MDTA Al-Hamid children in Medan Johor District.&#x0D; Keywords: Knowledge, Snack Consumption Behavior, Diarrhea, Children

Prevalence of vision conditions in children in a very remote Australian community

ABSTRACT Clinical relevance Understanding the prevalence of vision conditions in a population is critical for determining the most appropriate strategies for detecting and correcting eye conditions in a community. This is particularly important in very remote regions where access to vision testing services is limited. Background Although recent studies have provided detailed analyses of the prevalence of vision conditions in Aboriginal and/or Torres Strait Islander children in urban and regional areas of Australia, there is a paucity of research examining vision conditions in children in remote regions. Importantly, a significant proportion of the population in remote and very remote regions identify as Aboriginal and/or Torres Strait Islander people. Methods Comprehensive eye examinations were provided to 193 primary school children in a very remote Australian region. Ninety eight percent of children identified as Aboriginal and/or Torres Strait Islander. The eye examination included measures of visual acuity, cycloplegic autorefraction, binocular vision and accommodative function, ocular health and colour vision. Previous history of eye examinations and refractive correction were assessed through parental questionnaire. Results Although the average unaided vision in the population was good (mean: 0.02 ± 0.13 logMAR) and the prevalence of reduced unaided visual acuity (>0.3 logMAR in either eye) was low (4%), vision conditions were detected in 32% of children. The most common conditions were clinically significant refractive errors (18% of children) and binocular vision or accommodative disorders (16%). Of the total population of children tested, 10% had previously had an eye examination, and 2% were reported to have previously been prescribed spectacles. Conclusions In this population of children in a very remote Australian region, up to 1 in 3 children had a vision condition, with many of these conditions being uncorrected and undetected. These findings highlight the important need for additional resources to be made available to very remote communities for the detection and correction of vision conditions in childhood.

Epidemiology of fractures in children with cerebral palsy: a Swedish population-based registry study

BackgroundChildren with cerebral palsy (CP) form a heterogeneous group and may have risk or protective factors for fractures compared with typically developing children. The fracture sites may also differ from those of children who do not have CP. We analyzed the fracture epidemiology in a total population of children with CP.MethodsThis was a retrospective registry study based on data from the Swedish Cerebral Palsy Follow-Up Program (CPUP) and the Swedish National Patient Register. All children in the CPUP born in 2000–2015 were included. The Gross Motor Function Classification System (GMFCS) level, reported fractures, fracture site, and epilepsy diagnosis were recorded up to 2018. Hazards and hazard ratios were calculated for first-time fractures.ResultsOf the 3,902 participants, 368 (9.4%) had at least one reported fracture. The cumulative risk of sustaining a fracture before age 16 years was 38.3% (95% confidence interval 33.9–42.4). The hazard for fracture was 7 times higher in children with epilepsy. The overall fracture incidence was not statistically significantly related to sex or GMFCS level. Fractures in the upper extremities were most prevalent in children with a lower GMFCS level, and femoral fractures were most prevalent in children at GMFCS level V. Most fractures occurred in early childhood and after 8 years of age.ConclusionsChildren with CP were at similar risk of sustaining fractures as typically developing children, but the risk was higher in children with comorbid epilepsy. Fractures occurred in children at GMFCS levels I–III at sites similar to those for typically developing children; fractures in the upper extremities were the most frequent. Children at GMFCS levels IV or V and those with epilepsy were more likely to have a fracture in the lower extremities, and the femur was the most frequent site.

Understanding the Impact of Child, Intervention, and Family Factors on Developmental Trajectories of Children with Hearing Loss at Preschool Age: Design of the AChild Study

Children with hearing loss and their families represent a large variety with regard to their auditory, medical, psychological, and family resource characteristics. Despite recent advances, developmental outcomes are still below average, with a significant proportion of variety remaining unexplained. Furthermore, there is a lack of studies including the whole diversity of children with hearing loss. The AChild study (Austrian Children with Hearing Impairment—Longitudinal Databank) uses an epidemiological longitudinal design including all children living in Upper and Lower Austria with a permanent uni- or bilateral hearing loss below the age of 6 years, irrespective of additional disabilities, family language, and family resources. The demographic characteristics of the first 126 children enrolled in the study showed that about half of the children are either children with additional disabilities (31%) and/or children not growing up with the majority language (31.7%) that are usually excluded from comprehensive longitudinal studies. AChild aims for a characterization of the total population of young children with hearing loss including developmental outcomes. Another goal is the identification of early predictors of developmental trajectories and family outcomes. In addition to child-related predictors the examination of family–child transactions malleable by family-centred early intervention is of particular interest. The study is designed as participatory including parent representation atall stages. Measures have been chosen, following other large population-based studies in order to gain comparability and to ensure international data pooling.

The mental health of immigrant and refugee children in Canada: A scoping review

Introduction: First- and second-generation immigrant children under 15 years of age make up 37.5% of the total population of children in Canada. Immigrant children aged 10-19, irrespective of their immigration status, face more ethnic victimization at school and in their neighborhoods. By 2036, the number of immigrant children in Canada is predicted to increase by 49%.&#x0D; Method: A well-established Arksey and O’Malley’s five-stage methodological framework was applied to conduct this scoping review. This project reviewed the existing research literature on factors affecting immigrant and refugee children's mental health in Canada.&#x0D; Results: The mental health of immigrant and refugee children can be viewed as a combined product of personal, social, cultural, economic, and pre- and post-migratory factors. Immigrant and refugee children’s experiences of migration can be stressful and destabilizing. Service providers are not well trained and often cannot grasp the circumstances of immigrant and refugee children and families, which consequently disengages them from required treatment services and follow-up care.&#x0D; Conclusion: Reflection of diversity and inclusivity in mental health policies can influence actions in a primary care setting and reduce accessibility gaps and barriers that affect immigrant and refugee children in Canada.&#x0D; Keywords: child; Canada; immigrant; mental health; refugee

Metode Emo Demo Meningkatkan Pengetahuan dan Sikap Cuci Tangan Pakai Sabun (CTPS) pada Anak Usia Sekolah

The population of children in Indonesia is an average of 30% of the total population of Indonesia and children of elementary school age are the largest compared to others. There are 40.2% in Indonesia and around 54.2% in the City who have the habit of washing their hands. The COVID-19 pandemic is a threat to the health of all people, including school-age children. Emo Demo is a method of educating the public developed by the Global Alliance for Improved Nutrition .Handwashing with Soap is a program of the Ministry of Health in changing clean and healthy living behavior. This study aimed to identify the effect of the emo demo method on the knowledge and attitudes of CTPS in school-age children. The research design was a quasi-experimental with a pre-post test design with a control group. Data collection tools used questionnaires and observation sheets. CTPS education using the Emo Demo method was given once for 20 minutes to each group using display cards and simulated germicidal fluid and hand washing tools. The research sample consisted of 70 people consisting of 35 people in the intervention group and 35 in the control group. The analysis showed that there was a significant difference in the increase in the average value of knowledge and attitudes about CTPS in school-age children. Based on these results, it is expected that the use of learning media for school-age children is not monotonous, the Emo Demo method can be used as a method of education for school-age children.

The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better?

Background: Infectious diseases are a leading cause of morbidity and mortality worldwide. As of 2018, the total world population of children < 5 years of age was roughly estimated at 679 million. Of these children, an estimated 5.3 million died of all causes in 2018, with an estimated 700,000 who died of vaccine-preventable infectious diseases; 99% of the children who died had lived in low- and middle-income countries. The infectious diseases that remain major causes of mortality for which vaccines have been shown to provide proven preventive success include, in order of prevalence, are those caused by Streptococcus pneumoniae, Rotavirus, Bordetella pertussis, measles virus, Haemophilus influenzae type b and influenza virus. Objective: The purpose of the present report was to address the global burden of these six vaccine-preventable infectious diseases in children < 5 years of age, together with implications for the prevention of coronavirus disease 2019 (COVID-19) infection in children. Methods: The current immunization strategies for the prevention of the six vaccine-preventable infectious diseases in children are reviewed as a framework for new strategies of vaccine prevention of COVID-19 in children. Results: The burden of addressing vaccine prevention of future infectious disease in children can be effectively pursued through knowledge gained from past experiences with vaccine usage in these six vaccine-preventable childhood infectious diseases. Conclusion: Issues with regard to the burden of disease mortality, disease transmission, and available vaccines as well as vaccine successes and shortcomings for specific pathogens can serve as important landmarks for effective use of future vaccines. Although much success has been made globally in preventing these childhood deaths, much remains to be done.

Fidelity of Delivery and Contextual Factors Influencing Children's Level of Engagement: Process Evaluation of the Online Remote Behavioral Intervention for Tics Trial.

BackgroundThe Online Remote Behavioral Intervention for Tics (ORBIT) study was a multicenter randomized controlled trial of a complex intervention that consisted of a web-based behavioral intervention for children and young people with tic disorders. In the first part of a two-stage process evaluation, we conducted a mixed methods study exploring the reach, dose, and fidelity of the intervention and contextual factors influencing engagement.ObjectiveThis study aims to explore the fidelity of delivery and contextual factors underpinning the ORBIT trial.MethodsBaseline study data and intervention usage metrics from participants in the intervention arm were used as quantitative implementation data (N=112). The experiences of being in the intervention were explored through semistructured interviews with children (n=20) and parent participants (n=20), therapists (n=4), and referring clinicians (n=6). A principal component analysis was used to create a comprehensive, composite measure of children and young people’s engagement with the intervention. Engagement factor scores reflected relative uptake as assessed by a range of usage indices, including chapters accessed, number of pages visited, and number of log-ins. The engagement factor score was used as the dependent variable in a multiple linear regression analysis with various contextual variables as independent variables to assess if there were any significant predictors of engagement.ResultsThe intervention was implemented with high fidelity, and participants deemed the intervention acceptable and satisfactory. The engagement was high, with child participants completing an average of 7.5 of 10 (SD 2.7) chapters, and 88.4% (99/112) of participants completed the minimum of the first four chapters—the predefined threshold effective dose. Compared with the total population of children with tic disorders, participants in the sample tended to have more educated parents and lived in more economically advantaged areas; however, socioeconomic factors were not related to engagement factor scores. Factors associated with higher engagement factor scores included participants enrolled at the London site versus the Nottingham site (P=.01), self-referred versus clinic referred (P=.04), higher parental engagement as evidenced by the number of parental chapters completed (n=111; ρ=0.73; P<.001), and more therapist time for parents (n=111; ρ=0.46; P<.001). A multiple linear regression indicated that parents’ chapter completion (β=.69; t110=10.18; P<.001) and therapist time for parents (β=.19; t110=2.95; P=.004) were the only significant independent predictors of child engagement factor scores.ConclusionsOverall, the intervention had high fidelity of delivery and was evaluated positively by participants, although reach may have been constrained by the nature of the randomized controlled trial. Parental engagement and therapist time for parents were strong predictors of intervention implementation, which has important implications for designing and implementing digital therapeutic interventions in child and adolescent mental health services.International Registered Report Identifier (IRRID)RR2-10.1186/s13063-019-3974-3

Preliminary Evidence on the Impact of Hearing Aid Use on Falls Risk in Individuals With Self-Reported Hearing Loss.

Purpose Falls are considered a significant public health issue, and hearing loss has been shown to be an independent risk factor for falls. The primary objective of this study was to determine if hearing aid use modified (reduced) the association. We hypothesized that routine hearing aid use would reduce the impact of hearing loss on the odds of falling. If hearing aid users have reduced odds of falling, then that would have an important impact on falls prevention health care. Method Data from 8,091 individuals 40 years of age and older who completed National Health and Nutrition Examination Survey (NHANES) cycles 1999-2004 were used. NHANES comprises a series of cross-sectional studies, each of which is representative of the total civilian noninstitutionalized population of children and adults in the United States, enabling unbiased national estimates of health that can be independently reproduced. Self-reported hearing, hearing aid status, falls history, and comorbidities were extracted and analyzed using regression modeling. Results The 8,091 individuals were grouped based on a self-reported history of falls in the last year. Self-reported hearing loss was significantly associated with odds of falling. Categorizing individuals based on routine hearing aid use was included as an interaction term in the fully adjusted models and was not significant, suggesting no difference in falls based on hearing aid status. Conclusions The unique results of the current study show that when examining self-reported hearing in a nationally representative sample, hearing aid use does not appear to mitigate or modify the association between self-reported hearing and falls. Future research designs are highlighted to address limitations identified using NHANES data for this research and focus on the use of experimental designs to further understand the association between hearing loss and falls, including whether hearing loss may be a modifiable risk factor for falls. Supplemental Material https://doi.org/10.23641/asha.14642784.

Prevalence and Predictors of Dyslipidemia in Children and Adolescents in Yazd Greater Area, Yazd, Iran

Background: Dyslipidemia, a genetic and multifactorial disorder of lipoprotein metabolism, is defined by elevations in levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non–HDL-C), triglyceride, or some combination thereof, as well as lower levels of high-density lipoprotein (HDL) cholesterol. Objectives: This study aimed to investigate the prevalence and predictors of dyslipidemia in children and adolescents in the Yazd Greater Area, Yazd, Iran. Methods: This cross-sectional study was conducted as a part of the national project implemented in Yazd Greater Area, Yazd, Iran. The sampling was performed using a multi-stage cluster sampling method on three age groups of girls and boys (6-9, 10-14, and 15-18 years old). Out of the total 1,035 children and adolescents who participated in this study, only 784 participants remained in the study until the end. Data collection was performed using lifestyle questionnaires including Kiddie-SADS-Present and Lifetime Version. Results: The prevalence of high triglyceride was estimated at 1.4% and 4.2% in 6-9 and 10-18 years old children and adolescents, respectively. The prevalence of high cholesterol, LDL, and HDL was 3.2%, 3.2%, and 25.6%, respectively. The prevalence of dyslipidemia in the total population of children and adolescents in terms of demographic variables was 64.6% and 57.3% in boys and girls, respectively (P=0.038). Gender and increase in body mass index were significantly associated with dyslipidemia with OR=1.35; 95% CI: 1.01-1.81 and OR=13.781; 95% CI: 3.78- 46.43, respectively. However, after adjustment for other factors, only an increase in BMI was significantly associated with dyslipidemia (OR=16.08; 95% CI: 4.49-57.59). Conclusions: Overweight and obese adolescents had a higher concentration of serum blood triglycerides, compared to other adolescents. Weight control, lifestyle modification, and diet are three ways to reduce lipid disorders in adolescents.

Congenital anomalies in children with postneonatally acquired cerebral palsy: an international data linkage study.

To describe the major congenital anomalies present in children with postneonatally acquired cerebral palsy (CP), and to compare clinical outcomes and cause of postneonatally acquired CP between children with and without anomalies. Data were linked between total population CP and congenital anomaly registers in five European and three Australian regions for children born 1991 to 2009 (n=468 children with postneonatally acquired CP; 255 males, 213 females). Data were pooled and children classified into mutually exclusive categories based on type of congenital anomaly. The proportion of children with congenital anomalies was calculated. Clinical outcomes and cause of postneonatally acquired CP were compared between children with and without anomalies. Major congenital anomalies were reported in 25.6% (95% confidence interval [CI] 21.7-29.9) of children with postneonatally acquired CP. Cardiac anomalies, often severe, were common and present in 14.5% of children with postneonatally acquired CP. Clinical outcomes were not more severe in children with congenital anomalies than those without anomalies. Cause of postneonatally acquired CP differed with the presence of congenital anomalies, with cerebrovascular accidents predominating in the anomaly group. Congenital anomalies were likely associated with cause of postneonatally acquired CP in 77% of children with anomalies. In this large, international study of children with postneonatally acquired CP, congenital anomalies (particularly cardiac anomalies) were common. Future research should determine specific causal pathways to postneonatally acquired CP that include congenital anomalies to identify opportunities for prevention. One-quarter of children with postneonatally acquired cerebral palsy (CP) have a major congenital anomaly. Cardiac anomalies, often severe, are the most common anomalies. Causes of postneonatally acquired CP differ between children with and without congenital anomalies.