ResearchPad - children https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Newborn body composition after maternal bariatric surgery]]> https://www.researchpad.co/article/elastic_article_13862 In pregnancy after Roux-en-Y gastric bypass (RYGB), there is increased risk of low birthweight in the offspring. The present study examined how offspring body composition was affected by RYGB.Material and methodsMother-newborn dyads, where the mothers had undergone RYGB were included. Main outcome measure was neonatal body composition. Neonatal body composition was assessed by dual-energy X-ray absorptiometry scanning (DXA) within 48 hours after birth. In a statistical model offspring born after RYGB were compared with a reference material of offspring and analyses were made to estimate the effect of maternal pre-pregnancy body mass index (BMI), gestational weight gain, parity, gestational age at birth and newborn sex on newborn body composition. Analyses were made to estimate the impact of maternal weight loss before pregnancy and of other effects of bariatric surgery respectively. The study was performed at a university hospital between October 2012 and December 2013.ResultsWe included 25 mother-newborn dyads where the mothers had undergone RYGB and compared them to a reference material of 311 mother-newborn dyads with comparable pre-pregnancy BMI. Offspring born by mothers after RYGB had lower birthweight (335g, p<0.001), fat-free mass (268g, p<0.001) and fat% (2.8%, p<0.001) compared with reference material. Only 2% of the average reduction in newborn fat free mass could be attributed to maternal pre-pregnancy weight loss whereas other effects of RYGB accounted for 98%. Regarding reduction in fat mass 52% was attributed to weight loss and 47% to other effects of surgery.ConclusionOffspring born after maternal bariatric surgery, had lower birthweight, fat-free mass and fat percentage when compared with a reference material. RYGB itself and not the pre-pregnancy weight loss seems to have had the greatest impact on fetal growth. ]]> <![CDATA[Impacts of host gender on <i>Schistosoma mansoni</i> risk in rural Uganda—A mixed-methods approach]]> https://www.researchpad.co/article/elastic_article_13851 Globally, over 230 million people are infected with schistosomiasis, an infectious disease caused by parasitic helminths. Humans can get infected when they contact water which contains Schistosoma parasites. Although the disease can be treated with a drug, people get rapidly reinfected in certain high-transmission settings. Drug treatment alone may not be sufficient to eliminate this disease and additional interventions such as health promotion or improvements in water and sanitation need to be scaled up. To provide recommendations to these control programmes we carried out interdisciplinary research in Eastern Uganda to understand the influence of gender on schistosomiasis risk. We found that the water contact behaviour of boys and girls is quite similar, and we did not see differences in reinfection or genetic diversity of the parasite between boys and girls. Differences in water contact between genders is greater in adults, and further research is required for these individuals. In this setting, infection rates are high in school-aged children and there are no differences between genders. These results emphasise improved control efforts for all school-aged children in communities like these. Our interdisciplinary approach provided complementary findings. Such an integrated approach can therefore have more power to meaningfully inform policy on schistosomiasis control.

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<![CDATA[Psychological symptoms and quality of life after repeated exposure to earthquake: A cohort study in Italy]]> https://www.researchpad.co/article/elastic_article_13809 In 2005, a random sample of 200 people were assessed in Camerino, Italy, eight years after an earthquake. Psychological symptom levels were low and only one person had current Post-Traumatic Stress Disorder (PTSD). In 2016 a new earthquake occurred in Camerino. The study aims to assess the impact of the second exposure in the same cohort. A longitudinal study was conducted, 130 participants were re-interviewed between July and December 2017. Psychological symptoms were self-rated on the Brief Symptom Inventory (BSI) and the Global Severity Index (GSI) was analysed. Post-traumatic stress symptoms were self-rated on the Impact of Event Scale-Revised (IES-R). Subjective quality of life (SQOL) was assessed on the Manchester Short Assessment of Quality of Life (MANSA). Mean scores of GSI and IES-R were significantly higher than in 2005 (p<0.01 and p<0.001), whilst SQOL remained almost unchanged (p = 0.163). In 2017, 16.9% of the sample had reached the PTSD threshold whilst in 2005 only the 0.5% had reached it. Despite low symptom levels several years after an earthquake, people can show psychological distress after a new exposure, whilst average quality of life levels are not affected.

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<![CDATA[The effect of monetary incentive on survey response for vulnerable children and youths: A randomized controlled trial]]> https://www.researchpad.co/article/elastic_article_13807 In surveys non-responders may introduce bias and lower the validity of the studies. Ways to increase response rates are therefore important. The purpose of the study was to investigate if an unconditional monetary incentive can increase the response rate for vulnerable children and youths in a postal questionnaire survey.MethodsThe study was designed as a randomized controlled trial. The study population consisted of 262 children and youth who participated in an established intervention study aimed at creating networks for different groups of vulnerable children and youths. The mean age of the participants was 16.7 years (range 11–28) and 67.9% were female. The questionnaire was adapted to three different age groups and covered different aspects of the participants’ life situation, including the dimensions from the Strengths and Difficulties Questionnaire (SDQ). In the follow-up survey, participants were randomly allocated to two groups that either received a €15 voucher for a supermarket together with the questionnaire or only received the questionnaire. We used Poisson regression to estimate the differences in response rate (Rate Ratio RR) between the intervention group and the control group.ResultsThe response rate was 75.5% in the intervention group and 42.9% in the control group. The response rate in the intervention group was significantly higher than in the control group when adjusting for age and gender (Rate Ratio, RR 1.73; 95% CI 1.38–2.17). We did not find any significant differences in scales scores between the two groups for the five scales of the SDQ. In stratified analyses, we found the effect of the incentive to be higher for males (RR 2.81; 95% CI 1.61–4.91) than for females (1.43; 95% CI 1.12–1.84).ConclusionsMonetary incentives can increase the response rate for vulnerable children and youths in surveys.Trial registrationThe trial was retrospectively registered at ClinicalTrials.gov Identifier: NCT01741675. ]]> <![CDATA[Towards universal coverage for nutrition services in children under five years—A descriptive analysis of the capacity of level one hospitals to provide nutrition services in five provinces of Zambia]]> https://www.researchpad.co/article/elastic_article_7846 Malnutrition continues to be a major public health challenge in Zambia. To effectively address this, health systems must be well strengthened to deliver an effective continuum of care. This paper examines health systems issues and services in relation to nutritional support to children under five years, in order to identify gaps and propose interventions towards universal coverage of essential nutrition services.MethodsThis analysis utilized data from a cross sectional mixed-methods study on factors associated with Severe Acute Malnutrition (SAM) in under-five children to assess health facility nutrition services on offer at select level-one hospitals in five out of ten provinces in Zambia. Stata version 13 was used for analysis. We conducted univariate analysis to assess nutrition services offered, functionality of equipment and tools, availability of human resource and human resource development, and availability of drugs used for assessment and management of nutrition-related health outcomes.ResultsWe found large variations in the level of nutrition services on offer across districts and provinces. Eighty-eight percent of all the hospitals sampled provided group nutrition counseling and 92% of the hospitals in our sample offered individual nutrition counseling to their clients. Overall, the existence of referral and counter-referral systems between the Community Based Volunteers and hospitals were the lowest among all services assessed at 48% and 58% respectively. We also found inadequate numbers of human resource across all cadres with an exception of nutritionists as recommended by the Ministry of Health.ConclusionsThis study has revealed a number of gaps in the health system and health service delivery that requires to be addressed; most notably, a lack of tools, policies and guidelines, drugs and health specialists to help care for malnourished infants and children. Our findings also reveal inadequate referral systems between the community and health facilities in the management of severe acute malnutrition. Achieving universal coverage for nutrition services in Zambia will require a lot more attention to the health systems issues found in this study. ]]> <![CDATA[Managing possible serious bacterial infection of young infants where referral is not possible: Lessons from the early implementation experience in Kushtia District learning laboratory, Bangladesh]]> https://www.researchpad.co/article/elastic_article_7649 Serious infections account for 25% of global newborn deaths annually, most in low-resource settings where hospital-based treatment is not accessible or feasible. In Bangladesh, one-third of neonatal deaths are attributable to serious infection; in 2014, the government adopted new policy for outpatient management of danger signs indicating possible serious bacterial infections (PSBI) when referral was not possible. We conducted implementation research to understand what it takes for a district health team to implement quality outpatient PSBI management per national guidelines.MethodsPSBI management was introduced as part of the Comprehensive Newborn Care Package in 2015. The study piloted this package through government health systems with limited partner support to inform scale-up efforts. Data collection included facility register reviews for cases seen at primary level facilities; facility readiness and provider knowledge and skills assessments; household surveys capturing caregiver knowledge of newborn danger signs and care-seeking for newborn illness; and follow-up case tracking, capturing treatment adherence and outcomes. Analysis consisted of descriptive statistics.ResultsOver the 15-month implementation period, 1432 young infants received care, of which 649 (45%) were classified as PSBI. Estimated coverage of care-seeking increased from 22% to 42% during the implementation period. Although facility readiness and providers’ skills increased, providers’ adherence to guidelines was not optimal. Among locally managed PSBI cases, 75% completed the oral antibiotic course and 15% received the fourth day follow-up. Care-seeking remained high among private providers (95%), predominantly village health doctors (over 80%).ConclusionsFacility readiness, including health care provider knowledge and skills were strengthened; future efforts should focus on improving provider adherence to guidelines. Social and behavior change strategies targeting families and communities should explore shifting care-seeking from private, possibly less-qualified providers. Strategies to improve private sector management of PSBI cases and improved linkages between private and public sector providers could be explored. ]]> <![CDATA[Emotional facial perception development in 7, 9 and 11 year-old children: The emergence of a silent eye-tracked emotional other-race effect]]> https://www.researchpad.co/article/elastic_article_7635 The present study examined emotional facial perception (happy and angry) in 7, 9 and 11-year-old children from Caucasian and multicultural environments with an offset task for two ethnic groups of faces (Asian and Caucasian). In this task, participants were required to respond to a dynamic facial expression video when they believed that the first emotion presented had disappeared. Moreover, using an eye-tracker, we evaluated the ocular behavior pattern used to process these different faces. The analyses of reaction times do not show an emotional other-race effect (i.e., a facility in discriminating own-race faces over to other-race ones) in Caucasian children for Caucasian vs. Asian faces through offset times, but an effect of emotional face appeared in the oldest children. Furthermore, an eye-tracked ocular emotion and race-effect relative to processing strategies is observed and evolves between age 7 and 11. This study strengthens the interest in advancing an eye-tracking study in developmental and emotional processing studies, showing that even a “silent” effect should be detected and shrewdly analyzed through an objective means.

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<![CDATA[Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC]]> https://www.researchpad.co/article/elastic_article_7634 Kinshasa is Africa's third largest city and one of the continent’s most rapidly growing urban areas. PMA2020 data showed that Kinshasa has a modern contraceptive prevalence of 26.5% among married women in 2018. In Kinshasa’s method mix, the contraceptive implant recently became the dominant method among contraceptive users married and in union. This study provides insight into patterns of implant use in a high-fertility setting by evaluating the 24-month continuation rate for Implanon NXT and identifying the characteristics associated with discontinuation.MethodologyThis community-based, prospective cohort study followed 531 Implanon users aged 18–49 years at 6, 12 and 24 months. The following information was collected: socio-demographic characteristics, Method Information Index (MII) and contraceptive history. The main outcome variable for this study was implant discontinuation. The incidence rate of discontinuation is presented as events per 1000 person/months (p-m), from the date of enrolment. The Cox proportional hazards modelling was used to measure predictors of discontinuation.ResultsA total of 9158.13 p-m were available for analysis, with an overall incidence rate of 9.06 (95% CI: 9.04–9.08) removals per 1000 p-m. Of nine possible co-variates tested, the likelihood of discontinuation was higher among women who lived in military camps, had less than three children, never used injectables or implants in the past, had experienced heavy/prolonged bleeding, and whose MII score was less than 3.ConclusionIn addition to four client characteristics that predicted discontinuation, we identified one programmatic factor: quality of counseling as measured by the Method Information Index. Community providers in similar contexts should pay more attention to clients having less than three children, new adopters, and to clients living military camps as underserved population, where clients have less access to health facilities. More targeted counselling and follow-up is needed, especially on bleeding patterns. ]]> <![CDATA[Fingerprint evidence for the division of labour and learning pottery-making at Early Bronze Age Tell eá¹£-Ṣâfi/Gath, Israel]]> https://www.researchpad.co/article/N5152a5b5-1b3f-41e8-b706-9ccd50f6a496

The organization of craft production has long been a marker for broader social, economic and political changes that accompanied urbanism. The identity of producers who comprised production groups, communities, or workshops is out of reach using conventional archaeological data. There has been some success using epidermal prints on artefacts to identify the age and sex of producers. However, forensic research indicates that a combination of ridge breadth and ridge density would best identify the age and sex of individuals. To this end, we combine mean ridge breadth (MRB) and mean ridge density (MRD) to distinguish the age and sex of 112 fingerprints on Early Bronze Age (EB) III pottery from the early urban neighbourhood at Tell eṣ-Ṣâfi/Gath, Israel, dating to a 100 year time span. Our analysis accounts for the shrinkage of calcareous fabrics used to make six type of vessels, applies a modified version of the Kamp et al. regression equation to the MRB for each individual print, and infers sex by correlating MRD data to appropriate modern reference populations. When the results are combined, our analyses indicate that most fingerprints were made by adult and young males and the remainder by adult and young females. Children’s prints are in evidence but only occur on handles. Multiple prints of different age and sex on the same vessels suggest they were impressed during the training of young potters. Production appears dominated by adult and young males working alone, together, and in cooperation with adult and/or young females. Vessels with prints exclusively by females of any age are rare. This male dominant cooperative labour pattern contrasts recent studies showing that adult women primarily made Neolithic figurines in Anatolia, and more females than males were making pottery prior to the rise of city-states in northern Mesopotamia.

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<![CDATA[Assessment of availability, awareness and perception of stakeholders regarding preschool vision screening in Kumasi, Ghana: An exploratory study]]> https://www.researchpad.co/article/N637f6c02-dcec-48f9-ae4a-5e42bca666db

Background

Regardless of the importance of preschool vision screening (PSVS), there is limited data on the current state of these programs in Africa (particularly Ghana). This study sought to investigate the level of awareness and perception of stakeholders regarding PSVS, its availability and related policies/programmes in the Kumasi Metropolis, Ghana.

Methods

This descriptive cross-sectional study included 100 systematically sampled preschools in the metropolis (using probability proportional-to-size method); 72 private schools and 28 public schools. Convenience sampling was used to recruit stakeholders of preschools (teachers, head teachers, proprietors, administrators, directors, and educationists), and were interviewed using a well-structured questionnaire. Questionnaires were administered to all eligible respondents who were present at the time of data collection.

Results

A total of 344 respondents participated in the study; 123 (35.8%) males and 221 (64.2%) females. The overall mean age of respondents was 37.63 ±12.20 years (18–71 years). Of the respondents, 215 (62.5%), 94 (27.3%), and 35 (10.2%) were enrolled from private schools, public schools, and Metropolitan Education Directorate, respectively. 73.8% of respondents reported the absence of routine PSVS in schools whereas 90.1% reported no written policies for PSVS in schools. Only 63.6% of respondents were aware of PSVS whereas more than half (59.6%) of all respondents perceived PSVS to be very important for preschoolers. Private school ownership was significantly associated with availability of PSVS whereas age, teachers, private school ownership, and preschool experience > 10 years were significantly associated with awareness of PSVS (P < 0.05). However, there was no significant association between sociodemographic factors and perception of PSVS.

Conclusion

PSVS is largely unavailable in most Ghanaian schools. Majority of stakeholders were aware of PSVS and agreed to its implementation and incorporation into schools’ health programmes. There is the need to implement a national programme/policy on preschool vision screening in Ghana.

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<![CDATA[Children’s descriptions of playing and learning as related processes]]> https://www.researchpad.co/article/Nb68d6bfc-75c6-4e1a-9b4b-3dced51d37df

Many studies have examined children’s understanding of playing and learning as separate concepts, but the ways that children relate playing and learning to one another remain relatively unexplored. The current study asked 5- to 8-year-olds (N = 92) to define playing and learning, and examined whether children defined them as abstract processes or merely as labels for particular types of activities. We also asked children to state whether playing and learning can occur simultaneously, and examined whether they could give examples of playing and learning with attributes either congruent or incongruent with those activities. Older children were more likely to define both playing and learning in terms of abstract processes, rather than by describing particular topics or activities. Children who defined both playing and learning in this way were able to generate more examples of situations where they were simultaneously playing and learning, and were better able to generate examples of learning with characteristics of play, and examples of playing with characteristics of learning. These data suggest that children develop an understanding that learning and playing can coincide. These results are critical to researchers and educators who seek to integrate play and learning, as children’s beliefs about these concepts can influence how they reflect on playful learning opportunities.

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<![CDATA[Risk of infection in the first year of life in preterm children: An Austrian observational study]]> https://www.researchpad.co/article/Ne8c917d2-c06e-4527-bc81-08b9487488ae

Newborns, especially preterm infants, have an immature immune system, which, in combination with the required medical interventions necessary for keeping the neonate alive may lead to an increased risk of infection. Even after reaching stability and adapting to the environment, preterm infants have adverse prognoses regarding infections and long-term outcomes compared to their full-term counterparts. The objective of this study was to research differences in the number and severity of infections between preterm and full-term infants during their first year of life. To answer this question, a monocentric prospective study was conducted in a pediatric practice in Vienna, including 71 full-term infants and 72 preterm infants who were observed during their first year of life regarding occurring infections. In respective samples, there was a significantly higher total number of infections in preterm (mean 6.01 ± 3.90) compared to full-term infants (3.85 ± 1.72) during the observation period of one year. Particularly the count of respiratory and severe infections was considerably higher in preterm infants. Otorhinolaryngeal infections were the most frequent of all types of infections in both groups. The pregnancy period, number of siblings, and length of the postnatal hospital stay, were observed as significantly influencing factors which affected the total number of infections. The group of early term infants (37+0 weeks to 38+6) was not significantly different to late term babies (>39+0). The acquired knowledge about the increased risk of infections should lead to a more extensive care for preterm infants, with the objective of reducing the rates of complications, morbidity and mortality in this vulnerable age group in the future.

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<![CDATA[Prevalence and correlates of anemia among children aged 6-23 months in Wolaita Zone, Southern Ethiopia]]> https://www.researchpad.co/article/5c8c193ad5eed0c484b4d207

Background

Anemia, the world’s most common micro-nutrient deficiency disorder, can affect a person at any time and at all stages of life. Though all members of the community may face the problem, children aged 6–23 months are particularly at higher risk. If left untreated, it adversely affects the health, cognitive development, school achievement, and work performance. However, little was investigated among young children in Sub-Saharan countries including Ethiopia. This research aimed to investigate its magnitude and correlates to address the gap and guide design of evidence based intervention.

Methods

A community-based cross-sectional study was conducted from May -June 2016 in rural districts of Wolaita Zone. Multi-stage sampling technique was applied and 990 mother-child pairs were selected. Socio-demography, health and nutritional characteristics were collected by administering interview questionnaire to mothers/care-givers. Blood samples were taken to diagnose anemia by using HemoCue device, and the status was determined using cut-offs used for children aged 6–59 months. Hemoglobin concentration below 11.0 g/dl was considered anemic. Data were analyzed with Stata V14. Bivariate and multivariable logistic regressions were applied to identify candidates and predictor variables respectively. Statistical significance was determined at p-value < 0.05 at 95% confidence interval.

Results

The mean hemoglobin level of children was 10.44±1.3g/dl, and 65.7% of them were anemic. Among anemic children, 0.4% were severely anemic (<7.0g/dl), while 28.1% and 37.2% were mildly (10.0–10.9g/dl) and moderately (7.0–9.9g/dl) anemic, respectively. In the multivariable analysis, having maternal age of 35 years and above (AOR = 1.96), being government employee (AOR = 0.29), being merchant (AOR = 0.43) and ‘other’ occupation (AOR = 3.17) were correlated with anemia in children in rural Wolaita. Similarly, receiving anti-helminthic drugs (AOR = 0.39), being female child (AOR = 1.76), consuming poor dietary diversity (AOR = 1.40), and having moderate household food insecurity (AOR = 1.72) were associated with anemia in rural Wolaita.

Conclusion

A large majority of children in the rural Wolaita were anemic and the need for proven public health interventions such as food diversification, provision of anti-helminthic drugs and ensuring household food security is crucial. In addition, educating women on nutrition and diet diversification, as well as engaging them with alternative sources of income might be interventions in the study area.

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<![CDATA[A prospective, multi-center study of Candida bloodstream infections in Chile]]> https://www.researchpad.co/article/5c8c1960d5eed0c484b4d4f3

Background

Active surveillance is necessary for improving the management and outcome of patients with candidemia. The aim of this study was to describe epidemiologic and clinical features of candidemia in children and adults in tertiary level hospitals in Chile.

Methods

We conducted a prospective, multicenter, laboratory-based survey study of candidemia in 26 tertiary care hospitals in Chile, from January 2013 to October 2017.

Results

A total of 780 episodes of candidemia were included, with a median incidence of 0.47/1,000 admissions. Demographic, clinical and microbiological information of 384 cases of candidemia, from 18 hospitals (7,416 beds), was included in this report. One hundred and thirty-four episodes (35%) occurred in pediatric patients and 250 (65%) in adult population. Candida albicans (39%), Candida parapsilosis (30%) and Candida glabrata (10%) were the leading species, with a significant difference in the distribution of species between ages. The use of central venous catheter and antibiotics were the most frequent risk factors in all age groups (> 70%). Three hundred and fifteen strains were studied for antifungal susceptibility; 21 strains (6.6%) were resistant to fluconazole, itraconazole, voriconazole, anidulafungin or micafungin. The most commonly used antifungal therapies were fluconazole (39%) and echinocandins (36%). The overall 30-day survival was 74.2%, significantly higher in infants (82%) and children (86%) compared with neonates (72%), adults (71%) and elderly (70%).

Conclusions

Our prospective, multicenter surveillance study showed a low incidence of candidemia in Chile, with high 30-day survival, a large proportion of elderly patients, C. glabrata as the third most commonly identified strain, a 6.6% resistance to antifungal agents and a frequent use of echinocandins.

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<![CDATA[Preadolescent children’s perception of power imbalance in bullying: A thematic analysis]]> https://www.researchpad.co/article/5c8c194ad5eed0c484b4d34b

Bullying in schools is associated with an extensive public health burden. Bullying is intentional and goal oriented aggressive behavior in which the perpetrator exploits an imbalance of power to repeatedly dominate the victim. To differentiate bullying from aggressive behavior, assessment must include a valid measure of power imbalance as perceived by the victim. And yet, to date, there remains no agreement as to how to most accurately measure power imbalance among preadolescent children. This qualitative study explored children’s (age 9 to 11) understanding of power imbalance through thematic analysis of focus group discussions. Subthemes that emerged as influencing power imbalance include: age of victim, peer valued characteristics, and group membership and position. Subthemes of empathy and peer valued characteristics emerged as protecting against the negative impact of power imbalance.

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<![CDATA[Resolving "worm wars": An extended comparison review of findings from key economics and epidemiological studies]]> https://www.researchpad.co/article/5c8acc2bd5eed0c48498f08c ]]> <![CDATA[Boost your brain, while having a break! The effects of long-term cognitively engaging physical activity breaks on children’s executive functions and academic achievement]]> https://www.researchpad.co/article/5c897718d5eed0c4847d2449

Classroom-based physical activity (PA) is gaining attention in terms of its potential to enhance children’s cognitive functions, but it remains unclear as to which specific modality of PA affects cognitive functions most. The aim of the study was to examine the effects of qualitatively different PA breaks on children’s cognitive outcomes. Children (N = 142) aged between 7 and 9 years were allocated to a 20-week classroom-based PA program, with either high physical exertion and high cognitive engagement (combo group), high physical exertion and low cognitive engagement (aerobic group), or low physical exertion and high cognitive engagement (cognition group). Executive functions (updating, inhibition, shifting) and academic achievement (mathematics, spelling, reading) were measured pre- and post-intervention. Results showed that the combo group profited the most displaying enhanced shifting and mathematic performance. The cognition group profited only in terms of enhanced mathematic performance, whereas the aerobic group remained unaffected. These results suggest that the inclusion of cognitively engaging PA breaks seem to be a promising way to enhance school children’s cognitive functions.

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<![CDATA[A comparison study of anxiety in children undergoing brain MRI vs adults undergoing brain MRI vs children undergoing an electroencephalogram]]> https://www.researchpad.co/article/5c9902cbd5eed0c484b985cc

Background

Magnetic resonance imaging (MRI) of the brain in children and adolescents is a well-established method in both clinical practice and in neuroscientific research. This practice is sometimes viewed critically, as MRI scans might expose minors (e.g. through scan-associated fears) to more than the legally permissible “minimal burden”. While there is evidence that a significant portion of adults undergoing brain MRI scans experience anxiety, data on anxiety in children and adolescents undergoing brain MRI scans is rare. This study therefore aimed to examine the prevalence and level of anxiety in children and adolescents who had MRI scans of the brain, and to compare the results to adults undergoing brain MRI scans, and to children and adolescents undergoing electroencephalography (EEG; which is usually regarded a “minimal burden”).

Method

Participants were 57 children and adolescents who had a brain MRI scan (MRI-C; mean age 12.9 years), 28 adults who had a brain MRI scan (MRI-A; mean age 43.7 years), and 66 children and adolescents undergoing EEG (EEG-C; mean age 12.9 years). Anxiety was assessed on the subjective (situational anxiety) and on the physiological level (arousal), before and after the respective examination.

Results

More than 98% of children and adolescents reported no or only minimal fear during the MRI scan. Both pre- and post-examination, the MRI-C and the MRI-A groups did not differ significantly with respect to situational anxiety (p = 0.262 and p = 0.374, respectively), and to physiological arousal (p = 0.050, p = 0.472). Between the MRI-C and the EEG-C group, there were also no significant differences in terms of situational anxiety (p = 0.525, p = 0.875), or physiological arousal (p = 0.535, p = 0.189). Prior MRI experience did not significantly influence subjective or physiological anxiety parameters.

Conclusions

In this study, children and adolescents undergoing a brain MRI scan did not experience significantly more anxiety than those undergoing an EEG, or adults undergoing MRI scanning. Therefore, a general exclusion of minors from MRI research studies does not appear reasonable.

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<![CDATA[Delays in arrival and treatment in emergency departments: Women, children and non-trauma consultations the most at risk in humanitarian settings]]> https://www.researchpad.co/article/5c8823bcd5eed0c484638f1b

Introduction

Delays in arrival and treatment at health facilities lead to negative health outcomes. Individual and external factors could be associated with these delays. This study aimed to assess common factors associated with arrival and treatment delays in the emergency departments (ED) of three hospitals in humanitarian settings.

Methodology

This was a cross-sectional study based on routine data collected from three MSF-supported hospitals in Afghanistan, Haiti and Sierra Leone. We calculated the proportion of consultations with delay in arrival (>24 hours) and in treatment (based on target time according to triage categories). We used a multinomial logistic regression model (MLR) to analyse the association between age, sex, hospital and diagnosis (trauma and non-trauma) with these delays.

Results

We included 95,025 consultations. Males represented 65.2%, Delay in arrival was present in 27.8% of cases and delay in treatment in 27.2%. The MLR showed higher risk of delay in arrival for females (OR 1.2, 95% CI 1.2–1.3), children <5 (OR 1.4, 95% CI 1.4–1.5), patients attending to Gondama (OR 30.0, 95% CI 25.6–35.3) and non-trauma cases (OR 4.7, 95% CI 4.4–4.8). A higher risk of delay in treatment was observed for females (OR 1.1, 95% CI 1.0–1.1), children <5 (OR 2.0, 95% CI 1.9–2.1), patients attending to Martissant (OR 14.6, 95% CI 13.9–15.4) and non-trauma cases (OR 1.6, 95% CI 1.5–1.7).

Conclusions

Women, children <5 and non-trauma cases suffered most from delays. These delays could relate to educational and cultural barriers, and severity perception of the disease. Treatment delay could be due to insufficient resources with consequent overcrowding, and severity perception from medical staff for non-trauma patients. Extended community outreach, health promotion and support to community health workers could improve emergency care in humanitarian settings.

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<![CDATA[Influence of distance, area, and cultural context in active commuting: Continental and insular children]]> https://www.researchpad.co/article/5c8823ded5eed0c4846391ce

Commuting by walking or cycling is a way to increase physical activity levels. The objective of this article was to determine the modes of commuting to school and the distance and time of the way to school among children from Easter Island and from the mainland (Valparaíso), in Chile. A total of 666 children and adolescents aged 10 to 18 years old (208 from Easter Island and 458 from Valparaíso) participated and completed a valid questionnaire including data about age, gender, usual commuting mode to and from school, distance, and travel time. There are important differences in the mode of commuting between students of Valparaíso and Easter Island. Private transport is more commonly used in Valparaíso than in Easter Island (p<0.001). Furthermore, it was observed that cycling and public transportation are not used as mode of commuting in Valparaíso and Easter Island respectively. Students from Easter Island, who travel more distance and during more time, are more active than students from Valparaíso (going 24.8% and 17.6%; from: 61% and 28.8% respectively). This situation is influenced by the geographic context of the island, the distances from home to school, and the type of commuting, which fosters the level of active commuting. On the other hand, the passive modes of commuting to school are higher in the mainland urban setting of Valparaíso. It is necessary to study the diverse contexts of the Easter Island population, but, for now, the rural setting of Easter Island seems to be associated with a greater level of active commuting to school.

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