BACKGROUND Oral food challenge(OFC)is an integral part of confirming and evaluating the diagnosis of food allergy(FA),and most incidents of FA occur in children.FA significantly impairs the quality of life(QoL)and cau...BACKGROUND Oral food challenge(OFC)is an integral part of confirming and evaluating the diagnosis of food allergy(FA),and most incidents of FA occur in children.FA significantly impairs the quality of life(QoL)and causes limited activities outside the home for children and their parents.AIM To evaluate the effect of OFC on QoL and family activities in children with FA.METHODS This prospective study identified children suspected of FA using a skin prick test(SPT)between January 2022 and December 2024.These children conduct an elimination diet for 4 wk,followed by OFC under protocol.Rating scales eva-luated QoL using pediatric QoL inventory and family activities using family ac-tivities impact scale(FAIS),in which data are collected before and after an elimination diet and OFC.Statistical analysis utilized χ^(2),Spearman,paired t,Wilcoxon,independent t,and Mann–Whitney tests,with P<0.05 considered significant.RESULTS Most participants were boys(137;65.55%);102(64.56%)had a positive OFC and 92.40±4.22 after OFC(Z=12.537;P<0.001).In the FAIS score,the average result before OFC was 5.36±0.68 and 4.10±0.38 after OFC,which was a significant difference(Z=12.162;P<0.001).Although the difference in QoL before and after increased,and FAIS reduced,there was no significant difference.Additionally,most results of positive SPT are higher than positive OFC in each specific food allergen.CONCLUSION OFC may improve QoL and FAIS in children with FA and their families as it increases activities outside the home and reduces worry about allergen exposure.展开更多
BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress an...BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.展开更多
Objectives:The objective of this study is to evaluate the effect of simulation-based education(SBE)on the knowledge and skills of nursing students in managing childhood epileptic seizures.Materials and Methods:A quasi...Objectives:The objective of this study is to evaluate the effect of simulation-based education(SBE)on the knowledge and skills of nursing students in managing childhood epileptic seizures.Materials and Methods:A quasi-experimental design was conducted among 160 third-year B.Sc.nursing students at a SUM nursing college in Bhubaneswar,India.The experimental group(n=80)participated in a structured simulation-based session,while the control group(n=80)received routine lecture-demonstration sessions.Knowledge was measured using a 20-item multiple-choice questionnaire and skills were assessed through an Objective Structured Clinical Examination checklist.Results:The experimental group demonstrated significant improvements in posttest knowledge(13.15±1.40 vs.9.56±2.10;t=11.24,P<0.001)and skill scores(17.28±1.82 vs.12.42±2.18;t=10.96,P<0.001)compared with the control group.Ranked data analysis further confirmed higher postintervention knowledge and skill levels(Z=−-6.42 and−-6.55,respectively;P<0.001).These results indicated that SBE produced substantial gains in both cognitive and psychomotor domains.Conclusion:SBE significantly enhances nursing students’knowledge and skills in managing childhood epileptic seizures compared to traditional teaching.Incorporating structured simulation modules into pediatric nursing curricula can improve clinical competence,reduce anxiety,and bolster patient safety in pediatric emergency care.展开更多
Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and ca...Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]展开更多
Objective This study aimed to evaluate the association between susceptibility genes and non-alcoholic fatty liver disease(NAFLD)in children with obesity.Methods We conducted a two-step case-control study.Ninety-three ...Objective This study aimed to evaluate the association between susceptibility genes and non-alcoholic fatty liver disease(NAFLD)in children with obesity.Methods We conducted a two-step case-control study.Ninety-three participants were subjected to whole-exome sequencing(exploratory set).Differential genes identified in the small sample were validated in 1,022 participants using multiplex polymerase chain reaction and high-throughput sequencing(validation set).Results In the exploratory set,14 genes from the NAFLD-associated pathways were identified.In the validation set,after adjusting for sex,age,and body mass index,ECI2 rs2326408(dominant model:OR=1.33,95%CI:1.02–1.72;additive model:OR=1.22,95%CI:1.01–1.47),C6orf201 rs659305(dominant model:OR=1.30,95%CI:1.01–1.69;additive model:OR=1.21,95%CI:1.00–1.45),CALML5rs10904516(pre-ad dominant model:OR=1.36,95%CI:1.01–1.83;adjusted dominant model:OR=1.40,95%CI:1.03–1.91;and pre-ad additive model:OR=1.26,95%CI:1.04–1.66)polymorphisms were significantly associated with NAFLD in children with obesity(P<0.05).Interaction analysis revealed that the gene-gene interaction model of CALML5 rs10904516,COX11 rs17209882,and SCD5 rs3733228 was optional(P<0.05),demonstrating a negative interaction between the three genes.Conclusion In the Chinese population,the CALML5 rs10904516,C6orf201 rs659305,and ECI2rs2326408 variants could be genetic markers for NAFLD susceptibility.展开更多
BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this ...BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this relationship remain unclear.AIM To investigate emotion regulation habits impact on students negative emotions during lockdown,using the coronavirus disease 2019 pandemic as a case example.METHODS During the coronavirus disease 2019 lockdown,an online cross-sectional survey was conducted at a Chinese university.Emotional states were assessed using the Depression,Anxiety,and Stress Scale-21(DASS-21),while demographic data and emotion regulation habits were collected concurrently.Data analysis was performed using SPSS version 27.0 and includedχ^(2)-tests for intergroup comparisons,Spearman’s rank-order correlation coefficient analysis to examine associations,and stepwise linear regression modeling to explore the relationships between emotion regulation habits and emotional states.Statistical significance was set atα=0.05.RESULTS Among the 494 valid questionnaires analyzed,the prevalence rates of negative emotional states were as follows:Depression(65.0%),anxiety(69.4%),and stress(50.8%).DASS-21 scores(mean±SD)demonstrated significant symptomatology:Total(48.77±34.88),depression(16.21±12.18),anxiety(14.90±11.91),and stress(17.64±12.07).Significant positive intercorrelations were observed among all DASS-21 subscales(P<0.01).Regression analysis identified key predictors of negative emotions(P<0.05):Risk factors included late-night frequency and academic pressure,while protective factors were the frequency of parental contact and the number of same-gender friends.Additionally,compensatory spending and binge eating positively predicted all negative emotion scores(β>0,P<0.01),whereas appropriate recreational activities negatively predicted these scores(β<0,P<0.01).CONCLUSION High negative emotion prevalence occurred among confined students.Recreational activities were protective,while compensatory spending and binge eating were risk factors,necessitating guided emotion regulation.展开更多
Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-...Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-inflammatory,and immunomodulatory activities.However,its active constituents and mechanisms of action against diabetic foot remain to be elucidated.Methods:In this study,the chemical constituents of Sanhuang Oil were identified using UPLC-QE-Orbitrap-MS.Subsequently,the mechanism by which Sanhuang Oil promotes diabetic foot ulcer healing was predicted by integrating network pharmacology and molecular docking.Additionally,diabetic mouse model was established in ICR mice using a combination of a high-fat diet(HFD)and streptozotocin(STZ)chemical induction.A full-thickness skin defect was created on the dorsum of the mice.Wound healing and the healing rate were observed following Sanhuang Oil intervention.The mechanism underlying Sanhuang Oil’s promotion of diabetic ulcer healing was further investigated using transcriptomics and histopathological examination(H&E staining).Results:A total of 97 active ingredients were identified from Sanhuang Oil.Network pharmacology analysis predicted 543 common targets,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis identified 203 relevant pathways.Molecular docking further confirmed high binding affinity(binding energy≤−5.0 kcal/mol)between specific active components in Sanhuang Oil(e.g.,coptisine,phellodendrine,baicalein)and key targets associated with diabetic foot ulcers(e.g.,EGFR,AKT1,STAT3).In vivo experimental results demonstrated that the wound healing rate was significantly higher in Sanhuang Oil-treated groups compared to the model group(P<0.001).HE staining revealed that the high-dose Sanhuang Oil group exhibited more pronounced epithelial tissue coverage over the wound,reduced inflammatory cell infiltration,and increased collagen deposition and fibroblast proliferation.transcriptomic analysis identified Pdk4,Ttn,Csrp3,Actn2,Myoz2,Tnnc2,Myod1,Myog,Myot,and Myf6 as key regulatory proteins involved in promoting wound healing.Conclusion:Sanhuang Oil promotes wound healing in diabetic ulcer mice,potentially by mitigating inflammation and regulating key targets such as Pdk4 to enhance fibroblast function.These findings provide novel insights into the multi-target,multi-pathway mechanism of Sanhuang Oil for treating diabetic foot ulcers.展开更多
Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood...Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.展开更多
During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This tre...During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This trend,which parallels the increases in prevalence and degree of pediatric obesity,has caused great concern,even though T2 DM remains a relatively rare disease in children.Youth T2 DM differs not only from type 1 diabetes in children,from which it is sometimes difficult to differentiate,but also from T2 DM in adults,since it appears to be an aggressive disease with rapidly progressive β-cell decline,high treatment failure rate,and accelerated development of complications.Despite the recent research,many aspects of youth T2 DM still remain unknown,regarding both its pathophysiology and risk factor contribution,and its optimal management and prevention.Current management approaches include lifestyle changes,such as improved diet and increased physical activity,together with pharmacological interventions,including metformin,insulin,and the recently approved glucagonlike peptide-1 analog liraglutide.What is more important for everyone to realize though,from patients,families and physicians to schools,health services and policy-makers alike,is that T2 DM is a largely preventable disease that will be addressed effectively only if its major contributor(i.e.,pediatric obesity) is confronted and prevented at every possible stage of life,from conception until adulthood.Therefore,relevant comprehensive,coordinated,and innovative strategies are urgently needed.展开更多
Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle ...Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively;P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.展开更多
To understand the prevalence and rehabilitation status of autism and mental retardation in China. Methods Screening test and clinical assessment were conducted for the diagnosis of autism and mental retardation. The a...To understand the prevalence and rehabilitation status of autism and mental retardation in China. Methods Screening test and clinical assessment were conducted for the diagnosis of autism and mental retardation. The assessment included investigation of the histories of medical conditions and development of these two disorders, utilization and needs for the rehabilitation service, and related intellectual and behavioral appraisal. Results Among the 7345 children investigated, the prevalence of autism disorder was 1.10 cases per 1000 children aged 2-6 years （95% CI=0.34 to 2.54）, and the prevalence of mental retardation was 10.76 cases per 1000 children （95% CI=8.40 to 13.12）. All the children suffering from autistic disorder were intellectually disabled, whereas 31.0% of the non-autism mental retardates had other disabilities. The medical conditions prior to birth and perinatal period were important potential factors for autism. Half of the autistic children and 84% of the children with non-autism mental retardation had never received any rehabilitative service. Conclusions The prevalence of autistic disorder in children aged 2-6 years in Tianjin is rather high. It is urgent to improve the status of the autistic and intelligently disabled young children in China. In order to upgrade the level of early diagnostic and improve the intervention to autism and mental retardation, public awareness and training courses should be heightened.展开更多
Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (Qo...Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (QoL) and to effectively support these families in Japan.The objective of this study was to assess the actual conditions of families living with children having DDs and to explore the factors associated with family empowerment and parents' QoL.Methods: We surveyed ninety-three parents (78 mothers,15 fathers) from 78 families which lived with children with DDs in the capital region of Japan.We assessed two main outcomes using the Japanese versions of the following instruments: Family Empowerment Scale (FES),World Health Organization Quality of Life 26 (WHOQOL26),and other six outcomes.Correlation and multiple regression analyses were conducted.Results: No medication,cooperation with child rearing,assistance from a developmental support center,solved problems related to child rearing,and higher scores in Problem Solving contributed to higher FES scores.Higher WHOQOL26 scores were related to being a full-time housewife,higher self-esteem,no developmental support,a broad emotional support network,higher scores in Problem Solving and Role Function,and lower scores in Affective Reaction and General Function.Conclusions: We revealed that family empowerment and QoL of parents rearing children with DDs in Japan were affected by various subscales of family function and other family attributes.Effective interventions for improving family empowerment and QoL should be researched in the future.展开更多
AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from ...AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia.RESULTS Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements(according to 87% of participants) with a mean of one bowel movement per 3.59 ± 1.0 d, hard stools(83%), blood in the stools(36%), fecal incontinence(33%), and/or difficulty in defecating(47%). Only 26 pediatricians prescribe pharmacologic treatment as first therapeutic approach, while the vast majority prefers nonpharmacologic treatment, mostly(according to 68%) The preferred nonpharmacologic treatment are high-fiber diet(96%), increased fluid intake(90%), toilet training(74%), and abdominal massage(49%). Duration of non-pharmacological treatment was limited to 1 to 2 wk. Seventy percent of the pediatricians recommending toilet training could only mention some elements of the technique, and only 15% was able to explain it fully and correctly. Lactulose is the most frequent pharmacologic intervention used(87% of the participants), and rectal treatment with sodium citrate, sodium lauryl sulfo acetate, and sorbitol is the most frequent rectal treatment(85%). Only 51% will prescribe rectal treatment for fecal impaction. The majority of the pediatricians(69%) expect a positive response during the first week with a mean(± SD) of 4.1(± 2.56) d. Most participants(86%) treat during one month or even less. And the majority(67%) stops treatment when the frequency and/or consistency of the stools have become normal, or if the patient had no longer complaints.CONCLUSION These data provide an insight on the diagnosis and management of constipation in childhood in Indonesia. Although general pediatricians are aware of some important aspects of the diagnosis and mangement of constipation, overall knowledge is limited. Efforts should be made to improve the distribution of existing guidelines. These findings highlight and confirm the difficulties in spreading existing information from guidelines to general pediatricians.展开更多
The reported prevalence of autism spectrum disorder（ASD） has been increasing rapidly in many parts of the world. However, data on its prevalence in China are largely missing. Here, we assessed the suitability of the...The reported prevalence of autism spectrum disorder（ASD） has been increasing rapidly in many parts of the world. However, data on its prevalence in China are largely missing. Here, we assessed the suitability of the modi？ed Chinese version of a newly-developed ASD screening tool, the Modi？ed Chinese Autism Spectrum Rating Scales（MC-ASRS） in screening for ASD in Chi nese children aged 6–12 years, through comparison with the Social Responsiveness Scale（SRS） that has been widely used for ASD screening. We recruited the par ents/caregivers of 1588 typically-developing children and190 children with ASD aged 6–12 years to complete the MC-ASRS and SRS, and evaluated the validity of both scales in discriminating children with ASD from those developing typically. The results showed that MC-ASRSperformed as well as SRS in sensitivity, speci？city, and area-under-the-curve（both [0.95） in receiver operating characteristic analysis, with a fair false-negative rate.These results suggest that MC-ASRS is a promising tool for screening for children with ASD in the general Chinese population.展开更多
AIM To determine the clinical features of diabetes in children and adolescents in Ghana.METHODS Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric ...AIM To determine the clinical features of diabetes in children and adolescents in Ghana.METHODS Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auvip 2016. RESULTS One hundred and six subjects presented with diabetes. Ninety(84.9%) were diagnosed by clinical features and family history as type 1, and 16(15.1%) type 2. For type 1 subjects, age range at diagnosis was 0.9-19.9 year(y), peak age of onset 12-13 year, and 3.3% were < 5 year, 21.1% 5-< 10 year, 45.6% 10-< 15 year and 30.0% 15-< 20 year. Seventy-one point one percent were female. Common clinical features were polyuria(100%), polydipsia(98.9%), and weight loss(82.2%). Mean BMI SD was -0.54, range -3.84 to 2.47. 60.0% presented in diabetic ketoacidosis(DKA). Nine had infections at onset(skin, abscess, leg ulcer). Mean± SD HbA 1c at diagnosis was 12.7% ± 1.9%(115±21 mmol/mol). Four have since died: Hypoglycaemia(2), recurrent DKA(1), osteosarcoma(1). Two other type 1 cases died of DKA at presentation in emergency before being seen by the paediatric endocrinologist. Crude mortality rate including these 2 cases was 32.2/1000 patient years. Type 2 cases were 81% female, age of onset 9-19 year. Mean BMI SD was 1.49, range -0.87 to 2.61. Forty-three point eight percent presented in DKA. All type 2 cases had acanthosis nigricans. Overall, 9.8% did not have home refrigeration, most using clay pot evaporative cooling for insulin storage. CONCLUSION Type 1 occurs with a female preponderance and high DKA rates. Type 2 also occurs. Typology based on clinical features is difficult. Community and professional awareness is warranted.展开更多
BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood....BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.展开更多
In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the eff...In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.展开更多
Purpose:This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al.This study also aims to analys...Purpose:This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al.This study also aims to analyse the scales'validity and reliability in evaluating stigma perceptions amongst the aforementioned population.Methods:The population of this methodological study consisted of parents and 85 epileptic children between 9 and 16 years old.This population visited the paediatric neurology clinic of a hospital in Erzurum Province,Turkey,between April 2015 and January 2016.The scales of perceived stigma amongst children with epilepsy and their parents,as well as its Turkish version,were used as measuring tools.Experts were also consulted for their opinions.Meanwhile,Bartlett's test,Kaiser-Meyer-Olkin(KMO)index,exploratory factor analysis,principal component analysis,varimax rotation and scree plot test were used to determine the validity of the study,Moreover,the coefficients of Cronbach'sαand Pearson's product-moment correlation were used to identify internal consistency,homogeneity and thus reliability.Results:Evaluations and analyses indicated that the Turkish version of the child and parent scales can be used with a single dimension.The mean scores of such scales were 24.02±8.47 and 15.68±4.04,respectively.All item-total score correlations of the child and parent scales were found to be significant(P<0.05).The KMO coefficient of the child scale was 0.94,whereas the chi-square value of Bartlett's test of sphericity was significant at 209.311(P<0.05).Moreover,the KMO coefficient of the parent scale was found to be 0.80,whereas the chi-square value of Bartlett's test of sphericity was found to be significant at 209.311(P<0.05).The Cronbach'sαcoefficients were 0.95 and 0.87 for the child and parent scales,respectively.Conclusion:The Turkish version of the child and parent scales of perceived stigma is valid and reliable in measuring the perception of stigma amongst children with epilepsy and their parents.展开更多
Objective: To analyze the correlation between urine retinol binding protein-4 (RBP-4) and serum HbA1c?with glomerular filtration rate (GFR) in type 1 diabetic children. Methods:?This?was a crosssectional observational...Objective: To analyze the correlation between urine retinol binding protein-4 (RBP-4) and serum HbA1c?with glomerular filtration rate (GFR) in type 1 diabetic children. Methods:?This?was a crosssectional observational analytic?study. The subjects?were?type 1 diabetic children aged 2 - 14 years. Sample collection was conducted from October to November 2014. Exclusion criteria were patients with obesity, renal insufficiency?that?was not caused by diabetes, history of hepatic diseases, and history of blood cell disorders. We?performed anamnesis, physical examination, and blood sampling for serum HbA1c?and serum cystatin-C, and urine sampling for RBP-4?on all subjects. Glomerular filtration rate was calculated from the concentration level of cystatin-C using Filler formula. Data analysis was performed?by?Spearman test to determine the correlation between urine RBP-4 and serum HbA1c?with GFR. The Fisher’s exact test was used to determine the correlation between duration of diabetes and RBP-4, HbA1c, and also GFR. Results:?Twelve females (60%) and 8 males (40%) participated in the study. The mean age of the subjects with 95% CI?was: 10.5 (2 - 14) years while the mean age of duration diabetes with 95% CI: 3.8 (0.5 - 10) years. Twelve (60%) subjects had?<5 years duration of diabetes, while eight (40%) subjects had?≥5 years duration of diabetes. Twelve (60%) subjects had normal RBP-4 level, while eight (40%) subjects had?elevated RBP-4 level. The mean level of HbA1c?with 95% CI: 8.9 (5.1 - 15.2)%. Thirteen (65%) subjects had poor metabolic. The mean GFR of the subjects with 95% CI: 99.3 (35.2 - 147.4) mL/1.73/m2. Nineteen (95%) subjects had normal GFR, while 1 (5%) had renal insufficiency. The results of data analysis using Spearman test on the correlation between urine RBP-4 and serum HbA1cwith GFR were not significant. The result of correlation between duration of diabetes and urine RBP-4 was significant?using?Fischer’s test. Conclusion:?The results?showed?no correlation between urine RBP-4 and serum HbA1c?with GFR. Urine RBP-4 could?be considered to assess renal function in type 1 diabetic patients with a duration of diabetes of more than 5 years.展开更多
In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei...In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist ＂ parents＂ form＂ （Chinese version） and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children＇s and adolescents＂ aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students＂ interpersonal relationship were significantly associated with the childreffs and adolescents＂ aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.展开更多
文摘BACKGROUND Oral food challenge(OFC)is an integral part of confirming and evaluating the diagnosis of food allergy(FA),and most incidents of FA occur in children.FA significantly impairs the quality of life(QoL)and causes limited activities outside the home for children and their parents.AIM To evaluate the effect of OFC on QoL and family activities in children with FA.METHODS This prospective study identified children suspected of FA using a skin prick test(SPT)between January 2022 and December 2024.These children conduct an elimination diet for 4 wk,followed by OFC under protocol.Rating scales eva-luated QoL using pediatric QoL inventory and family activities using family ac-tivities impact scale(FAIS),in which data are collected before and after an elimination diet and OFC.Statistical analysis utilized χ^(2),Spearman,paired t,Wilcoxon,independent t,and Mann–Whitney tests,with P<0.05 considered significant.RESULTS Most participants were boys(137;65.55%);102(64.56%)had a positive OFC and 92.40±4.22 after OFC(Z=12.537;P<0.001).In the FAIS score,the average result before OFC was 5.36±0.68 and 4.10±0.38 after OFC,which was a significant difference(Z=12.162;P<0.001).Although the difference in QoL before and after increased,and FAIS reduced,there was no significant difference.Additionally,most results of positive SPT are higher than positive OFC in each specific food allergen.CONCLUSION OFC may improve QoL and FAIS in children with FA and their families as it increases activities outside the home and reduces worry about allergen exposure.
文摘BACKGROUND Attention deficit hyperactivity disorder(ADHD)affects approximately 5%of children worldwide and is associated with significant academic impairment.Parents of children with ADHD experience elevated stress and anxiety levels,which may further affect their children's educational outcomes.This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.AIM To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.METHODS A longitudinal cohort study was conducted from 2018 to 2024,enrolling 118 children with ADHD(aged 6-12 years)and their parents from three specialized educational centers.Parental anxiety was assessed using the Parenting Stress Index-4(PSI-4)and Parental Anxiety Scale.Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests.Assessments were conducted at baseline and every 6 months for 3 years.RESULTS Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD(β=-0.42,P<0.001).Children of parents with clinically significant anxiety(PSI-4 scores>85th percentile)showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels.The relationship was partially mediated by parent-child interaction quality(indirect effect=-0.18,95%CI:-0.26 to-0.10)and homework supervision practices(indirect effect=-0.15,95%CI:-0.22 to-0.08).CONCLUSION Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways.Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.
文摘Objectives:The objective of this study is to evaluate the effect of simulation-based education(SBE)on the knowledge and skills of nursing students in managing childhood epileptic seizures.Materials and Methods:A quasi-experimental design was conducted among 160 third-year B.Sc.nursing students at a SUM nursing college in Bhubaneswar,India.The experimental group(n=80)participated in a structured simulation-based session,while the control group(n=80)received routine lecture-demonstration sessions.Knowledge was measured using a 20-item multiple-choice questionnaire and skills were assessed through an Objective Structured Clinical Examination checklist.Results:The experimental group demonstrated significant improvements in posttest knowledge(13.15±1.40 vs.9.56±2.10;t=11.24,P<0.001)and skill scores(17.28±1.82 vs.12.42±2.18;t=10.96,P<0.001)compared with the control group.Ranked data analysis further confirmed higher postintervention knowledge and skill levels(Z=−-6.42 and−-6.55,respectively;P<0.001).These results indicated that SBE produced substantial gains in both cognitive and psychomotor domains.Conclusion:SBE significantly enhances nursing students’knowledge and skills in managing childhood epileptic seizures compared to traditional teaching.Incorporating structured simulation modules into pediatric nursing curricula can improve clinical competence,reduce anxiety,and bolster patient safety in pediatric emergency care.
基金supported by the National Natural Science Foundation of China(82371709).
文摘Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]
基金supported by the Hunan Provincial Natural Science Foundation of China(2024JJ6257)Hunan Children’s Hospital Cultivation Project Fund(2024GZPY04)+2 种基金Opening fundings of Hunan Provincial Key Laboratory of Pediatric Orthopedics(2023TP1019)Science and Technology Project of Furong Laboratory(2023SK2111)Hunan Provincial Clinical Medical Research Center for pediatric Limb Deformities(2019SK4006)。
文摘Objective This study aimed to evaluate the association between susceptibility genes and non-alcoholic fatty liver disease(NAFLD)in children with obesity.Methods We conducted a two-step case-control study.Ninety-three participants were subjected to whole-exome sequencing(exploratory set).Differential genes identified in the small sample were validated in 1,022 participants using multiplex polymerase chain reaction and high-throughput sequencing(validation set).Results In the exploratory set,14 genes from the NAFLD-associated pathways were identified.In the validation set,after adjusting for sex,age,and body mass index,ECI2 rs2326408(dominant model:OR=1.33,95%CI:1.02–1.72;additive model:OR=1.22,95%CI:1.01–1.47),C6orf201 rs659305(dominant model:OR=1.30,95%CI:1.01–1.69;additive model:OR=1.21,95%CI:1.00–1.45),CALML5rs10904516(pre-ad dominant model:OR=1.36,95%CI:1.01–1.83;adjusted dominant model:OR=1.40,95%CI:1.03–1.91;and pre-ad additive model:OR=1.26,95%CI:1.04–1.66)polymorphisms were significantly associated with NAFLD in children with obesity(P<0.05).Interaction analysis revealed that the gene-gene interaction model of CALML5 rs10904516,COX11 rs17209882,and SCD5 rs3733228 was optional(P<0.05),demonstrating a negative interaction between the three genes.Conclusion In the Chinese population,the CALML5 rs10904516,C6orf201 rs659305,and ECI2rs2326408 variants could be genetic markers for NAFLD susceptibility.
文摘BACKGROUND The prevalence of negative emotional states,such as anxiety and depression,has increased annually.Although personal habits are known to influence emotional regulation,the precise mechanisms underlying this relationship remain unclear.AIM To investigate emotion regulation habits impact on students negative emotions during lockdown,using the coronavirus disease 2019 pandemic as a case example.METHODS During the coronavirus disease 2019 lockdown,an online cross-sectional survey was conducted at a Chinese university.Emotional states were assessed using the Depression,Anxiety,and Stress Scale-21(DASS-21),while demographic data and emotion regulation habits were collected concurrently.Data analysis was performed using SPSS version 27.0 and includedχ^(2)-tests for intergroup comparisons,Spearman’s rank-order correlation coefficient analysis to examine associations,and stepwise linear regression modeling to explore the relationships between emotion regulation habits and emotional states.Statistical significance was set atα=0.05.RESULTS Among the 494 valid questionnaires analyzed,the prevalence rates of negative emotional states were as follows:Depression(65.0%),anxiety(69.4%),and stress(50.8%).DASS-21 scores(mean±SD)demonstrated significant symptomatology:Total(48.77±34.88),depression(16.21±12.18),anxiety(14.90±11.91),and stress(17.64±12.07).Significant positive intercorrelations were observed among all DASS-21 subscales(P<0.01).Regression analysis identified key predictors of negative emotions(P<0.05):Risk factors included late-night frequency and academic pressure,while protective factors were the frequency of parental contact and the number of same-gender friends.Additionally,compensatory spending and binge eating positively predicted all negative emotion scores(β>0,P<0.01),whereas appropriate recreational activities negatively predicted these scores(β<0,P<0.01).CONCLUSION High negative emotion prevalence occurred among confined students.Recreational activities were protective,while compensatory spending and binge eating were risk factors,necessitating guided emotion regulation.
基金supported by the Natural Science Foundation of Hubei Provincial Department of Education(D20232101)Shandong Second Medical University 2024 Affiliated Hospital(Teaching Hospital)Scientific Research Development Fund Project(2024FYQ026)+3 种基金the innovative Research Programme of Xiangyang No.1 People’s Hospital(XYY2023ZY01)Faculty Development Grants of Xiangyang No.1 People’s Hospital Affiliated to Hubei University of Medicine(XYY2023D05)Joint supported by Hubei Provincial Natural Science Foundation and Xiangyang of China(2025AFD091)Traditional Chinese Medicine Scientific Research Project of Hubei Provincial Administration of Traditional Chinese Medicine(ZY2025D019).
文摘Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-inflammatory,and immunomodulatory activities.However,its active constituents and mechanisms of action against diabetic foot remain to be elucidated.Methods:In this study,the chemical constituents of Sanhuang Oil were identified using UPLC-QE-Orbitrap-MS.Subsequently,the mechanism by which Sanhuang Oil promotes diabetic foot ulcer healing was predicted by integrating network pharmacology and molecular docking.Additionally,diabetic mouse model was established in ICR mice using a combination of a high-fat diet(HFD)and streptozotocin(STZ)chemical induction.A full-thickness skin defect was created on the dorsum of the mice.Wound healing and the healing rate were observed following Sanhuang Oil intervention.The mechanism underlying Sanhuang Oil’s promotion of diabetic ulcer healing was further investigated using transcriptomics and histopathological examination(H&E staining).Results:A total of 97 active ingredients were identified from Sanhuang Oil.Network pharmacology analysis predicted 543 common targets,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis identified 203 relevant pathways.Molecular docking further confirmed high binding affinity(binding energy≤−5.0 kcal/mol)between specific active components in Sanhuang Oil(e.g.,coptisine,phellodendrine,baicalein)and key targets associated with diabetic foot ulcers(e.g.,EGFR,AKT1,STAT3).In vivo experimental results demonstrated that the wound healing rate was significantly higher in Sanhuang Oil-treated groups compared to the model group(P<0.001).HE staining revealed that the high-dose Sanhuang Oil group exhibited more pronounced epithelial tissue coverage over the wound,reduced inflammatory cell infiltration,and increased collagen deposition and fibroblast proliferation.transcriptomic analysis identified Pdk4,Ttn,Csrp3,Actn2,Myoz2,Tnnc2,Myod1,Myog,Myot,and Myf6 as key regulatory proteins involved in promoting wound healing.Conclusion:Sanhuang Oil promotes wound healing in diabetic ulcer mice,potentially by mitigating inflammation and regulating key targets such as Pdk4 to enhance fibroblast function.These findings provide novel insights into the multi-target,multi-pathway mechanism of Sanhuang Oil for treating diabetic foot ulcers.
基金supported by the National Natural Science Foundation of China(Grant No.82373581 to Yuan Lin).
文摘Prenatal maternal psychological distress,particularly depression,has been increasingly recognized as a factor that influences fetal growth;however,its impact on early childhood development remains less well understood.The present study investigated the association between prenatal depression and children's growth trajectories,as well as the odds of overweight and obesity from 1 to 36 months,while also accounting for maternal anxiety and stress.We analyzed data from 4710 mother-child dyads in the Jiangsu Birth Cohort,assessing maternal psychological distress across trimesters and categorizing participants into groups with mild,moderate,and severe depressive symptomatology.Children's weight-for-length z-scores(WLZ)were used to assess overweight/obesity prevalence,and growth patterns were identified through trajectory models.The results from the generalized estimating equations analysis showed that greater depressive symptomatology during pregnancy was associated with a 28%to 41%increase in the odds of childhood overweight/obesity across all three trimesters,compared with mild depressive symptomatology.We identified five distinct WLZ growth trajectory patterns,and found that mothers with greater depressive symptomatology were 39%–47%more likely to have children who followed a very-high-stable growth trajectory,compared with mothers with mild depressive symptomatology.These findings highlight the significant impact of prenatal depression on adverse growth patterns and childhood overweight/obesity,underscoring the need for early intervention.
文摘During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This trend,which parallels the increases in prevalence and degree of pediatric obesity,has caused great concern,even though T2 DM remains a relatively rare disease in children.Youth T2 DM differs not only from type 1 diabetes in children,from which it is sometimes difficult to differentiate,but also from T2 DM in adults,since it appears to be an aggressive disease with rapidly progressive β-cell decline,high treatment failure rate,and accelerated development of complications.Despite the recent research,many aspects of youth T2 DM still remain unknown,regarding both its pathophysiology and risk factor contribution,and its optimal management and prevention.Current management approaches include lifestyle changes,such as improved diet and increased physical activity,together with pharmacological interventions,including metformin,insulin,and the recently approved glucagonlike peptide-1 analog liraglutide.What is more important for everyone to realize though,from patients,families and physicians to schools,health services and policy-makers alike,is that T2 DM is a largely preventable disease that will be addressed effectively only if its major contributor(i.e.,pediatric obesity) is confronted and prevented at every possible stage of life,from conception until adulthood.Therefore,relevant comprehensive,coordinated,and innovative strategies are urgently needed.
基金supported by the National Natural Science Foundation of China [81502823]Outstanding Young Talent Key program of College and University in Anhui province [gxyq ZD2017063]University Natural Science Foundation of Anhui province [KJ2019A0298]
文摘Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively;P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.
基金This study was supported by the "973" Program of the Ministry of Science and Technology, China (2001CB510310).
文摘To understand the prevalence and rehabilitation status of autism and mental retardation in China. Methods Screening test and clinical assessment were conducted for the diagnosis of autism and mental retardation. The assessment included investigation of the histories of medical conditions and development of these two disorders, utilization and needs for the rehabilitation service, and related intellectual and behavioral appraisal. Results Among the 7345 children investigated, the prevalence of autism disorder was 1.10 cases per 1000 children aged 2-6 years （95% CI=0.34 to 2.54）, and the prevalence of mental retardation was 10.76 cases per 1000 children （95% CI=8.40 to 13.12）. All the children suffering from autistic disorder were intellectually disabled, whereas 31.0% of the non-autism mental retardates had other disabilities. The medical conditions prior to birth and perinatal period were important potential factors for autism. Half of the autistic children and 84% of the children with non-autism mental retardation had never received any rehabilitative service. Conclusions The prevalence of autistic disorder in children aged 2-6 years in Tianjin is rather high. It is urgent to improve the status of the autistic and intelligently disabled young children in China. In order to upgrade the level of early diagnostic and improve the intervention to autism and mental retardation, public awareness and training courses should be heightened.
基金This study was funded by the Ministry of Education,Culture,Sports,Science,and Technology of Japan (Grant-in-Aid for Young Scientists (A),2014-2018,No.26713057)
文摘Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (QoL) and to effectively support these families in Japan.The objective of this study was to assess the actual conditions of families living with children having DDs and to explore the factors associated with family empowerment and parents' QoL.Methods: We surveyed ninety-three parents (78 mothers,15 fathers) from 78 families which lived with children with DDs in the capital region of Japan.We assessed two main outcomes using the Japanese versions of the following instruments: Family Empowerment Scale (FES),World Health Organization Quality of Life 26 (WHOQOL26),and other six outcomes.Correlation and multiple regression analyses were conducted.Results: No medication,cooperation with child rearing,assistance from a developmental support center,solved problems related to child rearing,and higher scores in Problem Solving contributed to higher FES scores.Higher WHOQOL26 scores were related to being a full-time housewife,higher self-esteem,no developmental support,a broad emotional support network,higher scores in Problem Solving and Role Function,and lower scores in Affective Reaction and General Function.Conclusions: We revealed that family empowerment and QoL of parents rearing children with DDs in Japan were affected by various subscales of family function and other family attributes.Effective interventions for improving family empowerment and QoL should be researched in the future.
文摘AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia.RESULTS Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements(according to 87% of participants) with a mean of one bowel movement per 3.59 ± 1.0 d, hard stools(83%), blood in the stools(36%), fecal incontinence(33%), and/or difficulty in defecating(47%). Only 26 pediatricians prescribe pharmacologic treatment as first therapeutic approach, while the vast majority prefers nonpharmacologic treatment, mostly(according to 68%) The preferred nonpharmacologic treatment are high-fiber diet(96%), increased fluid intake(90%), toilet training(74%), and abdominal massage(49%). Duration of non-pharmacological treatment was limited to 1 to 2 wk. Seventy percent of the pediatricians recommending toilet training could only mention some elements of the technique, and only 15% was able to explain it fully and correctly. Lactulose is the most frequent pharmacologic intervention used(87% of the participants), and rectal treatment with sodium citrate, sodium lauryl sulfo acetate, and sorbitol is the most frequent rectal treatment(85%). Only 51% will prescribe rectal treatment for fecal impaction. The majority of the pediatricians(69%) expect a positive response during the first week with a mean(± SD) of 4.1(± 2.56) d. Most participants(86%) treat during one month or even less. And the majority(67%) stops treatment when the frequency and/or consistency of the stools have become normal, or if the patient had no longer complaints.CONCLUSION These data provide an insight on the diagnosis and management of constipation in childhood in Indonesia. Although general pediatricians are aware of some important aspects of the diagnosis and mangement of constipation, overall knowledge is limited. Efforts should be made to improve the distribution of existing guidelines. These findings highlight and confirm the difficulties in spreading existing information from guidelines to general pediatricians.
基金supported by the National Health and Family Planning Commission of China(201302002)the National Natural Science Foundation of China(81371270Clinical Trials.gov number NCT 02200679)
文摘The reported prevalence of autism spectrum disorder（ASD） has been increasing rapidly in many parts of the world. However, data on its prevalence in China are largely missing. Here, we assessed the suitability of the modi？ed Chinese version of a newly-developed ASD screening tool, the Modi？ed Chinese Autism Spectrum Rating Scales（MC-ASRS） in screening for ASD in Chi nese children aged 6–12 years, through comparison with the Social Responsiveness Scale（SRS） that has been widely used for ASD screening. We recruited the par ents/caregivers of 1588 typically-developing children and190 children with ASD aged 6–12 years to complete the MC-ASRS and SRS, and evaluated the validity of both scales in discriminating children with ASD from those developing typically. The results showed that MC-ASRSperformed as well as SRS in sensitivity, speci？city, and area-under-the-curve（both [0.95） in receiver operating characteristic analysis, with a fair false-negative rate.These results suggest that MC-ASRS is a promising tool for screening for children with ASD in the general Chinese population.
文摘AIM To determine the clinical features of diabetes in children and adolescents in Ghana.METHODS Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auvip 2016. RESULTS One hundred and six subjects presented with diabetes. Ninety(84.9%) were diagnosed by clinical features and family history as type 1, and 16(15.1%) type 2. For type 1 subjects, age range at diagnosis was 0.9-19.9 year(y), peak age of onset 12-13 year, and 3.3% were < 5 year, 21.1% 5-< 10 year, 45.6% 10-< 15 year and 30.0% 15-< 20 year. Seventy-one point one percent were female. Common clinical features were polyuria(100%), polydipsia(98.9%), and weight loss(82.2%). Mean BMI SD was -0.54, range -3.84 to 2.47. 60.0% presented in diabetic ketoacidosis(DKA). Nine had infections at onset(skin, abscess, leg ulcer). Mean± SD HbA 1c at diagnosis was 12.7% ± 1.9%(115±21 mmol/mol). Four have since died: Hypoglycaemia(2), recurrent DKA(1), osteosarcoma(1). Two other type 1 cases died of DKA at presentation in emergency before being seen by the paediatric endocrinologist. Crude mortality rate including these 2 cases was 32.2/1000 patient years. Type 2 cases were 81% female, age of onset 9-19 year. Mean BMI SD was 1.49, range -0.87 to 2.61. Forty-three point eight percent presented in DKA. All type 2 cases had acanthosis nigricans. Overall, 9.8% did not have home refrigeration, most using clay pot evaporative cooling for insulin storage. CONCLUSION Type 1 occurs with a female preponderance and high DKA rates. Type 2 also occurs. Typology based on clinical features is difficult. Community and professional awareness is warranted.
基金Supported by the National Natural Science Foundation of China,No.81330068.
文摘BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.
文摘In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.
文摘Purpose:This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al.This study also aims to analyse the scales'validity and reliability in evaluating stigma perceptions amongst the aforementioned population.Methods:The population of this methodological study consisted of parents and 85 epileptic children between 9 and 16 years old.This population visited the paediatric neurology clinic of a hospital in Erzurum Province,Turkey,between April 2015 and January 2016.The scales of perceived stigma amongst children with epilepsy and their parents,as well as its Turkish version,were used as measuring tools.Experts were also consulted for their opinions.Meanwhile,Bartlett's test,Kaiser-Meyer-Olkin(KMO)index,exploratory factor analysis,principal component analysis,varimax rotation and scree plot test were used to determine the validity of the study,Moreover,the coefficients of Cronbach'sαand Pearson's product-moment correlation were used to identify internal consistency,homogeneity and thus reliability.Results:Evaluations and analyses indicated that the Turkish version of the child and parent scales can be used with a single dimension.The mean scores of such scales were 24.02±8.47 and 15.68±4.04,respectively.All item-total score correlations of the child and parent scales were found to be significant(P<0.05).The KMO coefficient of the child scale was 0.94,whereas the chi-square value of Bartlett's test of sphericity was significant at 209.311(P<0.05).Moreover,the KMO coefficient of the parent scale was found to be 0.80,whereas the chi-square value of Bartlett's test of sphericity was found to be significant at 209.311(P<0.05).The Cronbach'sαcoefficients were 0.95 and 0.87 for the child and parent scales,respectively.Conclusion:The Turkish version of the child and parent scales of perceived stigma is valid and reliable in measuring the perception of stigma amongst children with epilepsy and their parents.
文摘Objective: To analyze the correlation between urine retinol binding protein-4 (RBP-4) and serum HbA1c?with glomerular filtration rate (GFR) in type 1 diabetic children. Methods:?This?was a crosssectional observational analytic?study. The subjects?were?type 1 diabetic children aged 2 - 14 years. Sample collection was conducted from October to November 2014. Exclusion criteria were patients with obesity, renal insufficiency?that?was not caused by diabetes, history of hepatic diseases, and history of blood cell disorders. We?performed anamnesis, physical examination, and blood sampling for serum HbA1c?and serum cystatin-C, and urine sampling for RBP-4?on all subjects. Glomerular filtration rate was calculated from the concentration level of cystatin-C using Filler formula. Data analysis was performed?by?Spearman test to determine the correlation between urine RBP-4 and serum HbA1c?with GFR. The Fisher’s exact test was used to determine the correlation between duration of diabetes and RBP-4, HbA1c, and also GFR. Results:?Twelve females (60%) and 8 males (40%) participated in the study. The mean age of the subjects with 95% CI?was: 10.5 (2 - 14) years while the mean age of duration diabetes with 95% CI: 3.8 (0.5 - 10) years. Twelve (60%) subjects had?<5 years duration of diabetes, while eight (40%) subjects had?≥5 years duration of diabetes. Twelve (60%) subjects had normal RBP-4 level, while eight (40%) subjects had?elevated RBP-4 level. The mean level of HbA1c?with 95% CI: 8.9 (5.1 - 15.2)%. Thirteen (65%) subjects had poor metabolic. The mean GFR of the subjects with 95% CI: 99.3 (35.2 - 147.4) mL/1.73/m2. Nineteen (95%) subjects had normal GFR, while 1 (5%) had renal insufficiency. The results of data analysis using Spearman test on the correlation between urine RBP-4 and serum HbA1cwith GFR were not significant. The result of correlation between duration of diabetes and urine RBP-4 was significant?using?Fischer’s test. Conclusion:?The results?showed?no correlation between urine RBP-4 and serum HbA1c?with GFR. Urine RBP-4 could?be considered to assess renal function in type 1 diabetic patients with a duration of diabetes of more than 5 years.
文摘In order to identify family factors obviously relevant to aggression, and offer a theoretical foundation for the prevention of aggression, 4010 students from primary and secondary schools in 5 different areas in Hubei province were surveyed. The Child Behavior Checklist ＂ parents＂ form＂ （Chinese version） and the four scales of Family Environment Scale were used. A multiple logistic regression was used to identify risk factors of children＇s and adolescents＂ aggressive behavior. The results showed that maternal education, paternal occupation, family type, parental child-rearing attitude and patterns, students＂ interpersonal relationship were significantly associated with the childreffs and adolescents＂ aggression. The risk factors of aggression were parental child-rearing patterns, peer relationship, teacher-student relationship, and family conflicts.
