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Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates <32 weeks gestational age at birth and <10 days of life were recruited from four Canadian tertiary NICUs. Daily chart reviews of documented painful procedures, sucrose administration, and any associated adverse events were undertaken. One hundred sixty‐eight neonates underwent a total of 9093 skin‐breaking procedures (mean 54.1 [±65.2] procedures/neonate or 1.1 [±0.9] procedures/day/neonate) during an average NICU stay of 45.9 (±31.4) days. Pain severity was recorded for 5399/9093 (59.4%) of the painful procedures; the majority (5051 [93.5%]) were heel lances of moderate pain intensity. Sucrose was administered for 7839/9093 (86.2%) of painful procedures. The total average sucrose volume was 5.5 (±5.4) mL/neonate or 0.11 (±0.08) mL/neonate/day. Infants experienced an average of 7.9 (±12.7) minor adverse events associated with pain and/or sucrose administration that resolved without intervention. The total number of painful procedures, sucrose volume, and incidence of adverse events throughout the NICU stay were described addressing an important knowledge gap in neonatal pain. These data provide a baseline for examining the association between total sucrose volume during NICU stay and research on longer‐term behavioral and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Background: The Canadian 24-Hour Movement Guidelines for Children and Youth (“Guidelines”) not only pioneered the notion of an integrated movement continuum from sleep to vigorous-intensity physical activity but also introduced a new branded Guideline visual identity. Objectives: This study evaluated youths’ (N = 46) attention to and thoughts about the Guidelines and the brand. Design: A cross-sectional between-participants randomized intervention design was used. Sample: Canadian youth between 10 and 17 years of age comprised the study sample. Interventions: Participants were randomly assigned to view either branded Guidelines (n = 26) or unbranded Guidelines (n = 20). Youths’ eye-movements (e.g., dwell time, fixation count) were recorded during Guideline viewing. Participants completed a follow-up survey assessing brand perceptions and Guideline cognitions. Results: The branded Guidelines neither drew greater overall attention nor led to more positive brand perceptions or Guideline cognitions compared to the unbranded Guidelines. Conclusions: Exploratory analyses provide valuable, yet preliminary insight into how branding and Guideline content may shape how Guidelines are perceived and acted upon. These findings inform an agenda for future health education resources. [ABSTRACT FROM AUTHOR]

Background & Aims: Given that standardized language measures alone are inadequate for identifying functionally defined developmental language disorder (fDLD), this study investigated whether non‐linguistic cognitive abilities (procedural learning, motor functions, executive attention, processing speed) can increase the prediction accuracy of fDLD in children in linguistically diverse settings. Methods & Procedures: We examined non‐linguistic cognitive abilities in mono‐ and bilingual school‐aged children (ages 8–12) with and without fDLD. Typically developing (TD) children (14 monolinguals, 12 bilinguals) and children with fDLD (28 monolinguals, 12 bilinguals) completed tasks measuring motor functions, procedural learning, executive attention and processing speed. Children were assigned as fDLD based on parental or professional concerns regarding children's daily language functioning. If no concerns were present, children were assigned as TD. Standardized English scores, non‐verbal IQ scores and years of maternal education were also obtained. Likelihood ratios were used to examine how well each measure separated the fDLD versus TD groups. A binary logistic regression was used to test whether combined measures enhanced the prediction of identifying fDLD status. Outcomes & Results: A combination of linguistic and non‐linguistic measures provided the best distinction between fDLD and TD for both mono‐ and bilingual groups. For monolingual children, the combined measures include English language scores, functional motor abilities and processing speed, whereas for bilinguals, the combined measures include English language scores and procedural learning. Conclusions & Implications: A combination of non‐linguistic and linguistic measures significantly improved the distinction between fDLD and TD for both mono‐ and bilingual groups. This study supports the possibility of using non‐linguistic cognitive measures to identify fDLD in linguistically diverse settings. What this paper adds: What is already known on the subject: Given that standardized English language measures may fail to identify functional language disorder, we examined whether supplementing English language measures with non‐linguistic cognitive tasks could resolve the problem. Our study is based on the hypothesis that non‐linguistic cognitive abilities contribute to language processing and learning. This is further supported by previous findings that children with language disorder exhibit non‐linguistic cognitive deficits. What this paper adds to existing knowledge: The results indicated that a combination of linguistic and non‐linguistic cognitive abilities increased the prediction of functional language disorder in both mono‐ and bilingual children. What are the potential or actual clinical implications of this work?: This study supports the possibility of using non‐linguistic cognitive measures to identify the risk of language disorder in linguistically diverse settings. [ABSTRACT FROM AUTHOR]

Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Some Canadian schools have modified their daily schedules from the traditional school day (TSD) schedule (two 15‐minute breaks and one 60‐minute break) to a balanced school day (BSD) schedule (two 40‐minute breaks). While this change increases daily planning and instructional time, it also changes the amount of time available for moderate‐vigorous physical activity (MVPA). METHODS: This study uses a case‐control design to examine differences in objectively measured MVPA between children in 3 schools using a BSD schedule and 3 schools using a TSD schedule. Study participants (aged 10‐12 years) were recruited from schools in Ontario, Canada. RESULTS: Regardless of schedule type, girls had lower MVPA than boys, and as both boys and girls got older their MVPA significantly decreased. The findings indicate there was no statistically significant difference in the total minutes of in‐school MVPA between children from BSD schools and children from TSD schools. MVPA was significantly higher for older girls attending BSD schools than older girls attending TSD schools, suggesting that implementing a BSD may help curb declining MVPA as girls enter adolescence. CONCLUSION: Despite encouraging findings, more rigorous studies (ie, pre‐post experiments with control) are needed to better understand how changing schedules impacts children's health. [ABSTRACT FROM AUTHOR]

Background The body of literature on narratives of bilingual children with and without specific language impairment (SLI) is growing. However, little is known about the narrative abilities of bilingual preschool children with SLI and their patterns of growth. Aims To determine the similarities and differences in narrative abilities between preschoolers with and without SLI who are either monolingual or bilingual at two time points. Methods & Procedures Forty children completed a narrative retell task in English at two test points. The mean ages were 52 and 58 months at Times 1 and 2, respectively. We examined performance on measures of narrative macrostructure (narrative information) and microstructure (sentence length, number of different words, verb accuracy, first mentions) in monolingual and bilingual children with and without SLI. The bilingual children were from diverse first-language backgrounds and all spoke English most of the time. Outcomes & Results A series of repeated-measures analyses of variance was used with language ability (typical development or SLI) and bilingual status (monolingual versus bilingual) as the between-subjects factors and time (Times 1 or 2) as the within-subjects factor. Results indicated a significant main effect of time for four measures (i.e., Information Score, lexical diversity, sentence length and verb accuracy). The between-subjects analyses indicated a significant difference between the typically developing children and the children with SLI in all measures and a significant difference between monolingual and bilingual children for verb accuracy only. Conclusions & Implications This study showed that all four groups of children showed growth over a 6-month period and that bilingual children exposed predominantly to English in the home performed similarly to their monolingual peers in measures of narrative information, sentence length, number of different words and first mentions. [ABSTRACT FROM AUTHOR]

Parents ( n = 140) of children 2 to 7 years responded to an online survey regarding their children's experiences and conversations about death. A total of 75% of parents indicated that they had spoken to their child about death, and the majority of conversations were first initiated when children were between 3 and 3.5 years of age. Binary logistic regression analysis was used to explore factors that could predict conversations about death. Parents ( n = 88) provided narratives of the explanations of death that they gave their child and subsequently reported their level of satisfaction with their explanation. The content of the explanations was coded and examined in relation to children's age and parental satisfaction. Results revealed that parents who provided explanations to a continued existence after death reported significantly higher levels of satisfaction than those parents who discussed the absence of a future physical relationship after death. Finally, explanations of a continued existence were not always in reference to an afterlife and could include discussing the memory of the deceased or their continued impact even after death. Thus, when talking to young children about death, parents may feel greater satisfaction in finding ways to discuss the continued legacy of those who have died compared to more biological explanations. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify the pathways through which a preventive intervention targeting young low-SES disruptive boys could result in lower crime involvement during adulthood. Method: The preventive intervention was implemented when the children were between 7 and 9 years and included three components (i.e. social skills, parental practices, teacher support). Participants ( N = 250) were randomly allocated to the intervention or to a control group. The tested pathways included antisocial behaviour, school engagement, parental supervision and friends' deviancy, both during early and middle adolescence. Crime involvement was assessed in early adulthood. Results: The intervention reduced adult criminal involvement via reduced early and middle adolescent antisocial behaviours. Conclusion: This study adds to the small group of studies that have examined the mechanisms through which early preventive interventions might impact distal outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Acute gastroenteritis is a very common emergency department (ED) diagnosis accounting for greater than 1.5 million outpatient visits and 200,000 hospitalizations annually among children in the United States. Although guidelines exist to assist clinicians, they do not clearly address topics for which evidence is new or limited, including the use of antiemetic agents, probiotics, and intravenous (IV) fluid rehydration regimens. This study sought to describe the ED treatments administered to children with acute gastroenteritis and to compare management between Canadian and U.S. physicians practicing pediatric emergency medicine (PEM). Methods: Members of PEM research networks located in Canada and the United States were invited to participate in a cross-sectional, Internet-based survey. Participants were included if they are attending physicians and provide care to patients < 18 years of age in an ED. Results: In total, 235 of 339 (73%) eligible individuals responded. A total of 103 of 136 Canadian physicians (76%) report initiating oral rehydration therapy (ORT) in children with moderate dehydration, compared with 44 of 94 (47%) of their U.S. colleagues (p < 0.001). The latter more often administer antiemetic agents to children with vomiting (67% vs. 45%; p = 0.001). American physicians administer larger IV fluid bolus volumes (p < 0.001) and over shorter time periods (p = 0.001) and repeat the fluid boluses more frequently (p < 0.001). Probiotics are routinely recommended by only 35 of 230 respondents (15%). Conclusions: The treatment of pediatric gastroenteritis varies by geographic location and differs significantly between Canadian and American PEM physicians. Oral rehydration continues to be underused, particularly in the United States. Probiotic use remains uncommon, while ondansetron administration has become routine. Children frequently receive IV rehydration, with the rate and volume administered being greater in the United States. [ABSTRACT FROM AUTHOR]

Although intravenous (IV) magnesium (Mg) can decrease hospitalizations in children with severe acute asthma, its use is often limited to resistant disease, and disposition may be determined prior to its use. Since knowledge about practice patterns of IV Mg would enhance knowledge translation and guide future research, we surveyed pediatric emergency physicians with interest in clinical research to determine the frequency, indications, adverse events, and barriers to use of IV Mg in children with severe acute asthma. A cross-sectional online survey of two national pediatric emergency physician associations in Canada and the United States was conducted using a modified Dillman technique. Response rates were 124 of 180 (69%) in Canada and 75 of 108 (69%) in the United States. Although 88% of participants report knowing that Mg is effective, only 14 of 199 (7%) give it to prevent hospitalizations and 142 of 199 (71%) give it to prevent admissions to the intensive care unit (ICU). Thirty-eight percent of respondents use Mg in < 5% of stable children with severe acute asthma, while 79% use it in 50% or more of the ICU candidates with concern about impending respiratory failure. Seventy-nine percent of the participants report that < 5% of their patients given Mg are discharged home from the ED. Twenty-four percent of respondents who administer Mg have encountered associated severe hypotension requiring therapy, and 2% have witnessed-related apnea. Factors affecting Mg use include concern about side effects expressed by 24% of physicians and a belief that IV therapy is not necessary, expressed by 31%. Intravenous Mg appears to be uncommonly used in stable children with severe acute asthma and does not frequently play a role in reducing hospitalizations. Further research to justify its enhanced use and to better establish its true adverse effect profile is indicated. ACADEMIC EMERGENCY MEDICINE 2010; 17:1189-1196 © 2010 by the Society for Academic Emergency Medicine [ABSTRACT FROM AUTHOR]

The present study examined Chinese children's moral evaluations of truths and lies about one's own pro-social acts. Children ages 7, 9, and 11 were read vignettes in which a protagonist performs a good deed and is asked about it by a teacher, either in front of the class or in private. In response, the protagonist either tells a modest lie, which is highly valued by the Chinese culture, or tells an immodest truth, which violates the Chinese cultural norms about modesty. Children were asked to identify whether the protagonist's statement was the truth or a lie, and to evaluate how 'good' or 'bad' the statement was. Chinese children rated modest lies more positively than immodest truths, with this effect becoming more pronounced with age. Rural Chinese children and those with at least one nonprofessional parent rated immodest truths less positively when they were told in public rather than in private. Furthermore, Chinese children of parents with high collectivism scores valued modest lies more than did children of parents with low collectivism scores. These findings suggest that both macro- and micro-cultural factors contribute significantly to children's moral understanding of truth and lie telling. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective. Although Aboriginal children seem to be more susceptible to developing obesity and metabolic disorders than other ethnic groups in Canada, few studies have examined adiposity comprehensively in this population. The purpose of this study was to assess total and central adiposity in Canadian Aboriginal and Caucasian children matched by age, gender and maturity. Methods. A total of 212 Aboriginal and 204 Caucasian children (8–17 years) were recruited. Heights, weights and waist circumferences were measured and classified using international standards. Dual energy x-ray absorptiometry (DXA) indicated relative total body and trunk fatness. Age of peak height velocity was predicted from somatic growth. Descriptives with independent t-tests and Chi-square analyses were run to detect ethnic differences. ANCOVA was used to assess differences in total body and trunk fatness (covariates height, chronological age and biological age) in girls and boys separately. Results. Overweight/obesity and central adiposity were more prevalent in Aboriginal children compared with Caucasian children (p < 0.05). Ethnic differences in total body and trunk fatness were also significant, with Aboriginal girls and boys presenting, on average, 5.4% and 6.0% more total body fatness and 7.6% and 8.3% more trunk fatness, than Caucasian girls and boys, respectively (p < 0.01). Conclusion. Canadian Aboriginal children have greater prevalence of overweight/obesity and central adiposity, and higher relative total body fatness and trunk fatness than their Caucasian peers, which may predispose them to cardiovascular and metabolic disorders at a very young age. Longitudinal research is needed to confirm the associated health risks in this population. [ABSTRACT FROM AUTHOR]