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Participant attrition is a significant challenge for longitudinal studies, particularly those involving disadvantaged populations. We attempted to re-engage n = 990 families in a five-year follow-up of a randomised controlled trial of an early childhood parenting intervention. Tracing was attempted for n = 90/990 (9.1%) uncontactable participants. Evidence for the identification of a matching Facebook profile was classified as strong, moderate or weak. A private message was sent to those with strong evidence (n = 63/90, 70.0%), of which 32 responded, 22 agreed to participate and 19 provided data. Compared to participants engaged using traditional methods, those re-engaged through Facebook were more likely at initial recruitment to have a younger child (p =.02), to be a single parent (p =.04), less educated (p

Despite difficulties in reading and writing, some research suggests that dyslexia may be related to higher levels of creativity. However, this pattern is not consistently observed. The current research sought to ascertain whether individuals with clinically diagnosed dyslexia exhibit higher creativity than controls through a meta-analysis. Fourteen studies that assessed the creativity of 397 individuals with clinically diagnosed dyslexia and 453 controls were reviewed. Random-effects meta-analysis revealed an overall non-significant difference in creativity scores between those with dyslexia and controls. Additionally, method factors such as the type of creativity task and whether intelligence was controlled for, as well as sample-related factors such as gender, did not explain differences in the dyslexia-creativity relationship. Nonetheless, individuals with dyslexia significantly outperformed controls in creativity scores in adult samples, but not in younger child/adolescent samples. Overall, the current findings provide limited support for the idea that individuals with dyslexia are more creative, and that past evidence of this relationship may be limited to adult samples.

Objectives Our aim in this study was to identify patient-level barriers to attending pediatric type 1 diabetes mellitus (T1DM) clinic and to better understand the demographic and clinical characteristics of these reporting barriers. Methods Patients were recruited from pediatric T1DM clinics throughout British Columbia. Barriers to attending clinic were identified through a survey. Demographic and clinical characteristics of patients who reported difficulty attending clinic appointments were compared with those who did not. Results Of the 197 study participants, 31% reported difficulty attending appointments. Commonly reported barriers were distance to clinic and missing work. Younger child age and residing in northern regions increased the odds of reporting a barrier, whereas residing on Vancouver Island decreased odds of reporting a barrier. There were no differences in glycated hemoglobin levels between the 2 groups. Conclusions Approximately 1 in 3 patients identified challenges in attending T1DM appointments in British Columbia. Further research is needed to determine whether similar challenges exist in other provinces.

Siblings’ influence on youth aggressive behavior has been found in previous studies, but further research is needed in order to better understand both the shared relations between siblings’ levels of proactive and reactive subtypes of aggression as well as the factors contributing to this relationship, such as parent behavior. The current study extended the literature by examining the influence of older siblings’ proactive and reactive aggression on younger siblings and whether these associations were influenced by levels of observed parental criticism. Participants were 50 parent–child dyads. Children in each dyad (52% female; 76% Caucasian) were between the ages of 10 and 15 (M = 11.52; SD = 1.25). Parent-reported measures of their younger and older siblings’ proactive and reactive aggression were collected. Next, parents and the younger child engaged in a conversation task which was coded for parental criticism using a modified version of the Family Interaction Task. Results demonstrated that older siblings’ reactive aggression was positively associated with younger siblings’ reactive aggression and that the strength of this influence depended on levels of parental criticism (β = 0.21; SE = 0.10; p 0.00), such that stronger sibling influence was observed at greater levels of parental criticism. No influence of older siblings’ levels of proactive aggression was evident. Findings suggest that the degree of parental criticism is particularly salient when examining the association between siblings’ aggression.

Manufacturers label their sleeping bags with a temperature rating to assist consumers in selecting a bag that will provide them with an acceptable level of thermal protection under the expected conditions of use. These temperature ratings are typically based on thermal manikin testing and whole-body heat loss models. Due to physical and physiological differences between children and adults, existing adult sleeping bag temperature rating models cannot be applied to children's bags. Therefore, a model for determining the temperature ratings of children's sleeping bags is proposed. Issues related to measuring the thermal insulation of children's sleeping bags are also discussed. The results of the model indicate that an older child has a higher temperature rating than a younger child for the same level of insulation. This is due to the higher sleeping metabolic rate of younger children.

Background Mothers with lifelong care responsibilities might involuntarily be non-employed or work part-time, both of which are defined as “underemployment.” This study aimed to investigate who these underemployed mothers are and what are the factors associated with such employment hardship when having a child with intellectual disability (ID). Method An interview survey was conducted in 2011 in two local authorities of Taiwan on 876 working-age mothers with a child with intellectual disability; 514 of them were working part-time/non-employed and chosen as participants of this study. Results The mothers with a younger child with intellectual disability, a higher level of education, a lower level of family income and more family members with disabilities were more likely to be underemployed compared with the mothers who were voluntarily working part-time/non-employed. Conclusions The underemployed mothers were more likely to have financial difficulty and heavy caregiving loads; their employment hardship should be of concern for policymakers. peerReviewed

Aims Approximately 1/3 of all children will sustain a fracture before they turn 16 years old. Most are accidental but some are due to abuse, with the younger child at highest risk. We sought to assess how robustly such young children presenting to the Emergency Department (ED) in our Trust are assessed for abuse. Methods Both authors reviewed the notes for all children aged Results 34 had appropriate safeguarding information completed at Triage. In 75% of cases, the ‘mandatory’ Safeguarding Questions on the ED card were completed by the doctors. Only half of the assessments included a comment about development. 8 had ‘high risk’ injuries by radiological type– all were spiral fractures however none were under 12 months of age. The authors were concerned about 2 of these cases which either contained insufficient information or were not discussed with paediatrics when the mechanism was not absolutely clear. Only 44% of children were fully examined. In several cases, there was disparity between the opinion given in ED and that of the reviewers. The authors felt that an extra 7 patients had potential safeguarding concerns and should have been discussed with paediatrics, with a further 6 cases where there might have been safeguarding risk but information was insufficient. Interestingly, however, all eight who were seen by paediatrics were felt to be accidental or due to an underlying condition (two had genetic bone disorders and one had rickets). In several instances, the expected actions from the reviewers were not completed – see table 1. Conclusion Whilst some positives were demonstrated including some excellent individual assessments, use of interpreters and triage actions, the audit establishes the need for improvements in assessment of safeguarding risk.

Two children of 4 and 18 years of ages developed multiple supratentorial metastases at 3 years and 8 months follow up respectively, following their gross total microsurgical excision of medulloblastomas. Both the children received standard doses of craniospinal irradiation following surgery. An adjuvant chemotherapy was also offered to the younger child (of 4 years), who developed recurrence at posterior fossa along with supratentorial metastases. It is concluded, that early supratentorial metastases may occur even following gross total excision, craniospinal irradiation and chemotherapy of medulloblastomas. Probable routes of dissemination remain subarachnoid, cerebrospinal fluid and leptomeningeal.

PURPOSE To evaluate the current vision screening criteria regarding amblyopia and refractive errors, with emphasis on screening limits and retesting, in Region Vastra Gotaland (VGR), Sweden. Visual acuity (VA) screening is performed by nurses at primary healthcare centres (PHCs) in 4-year-old children and at school in 6- or 7-year-old children. Children with VA 0.19 logMAR) at either eye are referred. If VA is 0.65 in one or both eyes, a retest is performed by nurses at PHCs and schools, the children are then referred if VA is 0.10 logMAR). METHODS We included all children aged ≥5 and

Previous research demonstrates that children with attention-deficit/hyperactivity disorder (ADHD) can experience social difficulties. Therefore, the current study examined the effects of cross-age peer coaching on social behaviors of first graders with significant symptoms of ADHD using a multiple baseline design. Four students who met criteria for ADHD participated, along with four third- or fourth-grade coaches without ADHD. Coaching pairs met each morning to establish a goal for the younger child to meet during free time. Although results were variable, findings suggested that the cross-age coaching program led to decreases in negative social behavior, and was highly acceptable to participants.

Although mild homesickness during summer camp is common, 10 to 20% of children report moderate to severe homesickness that can interfere with their functioning during camp. Previous research has considered many risk and protective factors for homesickness, including prior camp experience and coping strategies. Few studies have examined the role of parent or child anxiety. Both are associated with child adjustment difficulties in school and clinic settings, but have rarely been examined in the camp setting. This exploratory study examined parents' worries about sending their children to camp, and children's anxiety symptoms in predicting homesickness during overnight summer camp. Participants included 275 children and adolescents (7 to 14 years, 131 male and 144 female). At the beginning of camp, parents/guardians reported their anxious expectations, and children completed several items from the Screen for Child Anxiety and Related Emotional Disorders (SCARED). Near the end of camp, children reported the amount of homesickness they experienced using items from the Rate Your Day-Revised checklist. The regression model accounted for 36% of the variance in homesickness, with younger child age, less prior camp experience, higher parental anxious expectations, and greater child separation anxiety uniquely predicting homesickness. Implications for including strategies for parents in homesickness prevention programs are discussed.

In recent decades, research on health care design and planning has highlighted the strong relationship between environmental characteristics and human health. According to a patient-centered model, the focus on the hospital environment is important in reducing the negative effects of hospitalization on the patient, especially in the case of children. In a hospital Pediatric Unit, a pictorial intervention, characterized by natural landscapes with cartoon characters, was introduced. The study sought to evaluate the effects of this intervention on the affective qualities attributed to the hospital environment by parents whose children were hospitalized; our main hypothesis was that the pictorial intervention would benefit parents, enhancing the positive and reducing the negative affective perception of the hospital environment. A total of 502 parents of admitted children aged 0–11 completed a questionnaire to describe the affective perception of the hospital environment, 200 before the pictorial intervention was performed, and 302 (200 parents of children with acute illness, 102 of children with chronic pathology) after it. Results revealed that the parental affective perception of the hospital environment significantly improved after the pictorial intervention, with almost no differences in relation to severity of child illness (acute versus chronic); a younger child age was negatively related to parental affective perception of the unit only in the condition without the intervention. Data suggest that the pictorial intervention represents a useful technique to create more welcoming hospital environments, reducing the negative affective perception of the unit in parents facing the stress of their child's hospitalization.

Cognitive-behavioral therapy (CBT) protocols for anxiety disorders have been shown to have efficacy with older children and adolescents; however, only recently have investigators begun to adapt and pilot such interventions for younger children. This article reviews data suggesting that even very young children can benefit from CBT for anxiety, discusses some of the necessary developmental adaptations when working with children of preschool and early elementary school age, and reviews studies that have implemented CBT for anxiety disorders with youngsters in this age range. The authors conclude with recommendations for future directions for research in this area.

This study evaluated emotional functioning in parents of children with food allergy and examined child factors as correlates of caregiver adjustment. Questionnaire data regarding parent subjective distress and emotional resources, allergy characteristics, and child behaviors were gathered from 282 caregivers of food-allergic children. Parents reported experiencing mild-to-moderate distress related to guilt and worry, unresolved anger and sorrow, and long-term uncertainty. Greater distress was associated with caring for a younger child and having a child with emotional or behavioral problems. Parents who perceived having more emotional resources endorsed less distress and had children with fewer emotional or behavioral problems.

This article focuses on key stages in the assessment of psychiatric disorders in children and adolescents. The main stages of the assessment interview are considered, including preparation for the interview, interview with the family, interview and observation of the child, interview with the parents, physical examination, and investigations, as well as the gathering of information from other sources. Some contextual factors are then considered in the formulation of the child’s difficulties. Key points are discussed as to how assessment of the adolescent may differ from that of a younger child and how the interview with an adolescent may be conducted in an ‘adolescent-friendly’ fashion.

Summary The Salter osteotomy has stood the test of time, proving to be a safe and effective means of improving acetabular cover in the younger child. Alternative procedures are briefly discussed and technical aspects are described.

Many controversies remain in Perthes'. These algorithms are presented as a way through the maze of contradictory and incomplete evidence. Catterall has emphasised the importance of clinical examination in the assessment of cases of Perthes' and this is particularly important in the younger group, many of whose hips heal very round, despite rather adverse-looking X-rays early on, because they have maintained an excellent, almost normal, range of movements. The older child or early adolescent with Perthes' requires urgent attention, as the femoral head lacks the regenerative capacity of the younger child. Before any operation in Perthes', action must be taken to unstiffen the hip. Containment procedures will fail if performed on a stiff hip and even salvage procedures are best performed on a hip that has been loosened as much as possible. Surgeons need to recall that most untreated Perthes' do not require intervention until the age of 40. If our interventions on the child result in hip replacement being required in the 20's, then we have not done that patient a service.

Hand trauma in children is common, but often inadequately assessed and treated. The types of injury vary with age depending on the pattern of hand use. Assessment of the injury, particularly in the younger child, can be difficult, given the inability or reluctance of the child to co-operate, both in providing a history and allowing an examination of the injured hand. The established principles of treatment for hand trauma, detailed elsewhere in this text, apply equally to children, but the healing and growth potential of the child has specific implications for management. The management plan also has to take into account the varying capacity of the child for co-operation with active rehabilitation programmes.

BACKGROUND Children living with a smoker experience increased environmental tobacco smoke (ETS) exposure, even when the smoker refrains from smoking inside the house, compared to children not living with a smoker. Given the risks of ETS in children, it was hypothesized that households with children are less likely than those without children to experience home ETS exposure. DESIGN Cross-sectional analysis of the Canadian Community Health Survey 2009-2010 for the association between children aged

Two consecutive cases of chronic dislocation of the head of the radius after missed Bado type-I Monteggia lesions are presented. Reduction was successfully achieved in both patients after ulnar corticotomy, gradual lengthening and angulation of the ulna using an external fixator. Open reduction or reconstruction of the radio-ulnar capitellar joint was not undertaken. The age at injury was seven years in the older and two years in the younger patient. The time from injury to treatment was five years in the older and three months in the younger child. At follow-up, nine years after completion of treatment in the older and eight months in the younger patient, both show satisfactory movement, function of the forearm and reduction of the head of the radius. This technique may be considered in missed Monteggia lesions before open procedures on the radio-ulnar capitellar joint are undertaken.

The effects of trauma in children are amply documented. This paper investigated the relationship between children's age and posttraumatic clusters of symptoms 30 months after the end of the Gulf War and the mother's reaction to the trauma 6 and 30 months after the war. Fifty-one children aged 6 to 8 years (3 to 5 years during the war) and their mothers were interviewed. Results showed no age differences in the various posttraumatic symptoms of the children. Correlations between the children's posttraumatic symptoms and both the general and the specific posttraumatic symptoms of their mothers were positive and significant in the 6-year-olds, positive and nonsignificant in the 7-year-olds, and nonsignificant and mostly negative in the 8-year-olds. These findings may reflect the developmental changes that render the older child more autonomous and the younger child rigidly attached to the mother after a traumatic event.

Objective. The purpose of this study was to determine the effect of the presence of passenger airbags on places where children sit when traveling in motor vehicles. Methodology. An observational and driver interview survey of 503 passenger vehicles was conducted in five New England states at randomly selected long- and short-distance travel sites during the summer of 1998. Each vehicle was occupied by at least 1 child Results. Controlling for the effects of the driver and vehicle characteristics, children Conclusions. Some New England drivers are protecting children from the risks of passenger airbags by seating them in the rear. There remains, however, a substantial number of children who are being exposed to the risk of passenger airbag deployment.

The surgical treatment of Perthes’ disease by femoral or innominate osteotomy is not as effective in those over the age of eight years as it is in the younger child. This has prompted the search for other types of management in those who are older. The preliminary results of the use of a lateral shelf acetabuloplasty for such cases have shown encouraging results at two years. The concern with such an operation is that it might interfere with the growth of the outer aspect of the acetabulum and so prejudice the long-term outcome. We describe a review at maturity of 26 children presenting with early disease after the age of eight years who were treated by lateral shelf acetabuloplasty. The results suggest that the outcome is improved; 22 of 27 hips were rated as Stulberg groups 1 to 3. Poor results occurred in children, particularly girls, presenting with Group-4 disease over the age of 11 years.

Pre-school siblings' comments about, and behaviour towards, their older, learning-disabled brothers and sisters are reported. Initially, some of the very young siblings want to be similar, and attempt to imitate their brothers and sisters, particularly if he or she is also physically disabled; this may be because of the immediate visibility of physical disability, which makes it appear interesting and important to the younger child. Before they are 2 years old, children are able to recognize that their older brothers and sisters are different, and often imitate the parents' behaviour towards the older child.

A group of 13 child sex abusers over the age of 65 years is described. They are similar in most respects to sex offenders against children in other age groups, with regard to the seriousness of the abusive behaviours described, but they differ in terms of being of higher socioeconomic status, having stable backgrounds and reporting low rates of personal sexual victimization. These factors may contribute to their apparent skill in avoiding detection. In common with younger child sex abusers, these elderly offenders demonstrate low levels of psychiatric illness, and in particular of organic disorders. There appears to be an increased tendency by the courts to consider non-custodial disposal options for elderly sex offenders as they are perceived as being less of a risk and their physical frailty may make them less able to tolerate the rigours of prison life.

The management of nasal deformities in children often presents the clinician with a challenging dilemma. In the younger child, emphasis should be placed on correction of the nasal airway whereas, in older children, external cosmetic deformity can be considered with safety. Appropriate surgical techniques will ensure an appropriate outcome. Careful planning, as well as sensitivity to growth and development of the nasal structures should be considered when such a procedure is to be undertaken. Older children and adolescents present no unique difficulties in septorhinoplasty and the usual principles commonly applied to adults may be followed. A safe and effective technique can be designed for each child and adolescent afflicted with both internal and external nasal deformities.

Acne vulgaris is classically considered a disease of adolescence. Although it most commonly occurs and has been best studied in that age group, it can develop at any time during childhood. It is important that health care practitioners recognize the manifestations of neonatal, infantile and childhood acne, as well as the differential diagnosis and best therapeutic approach in the younger child. Acneiform eruptions in infants and toddlers can occasionally be associated with scarring or with other significant disorders that may be life-threatening. In this article, the authors draw on their own clinical experience as well as the available literature to suggest an age-based approach to managing acne in children from the neonatal period through age 11 years.

This study identified and quantified rambling and trembling properties of the postural control system of children 4–12 years of age. Forty five children of varying ages (4-, 8-, and 12-years) and 15 adults stood upright on a force plate and performed 5 trials with and 5 trials without vision with each trial lasting 30 s. Center of pressure, rambling, trembling, mean sway amplitude, and predominant frequency were obtained. Results revealed that the displacement of the center of pressure and overall rambling trajectories were age-related with younger children swaying more than older children and adults. Similarly, overall trembling trajectories for younger children were larger compared with older children and adults. These results suggested that a younger child’s larger body sway mostly results from difficulties using sensory information when estimating overall body position and velocity in an upright stance and is less a result from the noise in the postural control system.

This paper reflects on issues raised by work with children in an ongoing child mobility study in three sub-Saharan African countries: Ghana, Malawi and South Africa. There are now 70 school pupils of varying ages involved in the project, but the paper is particularly concerned with the participation of those children 14 years and under. We examine the significant ethical issues associated with working with younger child researchers, and linked questions concerning the spaces open to them in African contexts where local cultural constructions of childhood and associated economic imperatives (which commonly drive family and household endeavour) help shape the attitudes of adults to children’s rights and responsibilities and inter-generational power relations.

Objective To analyze the characteristics of post-tonsillectomy bleeding and its management comparing with adults. Methods A retrospective chart review of 1489 patients who underwent tonsillectomy in our institution (June 2003–June 2006). Results Post-tonsillectomy bleeding rate was 3.1%, 2.5% and 10.8% in younger children (age ≤ 11 years), older children (12 ≤ age ≤ 15 years) and adults (age > 15 years), respectively. Although adults showed an unimodal peak time for onset of post-tonsillectomy bleeding, children showed a bimodal peak time. In the younger child group, all of the 28 bleeders had spontaneous hemostasis. However, in the older child group, there was no spontaneous hemostasis. Bleeding was controlled under local anesthesia in 3 patients and 2 patients required general anesthesia for bleeding control. In the adult group, spontaneous cessation of bleeding occurred in 25 patients (60.9%) and hemostasis under local or general anesthesia was performed in 16 (39.1%) patients. Conclusions Post-tonsillectomy bleeding occurred more frequently in adults than in children. Spontaneous hemostasis was more prevalent in children than in adults. Post-tonsillectomy bleeding in the younger child group was controlled with close observation alone.

In the 1980s home care, in contrast to hospital care, was reported substantially to reduce costs for third-party payers who provided funding for technology-assisted children. Savings were realized primarily because parents substituted for nurses, eliminating or reducing those costs. Third-party payers' savings thus were directly related to the number of hours parents assumed care. Because home care relies on parents doing some of the work of nurses, decisions regarding nursing hours must consider family factors in addition to medical factors. We evaluated the number of nursing hours 31 Minnesota families with technology-assisted children received, as well as the factors that determined the allotment of nursing hours. Most families (96.8%) received some hours of nursing hours. Most families (96.8%) received some hours of professional nursing care per day, and 16.1% received 24-hour care. Multiple regression, however, showed that family factors, rather than the child's medical condition, influenced the number of hours, with married, lower-income families with a younger child receiving the fewest. Further discussion and study are recommended to understand more fully the impact family factors have on the allotment of nursing hours and home care costs.

To examine and describe hidden child sexual molestation committed by adolescent males, 582 college men were surveyed via an extensive questionnaire. Three percent (N = 16) of the men reported activity that met the criterion for sexually molesting a younger child. Most of the victimization experiences were initiated by the men (86%), and most involved female victims (67%). Few differences emerged between the molesters and nonmolesters on the family background variables, current adjustment measures, or measures of attitudes conceptually linked to sexually aggressive behavior. Compared to nonmolesters, however, the molesters were more likely to endorse rape myths and were more likely to have been sexually victimized as children.

We studied 23 LeLievre's operations (lateral arthroereisis of the subtalar joint using the bank bone) performed in 13 patients for the treatment of paralytic pes plano-valgus. 9 patients (15 feet) had the diagnosis of mild cerebral palsy and 4 patients (8 feet) had psycho-motor retardation. 11 patients (19 feet) had Vulpius' operation or Achilles tendon lengthening simultaneously. The average age at surgery was 6 years and 11 months (range, 3 to 13 years) and the average duration of follow-up was 8 years (range, 4 to 13 years). On the weight-bearing films, lateral tab-first metatarsal angle and lateral talo-calcaneal angle were measured to evaluate the postoperative results.The overall results were excellent in 7 feet, good in 6, fair in 2 and poor in 8. Using the metacarpal or metatarsal bone and combined procedure with vulpius' operation or Achilles tendon lengthening, the results were excellent in 7 feet, good in 4, fair in 2 and poor in none.This operation is to be indicated for i) paralytic pes plano-valgus which resists conservative treatments, ii) the patient who had psycho-motor retardation or mild cerebral palsy, and iii) the younger child who is 7-8 years old or less.

This paper analyzes the radio frequencies (RF) exposure in the head tissues of children using a cellular handset or RF sources (a dipole and a generic handset) at 900, 1800, 2100 and 2400 MHz. Based on magnetic resonance imaging, child head models have been developed. The maximum specific absorption rate (SAR) over 10 g in the head has been analyzed in seven child and six adult heterogeneous head models. The influence of the variability in the same age class is carried out using models based on a morphing technique. The SAR over 1 g in specific tissues has also been assessed in the different types of child and adult head models. Comparisons are performed but nevertheless need to be confirmed since they have been derived from data sets of limited size. The simulations that have been performed show that the differences between the maximum SAR over 10 g estimated in the head models of the adults and the ones of the children are small compared to the standard deviations. But they indicate that the maximum SAR in 1 g of peripheral brain tissues of the child models aged between 5 and 8 years is about two times higher than in adult models. This difference is not observed for the child models of children above 8 years old: the maximum SAR in 1 g of peripheral brain tissues is about the same as the one in adult models. Such differences can be explained by the lower thicknesses of pinna, skin and skull of the younger child models.

Trading recipes with family members. Scanning the newspaper and clipping food coupons from store supplements. Making a grocery list. Deciding who will do the shopping. Noticing a billboard ad for a store’s fresh produce on the way to get enough gas to drive to that store. Remembering a newscast about the dangers of food additives. Placing an apple from New Zealand in the cart. Negotiating snack purchases with the oldest of the kids. Allowing a younger child, sitting in the grocery cart, to eat a free cookie from the in-store bakery while the shopping gets done. Managing the emotions of a child’s temper tantrum at the checkout lane. Noticing that the person first in line is (also) using food stamps. Unloading the groceries and putting them in specific places. Fixing and serving a meal from the food just purchased, then cleaning the dishes. Baking a cake for a family member, with the kids helping. Making a payment on the refrigerator. Weighing whether the family can afford a new microwave.

We report persistent galactorrhoea and raised prolactin in a woman taking methadone, which is commonly prescribed for the treatment of opiate dependence. A heroin smoking 28 year old mother of two (younger child aged 4), with hepatitis C (of nine years' duration), weighing 50 kg, was first prescribed 30 mg methadone a day for opiate dependence. She reported newly emergent galactorrhoea after four months of taking …

Geleophysic dysplasia is an autosomal recessive short-limbed, dysmorphic syndrome. The condition is frequently associated with cardiac valvular disease, which may result in secondary hypertrophy and cardiac failure. We describe two distantly related Pakistani children with classical features of geleophysic dysplasia. Pulmonary stenosis was recognized in both within a few months of birth. The younger child shows no signs of cardiac decompensation at the age of 7 years whilst her older cousin has developed a significant pulmonary gradient requiring surgical intervention in the second decade of life. The natural history of his disorder highlights that the cardiac involvement seen in apparently stable forms of geleophysic dysplasia is frequently progressive.

Enzyme replacement therapy is widely used as treatment for mucopolysaccharidosis I (MPS I), and there is evidence that this produces improvement in certain clinical domains. There does appear to be variation in the response of clinical features to treatment once these are established. In a reported sibling pair, when enzyme replacement therapy was commenced pre-symptomatically in the younger child, the natural history of the condition appeared to be affected. We present data from three siblings treated with enzyme replacement therapy at different ages which supports this finding.

The acquisition of reading is a complex neurobiologic process. Identifying the most effective instruction and remedial intervention methods for children at risk of developing reading problems and for those who are already struggling is equally complex. This article aims to provide the clinician with a review of more current findings on the prevention and remediation of reading problems in children, along with an approach to considering the diagnosis and treatment of a child with dyslexia. The first part of the review describes interventions targeted at preventing reading difficulties in the at-risk younger child. The second part of the review discusses the efficacy of approaches to treat the older, reading-disabled child (“intervention studies”). Factors that impact the response to treatment are also discussed, as are neuroimaging studies that offer insight into how the brain responds to treatment interventions. With appropriate instruction, at-risk readers can become both accurate and fluent readers. In contrast, although intensive, evidence-based remedial interventions can markedly improve reading accuracy in older, reading-disabled children, they have been significantly less effective in closing the fluency gap. Owing to the dynamic course of language development and the changes in language demands over time, even after a child has demonstrated a substantial response to treatment interventions, his or her subsequent progress should be carefully tracked to ensure optimal progress toward the development of functional reading and written language skills. ( J Child Neurol 2004;19:744—758).

Stealing a car, physically assaulting a younger child, running away from home, and talking back to a teacher are all actions that would be viewed with concern and perhaps condemnation by most members of society. However, whether these constitute illegal acts and whether the youth committing them would be considered a youthful offender depends on a number of considerations, including the laws and policies of the community in which the acts were committed and the age of the youth. Thus, running away from home constitutes a violation of the criminal code in some jurisdictions but not others. Similarly, the theft of a car by an 11-year old would be considered a criminal offense in some areas while in others the child would be too young to be charged with a crime. The implications of this variability in definition extend beyond the mere labeling of acts as criminal or noncriminal since they also determine whether or not the youth is designated as a juvenile offender.

Acne can occur at all ages. Several reviews have recently been published on this topic [1, 2, 3]. This monograph will cover the diagnosis and therapy of acne in the younger child.

In the study described in the article, two children had their prescribed behind-the-ear (BTE) hearing aids retro-fit to become open-fit (OF) BTEs. One child, age 12y, had a bilateral, high-frequency, sensorineural hearing loss (BHFL), with normal hearing in the low frequencies. The other child, age 6y, had a bilateral, reverse-slope, sensorineural hearing loss (BRSL), with normal hearing in the high frequencies. Sound localization measurements were made at Day 1 unaided and with the OF-BTEs and 1 year post for both children. Both children spontaneously reported an immediate improvement in the quality of their own voice when first exposed to the OF-BTEs. Only the younger child showed immediate localization advantage over unaided when using the OF-BTEs. However, changes in localization accuracy over time were measured for both children that could be attributed to “relearning” to localize with a new acoustic coupling of the hearing aid to the ear. After using OF-BTE hearing aids for 1 year, both children, wh...

The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children. (Korean J Pediatr Gastroenterol Nutr 2010; 13: 1∼6)

Caring for disabled children has become increasingly the responsibility of parents, even when the medical care is complex. To assess the time commitment required, 133 mothers of disabled children were asked to estimate by specific task categories the extra time required to care for the children. Total average daily care time was reported at 12 hours and 6 minutes, with 6 hours and 30 minutes consumed in "vigilant" tasks (i.e., watching a child who cannot be left alone and/or providing emotional support). Multiple regression analysis showed an increase in total caregiving hours associated with a younger child who was more physically and mentally impaired, and who required more medical treatments. The amount of time required by parents to care for their chronically ill children of necessity results in lost opportunities. Because this burden is experienced primarily by women and because professional nurses could alleviate some of the burden, this issue deserves further study.

Stature and body weight of two children, 12.5 and 9.3 years, and their mother were measured twice daily for 488 days, immediately after rising and just before bed. The time of the measurements was also recorded and diurnal changes during daytime and nighttime were estimated. Stature began to decrease instantaneously after rising. Therefore, morning measurements were made immediately after rising. Stature decreased during the day, and the mean daytime loss was 1.78 cm in the older child, 1.61 cm in the younger child, and 1.43 cm in the adult. Stature increased during sleep hours at night, and the mean nighttime gain was 1.79 cm, 1.63 cm, and 1.43 cm in each subject, respectively. Stature also increased after naps and a bath. Body weight decreased during sleep hours at night, and the mean nighttime loss was 0.46 kg, and 0.38 kg, and 0.36 kg in each subject, respectively. Diurnal changes were largest in the older child, while the ratios of changes (ΔST/ST, ΔWT/WT) were largest in the younger child whose growth rate was the greatest. In the children, the nighttime gain of stature was not as highly correlated with hours of sleep as in the adult. Diurnal change varies depending upon sleep hours and stage of growth. Rapid growth in stature of 1 cm in only three weeks was observed once in the younger child. During this period, diurnal change was smaller than the mean value over 488 days. In the older child, the growth rate decreased in both stature and weight about three months after menarche. © 1993 Wiley-Liss, Inc.

Two sisters are presented in whom posterior open bites have developed. Orthodontic treatment was not successful in correcting this aspect of the malocclusion in the older sibling. The younger child developed the same defect, and consequently orthodontic treatment is not being considered.

Pigmented villonodular synovitis is rare in the younger child. Polyarticular involvement in this condition, regardless of patient age, is distinctly uncommon. The authors describe a case of pigmented villonodular synovitis involving multiple joints in a young boy who also had congenital anomalies of the genitourinary tract. Although rare, pigmented villonodular synovitis should be considered in the differential diagnosis of multiple joint swellings in children with congenital anomalies.

It is always with great anticipation that one begins to review one of Leonard Swischuk's many publications. In this particular instance I had the added interest of having reviewed the previous, 1980, edition of this book, then titled Radiology of the Newborn and Young Infant . The change in title refleets much of what has changed in the practice of imaging diseases in the younger child. This book is presented in this textbook's traditional format divided into system-related chapters, eight in all. Within these chapters the material is presented in specific disease-related sections. Each of these sections ends with appropriate references. This juxtaposing of text and bibliography is an excellent method of integrating both items of information, but it does lead at times to the illustrations' lagging behind the text and gives rise to much turning of pages to find the appropriate figure. Some chapters stand out as being particularly good.