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Item does not contain fulltext OBJECTIVE: Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of child and parent outcomes. METHOD: A systematic search in PubMed, Ovid, Web of Knowledge, ERIC, and CINAHAL databases (up to February 5, 2013) identified published randomized controlled trials measuring a range of patient and parent outcomes for children and adolescents diagnosed with ADHD (or who met validated cutoffs on rating scales). RESULTS: Thirty-two of 2,057 nonduplicate screened records were analyzed. For assessments made by individuals closest to the treatment setting (usually unblinded), there were significant improvements in parenting quality (standardized mean difference [SMD] for positive parenting 0.68; SMD for negative parenting 0.57), parenting self-concept (SMD 0.37), and child ADHD (SMD 0.35), conduct problems (SMD 0.26), social skills (SMD 0.47), and academic performance (SMD 0.28). With probably blinded assessments, significant effects persisted for parenting (SMD for positive parenting 0.63; SMD for negative parenting 0.43) and conduct problems (SMD 0.31). CONCLUSION: In contrast to the lack of blinded evidence of ADHD symptom decrease, behavioral interventions have positive effects on a range of other outcomes when used with patients with ADHD. There is blinded evidence that they improve parenting and decrease childhood conduct problems. These effects also may feed through into a more positive parenting self-concept but not improved parent mental well-being.

Background: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. Objectives: We performed an individual participant data meta-analysis for 147,252 children of 31 birth cohort studies to determine the associations of birth and infant growth characteristics with the risks of preschool wheezing (1-4 years) and school-age asthma (5-10 years). Methods: First, we performed an adjusted 1-stage random-effect meta-analysis to assess the combined associations of gestational age, birth weight, and infant weight gain with childhood asthma. Second, we performed an adjusted 2-stage random-effect meta-analysis to assess the associations of preterm birth (gestational age < 37 weeks) and low birth weight (< 2500 g) with childhood asthma outcomes. Results: Younger gestational age at birth and higher infant weight gain were independently associated with higher risks of preschool wheezing and school-age asthma (P, Supported by the European Community's Seventh Framework Programme FP7/20072013, project CHICOS. The research leading to these results has received funding from the European Respiratory Society and the European Community's Seventh Framework Programme FP7/2007-2013-Marie Curie Actions under grant agreement RESPIRE, PCOFUND-GA-2008-229571.

To evaluate the effect of iron intervention on physical growth in fetuses, infants, children, and adolescents up to 18 years of age, a systematic review with meta-analysis of randomized controlled trials (RCTs) was conducted. Structured electronic searches were conducted to February 2010 using MEDLINE, Embase, and the Cochrane Library databases. RCTs that included iron-fortified foods, iron-fortified formula, or iron supplements and in which height, weight, mid-arm circumference (MAC), head circumference, birth weight, or length of gestation was evaluated were analyzed for inclusion. In total, 21 RCTs in infants, children, and adolescents and 7 studies in pregnant women met the inclusion criteria. The overall pooled result (random-effects model) showed no significant effects of iron intervention on any of the parameters measured. To accommodate wide heterogeneity, studies were stratified according to dose of iron, duration of intervention, age, and baseline iron status. However, only doses of 40–66 mg of supplemental iron and intervention in children ≥ 6 years of age showed a slight but significant association with weight and MAC.

Many people with severe disabilities face difficulties communicating with their communication partners and rely primarily on prelinguistic communication. It is accepted that dynamic assessment can play an important role in improving communication and in measuring a person's ability to learn new communicative skills. Less is known, however, about the application of dynamic assessment in the case of those who communicate at a prelinguistic level. The present article reviewed dynamic assessment procedures that addressed communication abilities in people communicating at a prelinguistic level and young children who communicate using speech, with the aim of identifying key elements of dynamic assessment for persons communicating at a prelinguistic level. The results indicated the need for the identification of contextual variables that support communicative competence, teaching communication partners new skills, and a procedure that is highly individualised. Further research on the validity and reliability of these dynamic assessments is strongly recommended.

Objective: Single nucleotide polymorphisms (SNPs) in genes involved in fatty acid metabolism (FADS1 FADS2 gene cluster) are associated with plasma lipid levels. We aimed to investigate whether these associations are already present early in life and compare the relative contribution of FADS SNPs vs traditional (non-genetic) factors as determinants of plasma lipid levels.Methods: Information on infants' plasma total cholesterol levels, genotypes of five FADS SNPs (rs174545, rs174546, rs174556, rs174561, and rs3834458), anthropometric data, maternal characteristics, and breastfeeding history was available for 521 2-year-old children from the KOALA Birth Cohort Study. For 295 of these 521 children, plasma HDLc and non-HDLc levels were also known. Multivariable linear regression analysis was used to study the associations of genetic and nongenetic determinants with cholesterol levels.Results: All FADS SNPs were significantly associated with total cholesterol levels. Heterozygous and homozygous for the minor allele children had about 4% and 8% lower total cholesterol levels than major allele homozygotes. In addition, homozygous for the minor allele children had about 7% lower HDLc levels. This difference reached significance for the SNPs rs174546 and rs3834458. The associations went in the same direction for non-HDLc, but statistical significance was not reached. The percentage of total variance of total cholesterol levels explained by FADS SNPs was relatively low (lower than 3%) but of the same order as that explained by gender and the non-genetic determinants together.Conclusions: FADS SNPs are associated with plasma total cholesterol and HDLc levels in preschool children. This brings a new piece of evidence to explain how blood lipid levels may track from childhood to adulthood. Moreover, the finding that these SNPs explain a similar amount of variance in total cholesterol levels as the non-genetic determinants studied reveals the potential importance of investigating the effects of genetic variations in early life.

Spoken word recognition, during gating, appears intact in specific language impairment (SLI). This study used gating to investigate the process in adolescents with autism spectrum disorders plus language impairment (ALI). Adolescents with ALI, SLI, and typical language development (TLD), matched on nonverbal IQ listened to gated words that varied in frequency (low/high) and number of phonological onset neighbors (low/high density). Adolescents with ALI required more speech input to initially identify low-frequency words with low competitor density than those with SLI and those with TLD, who did not differ. These differences may be due to less well specified word form representations in ALI.

Summary •Overweight and obesity prevalence estimates among children based on International Obesity Task Force definitions are substantially lower than estimates based on World Health Organization definitions. •Presence of a north–south gradient with the highest level of overweight found in southern European countries. •Intercountry comparisons of overweight and obesity in primary-school children in Europe based on measured data lack a similar data collection protocol. •Unique dataset on overweight and obesity based on measured weights and heights in 6–9-year-old children from 12 European countries using a harmonized surveillance methodology. •Because of the use of a consistent data collection protocol, it is possible to perform valid multiple comparisons between countries. •It demonstrates wide variations in overweight and obesity prevalence estimates among primary-school children between European countries and regions. Background Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative. Objective To present the anthropometric results of data collected in 2007/2008 and to investigate whether there exist differences across countries and between the sexes. Methods Weight and height were measured in 6–9-year-old children in 12 countries. Prevalence of overweight, obesity, stunting, thinness and underweight as well as mean Z-scores of anthropometric indices of height, weight and body mass index were calculated. Results A total of 168¿832 children were included in the analyses and a school participation rate of more than 95% was obtained in 8 out of 12 countries. Stunting, underweight and thinness were rarely prevalent. However, 19.3-49.0% of boys and 18.4-42.5% of girls were overweight (including obesity and based on the 2007 WHO growth reference).The prevalence of obesity ranged from 6.0 to 26.6% among boys and from 4.6 to 17.3% among girls. Multi-country comparisons suggest the presence of a north–south gradient with the highest level of overweight found in southern European countries. Conclusions Overweight among 6–9-year-old children is a serious public health concern and its variation across the European Region highly depends on the country. Comparable monitoring of child growth is possible across Europe and should be emphasized in national policies and implemented as part of action plans

ObjectiveSimulating the probable impact of grain amaranth and highly absorbable, low-Fe micronutrient powder (MNP) on Fe status in a potential target population is an essential step in choosing and developing an appropriate actual intervention.DesignWe simulated the potential effect of fortifying maize porridge with grain amaranth or MNP on the prevalence of inadequate Fe intake and Fe deficiency using data from two cross-sectional surveys. In the first survey (2008), dietary intake data were collected by two 24 h recalls (n 197). Biochemical data (n 70) were collected in the second survey (2010). A simulation with daily consumption for 80 d of non-fortified maize porridge (60 g of maize flour), amaranth-enriched porridge (80 g of grain amaranth–maize flour, 70:30 ratio) or maize porridge fortified with MNP (2·5 mg Fe as NaFeEDTA) was done.SettingMwingi District, Kenya.SubjectsPre-school children aged 12–23 months.ResultsPrevalence of anaemia, Fe deficiency and Fe-deficiency anaemia was 49 %, 46 % and 24 %, respectively. Consumption of non-fortified, amaranth-enriched and MNP-fortified maize porridge was estimated to provide a median daily Fe intake of 8·6 mg, 17·5 mg and 11·1 mg, respectively. The prevalence of inadequate Fe intake was reduced to 35 % in the amaranth-enriched porridge group and 45 % in the MNP-fortified porridge group, while ferritin concentration was increased in both (by 1·82 (95 % CI 1·42, 2·34) μg/l and 1·80 (95 % CI 1·40, 2·31) μg/l, respectively; P < 0·005) compared with the non-fortified maize porridge group, resulting in a decreased prevalence of Fe deficiency (27 %) in the two fortification groups.ConclusionsAddition of grain amaranth or low-Fe MNP to maize-based porridge has potential to improve Fe intake and status in pre-school children.

The purpose of this study was to gain insight into the relations between time use, dissatisfaction, and marital conflict about the division of house-hold labor and paid work. A cross-sectional survey was conducted among 54 Dutch couples who were either expecting their first child or had a first child under 12 months old. Couples experienced more conflict about household labor than about paid work. Conflict about household labor was related solely to wives' dissatisfaction with the division of household labor which was predicted by both their own and their spouse's contribution to housework. Conflict about paid work revolved around both spouses' dissatisfaction with the husband's working hours. The majority of spouses preferred husbands to spend less time on paid work.

Background Positive associations between motor competence and physical activity have been identified by means of variable-centered analyses. To expand the understanding of these associations, this study used a person-centered approach to investigate whether different combinations (i.e., profiles) of actual and perceived motor competence exist (aim 1); and to examine differences in physical activity levels (aim 2) and weight status (aim 3) among children with different motor competence-based profiles. Materials and Methods Children’s (N = 361; 180 boys = 50%; Mage = 9.50±1.24yrs) actual motor competence was measured with the Test of Gross Motor Development-2 and their perceived motor competence via the Self Perception Profile for Children. We assessed physical activity via accelerometers; height through stadiometers, and weight through scales. Cluster analyses (aim 1) and MANCOVAs (aim 2 & 3) were used to analyze the data. Results The analysis generated two predictable groups: one group displaying relatively high levels of both actual (M TGMD-2 percentile = 42.54, SD = 2.33) and perceived motor competence (M = 3.42, SD = .37; high-high), and one group with relatively low levels of both (M percentile = 9.71, SD = 3.21; M PMC = 2.52, SD = .35; low-low). One additional group was also identified as having relatively low levels of actual motor competence (M percentile = 4.22, SD = 2.85) but relatively high levels of perceived motor competence (M = 3.52, SD = .30; low-high). The high-high group demonstrated higher daily physical activity (M = 48.39±2.03) and lower BMI (M = 18.13±.43) than the low-low group (MMVPA = 37.93±2.01; MBMI = 20.22±.42). The low-high group had similar physical activity-levels as the low-low group (M = 36.21±2.18) and did not significantly differ in BMI (M = 19.49±.46) from the other two groups. Conclusions A combination of high actual and perceived motor competence is related to higher physical activity and lower weight status. It is thus recommended to expand health interventions in children with components that foster the development of both actual and perceived motor competence. Health professionals should furthermore pay sufficient attention to endorsing children’s actual and perceived motor competence.

This study investigates the use of subject-verb agreement and verb argument structure in the spoken Dutch of monolingual Dutch children with specific language impairment (SLI) and bilingual Frisian-Dutch children with SLI. Both SLI groups appeared to be less efficient in their use of subject-verb agreement and verb argument structure than the control group (consisting of monolingual typically developing Dutch children matched on mean length of utterance in morphemes) in that they showed significantly more agreement errors as well as a relation between verb agreement structure complexity and omission, a relation that the typically developing children failed to show. Furthermore, no significant differences were found between the monolingual and the bilingual SLI group. These findings indicate that subject-verb agreement and verb argument structure are both affected in SLI, but not more severely in bilinguals than in monolinguals.

International audience; The aim of this study was to determine whether or not pleasure, neutrality, and disgust expressed by eaters in photographs could affect the desire to eat food products to a greater extent in children than in adults. Children of 5 and 8 years of age, as well as adults, were presented with photographs of liked and disliked foods. These foods were presented either alone or with an eater who expressed three different emotions: pleasure, neutrality, or disgust. Results showed that, compared with food presented alone, food presented with a pleasant face increased the desire to eat disliked foods, particularly in children, and increased the desire to eat liked foods only in the 5-year-old children. In contrast, with a disgusted face, the desire to eat the liked foods decreased in all participants, although to a greater extent in children, while it had no effect on the desire to eat the disliked foods. Finally, food presented with a neutral face also increased and decreased the desire to eat disliked and liked foods, respectively, and in each case more for the 5-year-olds than for the older participants. In sum, the facial expressions of others influence the desire to eat liked and disliked foods and, to a greater extent, in younger children.

International audience; There is growing evidence of social disparities in overweight among European children. This paper examines whether there is an association between socioeconomic inequality and prevalence of child overweight in European countries, and if socioeconomic disparities in child overweight are increasing. We analyse cross-country comparisons of household inequality and child overweight prevalence in Europe and review within-country variations over time of childhood overweight by social grouping, drawn from a review of the literature. Data from 22 European countries suggest that greater inequality in household income is positively associated with both self-reported and measured child overweight prevalence. Moreover, seven studies from four countries reported on the influence of socioeconomic factors on the distribution of child overweight over time. Four out of seven reported widening social disparities in childhood overweight, a fifth found statistically significant disparities only in a small sub-group, one found non-statistically significant disparities, and a lack of social gradient was reported in the last study. Where there is evidence of a widening social gradient in child overweight, it is likely that the changes in lifestyles and dietary habits involved in the increase in the prevalence of overweight have had a less favourable impact in low socio-economic status groups than in the rest of the population. More profound structural changes, based on population-wide social and environmental interventions are needed to halt the increasing social gradient in child overweight in current and future generations.

Digestible carbohydrates are one of the main sources of dietary energy in infancy and childhood and are essential for growth and development. The aim of this narrative review is to outline the intakes of digestible carbohydrates and their role in health and disease, including the development of food preferences, as well the consequences of excess carbohydrate. Key experts in these fields provided up-to-date reviews of the literature. A search of available information on dietary intakes of children below the age of 4 years was conducted from 1985 up to 2010. Articles and reports including information about sugars and/or starch intakes were selected. A number of factors limit the ability to obtain an overall picture of carbohydrate intakes and food sources in this age group. These include small numbers of intake studies, differing approaches to analysing carbohydrate, a variety of terms used to describe sugars intakes and a dearth of information about starch intakes. Data suggest that sweet taste is preferred in infancy and later food choices. There are few established adverse consequences of high intakes of digestible carbohydrate for young children. The greatest evidence is for dental caries, although this is influenced by high intake frequency and poor oral hygiene. Evidence for detrimental effects on nutrient dilution, obesity, diabetes or cognition is limited. In infants, minimum carbohydrate (mainly lactose) intake should be 40% of total energy, gradually increasing to 55% energy by the age of 2 years.European Journal of Clinical Nutrition advance online publication, 4 April 2012; doi:10.1038/ejcn.2012.27. ispartof: European Journal of Clinical Nutrition vol:66 issue:7 pages:765-779 ispartof: location:England status: published

Background Fractional exhaled Nitric Oxide (FeNO) is a surrogate biomarker of the degree of eosinophilic airway inflammation. Using longitudinal latent class analysis, five wheezing phenotypes have been identified, characterized by different ages of onset and prognosis. Objectives To assess FeNO measured at 4 and 8 years in children with different phenotypes of wheeze and atopy. Methods Children participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study, a prospective birth cohort in the Netherlands. Respiratory health was assessed yearly by questionnaires until the age of 8 years; these data were used to identify five wheezing phenotypes. Associations between FeNO and wheezing phenotypes were investigated using weighted linear regression. Results Data on wheezing phenotypes and FeNO at 4 and 8 years were available in 588 and 973 children respectively. Compared with the phenotype of never and transient wheeze, FeNO at 4 years was higher in intermediate onset and persistent wheeze. FeNO at 8 years of age differed significantly between all phenotypes, with highest FeNO values for persistent, intermediate onset, and late onset wheeze. Rise in FeNO from 4 to 8 years in intermediate and late onset wheezers was significantly higher compared to FeNO rise in never and transient wheezers. Stratified analyses showed that the increase in FeNO in persistent, intermediate, and late onset wheeze was only present in children with allergic sensitization at 8 years. Conclusions and Clinical Relevance The FeNO measured at 8 years was associated with specific wheezing phenotypes, only among atopic children.

To compare the outcomes of percutaneous nephrolithotomy (PCNL) in 2 age groups. Fifty-one renal units (RU) of 45 patients were operated between January 2006 and December 2010. In all patients, PCNL was performed by pediatric nephroscope of 17F size through a 20F Amplatz sheath. Patients were examined in 2 groups (Group1: a parts per thousand currency sign5 years, Group 2: > 5 years) and outcomes were compared accordingly. The mean age was 5.95 +/- A 3.63 years and male-to-female ratio was 23/22. The mean stone burden, operative time, and postoperative hospital stay were 4.24 +/- A 2.03 cm(2), 94.30 +/- A 37.28 min, and 5.18 +/- A 2.97 days, respectively. In the postoperative period, 44 renal units (86.2%) were stone-free. Two age groups were similar regarding the postoperative hospital stay, gender distribution, stone location, stone composition, and complication rates. However, stone burden and number of access was less and stone-free rate was higher in younger age group. The stone-free rate in preschool children is at least as good as older children without an increase in complication rates. The older children (> 5 years) have a higher stone burden and need multiple accesses more frequently. The complications are mostly low grade and can be managed conservatively. Our results showed that PCNL in younger children as safe and effective as in the older children and age should not be considered as a limiting factor.

Hans Verhoef and colleagues report findings from a randomized trial conducted among Tanzanian children at high risk for malaria. Children in the trial received either daily oral supplementation with either zinc alone, multi-nutrients without zinc, multi-nutrients with zinc, or placebo. The investigators did not find evidence from this study that zinc or multi-nutrients protected against malaria episodes., Background It is uncertain to what extent oral supplementation with zinc can reduce episodes of malaria in endemic areas. Protection may depend on other nutrients. We measured the effect of supplementation with zinc and other nutrients on malaria rates. Methods and Findings In a 2×2 factorial trial, 612 rural Tanzanian children aged 6–60 months in an area with intense malaria transmission and with height-for-age z-score≤−1.5 SD were randomized to receive daily oral supplementation with either zinc alone (10 mg), multi-nutrients without zinc, multi-nutrients with zinc, or placebo. Intervention group was indicated by colour code, but neither participants, researchers, nor field staff knew who received what intervention. Those with Plasmodium infection at baseline were treated with artemether-lumefantrine. The primary outcome, an episode of malaria, was assessed among children reported sick at a primary care clinic, and pre-defined as current Plasmodium infection with an inflammatory response, shown by axillary temperature ≥37.5°C or whole blood C-reactive protein concentration ≥8 mg/L. Nutritional indicators were assessed at baseline and at 251 days (median; 95% reference range: 191–296 days). In the primary intention-to-treat analysis, we adjusted for pre-specified baseline factors, using Cox regression models that accounted for multiple episodes per child. 592 children completed the study. The primary analysis included 1,572 malaria episodes during 526 child-years of observation (median follow-up: 331 days). Malaria incidence in groups receiving zinc, multi-nutrients without zinc, multi-nutrients with zinc and placebo was 2.89/child-year, 2.95/child-year, 3.26/child-year, and 2.87/child-year, respectively. There was no evidence that multi-nutrients influenced the effect of zinc (or vice versa). Neither zinc nor multi-nutrients influenced malaria rates (marginal analysis; adjusted HR, 95% CI: 1.04, 0.93–1.18 and 1.10, 0.97–1.24 respectively). The prevalence of zinc deficiency (plasma zinc concentration, Editors' Summary Background Malaria is a serious global public-health problem. Half of the world's population is at risk of this parasitic disease, which kills a million people (mainly children living in sub-Saharan Africa) every year. Malaria is transmitted to people through the bites of infected night-flying mosquitoes. Soon after entering the human body, the parasite begins to replicate in red blood cells, bursting out every 2–3 days and infecting more red blood cells. The presence of the parasite in the blood stream (parasitemia) causes malaria's characteristic recurring fever and can cause life-threatening organ damage and anemia (insufficient quantity of red blood cells). Malaria transmission can be reduced by using insecticide sprays to control the mosquitoes that spread the parasite and by avoiding mosquito bites by sleeping under insecticide-treated bed nets. Effective treatment with antimalarial drugs can also reduce malaria transmission. Why Was This Study Done? One reason why malaria kills so many children in Africa is poverty. Many children in Africa are malnourished, and malnutrition—in particular, insufficient micronutrients in the diet—impairs the immune system, which increases the frequency and severity of many childhood diseases. Micronutrients are vitamins and minerals that everyone needs in small quantities for good health. Zinc is one of the micronutrients that helps to maintain a healthy immune system, but zinc deficiency is very common among African children. Zinc supplementation has been shown to reduce the burden of diarrhea in developing countries, so might it also reduce the burden of malaria? Unfortunately, the existing evidence is confusing—some trials show that zinc supplementation protects against malaria but others show no evidence of protection. One possibility for these conflicting results could be that zinc supplementation alone is not sufficient—supplementation with other micronutrients might be needed for zinc to have an effect. In this randomized trial (a study that compares the effects of different interventions in groups that initially are similar in all characteristics except for intervention), the researchers investigate the effect of supplementation with zinc alone and in combination with other micronutrients on the rate of uncomplicated (mild) malaria among children living in Tanzania. What Did the Researchers Do and Find? The researchers enrolled 612 children aged 6–60 months who were living in a rural area of Tanzania with intense malaria transmission and randomly assigned them to receive daily oral supplements containing zinc alone, multi-nutrients (including iron) without zinc, multi-nutrients with zinc, or a placebo (no micronutrients). Nutritional indicators (including zinc concentrations in blood plasma) were assessed at baseline and 6–10 months after starting the intervention. During the study period, there were 1,572 malaria episodes. The incidence of malaria in all four intervention groups was very similar (about three episodes per child-year), and there was no evidence that multi-nutrients influenced the effect of zinc (or vice versa). Moreover, none of the supplements had any effect on malaria rates when compared to the placebo, even though the occurrence of zinc deficiency was strongly reduced by zinc supplementation. In a secondary analysis in which they analyzed their data by iron status at baseline, the researchers found that multi-nutrient supplementation increased the overall number of malaria episodes in children with iron deficiency by 41%, whereas multi-nutrient supplementation had no effect on the number of malaria episodes among children who were iron-replete at baseline. What Do These Findings Mean? In this study, the researchers found no evidence that zinc supplementation protected against malaria among young children living in Tanzania when given alone or in combination with other multi-nutrients. However, the researchers did find some evidence that multi-nutrient supplementation may increase the risk of malaria in children with iron deficiency. Because this finding came out of a secondary analysis of the data, it needs to be confirmed in a trial specifically designed to assess the effect of multi-nutrient supplements on malaria risk in iron-deficient children. Nevertheless, it is a potentially worrying result because, on the basis of evidence from a single study, the World Health Organization currently recommends that regular iron supplements be given to iron-deficient children in settings where there is adequate access to anti-malarial treatment. This recommendation should be reconsidered, suggest the researchers, and the safety of multi-nutrient mixes that contain iron and that are dispensed in countries affected by malaria should also be carefully evaluated. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001125. Information is available from the World Health Organization on malaria (in several languages), on micronutrients, and on zinc deficiency; the 2010 World Malaria Report provides details of the current global malaria situation The US Centers for Disease Control and Prevention provide information on malaria (in English and Spanish), including a selection of personal stories about malaria Information is available from the Roll Back Malaria Partnership on the global control of malaria and on malaria in Africa The Malaria Centre at the UK London School of Hygiene & Tropical Medicine develops tools, techniques, and knowledge about malaria, and has a strong emphasis on teaching, training, and translating research outcomes into practice The Micronutrient Initiative, the Global Alliance for Improved Nutrition, and the Flour Fortification Initiative are not-for-profit organizations dedicated to ensuring that people in developing countries get the minerals and vitamins they need to survive and thrive The International Zinc Nutrition Consultative Group (iZiNCG) is a non-profit organization that aims to promote and assist efforts to reduce zinc deficiency worldwide, through advocacy efforts, education, and technical assistance MedlinePlus provides links to additional information on malaria (in English and Spanish)

Observational studies increasingly emphasize the impact of general parenting on the development of childhood overweight and obesity. The aim of the current literature review was to provide an overview of interventions addressing general parenting in order to prevent or treat childhood obesity. Electronic literature databases were systematically searched for relevant studies. Seven studies were eligible for inclusion. The studies described four different general parenting programs, which were supplemented with lifestyle components (i.e., physical activity and nutrition). All studies showed significant small to moderate intervention effects on at least one weight-related outcome measure. The current review shows that despite the emerging observational evidence for the role of parenting in children's weight-related outcomes, few interventions have been developed that address general parenting in the prevention of childhood obesity. These interventions provide evidence that the promotion of authoritative parenting is an effective strategy for the prevention and management of childhood obesity.

Background Accelerometers are considered to be the most promising tool for measuring physical activity (PA) in free-living young children. So far, no studies have examined the feasibility and validity of accelerometer measurements in children under 3 years of age. Therefore, the purpose of the present study was to examine the feasibility and validity of accelerometer measurements in toddlers (1- to 3-year olds). Methods Forty-seven toddlers (25 boys; 20 ± 4 months) wore a GT1M ActiGraph accelerometer for 6 consecutive days and parental perceptions of the acceptability of wearing the monitor were assessed to examine feasibility. To investigate the validity of the ActiGraph and the predictive validity of three ActiGraph cut points, accelerometer measurements of 31 toddlers (17 boys; 20 ± 4 months) during free play at child care were compared to directly observed PA, using the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P). Validity was assessed using Pearson and Spearman correlations and predictive validity using area under the Receiver Operating Characteristic curve (ROC-AUC). Results The feasibility examination indicated that accelerometer measurements of 30 toddlers (63.8%) could be included with a mean registration time of 564 ± 62 min during weekdays and 595 ± 83 min during weekend days. According to the parental reports, 83% perceived wearing the accelerometer as 'not unpleasant and not pleasant' and none as 'unpleasant'. The validity evaluation showed that mean ActiGraph activity counts were significantly and positively associated with mean OSRAC-P activity intensity (r = 0.66; p < 0.001; n = 31). Further, the correlation among the ActiGraph activity counts and the OSRAC-P activity intensity level during each observation interval was significantly positive (ρ = 0.52; p < 0.001; n = 4218). Finally, the three sedentary cut points exhibited poor to fair classification accuracy (ROC-AUC: 0.56 to 0.71) while the three light PA (ROC-AUC: 0.51 to 0.62) and the three moderate-to-vigorous PA cut points (ROC-AUC: 0.53 to 0.57) demonstrated poor classification accuracy with respect to detecting sedentary behavior, light PA and moderate-to-vigorous PA, respectively. Conclusions The present findings suggest that ActiGraph accelerometer measurements are feasible and valid for quantifying PA in toddlers. However, further research is needed to accurately identify PA intensities in toddlers using accelerometry.

This longitudinal study examined the additive and interactive effects of behavioral inhibition and a wide range of other vulnerability factors in the development of anxiety problems in youths. A sample of 261 children, aged 5 to 8 years, 124 behaviorally inhibited and 137 control children, were followed during a 3-year period. Assessments took place on three occasions to measure children's level of behavioral inhibition, anxiety disorder symptoms, other psychopathological symptoms, and a number of other vulnerability factors such as insecure attachment, negative parenting styles, adverse life events, and parental anxiety. Results obtained with Structural Equation Modeling indicated that behavioral inhibition primarily acted as a specific risk factor for the development of social anxiety symptoms. Furthermore, the longitudinal model showed additive as well as interactive effects for various vulnerability factors on the development of anxiety symptoms. That is, main effects of anxious rearing and parental trait anxiety were found, whereas behavioral inhibition and attachment had an interactive effect on anxiety symptomatology. Moreover, behavioral inhibition itself was also influenced by some of the vulnerability factors. These results provide support for dynamic, multifactorial models for the etiology of child anxiety problems.

Attention-deficit/hyperactivity disorder (ADHD) is a high-cost/high-burden disorder. Early detection and intervention may prevent or ameliorate the development of the disorder and reduce its long-term impact. In this article, we set out a rationale for an early detection and intervention program. First, we highlight the costs of the condition and second, we discuss the limitations of the current treatments. We then outline the potential value of an early detection and intervention program. We review evidence on predictors of poor outcomes for early ADHD signs and discuss how these might allow us to target early intervention more cost-effectively. We then examine potential barriers to engagement with at-risk samples. This leads to a discussion of possible intervention approaches and how these could be improved. Finally, we describe the Program for Early Detection and Intervention for ADHD (PEDIA), a 5-year program of research supported by the UK National Institute for Health Research and conducted at the University of Southampton (Southampton, UK), which aims to develop and evaluate a strategy for early intervention.

It is generally accepted that joint attention skills are impaired in children with autism spectrum disorder (ASD). In this study, social preference, attention disengagement and intention understanding, assumed to be associated with the development of joint attention, are explored in relation to joint attention skills in children with ASD at the age of 36 months. Response to joint attention was related to intention understanding, whereas the number of joint attention initiations was associated with attention disengagement, and somewhat less stronger with social preference. The level on which children initiated joint attention was related to social preference. Possible interpretations of these findings are discussed.

Evidence suggests that sensitivity to coherent motion (CM) is related to reading, but its role in the etiology of developmental dyslexia remains unclear. In this longitudinal study, CM sensitivity was measured in 31 children at family risk for dyslexia and 31 low-risk controls. Children, diagnosed with dyslexia in third grade (mean age=8 years 3 months), demonstrated reduced CM sensitivity in kindergarten (mean age=5 years 8 months), before they had learned to read. Preschool CM thresholds in controls also uniquely predicted future literacy achievement. When reassessed in first grade, CM sensitivity in the dyslexic children was age appropriate, and CM thresholds in the controls no longer predicted literacy acquisition. These findings contribute to the debate about the developmental relations between visual processing and reading acquisition. ispartof: Child Development vol:82 issue:3 pages:854-869 ispartof: location:United States status: published

Objective: To investigate the association between the child-care environment and physical activity of 2- and 3-year-olds. Based on an ecological view of environmental influences on health behavior, we hypothesized that the social and physical environment, as well as child characteristics (age and gender), would show independent and interactive effects on children's physical activity intensity. Design: Observations of physical activity intensity were performed among children (N = 175) at 9 Dutch child-care centers. Aspects of the child-care environment were assessed using the validated Environment and Policy Assessment and Observation (EPAO) Instrument. Multilevel linear regression analyses examined the association of environment and child characteristics with children's activity intensity. Moderation was tested by including interaction terms in the analyses, with subsequent post hoc analyses for significant interaction terms. Main Outcome Measure: Observed child physical activity intensity, measured with the Observational System for Recording Physical Activity in Children - Preschool Version. Results: A large proportion of the observed activities were classified as sedentary, while far fewer observations were classified as moderate or vigorous. Activity opportunities in the physical environment (assessed using EPAO) and prompts by staff and peers were significantly and positively related to physical activity intensity, while group size was negatively related to activity intensity. The influence of the physical environment was moderated by social environment (peer group size), while the social environment in turn interacted with child characteristics (age and gender) in determining activity intensity. Conclusion: Our findings are in line with the ecological perspective regarding environmental influences on behavior, and stress the importance of incorporating the child-care environment in efforts to prevent childhood overweight and obesity. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

This within-family study investigated whether mothers differentiate between children in their interactive behavior. Mothers were observed during a play and a task interaction separately with their child with autism spectrum disorder (ASD) (between 46 and 84 months old, M = 68) and with a younger sibling (between 29 and 67 months old, M = 48). Additionally, the social behavior of the children with ASD and their non-ASD siblings was compared. Results show that mothers differentiated in their responsiveness but not in their initiatives toward the children. Children with ASD and their non-ASD siblings were equally responsive but children with ASD were more imperative toward their caregiver. Several interpretations of these findings are discussed. Finally, it is concluded that family-based interventions will benefit from a better understanding of the effect of ASD on mother-child interactions within families with a child with ASD. Therefore, between-family studies should be complemented with within-family studies. Autism Res 2011,4:358-367. © 2011 International Society for Autism Research, Wiley Periodicals, Inc.

Background The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.

Wheezing phenotypes in young children have usually been described on the basis of questionnaire surveys instead of prospectively doctor-diagnosed episodes, and have never been described in terms of incidence rates.To identify wheezing phenotypes in the first three years and describe their incidence trends, and to investigate their relationship with asthma at six years of age.Doctor-diagnosed wheezing episodes in the first 36 months and active asthma at six years were identified in a historical cohort of 3,739 children followed from birth in 29 primary care health centres in Spain. Wheezing phenotypes were identified by means of latent class analysis. Changes in incidence rates of wheezing were identified through joinpoint regression models and their predictive ability for asthma was analysed.One never/infrequent wheeze phenotype and three wheezing phenotypes were identified. There were two early phenotypes which started wheezing at a median age of six months, one of which was transient while the other had a heavy recurrence of episodes. A third phenotype exhibited a delayed onset of wheezing, a constant rise in incidence through the first 36 months, and a relationship with allergic asthma. These three phenotypes had a higher prevalence of active asthma at six years than the never/infrequent wheeze phenotype, but the classification had a weak predictive ability for asthma due to low sensitivity.The use of incidence rates contributes to the clarification of the natural history of infant wheezing.

The diet quality index (DQI) for preschool children is a new index developed to reflect compliance with four main food-based dietary guidelines for preschool children in Flanders. The present study investigates: (1) the validity of this index by comparing DQI scores for preschool children with nutrient intakes, both of which were derived from 3 d estimated diet records; (2) the reproducibility of the DQI for preschoolers based on a parentally reported forty-seven-item FFQ DQI, which was repeated after 5 weeks; (3) the relative validity of the FFQ DQI with 3 d record DQI scores as reference. The study sample included 510 and 58 preschoolers (2·5–6·5 years) for validity and reproducibility analyses, respectively. Increasing 3 d record DQI scores were associated with decreasing consumption of added sugars, and increasing intakes of fibre, water, Ca and many micronutrients. Mean FFQ DQI test–retest scores were not significantly different: 72 (sd11)v.71 (sd10) (P = 0·218) out of a maximum of 100. Mean 3 d record DQI score (66 (sd10)) was significantly lower than mean FFQ DQI (71 (sd10);P

Introduction: A heavier weight in adults is becoming the norm rather than an abnormal weight. Whether the same trend is happening in children is unknown. Objective: To assess the perception of the weight of 4- to 5-year-old children and the recognition of overweight by both parents. Design: Population-based survey. Participants: A questionnaire was sent to parents of 11

The aim of this article is to describe the paediatric highlights from the 2009 European Respiratory Society Annual Congress in Vienna, Austria. The best abstracts from the seven groups of the Paediatric Assembly (asthma and allergy, respiratory epidemiology, cystic fibrosis, respiratory physiology, respiratory infections and immunology, neonatology and paediatric intensive care, and bronchology) are presented alongside findings from the current literature.

Objective: As dopamine functioning varies by sex and age it might be expected that the effects of methylphenidate or amfetamine, the psychostimulants used for the treatment of Attention Deficit /Hyperactivity Disorder (ADHD), will also be moderated by these factors. Here we review the published literature on whether stimulant effects in ADHD symptoms vary by age and sex. Method: We searched for studies published from 1989 until October 2009. Databases searched included U. S. National Library of Medicine (PubMed), Medline, EMBASE, PsycINFO and ISI Web of Knowledge. Firstly, we reviewed the effects of stimulant drugs on male and female patients and also patients of pre-school, middle childhood, adolescence and adulthood. Secondly, we reviewed studies that directly tested the moderating effect of age and sex on stimulant treatment outcome. Results: Randomised controlled trials confirm that stimulant medication is efficacious for, and well tolerated by, males and females and patients across the age range; although preschoolers appear to have a less beneficial response and more side effects. Few studies that specifically examined the moderating effect of age and/or sex were identified. For sex, no effects on overall response were found, although one study reported that sex moderated methylphenidate pharmacodynamics. The few effects found for age were small and inconsistent. Conclusions: The available evidence suggests that stimulant medication, when appropriately administered, has efficacy as an ADHD treatment for both sexes and across all ages. There are currently too few published papers examining the effects of sex and age to draw strong conclusions about moderation. Further studies of the pharmacodynamics of stimulants on symptoms measured using objective tests in the laboratory or classroom setting need to be undertaken.

Mammals, including humans, show sex differences in juvenile play behavior. In rodents and nonhuman primates, these behavioral sex differences result, in part, from sex differences in androgens during early development. Girls exposed to high levels of androgen prenatally, because of the genetic disorder congenital adrenal hyperplasia, show increased male-typical play, suggesting similar hormonal influences on human development, at least in females. Here, we report that fetal testosterone measured from amniotic fluid relates positively to male-typical scores on a standardized questionnaire measure of sex-typical play in both boys and girls. These results show, for the first time, a link between fetal testosterone and the development of sex-typical play in children from the general population, and are the first data linking high levels of prenatal testosterone to increased male-typical play behavior in boys.

Contains fulltext : 80144.pdf (Publisher’s version ) (Closed access) To examine the inter-rater reliability and stability of autism spectrum disorder (ASD) diagnoses made at a very early age in children identified through a screening procedure around 14 months of age. In a prospective design, preschoolers were recruited from a screening study for ASD. The inter-rater reliability of the diagnosis of ASD was measured through an independent assessment of a randomly selected subsample of 38 patients by two other psychiatrists. The diagnoses at 23 months and 42 months of 131 patients, based on the clinical assessment and the diagnostic classifications of standardised instruments, were compared to evaluate stability of the diagnosis of ASD. Inter-rater reliability on a diagnosis of ASD versus non-ASD at 23 months was 87% with a weighted kappa of 0.74 (SE 0.11). The stability of the different diagnoses in the autism spectrum was 63% for autistic disorder, 54% for pervasive developmental disorder, not otherwise specified (PDD-NOS), and 91% for the whole category of ASD. Most diagnostic changes at 42 months were within the autism spectrum from autistic disorder to PDD-NOS and were mainly due to diminished symptom severity. Children who moved outside the ASD category at 42 months made significantly larger gains in cognitive and language skills than children with a stable ASD diagnosis. In conclusion, the inter-rater reliability and stability of the diagnoses of ASD established at 23 months in this population-based sample of very young children are good.

Objectives: To evaluate dietary zinc and other divalent minerals intake among the population of Jiangsu Province. Methods: 3,867 subjects aged 4-89 years were representatively sampled in two urban and six rural areas of Jiangsu Province. Dietary intake was assessed using 24-hour recalls on three consecutive days. Insufficient zinc intake was calculated based on the Chinese Dietary Reference Intakes. Results: Overall, the percentage of subjects with insufficient intake of zinc was 22.9%, with a declining trend with age. Except for the group >=50 years, mean zinc intake of all other groups were below the age- and sex- specific Recommended Nutrition Intakes (RNI). Approximately 2/3rds of the subjects =50 years (OR: 0.76, 95% CI: 0.66-0.8; OR:0.55, 95%CI: 0.47-0.64). Mean intake of iron, copper, magnesium and selenium met the Chinese DRIs respectively, except for selenium in females. The prevalence of insufficient intake of copper, magnesium and selenium was 37.2%, 22.8% and 29.3%, respectively, while the overall prevalence of insufficient iron intake was only 3.4%. Conclusion: Dietary zinc intake of the Jiangsu Province population does not generally meet the Chinese RNI. Children and adolescents in particular have a higher risk of insufficient zinc intake

Investigated the relationships between play and family environmental conditions in a survey of 67 Dutch mothers (aged 23–35 yrs) of preschool children (aged 20–24 mo). Variables included parents' child-rearing orientation and play concept, the degree to which and reasons why they believe play is important, the way they intend to stimulate play, and the way they experience characteristics of their children. The play concept was wide, with 32 of 40 common child activities considered to be play forms by most parents. Play was estimated as being of great importance for child development, and culturally oriented parents tended to show the highest interest in play. There were more relations between perceived educational tasks, the way children are experienced, and opinions about play than between those factors and intentions of play stimulation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

HOUWEN, S., E. HARTMAN, and C. VISSCHER. Physical Activity and Motor Skills in Children with and without Visual Impairments. Med. Sci. Sports Exerc., Vol. 41, No, 1, pp. 103-109, 2009. Purpose: To examine the physical activity levels of children with and without visual impairments(VI). We further investigated 1) whether degree of VI was associated with activity level, 2) whether body composition was associated with activity level, and 3) whether interrelationships existed between activity level and motor skill performance. Methods: Ninety-six children with and without VI, ages 6 to 12 yr, attending mainstream schools participated. Physical activity was assessed by the GTI M accelerometer and motor skill performance by the Test of Gross Motor Development-2. Body composition was also determined. Results: Total activity [counts per minute (cpm)] was significantly higher in children without VI than in children with VI, 578.1 versus 473.2 cpm. Time spent in sedentary and light behaviors averaged 81.4% and 15.9% in the children with VI and 78.1% and 18.6% in the children without VI, with significant between-group differences. Participation in moderate-to-vigorous physical activity (MVPA),A,as significantly higher in children without VI versus children with Vi. Degree of VI, body mass index (BMI), and percent body fat were correlated with time spent in sedentary and light activity in children with VI. Time spent in sedentary activity was inversely correlated with locomotor and object control scores in children with VI. Light activity was positively associated with locomotor scores,, total activity and MVPA were positively associated with object control scores. For children without VI, total activity and time spent in MVPA were positively associated with locomotor scores, and time spent in sedentary activity inversely associated with object control scores. Conclusions: The present results emphasize the importance of promoting an active lifestyle in children. Special attention has to be paid to children with lower visual acuities and children with higher BMI.

Background In the numerical Stroop paradigm (NSP) participants decide whether a digit is numerically or physically larger than another simultaneously presented digit. This paradigm is frequently used to assess the automatic number processing abilities of children. Currently it is unclear whether an equally refined evaluation of numerical magnitude occurs in both controlled (the numerical comparison task of the NSP) and automatic (the physical comparison task of the NSP) numerical comparison in both children and adults. One of our objectives was to respond this question by measuring the speed of controlled and automatic magnitude processing in children and adults in the NSP. Another objective was to determine how the immature executive functions of children affect their cognitive functions relative to adults in numerical comparison. Methods and results The speed of numerical comparison was determined by monitoring the electro-encephalographic (EEG) numerical distance effect: The amplitude of EEG measures is modulated as a function of numerical distance between the to-be-compared digits. EEG numerical distance effects occurred between 140–320 ms after stimulus presentation in both controlled and automatic numerical comparison in all age groups. Executive functions were assessed by analyzing facilitation and interference effects on the latency of the P3b event-related potential component and the lateralized readiness potential (LRP). Interference effects were more related to response than to stimulus processing in children as compared with adults. The LRP revealed that the difficulty to inhibit irrelevant response tendencies was a major factor behind interference in the numerical task in children. Conclusion The timing of the EEG distance effect suggests that a refined evaluation of numerical magnitude happened at a similar speed in each age group during both controlled and automatic magnitude processing. The larger response interference in children than in adults suggests that despite the similar behavioural profile of children and adults, partially different cognitive processes underlie their performance in the NSP. Further, behavioural effects in the NSP depend on interactions between comparison, facilitation/interference and response-related processes. Our data suggest that caution is needed when using the NSP to compare behavioural markers of the numerical processing skills of children and adults.

The objective of the study was to assess the prevalence of sub clinical vitamin A deficiency and anemia in Vietnamese children. For this, a cross-sectional survey was conducted in 40 villages (clus-ters) of four ecological regions in Vietnam during Apr-May 2001. In total 1657 children less than 5 years old were included by a cluster random sampling method. The prevalence of sub clinical vita-min A deficiency (serum retinol