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Introduction Community-academic partnerships (CAPs) aim to improve neighborhood population health. Though measuring the impact of partnership activities at a population level can be difficult, evaluating indicators of wellbeing may increase understanding of how communities benefit from CAPs. This study examined child health indicators over time in two low-income, predominantly Black/African American and Hispanic communities where partnerships between an academic child development center and community coalitions were formed with the intention of improving child well-being. Methods Trends in three child wellbeing indicators (graduation rates, kindergarten readiness, and proportion of youth in school and/or employed) were compared between two CAP communities and several neighboring comparison communities. Data between 2011 and 2017 were analyzed to calculate percent change from baseline and mapped using ArcGIS to visualize trends by zip code. Proportions of youth meeting benchmarks were also determined. Results Kindergarten readiness and high-school graduation rates improved in CAP communities but not in geographically proximal and socioeconomically similar comparison communities. No improvements were found in the proportion of youth in school or employed. Discussion This study revealed population-level indicators improved over time in CAP communities. Because community-level child health and wellbeing are influenced by many factors, this correlation is not proof of a causal relationship. Assessing population level indicators can nonetheless provide insight into the benefit of CAPs, and the commitment to monitoring such outcomes can itself advance how academic and community partners plan activities and set long-term goals., Author(s): Renae D. Schmidt [sup.1] , F. Daniel Armstrong [sup.2] , Viviana E. Horigian [sup.1] , Graylyn Swilley-Woods [sup.3] , Betty Alonso [sup.4] , Douglene Jackson [sup.2] , Ruby Natale [...]

Successful treatment of many childhood diseases once considered terminal has resulted in the emergence of long-term effects of the disease or consequences of treatment that were previously unrecognized. Many of these long-term effects involve the central nervous system (CNS) and are developmental in the way that they emerge over time. Because we are now able to observe the natural history of childhood diseases such as sickle cell anemia or HIV, or the consequences of treatment of disease such as leukemia, brain tumors, or kidney disease, we are also able to study a number of biological mechanisms that result in long-term neurocognitive impairment. While some of the neurodevelopmental outcomes can be directly linked to structural damage of the CNS, other systems (e.g., hematologic, immunologic, pulmonary) appear to play crucial indirect roles in the development of the CNS and neurocognitive abilities because of the way that they affect the course of brain development and activity of the brain across time. Important interactions between acute disease factors, biological mechanisms, age at the time of disease or treatment effect, and disruptions in patterns of development after successful treatment or management all provide support for a neurodevelopmental model of childhood chronic illness. Testing this model may make it possible to more accurately predict the timing and degree of severity of long-term neurodevelopmental consequences, provide guidance for improved treatment and prevention, and offer better understanding of neurodevelopmental disruptions that occur in other non-chronic illness related disabilities.

This article reviews the effects of human immunodeficiency virus (HIV) on the central nervous system and the educational implications of increasing numbers of students with perinatal HIV infection and pediatric acquired immunodeficiency syndrome (AIDS). Studies on the relationship between HIV and child development are urged. (Author/DB)

Several cross-sectional studies are conducted to analyze the neurophysical dysfunction and abnormalities exhibited by the adults with sickle cell anemia. Such adults are shown to exhibit extremely reduced cognitive performance.

Strokes in children with sickle cell disease (SCD) appear to put these children at a greater risk for future neurological abnormalities. Researchers compared brain scans, behavior surveys, and the results of neurological tests including tests of intelligence, reading and math ability, and motor skills among 194 children aged six to 12 years with sickle cell disease. Of the 17% who had abnormal brain scans 12.4% had evidence of a previously unidentified or silent stroke. Children carrying two copies of the sickle cell gene whom either had an identified or silent stroke scored lower on the intelligence, reading and math, and motor skills' tests than those without abnormal brain scans. Children who had an identified stroke scored more poorly than those with a silent stroke. Behavioral survey results were similar for all patients., Objective. Brain magnetic resonance imaging (MRI) and neuropsychological evaluations were conducted to determine whether neuroradiographic evidence of infarct in children with sickle cell disease between ages 6 and 12 years would result in impairment in cognitive and academic functioning. Method and Design. Children enrolled in the Cooperative Study of Sickle Cell Disease were evaluated with brain MRI and neuropsychological evaluation. Completed studies were obtained for 194 children, 135 with HbSS. MRIs were categorized according to the presence of T2-weighted, high-intensity images suggestive of infarct and were further categorized on the basis of a clinical history of cerebrovascular accident (CVA). An abnormal MRI but no clinical history of CVA was classified as a silent infarct. Neuropsychological evaluations included assessment of both global intellectual functioning and specific academic and neuropsychological functions. Results. Central nervous system (CNS) abnormalities were identified on MRI in 17.9% of the children (22.2% of children homozygous for HbS), and a clinical history of CVA (N = 9, 4.6%) was identified in only children with HbSS disease. Subsequent analyses examined only children with HbSS. Children with a history of CVA performed significantly poorer than children with silent infarcts or no MRI abnormality on most neuropsychological evaluation measures. Children with silent infarcts on MRI performed significantly poorer than children with no MRI abnormality on tests of arithmetic, vocabulary, and visual motor speed and coordination. Conclusions. These results substantiate the importance of careful evaluation, educational planning, and medical intervention for CNS-related complications in children with sickle cell disease. Pediatrics 1996;97:864-870; sickle cell disease, neuropsychological, magnetic resonance imaging, cognitive deficits, stroke, infarcts, cerebrovascular accident., ABSTRACT Dempster Ws, Sive AA, Rosseau S, et al. Misplaced iron in kwashiorkor. Eur J Clin Nutr. 1995;49:202-210. This article addresses the unsettled controversy about the use of iron in [...]

HIV may cause developmental delay in infected infants. HIV is known to cause neurologic complications. Researchers administered a test of infant development every three months up to 24 months of age to 126 infants born to HIV-positive mothers. At 24 months, children were tested for HIV status and 28 seropositive infants were identified. HIV-infected infants scored lower than noninfected infants on tests of both mental development and performance. HIV-infected infants acquired new skills but were significantly developmentally delayed compared with noninfected infants. Among noninfected infants, only 1% were severely developmentally delayed on the mental score and no infant rated as severely delayed on the performance score. By contrast, 21% of HIV-infected infants were rated as severely developmentally delayed on the mental score and 29% on the performance score. The gap between infected and noninfected infants is likely to grow as HIV continues to take its toll., Objective. This study documents delays in the mental and motor functioning of infants perinatally infected with human immunodeficiency virus (HIV) while controlling for confounding effects of prenatal drug exposure, ethnicity, socioeconomic status, and maternal separation and death. Methods. The cognitive and motor development of 126 infants born to nondrug-using, HIV-seropositive Haitian women was assessed at 3-month intervals through 24 months of age using the Bayley Scales of Infant Development. By 18 months of age, 28 of the infants were diagnosed as HIV-infected, and the 98 uninfected infants served as a control group. The infected and uninfected infants did not differ with respect to mean gestational age, birth weight, ethnicity, or rates of maternal separation and death. Results. By 3 months of age, the mean mental and motor scores of the infected infants were significantly lower than those of the uninfected controls. Furthermore, the initial differences between the two groups increased over time, as many of the infected infants became increasingly delayed. Although the infected infants tended to perform more poorly than the uninfected infants, nearly one third of the infected infants exhibited relatively normal cognitive development and half demonstrated relatively normal motor development. Conclusions. Over the first 24 months of life, the mean rate of development of HIV-infected infants is significantly slower than that of noninfected infants born to seropositive mothers. This occurs even when the effects are not confounded with those of prenatal drug exposure. Pediatrics 1995;96:1078-1082; HIV, pediatric, developmental delay., ABBREVIATIONS. HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome; SES, socioeconomic status; HIV-1, human immunodeficiency virus type 1; BSID, Bayley Scales of Infant Development; NS, not significant. Although human immunodeficiency [...]

Concerns about inadequate treatment of pain in children have prompted policy statements and clinical reports by the American Academy of Pediatrics. (1,2) It has also been suggested that failure to [...]