Digital Commons Network^™

Cervicofacial Actinomycosis In The Pediatric Population: Presentation And Management, Karan Gandhi, Benjamin D. Van Der Woerd, M. Elise Graham, Michelle Barton, Julie E. Strychowsky

Paediatrics Publications

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and …

Cervicofacial Actinomycosis In The Pediatric Population: Presentation And Management, Karan Gandhi, Benjamin D. Van Der Woerd, M. Elise Graham, Michelle Barton, Julie E. Strychowsky

Paediatrics Publications

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and …

Assessing Needs And Outcomes Of Children And Youth Receiving Intensive Services, Laura Theall, Kim Arbeau, Keith Willoughby, Jeff St. Pierre, Gwynne Ng, Shannon L. Stewart

Paediatrics Publications

This study investigated whether children/youth in Ontario triaged to residential services showed a higher intensity of need than those referred to outpatient services, and whether residential treatment gains were sufficient for transition to community services. Participants included 2053 children/youth assessed at 23 diverse mental health agencies across Ontario using the interRAI™ Child and Youth Mental Health (ChYMH) instrument. Various presenting problems were examined utilizing scales including: Disruptive/Aggressive Behavior, Hyperactive/Distraction, Social Disengagement, Anxiety, and Sleep Difficulties. Analyses were conducted separately for boys and girls. Notable differences were found in the initial assessment, with residential boys scoring higher on all scales than …

Paediatric Serum Sickness-Like Reaction: A 10-Year Retrospective Cohort Study, Blanca R. Del Pozzo-Magaña, Awatif Abuzgaia, Barbara Murray, Michael J. Rieder, Alejandro Lazo-Langner

Paediatrics Publications

Background: Serum sickness-like reaction (SSLR) is an acute inflammatory condition affecting predominantly children. The pathophysiology remains unclear, but drugs are considered the main trigger. Objective: The aim of this study was to describe the clinical and laboratory features, triggers, and treatment modalities in children diagnosed with SSLR. Methods: We conducted a 10-year retrospective cohort study including all paediatric patients (0 to 18 years old) with query SSLR referred to the Adverse Drug Reactions Clinic at the Children's Hospital of Western Ontario. Diagnostic criteria included acute skin rash plus joint inflammation with or without fever. Results: We included 83 patients (47 …

Adverse Events Associated With Nifurtimox Treatment For Chagas Disease In Children And Adults, A. J. Berenstein, N. Falk, G. Moscatelli, S. Moroni, N. González, F. Garcia-Bournissen, G. Ballering, H. Freilij, J. Altcheh

Paediatrics Publications

Nifurtimox (NF) is one of the only two drugs currently available for Chagas disease (ChD) treatment. However, data on NF safety are scarce, and many physicians defer or refuse NF treatment because of concerns about drug tolerance. In a retrospective study of adverse drug reactions (ADRs) associated with NF treatment of ChD, children received NF doses of 10 to 15 mg/kg/day for 60 to 90 days, and adults received 8 to 10 mg/kg/day for 30 days. A total of 215 children (median age, 2.6 years; range, 0 to 17 years) and 105 adults (median age, 34 years; range, 18 to …

Children’S Perspectives On Outpatient Physician Visits: Capturing A Missing Voice In Patient-Centered Care, Jessica S. Dalley, Barbara A. Morrongiello, C. Meghan Mcmurtry

Paediatrics Publications

Actively involving children in their healthcare is a core value of patient-centered care. This is the first study to directly obtain children’s detailed perspectives on positive and negative aspects of outpatient physician visits in a primary care setting (e.g., checkups) and their preferred level of participation. Individual interviews were conducted with 167 children (female n = 82, male n = 85; ages 7–10, Mage = 8.07 years, SD = 0.82). Open-ended questions were used so that children’s responses were not confined to researchers’ assumptions, followed by close-ended questions to meet specific objectives. Quantitative content analysis, correlations, logistic regression, and Cochran’s …

Measuring Temporal Differences In Rural Canadian Children’S Moderate-To-Vigorous Physical Activity, Brenton L.G. Button, Andrew F. Clark, Gina Martin, Megan Graat, Jason A. Gilliland

Paediatrics Publications

The purpose of this study was to measure the factors that influence children’s moderate-to-vigorous physical activity (MVPA) during school curriculum time, recess time, and outside school time in a rural area. During the Fall and Winter of 2016, 34 boys and 55 girls aged 8–14 years from rural communities in rural Northwestern Ontario participated in the Spatial Temporal Environment and Activity Monitoring project. The children’s MVPA was measured using an accelerometer, and child-level demographic, behavioral, and environmental data were gathered from surveys, passively logging global positioning units, and municipal datasets. Data on daily temperature and precipitation were gathered from the …

Social Assistance And Trajectories Of Child Mental Health Problems In Canada: Evidence From The National Longitudinal Survey Of Children And Youth, Jinette Comeau, Laura Duncan, Katholiki Georgiades, Li Wang, Michael H. Boyle

Paediatrics Publications

Objectives: To examine the link between stability and change in social assistance (SA) use and children’s mental health trajectories to better understand whether social policies targeted at low-income families might be an effective population-based mechanism for preventing mental health problems among children at risk. Methods: The National Longitudinal Survey of Children and Youth (N = 8981) is used to classify children into 5 categories based on their family’s pattern of SA use from age 4–5 to 10–11: always or never on SA, a single transition on or off SA, or fluctuations on and off SA. Latent growth modelling is used …

Exploring Children's Perceptions Of Barriers And Facilitators To Physical Activity In Rural Northwestern Ontario, Canada, Brenton L.G. Button, Suzanne Tillmann, Jason Gilliland

Paediatrics Publications

Introduction: Low levels of physical activity among children are a significant public health concern in several industrialized nations. The current research body has failed to gather adequate information on various geographic regions. Understanding barriers and facilitators in different rural regions is imperative for creating successful physical activity interventions for children in rural areas. The purpose of this study is to explore rural children's perspectives on physical activity and to discuss barriers or facilitators to physical activity participation in rural Northwestern Ontario, Canada. Methods: Children (n=84) in Grades 4-8 (ages 8-14 years) in rural Northwestern Ontario participated in focus groups to …

Six-Month Prevalence Of Mental Disorders And Service Contacts Among Children And Youth In Ontario: Evidence From The 2014 Ontario Child Health Study, Katholiki Georgiades, Laura Duncan, Laura Duncan, Li Wang, Jinette Comeau, Jinette Comeau, Michael H. Boyle, Michael H. Boyle, Tracie O. Afifi, William R. Avison, Graham Reid, Kathryn Bennett, Terry Bennett, Khrista Boylan, Michelle Butt, Charles Cunningham, Eric Duku, Jim Dunn, Stelios Georgiades, Andrea Gonzalez, Geoffrey Hall, Magdalena Janus, Melissa Kimber, Ellen Lipman, Harriet Macmillan, Peter Rosenbaum, Roberto Sassi, Louis Schmidt, Noam Soreni

Paediatrics Publications

Objectives: To present the 6-month prevalence and sociodemographic correlates of mental disorders and mental health–related service contacts in a sample of children (4 to 11 years) and youth (12 to 17 years) in Ontario. Methods: The 2014 Ontario Child Health Study is a provincially representative survey of 6537 families with children aged 4 to 17 years in Ontario. DSM-IV-TR mental disorders were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and included mood (major depressive episode), anxiety (generalized anxiety, separation anxiety, social phobia, specific phobia), and behaviour disorders (attention-deficit/hyperactivity disorder, oppositional-defiant disorder, conduct disorder).The MINI-KID was …

Treatment-Related Mortality In Newly Diagnosed Pediatric Cancer: A Population-Based Analysis., Paul Gibson, Jason D Pole, Tanya Lazor, Donna Johnston, Carol Portwine, Mariana Silva, Sarah Alexander, Lillian Sung

Paediatrics Publications

Using a previously developed reliable and valid treatment-related mortality (TRM) definition, our objective was to describe the proportion of children newly diagnosed with cancer experiencing TRM and to identify risk factors for TRM in a population-based cohort. We included children with cancerincluded, 179 had TRM, 478 died of progressive disease, and 4522 were still alive. At 5 years, the cumulative incidence of TRM among the entire cohort was 3.9% (95% confidence interval (CI) 3.3-4.5%). When compared to brain tumor patients, leukemia and lymphoma patients had a significantly higher risk of TRM (hazard ratio (HR) 2.5, 95% CI: 1.6-4.0; P < 0.0001). Infants were at significantly higher risk of TRM across diagnostic groups. Other factors associated with higher risks of TRM were metastatic disease (P < 0.0001), diagnosis prior to 1 January 2008 (P = 0.001), hematopoietic stem cell transplantation (HSCT) (P < 0.0001), and relapse (P < 0.0001). The 5-year cumulative incidence of TRM was 3.9% among newly diagnosed children with cancer. Infants were at higher risk of TRM across diagnostic groups. Other risk factors for TRM were leukemia or lymphoma, metastatic disease, earlier diagnosis year, HSCT, and relapse. Future work should further refine prognostic factors by specific cancer diagnosis to best understand when and how to intervene to improve outcomes.

Treatment-Related Mortality In Newly Diagnosed Pediatric Cancer: A Population-Based Analysis, Paul Gibson, Jason D Pole, Tanya Lazor, Donna Johnston, Carol Portwine, Mariana Silva, Sarah Alexander, Lillian Sung

Paediatrics Publications

Using a previously developed reliable and valid treatment-related mortality (TRM) definition, our objective was to describe the proportion of children newly diagnosed with cancer experiencing TRM and to identify risk factors for TRM in a population-based cohort. We included children with cancerincluded, 179 had TRM, 478 died of progressive disease, and 4522 were still alive. At 5 years, the cumulative incidence of TRM among the entire cohort was 3.9% (95% confidence interval (CI) 3.3-4.5%). When compared to brain tumor patients, leukemia and lymphoma patients had a significantly higher risk of TRM (hazard ratio (HR) 2.5, 95% CI: 1.6-4.0; P < 0.0001). Infants were at significantly higher risk of TRM across diagnostic groups. Other factors associated with higher risks of TRM were metastatic disease (P < 0.0001), diagnosis prior to 1 January 2008 (P = 0.001), hematopoietic stem cell transplantation (HSCT) (P < 0.0001), and relapse (P < 0.0001). The 5-year cumulative incidence of TRM was 3.9% among newly diagnosed children with cancer. Infants were at higher risk of TRM across diagnostic groups. Other risk factors for TRM were leukemia or lymphoma, metastatic disease, earlier diagnosis year, HSCT, and relapse. Future work should further refine prognostic factors by specific cancer diagnosis to best understand when and how to intervene to improve outcomes.

The Role Of Adverse Childhood Experiences As Determinants Of Non-Suicidal Self-Injury Among Children And Adolescents Referred To Community And Inpatient Mental Health Settings, Philip Baiden, Shannon L. Stewart, Barbara Fallon

Paediatrics Publications

The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8–18 years (M = 12.49; SD = 2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, …

Caring For Children With Intellectual Disabilities Part 1: Experience With The Population, Pain-Related Beliefs, And Care Decisions, Lara M. Genik, C. Meghan Mcmurtry, Lynn M. Breau

Paediatrics Publications

Some children with intellectual disabilities (ID): experience pain more frequently than children without ID, express their pain differently, and are incapable of providing self-reports. No research has examined disability and pain-related beliefs of respite workers (RW) and their relations to pain assessment and management decisions for children with ID. Objectives (1) compare disability and pain-related beliefs between RW and a sample with little experience in ID; (2) determine whether individuals’ beliefs and personal characteristics are related to pain assessment and management decisions. Participants Fifty-six RW (aged: 18–67 years, Mage = 33.37, 46 female) and 141 emerging adults (aged: 18–31 years, …

Remote Lifestyle Counseling Influences Cardiovascular Health Outcomes In Youth With Overweight Or Obesity And Congenital Heart Disease, Luis Altamirano-Diaz, Meghan Rombeek, Stefanie De Jesus, Eva Welisch, Harry Prapavessis, Adam A Dempsey, Douglas Fraser, Michael R Miller, Kambiz Norozi

Paediatrics Publications

Background: Children with overweight/obesity and congenital heart disease (CHD) are at increased cardiovascular risk. A lifestyle intervention may help reduce these risks. We sought to determine the feasibility of a smartphone-based lifestyle intervention to improve cardiovascular health outcomes in children with overweight/obesity and CHD.

Methods: We examined the effect of bi-weekly nutrition and fitness counseling delivered

Results: Statistically significant decreases in waist circumference (WC), body mass index

Conclusion: The observed changes in anthropometry were positive with significant improvement to some cardiovascular and metabolic risk indicators. However, this was only observed in the operated group suggesting that other factors, such as …

Impact Of Registration On Clinical Trials On Infection Risk In Pediatric Acute Myeloid Leukemia, David Dix, Richard Aplenc, Lynette Bowes, Sonia Cellot, Marie Chantal Ethier, Jim Feusner, Biljana Gillmeister, Donna L. Johnston, Victor Lewis, Bruno Michon, David Mitchell, Carol Portwine, Victoria Price, Mariana Silva, Kent Stobart, Rochelle Yanofsky, Shayna Zelcer, Joseph Beyene, Lillian Sung

Paediatrics Publications

Little is known about the impact of enrollment on therapeutic clinical trials on adverse event rates. Primary objective was to describe the impact of clinical trial registration on sterile site microbiologically documented infection for children with newly diagnosed acute myeloid leukemia (AML). We conducted a multicenter cohort study that included children aged ≤18 years with de novo AML. Primary outcome was microbiologically documented sterile site infection. Infection rates were compared between those registered and not registered on clinical trials. Five hundred seventy-four children with AML were included of which 198 (34.5%) were registered on a therapeutic clinical trial. Overall, 400 …

Quality Of Life In Children With Adverse Drug Reactions: A Narrative And Systematic Review, Blanca R. Del Pozzo-Magaña, Michael J. Rieder, Alejandro Lazo-Langner

Paediatrics Publications

Aims Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. Methods We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the …

Incident Vertebral Fractures And Risk Factors In The First Three Years Following Glucocorticoid Initiation Among Pediatric Patients With Rheumatic Disorders, Claire M.A. Leblanc, Jinhui Ma, Monica Taljaard, Johannes Roth, Rosie Scuccimarri, Paivi Miettunen, Bianca Lang, Adam M. Huber, Kristin Houghton, Jacob L. Jaremko, Josephine Ho, Nazih Shenouda, Mary Ann Matzinger, Brian Lentle, Robert Stein, Anne Marie Sbrocchi, Kiem Oen, Celia Rodd, Roman Jurencak, Elizabeth A. Cummings, Robert Couch, David A. Cabral, Stephanie Atkinson, Nathalie Alos, Frank Rauch, Kerry Siminoski

Paediatrics Publications

Vertebral fractures are an important yet underrecognized manifestation of osteoporosis in children with chronic, glucocorticoid-treated illnesses. Our goal was to determine the incidence and clinical predictors of vertebral fractures in the 3 years following glucocorticoid initiation among pediatric patients with rheumatic disorders. Incident vertebral fractures were evaluated according to the Genant semiquantitative method on lateral radiographs at baseline and then annually in the 3 years following glucocorticoid initiation. Extended Cox models were used to assess the association between vertebral fractures and clinical risk predictors. A total of 134 children with rheumatic disorders were enrolled in the study (mean ± standard …

Observer Perceptions Of Pain In Children With Cognitive Impairments: Vignette Development And Validation, Lara M. Genik, C. Meghan Mcmurtry, Lynn M. Breau

Paediatrics Publications

AIM: Develop vignettes depicting different pain types in verbal and nonverbal children with cognitive impairments that could help examine pain assessment and management decisions of secondary caregivers, and conduct initial convergent and divergent validity analyses.

Predictors Of Obesity Among Métis Children: Socio-Economic, Behavioural And Cultural Factors, Martin J. Cooke, Piotr Wilk, Kenneth W. Paul, Shelley L.H. Gonneville

Paediatrics Publications

Objectives: To examine the socio-economic, behavioural and Métis-specific factors that predict obesity among Métis children aged 6 to 14 years. Socio-economic factors included household structure and income, parental education and food insecurity. Cultural factors included knowledge of an Aboriginal language, participation in cultural activities, time spent with Elders and parental residential school attendance. Methods: The 2006 Aboriginal Peoples Survey, Children and Youth component collected data about Métis children, including child height and weight, reported by the person most knowledgeable about the child (PMK). Multivariate binary logistic regression was used to predict obesity, defined using IOTF BMI cut-offs. After testing for …

The Impact Of Action Schools! Bc On The Health Of Aboriginal Children And Youth Living In Rural And Remote Communities In British Columbia, Dona Tomlin, P. J. Naylor, Heather Mckay, Alexandra Zorzi, Marc Mitchell, Constadina Panagiotopoulos

Paediatrics Publications

Objectives: The aim of the study was to determine the short-term impact of a 7-month whole-school physical activity and healthy eating intervention (Action Schools! BC) over the 2007-2008 school year for children and youth in 3 remote First Nations villages in northwestern British Columbia. Study design: A pre-experimental pre/post design was conducted with 148 children and youth (77 males, 71 females; age 12.5±2.2 yrs). Methods: We evaluated changes in obesity (body mass index [wt/ht 2] and waist circumference z-scores: zBMI and zWC), aerobic fitness (20-m shuttle run), physical activity (PA; physical activity questionnaire and accelerometry), healthy eating (dietary recall) and …

A Preliminary Examination Of The Psychometric Properties Of The Coparenting Questionnaire And The Diabetes-Specific Coparenting Questionnaire In Families Of Children With Type I Diabetes, Mor Barzel, Graham J. Reid

Paediatrics Publications

Objectives: To examine the structure and psychometric properties of a general childrearing [Coparenting Questionnaire (CQ)] and an adapted Diabetes-Specific Coparenting Questionnaire (DCQ) and compare general and diabetes-specific coparenting among two-parent families caring for a child with type I diabetes. Methods: Mothers and fathers of children (N=61) aged 8-12 years with type I diabetes completed self-report measures of marital functioning, parenting, and coparenting, including the CQ and DCQ. Results: Confirmatory factor analyses favored the hypothesized 3-factor model for mothers and fathers for the CQ and DCQ. The internal consistencies and convergent validities of the CQ and DCQ were adequate. Coparenting conflict …

Coparenting In Relation To Children's Psychosocial And Diabetes-Specific Adjustment, Mor Barzel, Graham J. Reid

Paediatrics Publications

Objective: To explore the potential utility of a general and diabetes-specific measure of coparenting by evaluating linkages between coparenting and both the psychosocial and medical adjustment of children with type 1 diabetes (TID). Method: Mothers and fathers of children (ages 8-12 years; n=61) with TID completed questionnaires including measures of general and diabetes-specific coparenting, and children's internalizing and externalizing problems. Medical adjustment included parent-reported diabetes management behaviors, children's self-reported diabetes quality of life (QOL), and metabolic control (HbA1c) assessed during clinic appointments. Results: Coparenting conflict around general child rearing tasks was significantly related to children's internalizing and externalizing problems. Diabetes-specific …