Digital Commons Network^™

Smartphones For Smart Eating: Evaluating The Effectiveness Of Smartphone Applications On Improving Adolescent Food Knowledge, Heather A. Jantzi

Electronic Thesis and Dissertation Repository

Many Canadian adolescents have unhealthy eating habits which are risk factors for developing chronic diseases later in life. Food literacy plays a role in healthy eating habits but teens in Ontario currently lack sufficient nutrition education learning opportunities in home and school environments. Across health research, smartphones have been utilized as a novel medium to promote learning and alter behaviour. This thesis seeks to understand the effectiveness of smartphone applications at improving food knowledge in adolescents through (i) a systematic review of published interventions, and (ii) by investigating the efficacy of a novel location-based smartphone application. Findings from this thesis …

Female Athlete Health Domains: A Supplement To The International Olympic Committee Consensus Statement On Methods For Recording And Reporting Epidemiological Data On Injury And Illness In Sport., Isabel S Moore, Kay M Crossley, Kari Bo, Margo Mountjoy, Kathryn E Ackerman, Juliana Da Silva Antero, Jorunn Sundgot Borgen, Wendy J Brown, Caroline S Bolling, Benjamin Clarsen, Wayne Derman, Paul Dijkstra, Amber Donaldson, Kirsty J Elliott-Sale, Carolyn A Emery, Lene Haakstad, Astrid Junge, Nonhlanhla S Mkumbuzi, Sophia Nimphius, Debbie Palmer, Mireille Van Poppel, Jane S Thornton, Rita Tomás, Phathokuhle C Zondi, Evert Verhagen

Family Medicine Publications

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) …

Characterizing And Predicting Canadian Adolescents’ Internalizing Symptoms In The First Year Of The Covid-19 Pandemic, Haley E. Green, Andrew R. Daoust, Matthew R. J. Vandermeer, Pan Liu, Kasey Stanton, Kate L. Harkness, Elizabeth P. Hayden

Psychology Publications

To date, most longitudinal studies of adolescents’ internalizing symptoms during the COVID-19 pandemic include few time points, limiting knowledge about the long-term course of adolescents’ mental health during the pandemic. Moreover, examining intraindividual variability in symptoms, which may have important implications for adolescents’ adjustment beyond mean or “typical” symptoms, requires multiple time points. We examined the course of internalizing symptoms in 271 Ontario adolescents (mean n = 193 across time points) during the first year of the pandemic (March 2020–April 2021) via mixed-effect location scale models, drawing upon established internalizing symptom risk factors as predictors of mean trends and intraindividual …

The Prevalence And Impact Of Adolescent Hospitalization To Adult Psychiatric Units., Samantha Mcrae, Jordan Edwards, Kathy N Speechley, Javeed Sukhera, Guangyong Zou, Kelly K. Anderson

Epidemiology and Biostatistics Publications

BACKGROUND: With increasing psychiatric hospitalizations among adolescents and constrained hospital resources, there are times when youth are hospitalized in adult inpatient psychiatry units. Evidence on the prevalence of this practice and associated impacts is lacking.

AIMS: We sought to explore the prevalence, determinants, and outcomes related to the hospitalization of adolescents aged 12-17 years on adult inpatient psychiatry units in Ontario.

METHODS: Using health administrative data, we constructed a cohort of adolescents with an inpatient psychiatric admission in Ontario (2007-2011). We classified adolescents as having an admission to an adult psychiatry unit or to other inpatient units. Multivariable regression models …

Characterizing And Predicting Canadian Adolescents’ Internalizing Symptoms In The First Year Of The Covid-19 Pandemic, Haley Elizabeth Green

Electronic Thesis and Dissertation Repository

Most studies of adolescents’ internalizing symptoms during the COVID-19 pandemic have included few data waves, limiting long-term conclusions about adolescents’ mental health during the pandemic. Collecting only a few waves of data precludes examination of intraindividual symptom variability, which may have implications for adjustment beyond mean symptoms. We characterized mean n = 192 adolescents’ internalizing symptoms from March 2020-April 2021 and used mixed effect location scale models to examine established risk factors as predictors of mean trends and intraindividual variability in adolescents’ internalizing symptoms. Adolescents’ symptoms were relatively stable and low over the first year of the pandemic; severity peaked …

Capital Distress: Productive Citizenship And Mental Health In Adolescent Literature, Jeremy Tl Johnston

Electronic Thesis and Dissertation Repository

This dissertation explores the complexities of adolescent mental health under neoliberal capitalism in twentieth- and twenty-first-century U.S. fiction about and for adolescents. Drawn on research that defines youth citizenship as responsibilities-based in nature, this project outlines the ways contemporary young adult (YA) novels of mental distress reveal an inextricable link between adolescent mental health and the conditions of what I term productive citizenship. Constituting my theorization of productive citizenship are three distinct tenets adolescents must adhere to: (1) displaying the motivation to achieve specific goals; (2) showing a propensity for self-reliance and individuality; and (3) accepting the translation of …

“I Am The Expert” : The Process Of Adolescent Transition In The Self-Management Of Hearing Healthcare. A Constructivist Grounded Theory Study, Christine N. Meston

Electronic Thesis and Dissertation Repository

Adolescence is a time when adult behaviours become established and adolescents are more able to manage aspects of their healthcare. Research has examined adolescent transitions to self-manage their personal healthcare needs associated with chronic diseases. Providing children and adolescents with information about their health is an ongoing process and, as they mature, they should be allowed to take on more responsibility for their healthcare management. The purpose of this study was to explore the transition for adolescents who are deaf and hard of hearing toward the self-management of their hearing healthcare. A constructivist grounded theory approach was used to develop …

Automated Office Blood Pressure Measurement For The Diagnosis Of Hypertension, Guido Filler, Maria E Díaz-González De Ferris

Paediatrics Publications

Editorial

Student Feedback To Tailor The Card™ System For Improving The Immunization Experience At School, Charlotte Logeman, Anna Taddio, C. Meghan Mcmurtry, Lucie Bucci, Noni Macdonald, Garth Chalmers, Victoria Gudzak, Vibhuti Shah

Paediatrics Publications

Increasing the comfort of vaccine delivery at school is needed to improve the immunization experience for students. We created the CARD™ (C—Comfort, A—Ask, R—Relax and D—Distract) system to address this clinical care gap. Originally designed for grade 7 students, this study examined the perceptions of grade 9 students of CARD™. Grade 9 students who had experience with school-based immunizations, either as recipients or onlookers (n = 7; 100% females 14 years old) participated. Students answered pre–post surveys, reviewed CARD™ educational materials and participated in a semi-structured focus group discussion. The Consolidated Framework for Implementation Research (CFIR) was used as the …

Signs With A Side Of Fries: The Influence Of Outdoor Advertising On Retail Food Outlet Purchases By Adolescents, Alexander Wray

Electronic Thesis and Dissertation Repository

Most Canadian adolescents have diets high in fat, sodium, and free sugar. There are concerns among researchers and policymakers that food and beverage marketing has an adverse impact on adolescent dietary attitudes, knowledge, and behaviours. The food environment plays an important role in shaping diets and health. The food information environment, and more specifically outdoor food and beverage advertising, may have an effect on adolescent food and beverage purchases. This thesis investigates the associations between the availability of, accessibility to, or exposure to outdoor advertising and retail food outlets, coupled with attitudes related to food and beverage consumption, and purchases …

Age At Migration And The Risk Of Psychotic Disorders: A Systematic Review And Meta-Analysis., Kelly K. Anderson, Jordan Edwards

Epidemiology and Biostatistics Publications

OBJECTIVE: To conduct a systematic review and meta-analysis of the existing evidence on the association between age at migration and the risk of psychotic disorders.

METHODS: Observational studies were eligible for inclusion if they presented data on the association between age at migration and the risk of psychotic disorders among first-generation migrant groups. We used two random effects meta-analyses to pool effect estimates for each stratum of age at migration relative to (i) a native-born reference category and (ii) the youngest age stratum (0 to 2 years).

RESULTS: Ten studies met inclusion criteria, and five were included in the meta-analysis. …

Physical Activity And Social Connectedness Interventions In Outdoor Spaces Among Children And Youth: A Rapid Review, Alexander Wray, Gina Martin, Emma Ostermeier, Alina Medeiros, Malcolm Little, Kristen Reilly, Jason Gilliland

Paediatrics Publications

Introduction: The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth. Methods: We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia …

Pain Squad+ Smartphone App To Support Real-Time Pain Treatment For Adolescents With Cancer: Protocol For A Randomised Controlled Trial., Lindsay Jibb, Paul C Nathan, Vicky Breakey, Conrad Fernandez, Donna Johnston, Victor Lewis, Sarah Mckillop, Serina Patel, Christine Sabapathy, Caron Strahlendorf, J Charles Victor, Myla E Moretti, Cynthia Nguyen, Amos Hundert, Celia Cassiani, Graziella El-Khechen Richandi, Hayley Insull, Rachel Hamilton, Geoffrey Fang, Susan Kuczynski, Jennifer Stinson

Paediatrics Publications

INTRODUCTION: Pain negatively affects the health-related quality of life (HRQL) of adolescents with cancer. The Pain Squad+ smartphone-based application (app), has been developed to provide adolescents with real-time pain self-management support. The app uses a validated pain assessment and personalised pain treatment advice with centralised decision support via a registered nurse to enable real-time pain treatment in all settings. The algorithm informing pain treatment advice is evidence-based and expert-vetted. This trial will longitudinally evaluate the impact of Pain Squad+, with or without the addition of nurse support, on adolescent health and cost outcomes.

METHODS AND ANALYSIS: This will be a …

Predictors Of Bicuspid Aortic Valve-Associated Aortopathy In Childhood: A Report From The Mibava Consortium, Michael Grattan, Andrea Prince, Rawan K Rumman, Conall Morgan, Michele Petrovic, Amanda Hauck, Luciana Young, Anders Franco-Cereceda, Bart Loeys, Salah A Mohamed, Harry Dietz, Seema Mital, Chun-Po Steve Fan, Cedric Manlhiot, Gregor Andelfinger, Luc Mertens

Paediatrics Publications

BACKGROUND: Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect affecting 1% to 2% of the population. It is associated with ascending aorta dilatation. Valve morphology, aortic stenosis (AS), and aortic insufficiency (AI) have been proposed as potential risk factors; however, evaluating their role is difficult, as these factors are inherently related. The aim of this study was to determine whether BAV morphology and dysfunction are independent determinants for ascending aorta dilatation in pediatric patients.

METHODS: A multicenter, retrospective, cross-sectional study of pediatric BAV patients followed since 2004 was performed. Imaging data were assessed for BAV morphology, severity …

Osteochondritis Dissecans In Pediatric Patients With Juvenile Idiopathic Arthritis., Bradley C Jackson, Debra L Bartley, Roberta A Berard

Paediatrics Publications

No abstract provided.

Healthcare Utilization Costs Of Emerging Adults With Mood And Anxiety Disorders In An Early Intervention Treatment Program Compared To A Matched Cohort, Ava A. John-Baptiste, Lihua Li, Wanrudee Isaranuwatchai, Elizabeth Osuch, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: The First Episode Mood and Anxiety Disorder Program (FEMAP) provides treatment to emerging adults with mood and anxiety disorders in an accessible, youth-friendly environment. We sought to investigate FEMAP's impact on the costs of care.

METHODS: We conducted a retrospective observational study of one-year health service costs using linked administrative datasets to compare emerging adults treated at FEMAP (FEMAP users) to propensity-score matched controls (non-users). Costs from the perspective of the Ontario Ministry of Health and Long-Term Care, included drug benefit claims, inpatient, physician and ambulatory care services. We used bootstrapping to perform unadjusted comparisons between FEMAP users and …

Preventing Adolescent Dating Violence: An Outcomes Protocol For Evaluating A Gender-Transformative Healthy Relationships Promotion Program, Deinera Exner-Cortens, Alysia Wright, Debb Hurlock, Roseline Carter, Pam Krause, Claire Crooks

Journal Articles

Adolescent dating violence (ADV) is a pressing public health problem in North America. Strategies to prevent perpetration are needed, and a substantial body of research demonstrates the importance of applying a gender lens to target root causes of adolescent dating violence as part of effective prevention. To date, however, there has been limited research on how to specifically engage boys in adolescent dating violence prevention. In this short communication, we describe the protocol for a longitudinal, quasi-experimental outcome evaluation of a program called WiseGuyz. WiseGuyz is a community-facilitated, gender-transformative healthy relationships program for mid-adolescent male-identified youth that aims to reduce …

Development Of A Teen-Informed Coding Tool To Measure The Power Of Food Advertisements, Drew D. Bowman, Leia M. Minaker, Bonnie J.K. Simpson, Jason A. Gilliland

Paediatrics Publications

The food-related information environment, comprised of food and beverage advertising within one’s surroundings, is a growing concern for adolescent health given that food marketing disproportionately targets adolescents. Despite strong public interest concerning the effects of food marketing on child health, there is limited evidence focused on outdoor food advertising in relation to teenage diets, food purchasing, and perceptions. Further, limited research has considered both the exposure to and influence of such advertisements. This study used a novel multi-method approach to identify and quantify the features of outdoor food and beverage advertisements that are most effective at drawing teenagers into retail …

Impact Of Diagnostic Terminology On Parental Attitudes Toward Concussion And Brain Injury, Naomi Sanderson

Electronic Thesis and Dissertation Repository

Although some have argued that the terms concussion and mild traumatic brain injury (mTBI) should not be used interchangeably, any differences between the diagnoses are subtle. In this study, we recruited 98 individuals through Amazon Mechanical Turk who self-identified as having children between the ages of 13 and 18 (inclusive). Participants were asked questions about a hypothetical injury to their child, related to symptoms, participation in school and physical activity, and recovery prognosis. Roughly half (n = 51) were asked these questions in reference to a “concussion”, and the remainder (n = 47) were asked questions in reference to an …

The Role Of Outcome Expectancy In Therapeutic Change Across Psychotherapy Versus Pharmacotherapy For Depression., Thulasi Thiruchselvam, David J A Dozois, R Michael Bagby, Daniela S S Lobo, Lakshmi N Ravindran, Lena C Quilty

Psychology Publications

BACKGROUND: Patient outcome expectancy - the belief that treatment will lead to an improvement in symptoms - is linked to favourable therapeutic outcomes in major depressive disorder (MDD). The present study extends this literature by investigating the temporal dynamics of expectancy, and by exploring whether expectancy during treatment is linked to differential outcomes across treatment modalities, for both optimistic versus pessimistic expectancy.

METHODS: A total of 104 patients with MDD were randomized to receive either cognitive behavioral therapy (CBT) or pharmacotherapy for 16 weeks. Outcome expectancy was measured throughout treatment using the Depression Change Expectancy Scale (DCES). Depression severity was …

Patterns Of Joint Involvement In Juvenile Idiopathic Arthritis And Prediction Of Disease Course: A Prospective Study With Multilayer Non-Negative Matrix Factorization., Simon W M Eng, Florence A Aeschlimann, Mira Van Veenendaal, Roberta A Berard, Alan M Rosenberg, Quaid Morris, Rae S M Yeung

Paediatrics Publications

BACKGROUND:
Joint inflammation is the common feature underlying juvenile idiopathic arthritis (JIA). Clinicians recognize patterns of joint involvement currently not part of the International League of Associations for Rheumatology (ILAR) classification. Using unsupervised machine learning, we sought to uncover data-driven joint patterns that predict clinical phenotype and disease trajectories.

METHODS AND FINDINGS:
We analyzed prospectively collected clinical data, including joint involvement using a standard 71-joint homunculus, for 640 discovery patients with newly diagnosed JIA enrolled in a Canada-wide study who were followed serially for five years, treatment-naïve except for nonsteroidal anti-inflammatory drugs (NSAIDs) and diagnosed within one year of symptom …

Multicentre, Randomised Clinical Trial Of Paediatric Concussion Assessment Of Rest And Exertion (Pedcare): A Study To Determine When To Resume Physical Activities Following Concussion In Children., Andrée-Anne Ledoux, Nicholas J Barrowman, Kathy Boutis, Adrienne Davis, Sarah Reid, Gurinder Sangha, Ken J Farion, Kevin Belanger, Mark S Tremblay, Keith Owen Yeates, Carol Dematteo, Nick Reed, Roger Zemek

Paediatrics Publications

INTRODUCTION:
Rest until symptom-free, followed by a progressive stepwise return to activities, is often prescribed in the management of paediatric concussions. Recent evidence suggests prolonged rest may hinder recovery, and early resumption of physical activity may be associated with more rapid recovery postconcussion. The primary objective is to determine whether the early reintroduction of non-contact physical activity beginning 72 hours postinjury reduces postconcussive symptoms at 2 weeks in children following an acute concussion as compared with a rest until asymptomatic protocol.

METHODS AND ANALYSIS:
This study is a randomised clinical trial across three Canadian academic paediatric emergency departments. A total …

"C.H.A.M.P. Families": Description And Theoretical Foundations Of A Paediatric Overweight And Obesity Intervention Targeting Parents-A Single-Centre Non-Randomised Feasibility Study., Kristen Reilly, Trish Tucker, Jennifer D. Irwin Phd, Andrew Johnson, Erin S Pearson, Dirk E Bock, Shauna M. Burke

Paediatrics Publications

Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families was a single-centre, prospective intervention offered to parents of children aged between 6⁻14 years with a body mass index (BMI) ≥85th percentile for age and sex. The intervention included: (1) eight group-based (parent-only) education sessions over 13-weeks; (2) eight home-based activities; and (3) two group-based (family) follow-up support sessions. The first section of the manuscript contains a …

Magnetic Resonance Imaging In The Diagnosis Of White Matter Signal Abnormalities., Ravi Datar, Asuri Narayan Prasad, Keng Yeow Tay, Charles Anthony Rupar, Pavlo Ohorodnyk, Michael Miller, Chitra Prasad

Paediatrics Publications

Background White matter abnormalities (WMAs) pose a diagnostic challenge when trying to establish etiologic diagnoses. During childhood and adult years, genetic disorders, metabolic disorders and acquired conditions are included in differential diagnoses. To assist clinicians and radiologists, a structured algorithm using cranial magnetic resonance imaging (MRI) has been recommended to aid in establishing working diagnoses that facilitate appropriate biochemical and genetic investigations. This retrospective pilot study investigated the validity and diagnostic utility of this algorithm when applied to white matter signal abnormalities (WMSAs) reported on imaging studies of patients seen in our clinics. Methods The MRI algorithm was applied to …

Oscillometry And Pulmonary Mri Measurements Of Ventilation Heterogeneity In Obstructive Lung Disease: Relationship To Quality Of Life And Disease Control, Heather M Young, Fumin Guo, Rachel L Eddy, Geoffrey Maksym, Grace Parraga

Medical Biophysics Publications

Ventilation heterogeneity is a hallmark finding in obstructive lung disease and may be evaluated using a variety of methods, including multiple-breath gas washout and pulmonary imaging. Such methods provide an opportunity to better understand the relationships between structural and functional abnormalities in the lungs, and their relationships with important clinical outcomes. We measured ventilation heterogeneity and respiratory impedance in 100 subjects [50 patients with asthma, 22 ex-smokers, and 28 patients with chronic obstructive pulmonary disease (COPD)] using oscillometry and hyperpolarized

Does Specialist Physician Supply Affect Pediatric Asthma Health Outcomes?, Guido Filler, Tom Kovesi, Erik Bourdon, Sarah Ann Jones, Laurentiu Givelichian, Cheryl Rockman-Greenberg, Jason Gilliland, Marion Williams, Elaine Orrbine, Bruno Piedboeuf

Paediatrics Publications

Background

Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities.

Methods

This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into "peer groups" by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. …

Seeing The Forest And The Trees: Default Local Processing In Individuals With High Autistic Traits Does Not Come At The Expense Of Global Attention., Ryan A Stevenson, Sol Z Sun, Naomi Hazlett, Jonathan S Cant, Morgan D Barense, Susanne Ferber

Brain and Mind Institute Researchers' Publications

Atypical sensory perception is one of the most ubiquitous symptoms of autism, including a tendency towards a local-processing bias. We investigated whether local-processing biases were associated with global-processing impairments on a global/local attentional-scope paradigm in conjunction with a composite-face task. Behavioural results were related to individuals' levels of autistic traits, specifically the Attention to Detail subscale of the Autism Quotient, and the Sensory Profile Questionnaire. Individuals showing high rates of Attention to Detail were more susceptible to global attentional-scope manipulations, suggesting that local-processing biases associated with Attention to Detail do not come at the cost of a global-processing deficit, but …

Peripheral Blood Epi-Signature Of Claes-Jensen Syndrome Enables Sensitive And Specific Identification Of Patients And Healthy Carriers With Pathogenic Mutations In Kdm5c, Laila C Schenkel, Erfan Aref-Eshghi, Cindy Skinner, Peter Ainsworth, Hanxin Lin, Guillaume Paré, David I Rodenhiser, Charles Schwartz, Bekim Sadikovic

Paediatrics Publications

Background

Claes-Jensen syndrome is an X-linked inherited intellectual disability caused by mutations in the

Results

Genome-wide DNA methylation analysis of 7 male patients affected with Claes-Jensen syndrome and 56 age- and sex-matched controls identified a specific DNA methylation defect (epi-signature) in the peripheral blood of these patients, including 1769 individual CpGs and 9 genomic regions. Six healthy female carriers showed less pronounced but distinctive changes in the same regions enabling their differentiation from both patients and controls. Highly specific computational model using the most significant methylation changes demonstrated 100% accuracy in differentiating patients, carriers, and controls in the training cohort, …

The Prevalence Of Human Papillomavirus In Pediatric Tonsils: A Systematic Review Of The Literature, Monika Wojtera, Josee Paradis, Murad Husein, Anthony C Nichols, John W Barrett, Marina I Salvadori, Julie E Strychowsky

Paediatrics Publications

Background

HPV-related head and neck cancer rates have been increasing in recent years, with the tonsils being the most commonly affected site. However, the current rate of HPV infection in the pediatric population remains poorly defined. The objective of this study was to systematically review and evaluate the prevalence and distribution of HPV in the tonsils of pediatric patients undergoing routine tonsillectomy.

Methods and Results

The literature was searched using PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, and ProQuest Dissertations & Theses Global databases (inception to December 2017) by two independent review authors. Inclusion criteria included articles which evaluated the prevalence …

Mental Disorder In Children With Physical Conditions: A Pilot Study, Alexandra Butler, Ryan J Van Lieshout, Ellen Louise Lipman, Harriet L Macmillan, Andrea Gonzalez, Jan Willem Gorter, Kathy Georgiades, Kathy N Speechley, Michael H Boyle, Mark A Ferro

Paediatrics Publications

Objectives

Methodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.

Design

Prospective pilot study.

Setting

Two children's tertiary-care hospitals.

Participants

Children aged 6-16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.

Outcome Measures

Response, …