Medicine and Health Sciences Commons^™

Hospital Readmissions For Childhood Asthma: The Role Of Individual And Neighborhood Factors., Sze Yan Liu, Deborah Pearlman

Sze Yan Liu

Objectives

This study used a Cox proportional hazards model to determine whether neighborhood characteristics are associated with risk of readmission for childhood asthma independently of individual characteristics.

Methods

Rhode Island Hospital Discharge Data from 2001 to 2005 were used to identify children younger than 19 years of age at the time of the index (i.e., first) asthma admission, defined as a primary diagnosis of asthma or a primary diagnosis of respiratory illness with a secondary or tertiary diagnosis of asthma (n=2,919). Hazard ratios of repeat hospitalizations for childhood asthma from 2001 to 2005 were estimated, controlling for individual- …

Partial Clinical Remission Of Type 1 Diabetes Mellitus In Children: Clinical Applications And Challenges With Its Definitions, Benjamin U. Nwosu

Benjamin U. Nwosu

The honeymoon phase, or partial clinical remission (PCR) phase, of Type 1 diabetes mellitus (T1DM) is a transitory period that is marked by endogenous insulin production by surviving β cells following a diabetes diagnosis and the introduction of insulin therapy. It is a critical window in the course of the disease that has short and long-term implications for the patient, such as a significant reduction in the risk of long-term complications of T1DM. To promote long-term cardiovascular health in children with newly diagnosed T1DM, three key steps are necessary: the generation of a predictive model for non-remission, the adoption of …

Pubertal Lipid Levels Are Significantly Lower In Youth With Type 1 Diabetes Who Experienced Partial Clinical Remission, Benjamin U. Nwosu, Shwetha Rupendu, Emily Zitek-Morrison, Deepa Patel, Tony R. Villalobos-Ortiz, Gabrielle Jasmin, Bruce A. Barton

Benjamin U. Nwosu

Importance: The physiologic changes in lipids during puberty in type 1 diabetes (T1D) is unclear as subjects in previous studies were not stratified by partial clinical remission (PCR) status.

Aim: To determine the effect of PCR on lipid changes during puberty in youth with T1D.

Subjects and Methods: A retrospective cross-sectional study of 194 subjects consisting of 71 controls of age 12.9±1.3y and 123 subjects with T1D stratified into remitters (n=44, age 13.0±0.8y) and non-remitters (n=79, age 11.2±0.6y). PCR was defined as insulin-dose adjusted HbA1c of ≤9. Pubertal status was determined by Tanner staging.

Results: Among the pubertal cohort, low-density …

Tobacco Smoke Exposure Is An Independent Predictor Of Vitamin D Deficiency In Us Children, Benjamin U. Nwosu, Philip Kum-Nji

Benjamin U. Nwosu

IMPORTANCE: The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children.

METHODS: Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 >years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke exposure on …

Ibusy: Research On Children, Families, And Smartphones, Bill R. Garris, Lindsay Lester, Erin Doran, Andrea Lowery

Bill R. Garris

Within the past 10 years, mobile devices have been widely adopted by adults and are now present in the lives of almost all U.S. children. While phones are common, our understanding of what effect this technology has upon children's development is lagging. Bioecological theory and attachment theory suggest that this new technology may be disruptive, especially to the degree to which it interferes with the parent-child relationship. This article reflects a National Organization for Human Services conference presentation and shares preliminary results from semi-structured interviews conducted with 18 youth, ages 7 through 11. Only four of eighteen interviewees voiced any …

Children With Type 1 Diabetes Who Experienced A Honeymoon Phase Had Significantly Lower Ldl Cholesterol 5 Years After Diagnosis, Benjamin U. Nwosu, Bo Zhang, Sanaa S. Ayyoub, Stephanie Choi, Tony R. Villalobos-Ortiz, Laura C. Alonso, Bruce A. Barton

Benjamin U. Nwosu

IMPORTANCE: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized.

AIM: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status.

SUBJECTS AND METHODS: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 +/- 2.9 years, [male 11.7 +/- 2.9 years, (n = 55); female 12.0 +/- …

Data From: Tobacco Smoke Exposure Is An Independent Predictor Of Vitamin D Deficiency In Us Children, Benjamin U. Nwosu, Philip Kum-Nji

Benjamin U. Nwosu

Manuscript abstract:

IMPORTANCE:

The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children.

METHODS:

Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 >years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke …

Assessment Of Single-Word Production For Children Under Three Years Of Age: Comparison Of Children With And Without Cleft Palate, Nancy J. Scherer, A. Lynn Williams, Carol Stoel-Gammon, Ann Kaiser

A. Lynn Williams

Background. This study reports comparative phonological assessment results for children with cleft lip and/or palate (CLP) to typically developing peers using an evaluation tool for early phonological skills. Methods. Children without clefts (NC = noncleft) and 24 children with CLP, ages of 18–36 months, were evaluated using the Profile of Early Expressive Phonological Skills (PEEPSs) [1]. Children interacted with toy manipulatives to elicit a representative sample of target English consonants and syllable structures that are typically acquired by children between 18 and 27 months of age. Results. Results revealed significant differences between the two groups with regard to measures of …

The Icf-Cy As Framework For International Collaboration To Improve Services For Children With Communication Disorders, Brenda Louw, Juan Bornman

Brenda Louw

The purpose of this presentation is to describe the application of The International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) (WHO, 2007) as a framework for international collaboration with the aim of translating an outcomes measure and to field test the clinical applicability and cultural validity thereof.

A New Perspective On The Outcomes Of Children With Cleft Lip And Palate: Application Of The Icf-Cy, Brenda Louw

Brenda Louw

Learner Outcomes:

• Acknowledge the application value of the ICF to individuals with CLP.
• Integrate the ICF framework into the assessment of individuals with CLP.
• Formulate intervention goals that go beyond speech production skills to include functional communication outcomes in a variety of life situations.
• Include improvement and changes in communication participation in everyday functioning in assessment and progress reports.

A Proposed Holistic Model Of Assessment For Children With Cleft Palate Within The Icf-Cy Framework, Rabia Foreman, Jamesa Ewing, Olivia Hawley, Mariana De Cassia Macedo, Naiara Rodrigues Carlota Do Nascimento, Brenda Louw, Luciana Maximino

Brenda Louw

The purpose of this project is to describe a proposed model for the assessment of children with cleft palate within the framework of the ICF-CY (WHO, 2007). Suggestions for clinical application and cleft palate curricula are made, and future research needs are identified.

Development Of Metalinguistic Awareness: Evidence From Children’S Overt Productions, Laura Kirkby, Mallory Dingess, Jamesa Ewing, Whitney Salvers, Kerry Proctor-Williams

Kerry Proctor-Williams

This study examined whether metalinguistic frequency increases or utterance type changes with age in children with typical language. Overt metalinguistic productions of 32 children, 3;0-5;7, were collected during recast intervention. Overall, the data showed changes in frequency and proportion of types with age.

The Elicitation Method For Past Tense Verb Production In Children With Specific Language Impairment And Typical Language, Morgan Geise, Heather Green, Olivia Hart, Abbi Leitnaker, Kerry Proctor-Williams

Kerry Proctor-Williams

Past tense verb production in children with specific language impairment and language-matched children with typical language was compared using language samples and a standardized probe (Rice/Wexler Test of Early Grammatical Impairment). Analyses revealed accuracy and error type differences between elicitation types and groups. Results have important clinical practice implications.

A Comparison Of Nal And Dsl Prescriptive Methods For Paediatric Hearing-Aid Fitting: Predicted Speech Intelligibility And Loudness, Teresa Y.C. Ching, Earl E. Johnson, Sanna Hou, Harvey Dillon, Vicky Zhang, Lauren Burns, Patricia Van Buynder, Angela Wong, Christopher Flynn

Earl E. Johnson

Objective: To examine the impact of prescription on predicted speech intelligibility and loudness for children. Design: A between-group comparison of speech intelligibility index (SII) and loudness, based on hearing aids fitted according to NAL-NL1, DSL v4.1, or DSL m[i/o] prescriptions. A within-group comparison of gains prescribed by DSL m[i/o] and NAL-NL2 for children in terms of SII and loudness. Study sample: Participants were 200 children, who were randomly assigned to first hearing-aid fitting with either NAL-NL1, DSL v4.1, or DSL m[i/o]. Audiometric data and hearing-aid data at 3 years of age were used. Results: On average, SII calculated on the …

Hearing-Aid Safety: A Comparison Of Estimated Threshold Shifts For Gains Recommended By Nal-Nl2 And Dsl M[I/O] Prescriptions For Children, Teresa Y. C. Ching, Earl E. Johnson, Mark Seeto, John H. Macrae

Earl E. Johnson

Objective: To investigate the predicted threshold shift associated with the use of nonlinear hearing aids fitted to the NAL-NL2 or the DSL m[i/o] prescription for children with the same audiograms. For medium and high input levels, we asked: (1) How does predicted asymptotic threshold shifts (ATS) differ according to the choice of prescription? (2) How does predicted ATS vary with hearing level for gains prescribed by the two prescriptions? Design: A mathematical model consisting of the modified power law combined with equations for predicting temporary threshold shift (Macrae, 1994b) was used to predict ATS. Study sample: Predicted threshold shift were …

Data From: Children With Type 1 Diabetes Who Experienced A Honeymoon Phase Had Significantly Lower Ldl Cholesterol 5 Years After Diagnosis, Benjamin U. Nwosu, Bo Zhang, Sanaa S. Ayyoub, Stephanie Choi, Tony R. Villalobos-Ortiz, Laura C. Alonso, Bruce A. Barton

Benjamin U. Nwosu

Manuscript abstract:

Importance: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized.

Aim: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status.

Subjects and Methods: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 ± 2.9 years, [male 11.7 ± 2.9 years, (n=55); female 12.0 ± …

Enterocutaneous Fistulae In Children - A Management Challenge, Ali Imran Amjad, Saqib Hamid Qazi, Zafar Nazir

Zafar Nazir

No abstract provided.

Randomized Vitamin D Supplementation In Vitamin D Deficient Obese Children From West Virginia, Yoram Elitsur Md, Deborah L. Preston

Yoram Elitsur

Objective: Vitamin D (Vit D) deficiency is a very common problem in obese children, but clinical guidelines for maintenance or treatment have not been published for this population. The aim was to assess the benefit of 2 months Vit D supplementation given to deficient obese children from WV. Design: Vit D deficient obese children were prospectively recruited. Exclusion criteria included <8 years, and medical conditions that may affect Vit D homeostasis. Participants were randomized into two supplement groups: 5,000IU/day (Group A) or 50,000IU/week (Group B). Serum 25(OH)D levels were measured at baseline and post-treatment. Results: Sixty obese children were screened of whom 39 (65%) were deficient (<20ng/ml). Of the 39 recruited, 26 completed the study. The mean serum 25(OH)D after 2 months treatment were significantly higher in Group B (p= 0.02), but most reached normal levels (>30ng/ml). Conclusions: Two months Vit D supplementation (5000IU/day or 50,000IU/week) was sufficient to normalize 25(OH)D levels in Vit D deficient obese West Virginian children.

Helicobacter-Pylori Negative Gastritis In Children—A New Clinical Enigma, Yoram Elitsur, Deborah L. Preston

Yoram Elitsur

The decrease in the prevalence of Helicobacter pylori (Hp) infection in children in the world gave rise to a new pathological finding termed as Hp-negative gastritis. Unfortunately, the term “Hp-negative gastritis” has not been identified as a pathological process and has the status of a “second cousin”; in most publications it was never mentioned as a subject to be dealt with, but was “left over” data that was never the topic of the manuscripts’ discussions. Only recently has the topic captured the attention of the pathologists who described this phenomenon in adults, yet the pathological and/or clinical spectrum or significance …

A Predictive Model For Lack Of Partial Clinical Remission In New-Onset Pediatric Type 1 Diabetes, Katherine R. Marino, Rachel L. Lundberg, Aastha Jasrotia, Louise Maranda, Michael J. Thompson, Bruce A. Barton, Laura C. Alonso, Benjamin U. Nwosu

Benjamin U. Nwosu

IMPORTANCE: >50% of patients with new-onset type 1 diabetes (T1D) do not enter partial clinical remission (PCR); early identification of these patients may improve initial glycemic control and reduce long-term complications. AIM: To determine whether routinely obtainable clinical parameters predict non-remission in children and adolescents with new-onset T1D. SUBJECTS AND METHODS: Data on remission were collected for the first 36 months of disease in 204 subjects of ages 2-14 years with new-onset type 1 diabetes. There were 86 remitters (age 9.1±3.0y; male 57%), and 118 non-remitters (age 7.0±3.1y; male 40.7%). PCR was defined as insulin-dose adjusted hemoglobin A1c of ≤9. …

Data From: A Predictive Model For Lack Of Partial Clinical Remission In New-Onset Pediatric Type 1 Diabetes, Katherine R. Marino, Rachel L. Lundberg, Aastha Jasrotia, Louise S. Maranda, Michael J. Thompson, Bruce A. Barton, Laura C. Alonso, Benjamin U. Nwosu

Benjamin U. Nwosu

Manuscript abstract:

IMPORTANCE: >50% of patients with new-onset type 1 diabetes (T1D) do not enter partial clinical remission (PCR); early identification of these patients may improve initial glycemic control and reduce long-term complications.

AIM: To determine whether routinely obtainable clinical parameters predict non-remission in children and adolescents with new-onset T1D.

SUBJECTS AND METHODS: Data on remission were collected for the first 36 months of disease in 204 subjects of ages 2-14 years with new-onset type 1 diabetes. There were 86 remitters (age 9.1±3.0y; male 57%), and 118 non-remitters (age 7.0±3.1y; male 40.7%). PCR was defined as insulin-dose adjusted hemoglobin A1c …

Clinical Topic Review 2013 - Behavioral Health Screening Among Masshealth Children And Adolescents, Judith A. Savageau, Georgianna Willis, Kathy Muhr, David M. Keller, Gideon Aweh, Elizabeth O'Connell

Judith A. Savageau

Results from the 2013 evaluation suggest that the Children’s Behavioral Health Initiative had a large impact on formal behavioral health screening and treatment utilization among children and adolescents enrolled in MassHealth.

Clinical Topic Review: Behavioral Health Screening For Children With Well Visits, Judith A. Savageau, Linda M. Cabral, Jack Gettens, Elizabeth O'Connell, Lana Miller, Susan Maguire

Judith A. Savageau

The first Clinical Topic Review was conducted in order to better understand how behavioral health screenings were occurring for children and adolescents during well visits prior to the implementation of a requirement that primary care providers perform behavioral health screening using a standardized behavioral health screening tool during every well child visit.

Safety Of Infliximab In Children With Ibd: The Experience Of An Academic Center In Wv, Michael Northcutt Md, Awni Al-Subu Md, Brooke Bella Rn, Yoram Elitsur Md

Yoram Elitsur

BACKGROUND: The immune-modulating drug, infliximab, is approved for Inflammatory Bowel Disease (IBD) treatment in children. Chronic therapy with infliximab is associated with the development of early and delayed infusion reactions. We reviewed our experience with infliximab treatment and its side effects in a cohort of children diagnosed with IBD who were treated in our clinic. METHODS: A retrospective analysis of all IBD children treated with infliximab in our center from 2006-2011 was performed. The demographic, chronological and clinical data were recorded. The infliximab infusion was given at 5mg/ kg according to a standard protocol after pre-treatment with low dose steroid …

Assessment Of Fundamental Movement Skills In Australian Children: The Validation Of A Fundamental Motor Skills Quotient (Fmsq), Beth Hands, Fleur Mcintyre

Beth Hands

Objectives: The development of proficient fundamental movement skills (FMS) in children is important for physical, cognitive and social development, and to establish a foundation for an active lifestyle. Many teachers, coaches and physical activity program deliverers use real time observation of individual skill performances during physical activities to assess proficiency in young children. However, a valid method to quantify these observations to provide an overall motor competence is not available. Design: A small pilot validation study using the Bland Altman method to compare scores on the McCarron Assessment of Neuromuscular Development (MAND) and a Fundamental Movement Skill Quotient (FMSQ) (M …

The Associations Between Physical Activity, Screen Time And Weight From 6 To 14 Years: The Raine Study, Beth P. Hands, Paola Chivers, Helen Parker, Garth Kendall, Lawrence Beilin, Dawne Larkin

Paola Chivers

To examine the strength and direction of the relationship between physical activity level, screen use and BMI in a cohort at ages 6, 8, 10 and 14 yrs as part of a prospective longitudinal cohort study. The sample comprised 1403 males and females who participated in the follow-up survey at 14 yrs of age between 2003 and 2005. Exploratory structural equation modelling was used to examine the interrelationships between physical activity level, BMI and screen time at 6, 8, 10 and 14 yrs. Predictors of BMI at 6, 8, 10 and 14 yrs explained 1.3, 76.1, 80.1 and 73.1 percent …

Manic Symptoms And Behavioral Dysregulation In Youth With Velocardiofacial Syndrome (22q11.2 Deletion Syndrome)., Alka Aneja, Wanda Fremont, Kevin Antshel, Stephen Faraone, Nuria Abdulsabur, Anne Marie Higgins, Robert Shprintzen, Wendy Kates

Robert J. Shprintzen

Mania and bipolar disorder have been reported in adolescents and adults with velocardiofacial syndrome (VCFS; also known as 22q11.2 deletion syndrome). Children with VCFS have a high prevalence of attention-deficit/hyperactivity disorder (ADHD), which may constitute a risk factor for the eventual development of bipolar disorder in this population. Therefore, we sought to determine whether children with VCFS exhibit more manic symptoms than community controls that also may have learning disorders and ADHD. The study population consisted of 86 children with VCFS and 36 community controls from ages 9 to 15 years, using measures of Young Mania Rating Scale-Parent Version, Schedule …

Effects Of An After-School Care-Administered Physical Activity And Nutrition Protocol On Body Mass Index, Fitness Levels, And Targeted Psychological Factors In 5-To 8-Year-Olds, James Annesi, Alice Smith, Stephanie Walsh, Nicole Mareno, Kathleen Smith

Nicole Mareno

Sensory Processing Correlates Of Occupational Performance In Children With Fragile X Syndrome: Preliminary Findings, G. T. Baranek, Y. H. Chin, L. G. Hess, J. G. Hatton, S. R. Hooper

Laura Greiss Hess

This timely source book, featuring the latest in research (2000 - 2003) from the American Journal of Occupational Therapy in one easy reference, covers topics such as handwriting, ADHD, motor skills, sensory issues, play, physical disability, autism, school performance, stigma, and self-image. ~ Publisher

Food Patterns Of Australian Children Ages 9 To 13 Y In Relation To Ω-3 Long Chain Polyunsaturated Intake, Setyaningrum Rahmawaty, Philippa Lyons-Wall, Marijka Batterham, Karen Charlton, Barbara J. Meyer

Dr Marijka Batterham

Objective: The aim of this study was to examine food patterns of Australian children ages 9 to 13 y in relation to ω-3 long-chain polyunsaturated fatty acid (ω-3 LCPUFA) intake. Methods: Secondary analysis was conducted on nationally representative food data of 1110 Australian children ages 9 to 13 y (525 boys and 585 girls) that was obtained using two 24-h recalls. Principle component factor analysis was used to identify food patterns. Discriminant function analysis was used to identify the relationship between the food patterns and total ω-3 LCPUFA intake. Results: Four major food patterns emerged for each sex. For boys …