Socioeconomic and ethnic group differences in self reported health status and use of health services by children and young people in England: cross sectional study

ObjectivesTo examine whether self reported health status and use of health services varies in children of different social class and ethnic group.DesignCross sectional study from the 1999 health survey for England.Subjects6648 children and young adults aged 2-20 years.SettingPrivate households in England.ResultsLarge socioeconomic differences were observed between ethnic subgroups; a higher proportion of Afro-Caribbean, Indian, Pakistani, and Bangladeshi children belonged to lower social classes than the general population. The proportion of children and young adults reporting acute illnesses in the preceding two weeks was lower in Bangladeshi and Chinese subgroups (odds ratio 0.41, 95% confidence interval 0.27 to 0.61 and 0.46, 0.28 to 0.77, respectively) than in the general population. Longstanding illnesses was less common in Bangladeshi and Pakistani children (0.52, 0.40 to 0.67 and 0.57, 0.46 to 0.70) than in the general population. Irish and Afro-Caribbean children reported the highest prevalence of asthma (19.5% and 17.7%) and Bangladeshi children the lowest (8.2%). A higher proportion of Afro-Caribbean children reported major injuiries than the general population (11.0% v 10.0%), and children from all Asian subgroups reported fewer major and minor injuries than the general population. Indian and Pakistani children were more likely to have consulted their general practitioner in the preceding fortnight than the general population (1.86, 1.35 to 2.57 and 1.51, 1.13 to 2.01, respectively). Indian, Pakistani, Bangladeshi, and Chinese children were less likely to have attended outpatient departments in the preceding three months. No significant differences were found between ethnic groups in the admission of inpatients to hospitals. Acute and chronic illness were the best predictors of children''s use of health services. Social classes did not differ in self reported prevalence of treated infections, major injuries, or minor injuries, and no socioeconomic differences were seen in the use of primary and secondary healthcare services.ConclusionsChildren''s use of health services reflected health status rather than ethnic group or socioeconomic status, implying that equity of access has been partly achieved, although reasons why children from ethnic minority groups are able to access primary care but receive less secondary care need to be investigated.

What is already known on this topic

Children from lower socioeconomic classes and from Indian ethnic subgroups may make more use of general practitioners'' services than other childrenAfro-Caribbean, Indian, Pakistani, and Bangladeshi children are less likely to be referred to outpatient and inpatient services at hospitals than white children

What this study adds

Indian, Pakistani, and Bangladeshi children reported less acute and chronic illness, asthma, and injuries than the general population, whereas Afro-Caribbean children reported moreChildren''s self reported health status and use of health services did not vary by social classIndian and Pakistani children make more use of general practitioners'' services, but Indian, Pakistani, Bangladeshi, and Chinese children are less likely to be referred to outpatient clinicsSelf reported health status rather than socioeconomic status or ethnicity is the best predictor of use of primary and secondary services     

Companion Animals and other Factors Affecting Young Children's Development

ABSTRACT

This study focuses on three factors presumed to affect young children's development: their age, the quality of their home environments, and the child-pet relationship. Three sets of analyses are presented: effects associated with pet ownership (pet presence), effects associated with the strength of the child-pet relationship, and the combined effects of age, home environment, and the child-companion animal relationship. This study includes both a parent survey (n = 88) and in-home assessments (n = 44) of the three- to six-year-old children. The analyses support the hypothesis that normal preschool children's intellectual, motor, and social development is associated with the presence of a companion animal and increases with their age, the quality of their home environment, and their relationship with a companion animal. While the children's age and the quality of their home environments were associated with measures of the children's cognitive, motor, and social development, the companion animal effect was limited to the young children's social development including their empathy for other children.     

Abstracts

Abstract

Exposure to pets and wildlife can help children develop positive attitudes toward animals, which can foster the development of empathy and ecological stewardship. However, geographical, logistical and economic restrictions limit opportunities for many youth to interact directly with live animals. Thus, educational interventions that utilize imitation animal artifacts rather than live animals, and which are effective in helping children develop an understanding of animals, present an important resource for educators. In the current study, the impact of a curriculum that employs imitation animal artifacts on children's perceptions of their relationships to animals was assessed. Third grade children's (n = 96) perceptions of their relationships to animals were analyzed by means of a drawing assessment tool. An analytic scoring rubric was used to assess three features of the drawings: Interactivity, Affect, and Realism. The combination of these elements was defined as the construct Self–Animal Perception. Change in Self–Animal Perception was assessed over time using repeated measures ANOVA. The curriculum intervention resulted in significant improvement in Self–Animal Perception scores relative to controls. The Self–Animal Perception construct and the drawing assessment tool utilized for measuring children's perceived relationships to animals are discussed.     

儿童运动发育迟缓与血碱性磷酸酶、血25-羟维生素D3表达水平的相关性

摘要 目的：探讨儿童运动发育迟缓与血碱性磷酸酶(Alkaline phosphatase,ALP)、血25-羟维生素D3[25(OH)D3]表达水平的相关性。方法：2016年10月到2018年6月选择在本院儿保科门诊就诊500例(6~12月龄)的儿童作为研究对象,诊断儿童发育迟缓的发生率,检测发育迟缓患儿血清ALP与25(OH)D3水平,Gesell测评评定小儿的运动发育状况,所有患儿每天均给予了维生素D3 400 IU,对于发育迟缓患儿每天给予维生素D 800 IU~1200 IU补充,治疗3个月,再做Gesell测评评估其运动发育水平,对比治疗后运动发育情况,并分析影响儿童运动发育的相关因素。结果：在500例小儿中,判断为运动发育迟缓120例(迟缓组),占比24.0 %。两组小儿的性别、胎龄、分娩方式、出生体重、头围、身长等对比差异无统计学意义(P>0.05)。迟缓组的血清ALP水平高于非迟缓组(P<0.05),25(OH)D3水平低于非迟缓组(P<0.05)。迟缓组的大动作、精细运动、适应性行为、语言、个人社交评分都低于非迟缓组(P<0.05),迟缓组治疗后,大动作、精细运动、适应性行为、语言、个人社交评分均显著升高(P<0.05)。在120例发育迟缓中,Pearson分析显示ALP、25(OH)D3与小儿运动迟缓发育具有相关性(P<0.05);二分类多因素条件Logistic分析结果显示ALP、25(OH)D3都影响儿童运动发育迟缓的主要因素(P<0.05)。结论：儿童运动发育迟缓与血清ALP、25(OH)D3水平存在相关性,两者的联合检测可为儿童发育迟缓的早期诊断提供实验依据,经过维生素D治疗后,能显著的改善其患儿的运动发育,有很好的应用价值。     

Parental Perceptions of their Children's Involvement with Household Pets: A Test of a Specificity Model of Nurturance

ABSTRACT

To test hypotheses derived from a specificity model of the development of children's nurturance, parents of preschool, second-grade and fifth-grade children (n=707) reported the frequency of their children's play with and care of pets as well as play and care directed to younger siblings, non-family babies, and elderly persons. Parents also reported on their children's frequency of expressed interest in animals, babies, and nurture in general. As predicted, gender differences were found for frequency of time spent with babies but not with pets. Frequency of time with pets was related to expressed interest in animals but not in babies. Children who had pets but no younger siblings were reported to spend more time with pets than were children with both pets and younger siblings. Children without pets were reported to express interest in babies more often than did pet owning children.     

支气管哮喘患儿病情控制的影响因素及其家长知信行问卷调查分析

摘要 目的：调查支气管哮喘患儿家长知信行情况,并分析支气管哮喘患儿病情控制的影响因素。方法：于2016年7月~2020年7月期间,选取我院收治的500例支气管哮喘患儿及其家长作为研究对象。患儿家长知信行情况采用《哮喘患儿家长知信行问卷》调查。患儿近4周的病情控制水平参照《诸福棠实用儿科学(第8版)》中的相关标准进行确定,病情控制水平包括良好控制、部分控制和未控制。将良好控制、部分控制的患儿纳为哮喘控制组,将未控制的患儿纳为哮喘未控制组。采用本院自制的调查量表调查患儿及其家长的信息,分析支气管哮喘患儿病情控制的影响因素。结果：支气管哮喘儿童家长知信行情况不容乐观。支气管哮喘患儿病情控制率为38.06%（187/491）。单因素分析结果表明,支气管哮喘患儿病情控制与家庭人均月收入、患儿个人过敏史、家长受教育程度、哮喘家族史、是否坚持长期用药、是否定期复诊有关（P<0.05）。多因素Logistic回归分析结果显示,家长受教育程度、家庭人均月收入、患儿个人过敏史、哮喘家族史、是否坚持长期用药、是否定期复诊均是支气管哮喘患儿病情控制的影响因素（P<0.05）。结论：本研究中支气管哮喘患儿病情控制水平一般,且支气管哮喘儿童家长知信行情况不容乐观,其中家长受教育程度、家庭人均月收入、患儿个人过敏史等均是支气管哮喘患儿病情控制的影响因素,临床中应结合相关因素进行针对性的干预或治疗,以期实现对支气管哮喘患儿病情的良好控制。     

儿童重症监护病房医院感染暴发白色念珠菌血流感染4例分析

摘要 目的：探讨儿童重症监护病房白色念珠菌血流感染暴发的临床表现、危险因素、控制措施等,为预防和控制院内白色念珠菌血流感染暴发提供科学依据。方法：以2018年7月我院儿童重症监护病房发生的4例白色念珠菌血流感染暴发患儿为研究对象,分析患儿临床情况、临床特征、危险因素、暴发原因以及采取的预防控制措施。结果：4例医院感染暴发白色念珠菌血流感染患儿均存在基础疾病、有机械通气史、存在中心静脉或动脉置管、静脉或动脉置管前后均使用碘伏消毒、曾使用广谱抗生素、输血制品,白色念珠菌血流感染后最突出的临床表现均是发热。药敏方面,医院感染暴发的4例白色念珠菌感染患儿对唑类及5-氟胞嘧啶均耐药,但对两性霉素B均敏感。经拔除血管置管、减少或者避免广谱抗菌药的应用,根据药敏使用卡泊芬净及两性霉素B抗真菌等积极治疗,1例患儿放弃治疗后死亡,3例患儿顺利出院。通过Fisher确切概率法分析可知,留置中心静脉或动脉置管是儿童重症监护病房发生医院感染暴发白色念珠菌血流感染的危险因素（P<0.05）。结论：留置中心静脉或动脉置管是儿童重症监护病房发生医院感染暴发白色念珠菌血流感染的危险因素,医院感染暴发白色念珠菌血流感染患儿最突出的临床表现是发热,唑类及5-氟胞嘧啶耐药的患儿使用卡泊芬净及两性霉素B可能获得较好的治疗效果。     

Children's health and their mothers’ risk of divorce or separation

Abstract

The purpose of this study is to determine how children's health conditions are related to their mothers’ risk of divorce or separation. The study is based on data from over 7,000 children born to once‐married mothers identified in the 1988 Child Health Supplement to the National Health Interview Survey. The effects of 15 childhood health conditions on the mothers’ risk of divorce are estimated with Cox's proportional hazard models. Controlling for demographic, marital, and reproductive measures, we find that mothers’ prospects for divorce are affected both positively or negatively by their children's health status, depending on the type of childhood condition and, in the case of low birth weight children, timing within the marriage. Women whose children have congenital heart disease, cerebral palsy, are blind, or had low birth weight appear to have higher risks of marital disruption than mothers of healthy children. In contrast, mothers whose children have migraines, learning disabilities, respiratory allergies, missing/deformed digits or limbs, or asthma have somewhat lower rates of divorce.     

Trends of overweight and obesity among white and american indian school children in south dakota, 1998–2010

Objective:

To investigate the prevalence of overweight and obesity among white and American Indian children in a predominantly rural state.

Design and Methods:

Using a repeated, cross‐sectional design of school children's height and weight, the study sample included 361,352 measures of children who were 5.0–19.9 years, attending school across 13 academic calendar years. Trained staff measured height, weight, and recorded gender, age, and race. Data were voluntarily reported to the State Department of Health.

Results:

American Indian children consistently had higher rates of overweight and obesity compared to white children. Across the years, 16.3% of white students were overweight, whereas 19.3% of American Indian students were overweight. In addition, 14.5% of white children were obese and 25.9% of American Indian children were obese. Examining by rural versus urban schools, prevalence of overweight had been increasing among white male and female students and American Indian female students living in rural areas. Obesity is also increasing among rural white females and male and female American Indian children.

Conclusions:

The findings here suggest that although American Indian children are at higher risk, in general, compared to white children, rural populations in general are experiencing increases in childhood overweight and obesity. Targeted rural interventions beginning at an early age are necessary to improve the health of rural children, especially in American Indian communities.     

Raising grateful children one day at a time

ABSTRACT

We examined micro developmental processes related to the socialization of children's gratitude by testing whether parents who engage in more frequent daily socialization practices targeting children's gratitude reported more frequent gratitude displays by their children after controlling for potential confounds. 101 parent-child dyads completed a baseline lab visit followed by a seven-day diary study. Using multi-level modeling, we found that parents who engaged in more frequent gratitude socialization acts reported more frequent displays of gratitude by their children across the seven-days (between-dyad effect) and that on days when a parent engaged in more socialization acts than usual parents reported relative increases in gratitude displays by their children (within-dyad effect). These findings show that parent socialization acts are associated with children’s displayed gratitude and point to the need for future work to explore reactive and proactive parent-child interactions that may underlie these associations as well as associations between micro-developmental and macro-developmental processes.     

Is Parental Control over Children's Eating Associated with Childhood Obesity? Results from a Population‐Based Sample of Third Graders

Objective: Identifying parental behaviors that influence childhood obesity is critical for the development of effective prevention and treatment programs. Findings from a prior laboratory study suggest that parents who impose control over their children's eating may interfere with their children's ability to regulate intake, potentially resulting in overweight. These findings have been widely endorsed; however, the direct relationship between parental control of children's intake and their children's degree of overweight has not been shown in a generalized sample. Research Methods and Procedures: This study surveyed 792 third‐grade children with diverse ethnic and socioeconomic backgrounds from 13 public elementary schools. Parental control over children's intake was assessed through telephone interviews using a state‐of‐the‐art instrument, and children were measured for height, weight, and triceps skinfold thickness. Results: Counter to the hypothesis, parental control over children's intake was inversely associated with overweight in girls, as measured by body mass index, r = ?0.12, p < 0.05, and triceps skinfolds, r = ?0.11, p < 0.05. This weak relationship became only marginally significant when controlling for parents’ perceptions of their own weight, level of household education, and children's age. No relationship between parental control of children's intake and their children's degree of overweight was found in boys. Discussion: Previous observations of the influence of parental control over children's intake in middle‐class white families did not generalize to 8‐ to 9‐year‐olds in families with diverse socioeconomic and ethnic backgrounds. The present findings reveal a more complex relationship between parental behaviors and children's weight status.     

Child–Companion Animal Attachment Bonds in Single and Two-Parent Families

ABSTRACT

This study addressed the issue of whether children who potentially have reduced access to parental resources have a stronger attachment bond with a dog, compared with children who have greater access. The study compared children in single-parent families with those in two-parent families on level of attachment to their family dog. Parents judged children's level of attachment to dogs by completing the Companion Animal Bonding Scale. The children's ages ranged between three and twelve years. Overall, children in single-parent families did show significantly higher levels of attachment to dogs than children in two-parent families. A comparison of attachment to dogs across family type showed that children in the early childhood stage in single-parent families had significantly higher levels of bonding with dogs than children in the early childhood stage in two-parent families. For the middle childhood stage there was no significant difference between family type and attachment to dogs. Comparisons within family type showed mixed results, and there were no significant gender differences in attachment levels across family type. Findings are discussed in light of attachment theory, family systems theory and implications for child development.     

Early childhood arts education in the United States: A special issue of Arts Education Policy Review

ABSTRACT

In this introduction to Early Childhood Arts Education in the United States, a special issue of Arts Education Policy Review, the editors provide a platform for stakeholders' increased awareness and understandings of the need to ensure children's rights to arts education. They summarize the five articles comprising this issue, and invite stakeholders to consider example action steps to apply content from this Issue to arts interactions with young children.     

便携式运动能力检测系统的研制

目的:检测儿童的平衡能力和下肢力量,研究评估儿童运动能力的相关指标。方法:设计了一套便携式运动能力检测系统,检测儿童的平衡能力和下肢力量。本系统由运动能力检测设备和上位机数据分析存储展示部分组成。结果:研制的便携式运动能力检测系统具有可穿戴、功耗低等优点,能够准确地记录儿童的运动数据。结论:便携式运动能力检测系统能够检测使用者在运动过程中的平衡数据和下肢力量数据,及时发现运动能力的缺陷,为儿童的日常生活和锻炼提供参考。     

小儿推拿疗法联合中药热奄包治疗小儿夜啼的疗效及对睡眠质量和生长发育的影响

摘要 目的：探讨小儿推拿疗法联合中药热奄包治疗小儿夜啼的疗效及对睡眠质量和生长发育的影响。方法：选取2019年4月~到2021年8月期间石家庄市中医院收治的120例夜啼患儿作为研究对象。根据双色球法将患儿分为对照组（常规药物治疗）和观察组（对照组的基础上接受小儿推拿疗法联合中药热奄包治疗）,各为60例。对比两组疗效、中医证候评分、睡眠质量、生长发育相关指标和不良反应发生情况。结果：与对照组相比,观察组的临床总有效率明显升高（P<0.05）。与对照组相比,观察组治疗1周后啼哭、腹喜按摩、睡喜蜷曲、四肢欠温、大便稀溏、小便色清评分更低（P<0.05）。与对照组相比,观察组治疗1周后白天睡眠时间、夜间睡眠时间更长,夜间清醒时间更短,夜醒次数更少（P<0.05）。与对照组相比,观察组治疗6个月后年龄别体质量Z值（WAZ）、年龄别身长Z值（LAZ）、身长别体质量Z值（WLZ）和头围Z值（HCZ）更大（P<0.05）。治疗期间两组均未出现不良反应。结论：小儿推拿疗法联合中药热奄包治疗小儿夜啼,可有效改善患儿临床症状,提高睡眠质量,促进生长发育。     

哮喘儿童父母知识知晓率、用药依从性及影响因素分析

目的:了解哮喘儿童父母的对疾病知识的掌握情况以及儿童的服药依从情况和影响因素,为提高哮喘儿童的控制率提供参考依据。方法:选择2015年1月-2015年12月于上海市第十人民医院儿科门诊诊治的支气管哮喘儿童93例,调查其哮喘控制情况、哮喘服药依从性和父母基本情况与相关知识。依从性与知识知晓率的比较采用双向有序的检验,影响因素采用有序结果的累积优势Logistic回归分析。结果:本次调查93例哮喘儿童中,哮喘完全控制率为23.7%,儿童服药依从性好的比率为25.8%,哮喘儿童父母相关知识知晓率高的比率为25.8%,儿童哮喘控制率与服药依从性之间存在相关性(P=0.029),哮喘儿童服药依从性与哮喘儿童父母相关知识知晓率之间存在相关性(P=0.035)。哮喘儿童的服药依从性受到儿童性别(OR=1.153,95%CI:1.04-1.96)、家族史(OR=1.402,95%CI:1.20-2.33)、知识知晓率(OR=1.828,95%CI:1.05-3.17)和病程(OR=0.758,95%CI:0.35-0.97)等因素的影响(P0.05)。结论:哮喘儿童的服药依从性受到儿童性别、家族史、知识知晓率和病程等因素的影响,要充分发挥儿童父母的作用,从医院内干预逐渐进入家庭干预,通过对父母或者监护人的认知或用药知识的提高,切实提高哮喘儿童的用药依从性和哮喘的控制率。     

“Gift Giving” by Wild Bottle nose Dolphins (Tursiops sp.) to Humans at a Wild Dolphin Provisioning Program,Tangalooma, Australia

ABSTRACT

While there is increasing interest in the impact of animal interactions upon children's wellbeing and attitudes, there has been less attention paid to the specific characteristics of the animals that attract and engage children. We used a within-subjects design to explore how differences in animal features (such as their animacy, size, and texture) impacted upon pre-school children's social and emotional responses. This study examined pre-schoolers' interactions with two animal-like robots (Teksta and Scoozie), two insect types (stick insects and hissing cockroaches) and a dog (Teasel, a West Highland Terrier). Nineteen preschool participants aged 35–57 months were videoed while interacting with the experimenter, a peer, and each stimulus (presented individually). We used both verbal and nonverbal behaviors to evaluate interactions and emotional responses to the stimuli and found that these two measures could be incongruent, highlighting the need for systematic approaches to evaluating children's interactions with animals. We categorized the content of children's dialogues in relation to psychological and biological attributes of each stimulus and their distinctions between living and non-living stimuli; the majority of comments were biological, with psychological terms largely reserved for the dog and mammal-like robot only. Comments relating to living qualities revealed ambiguity towards attributes that denote differences between living and non-living creatures. We used a range of nonverbal measures, including willingness to approach and touch stimuli, rates of self-touching, facial expressions of emotion, and touch to others. Insects (hissing cockroaches and stick insects) received the most negative verbal and nonverbal responses. The mammal-like robot (rounded, fluffy body shape, large eyes, and sympathetic sounds) was viewed much more positively than its metallic counterpart, as was the real dog. We propose that these interactions provide information on how children perceive animals and a platform for the examination of human socio-emotional and cognitive development more generally. The children engaged in social referencing to the adult experimenter rather than familiar peers when uncertain about the stimuli presented, suggesting that caregivers have a primary role in shaping children's responses to animals.     

Stress exposure in specific growth periods associates with children's weight,height, and body mass index

Objectives

We investigate associations between children exposure to stressful events, considering: (1) the period in which the event took place, (2) the type of event, and (3) the cumulative effect of the events on children's weight, height and body mass index (BMI).

Methods

A total of 8429 Portuguese children (3349 exposed to at least one stressful event during their lifetime; 50.2% males; mean age = 7.21 ± 1.85 years) were included in the analysis. The occurrence of stressful (i.e., adverse) events was reported in a parental questionnaire; children's weight and height were objectively measured.

Results

When the stress event took place in the first 2 years of life, compared with during pregnancy or after the 2 years, children were shorter; but the association was weak and only significant for boys. After adjustment for child's birthweight, gestational age, breastfeeding duration, number of siblings, and father's education, the experience of 3+ stressful events (vs. 1 or 2) was associated with higher weight and height in boys. No interaction effect was found between stress and BMI.

Discussion

We found some evidence of associations between exposure to stressful events and physical growth of boys. We highlight the complex relationship between exposure to stressful experiences and children's physical growth, particularly the different effects of specific characteristics of the stress event and the sex differences.

     

Qualitative interview study of communication between parents and children about maternal breast cancer

ObjectiveTo examine parents'' communication with their children about the diagnosis and initial treatment of breast cancer in the mother.DesignQualitative interview study within cross sectional cohort.SettingTwo breast cancer treatment centres.Participants32 women with stage I or stage II breast cancer with a total of 56 school aged children.ResultsWomen were most likely to begin talking to their children after their diagnosis had been confirmed by biopsy, but a minority waited until after surgery or said nothing at all. Family discussion did not necessarily include mention of cancer. There was considerable consistency in the reasons given for either discussing or not discussing the diagnosis. The most common reason for not communicating was avoidance of children''s questions and particularly those about death. While most mothers experienced helpful discussion with a doctor concerning their illness, few were offered help with talking to children; many would have liked help, particularly the opportunity for both parents to talk to a health professional with experience in understanding and talking to children.ConclusionsParents diagnosed with cancer or other serious illnesses should be offered help to think about whether, what, and how to tell their children and about what children can understand, especially as they may well be struggling themselves to come to terms with their illness.