Cumulative Risks of Foster Care Placement for Danish Children

Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children.     

Important Mycoses in Children in South America

Invasive fungal disease (IFD) is an important infection with high rates of morbidity and mortality in hospitalized patients. Data on incidence, risk factors, and mortality of IFD in the pediatric population, mainly in South America, are scarce. The aim of this paper was to review the literature about the most important IFD in pediatrics in South America. We searched three electronic databases (Medline, Lilacs, and Cochrane databases) for studies published between 2012 and 2015; case reports and editorial were excluded. Twenty-two articles were found on Candida spp. infections; eight on Paracoccidiodes spp.; two on Cryptococcus spp.; and one on Aspergillus spp. Candida albicans was the main agent, followed by Candida parapsilosis in pediatric population. Paracoccidioides spp. had a prevalence ranging from 2.3 to 35.3 % with ages between 11 and 29 years, malnutrition, and hepatic involvement related to the worst prognosis. Cryptococcus spp. showed a prevalence of 2.6 % in under 16 years old, with cryptococcal meningitis most observed, mainly by Cryptococcus neoformans (94.1 %). Aspergillosis and other mold infections, as zygomycosis and fusariosis occurring mostly in immunocompromised children, related with relevant morbidity and mortality in this population.     

Screening Foster Children for Mental Disorders: Properties of the Strengths and Difficulties Questionnaire

Background

High prevalence of mental disorders among foster children highlight the need to examine the mental health of children placed out of home. We examined the properties of the Strengths and Difficulties Questionnaire (SDQ) in screening school-aged foster children for mental disorders.

Methods

Foster parents and teachers of 279 foster children completed the SDQ and the diagnostic interview Developmental and Well-Being Assessment (DAWBA). Using the diagnoses derived from the DAWBA as the standard, we examined the performance of the SDQ scales as dimensional measures of mental health problems using receiver operating characteristic (ROC) analyses. Recommended cut-off scores were derived from ROC coordinates. The SDQ predictive algorithms were also examined.

Results

ROC analyses supported the screening properties of the SDQ Total difficulties and Impact scores (AUC = 0.80–0.83). Logistic regression analyses showed that the prevalence of mental disorders increased linearly with higher SDQ Total difficulties scores (X² = 121.47, df = 13, p<.001) and Impact scores (X² = 69.93, df = 6, p<.001). Our results indicated that there is an additive value of combining the scores from the Total difficulties and Impact scales, where scores above cut-off on any of the two scales predicted disorders with high sensitivity (89.1%), but moderate specificity (62.1%). Scores above cut-off on both scales yielded somewhat lower sensitivity (73.4%), but higher specificity (81.1%). The SDQ multi-informant algorithm showed low discriminative ability for the main diagnostic categories, with an exception being the SDQ Conduct subscale, which accurately predicted the absence of behavioural disorders (LHR− = 0.00).

Conclusions

The results support the use of the SDQ Total difficulties and Impact scales when screening foster children for mental health problems. Cut-off values for both scales are suggested. The SDQ multi-informant algorithms are not recommended for mental health screening of foster children in Norway.     

Intestinal Parasites in Immigrant Children From Central America

To begin to characterize the health needs of the growing number of refugees from Central America, we compiled the results of examinations for ova and parasites of a single stool specimen of each of 128 children of Central American and Mexican background who entered our health center during a four-month period. Among the 96 children who were born in Central America or Mexico, there was a 65% prevalence of parasitic infestation. Pathogens were found in 46% and multiple pathogens in 14%. Among the 32 American-born children there was a 13% prevalence of parasitic infection, but no pathogens were found. There was no correlation between symptoms and the presence of parasites. Screening Central American immigrant children for intestinal parasites is a high-yield procedure and should be part of their routine health care.     

I Am My Language: Discourses of Women and Children in the Borderlands.

. Am My Language: Discourses of Women and Children in the Borderlands. Norma González. Tucson: University of Arizona Press, 2001. 240 pp.     

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus

Objective

There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness.

Methods

A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data.

Results

The cost was €326.3 per parent, of which €53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and €272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of €47 290 per gained QALY. The sensitivity analyses resulted in ratios from €41 739 to €55 072. With the common Swedish threshold value of €55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent.

Conclusion

Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.     

Mothering influences the distribution of activity in young domestic chicks

The aim of this study was to determine whether the presence of a maternal hen influences the quality, quantity, and distribution of activity in young chicks. Brooded and nonbrooded chicks were observed during the entire light phase when they were 4 d of age. Our results revealed that although both brooded and nonbrooded chicks expressed the same behavioral items and in quite the same quantity, activity bouts were much longer in brooded chicks. However, only brooded chicks presented a high level of ultradian rhythmicity. Moreover, the brooded chicks made greater use of the space. The presence and the behavior of maternal hens appeared to provide structuring factors for the expression of the chicks' behavior.     

Social and Demographic Influences on Mothering Style in Pigtail Macaques

This study represents the first investigation of variability in mothering styles in pigtail macaques, Macaca nemestrina nemestrina. Fifteen group-living mother-infant pairs were focally observed during the first 12 wk of infant life and several measures of maternal and infant behavior were recorded. Variability in mothering styles occurred along the three dimensions of maternal protectivencss, rejection, and warmth. Maternal parity and aggression received by mothers were the best predictors of variability in protectiveness and warmth, whereas variability in rejection was not predicted by any of the variables considered. This study provides clear evidence that aggression towards mothers and previous maternal experience have an important influence on mothering styles in pigtail macaques.     

Mothering influences the distribution of activity in young domestic chicks

The aim of this study was to determine whether the presence of a maternal hen influences the quality, quantity, and distribution of activity in young chicks. Brooded and nonbrooded chicks were observed during the entire light phase when they were 4 d of age. Our results revealed that although both brooded and nonbrooded chicks expressed the same behavioral items and in quite the same quantity, activity bouts were much longer in brooded chicks. However, only brooded chicks presented a high level of ultradian rhythmicity. Moreover, the brooded chicks made greater use of the space. The presence and the behavior of maternal hens appeared to provide structuring factors for the expression of the chicks' behavior.