Chronic illness and functional limitation in Ontario children: findings of the Ontario Child Health Study.

The Ontario Child Health Study (OCHS) was based on interviews of 1869 Ontario families who were selected by means of a stratified, multistaged sampling method from the 1981 census of Canada. Its primary purpose was to determine the prevalence and distribution of mental health problems in Ontario children aged 4 to 16 years and their families, but it also allowed an estimate of other significant medical conditions and provided an overview of these children''s use of health care, education and social services. Our results are based on questionnaire responses concerning 3294 children. Limitation of function without a chronic illness or medical condition was reported in 1.9%, the converse in 14.0%, and a chronic illness or medical condition with limitation of function in 3.7%. When the three groups are considered together, 19.6% of Ontario children had a chronic health problem. Children of lower socioeconomic status were much more likely to have chronic health problems. Overall, children with chronic health problems were more likely to use physician, special education, social and mental health services. These findings have implications for those who provide services for children, plan community programs or train professionals in caring for children.     

Epilepsy in the first 10 years of life: findings of the child health and education study.

OBJECTIVES--To identify children with afebrile seizures in a national cohort, classify the seizures, and document progress in the first 10 years of life. DESIGN--Population based birth cohort study. SETTING--The child health and education study, which includes 16,004 neonatal survivors (98.5% of infants born in the United Kingdom during one week of April 1970). SUBJECTS--14,676 children for whom relevant information was available. MAIN OUTCOME MEASURES--Responses to parental and general practitioner questionnaires and hospital records at 5 and 10 years after birth. RESULTS--84 children (42 boys, 42 girls) had had one or more afebrile seizure (incidence 5.7/1000). 63 children (31 boys, 32 girls) had epilepsy (incidence 4.3/1000). 49 of 55 children had a second seizure within a year of the first. The commonest seizure types were tonic-clonic (42) and complex partial (25). A greater proportion of children with complex partial seizures had recurrences. Children who had infantile spasms or a mixed seizure disorder had a poor outcome. All six children who died had symptomatic seizures in the first year, but seizures were not the direct cause of death. CONCLUSIONS--The results of this study are probably representative of seizure patterns in the general population. Outcome after seizures is determined more by the underlying disease than by the seizures themselves.     

Epilepsy and Pregnancy: A Report from the Oxford Record Linkage Study

The files of the Oxford Record Linkage Study were used to identify 223 infants delivered to 168 epileptic women as the result of 218 pregnancies. There were six stillbirths, two of which were grossly malformed. It was shown that the population of epileptic mothers differed significantly from the total reproducing population in respect of social class. Each pregnancy resulting in a livebirth was therefore matched exactly for social class, civil status, maternal age, parity, hospital, and year of delivery with three control deliveries resulting in livebirths. The defects noted at birth were abstracted from the Record Linkage files, and any subsequent hospital admissions or deaths of the children were also abstracted.There were highly significant excesses of congenital abnormalities among the infants born to epileptic mothers (13·8% of livebirths had some degree of defect of congenital origin compared with 5·6% of controls, P <0·0005). It was shown that neither the frequency with which the mother had fits nor the length of time she had had the epilepsy seemed to bear any relation to the frequency of defects in the offspring—with the exception of the two mothers who developed epilepsy in the first     

National styles of regulation: Child care in three countries

An analysis of child care regulations in Germany, Sweden, and the United States reveals distinctive national policy styles. A social constructionist perspective, with its emphasis on variable problem definitions, helps to explain such differences. However, a full understanding of regulatory differences requires attention to regulatory solutions as well. By disaggregating the concept of regulation, we are able to demonstrate rather different rank-orderings of our three countries in their regulatory solutions. We attribute these differences to cultural, institutional, and political characteristics of the three countries.     

A Psychological Study of the Development of Motor Activity in the Preschool-Age Child

During the period from 4 to 6 years, the preschooler's motor activity becomes stronger and hardier, and his movements become more dextrous and coordinated. During this period a child also acquires a number of new motor skills that will play an important role in later life. Finally, he learns to execute movements consciously and deliberately.     

Lacerations from glass in childhood.

A study of 62 glass injuries to children serious enough to warrant admission to hospital showed that 30 were due to architectural glass in doors or windows and 26 of these occurred in houses. Glass bottles caused 12 injuries. Architectural glass produced more serious injuries affecting major arteries, nerves and tendons, and internal viscera. In view of the frequency and severity of architectural glass injuries in houses, safety glass in recommended for all glass doors, French windows, patio doors, and the lower parts of windows.     

Risk of acute childhood leukaemia in Sweden after the Chernobyl reactor accident. Swedish Child Leukaemia Group.

OBJECTIVE--To evaluate the risk of acute childhood leukaemia in areas of Sweden contaminated after the Chernobyl reactor accident in April 1986. DESIGN--Population based study of childhood leukaemia diagnosed during 1980-92. SETTING--Coordinates for places of residence of all 1.6 million children aged 0-15 years; aerial mapped areas of Sweden heavily contaminated after the Chernobyl accident. SUBJECTS--888 children aged 0-15 years with acute leukaemia diagnosed in Sweden during 1980-92, identified with place of birth and residence at diagnosis. MAIN OUTCOME MEASURES--Risk of leukaemia in areas contaminated after the Chernobyl accident compared with the rest of Sweden and in the same areas before the accident. RESULTS--During six and a half years of follow up after the accident the odds ratio for acute leukaemia was 0.9 (95% confidence interval 0.6 to 1.4) in highly contaminated areas (> or = 10 kBq/m2) compared with the same areas before the accident. For the subgroup acute lymphoblastic leukaemia in children aged under 5 years at diagnosis the odds ratio was 1.5 (0.8 to 2.6). For all cases diagnosed after May 1986 in highly contaminated areas compared with areas of low contamination the odds ratio was 0.9 (0.7 to 1.3). For acute lymphoblastic leukaemia in children aged under 5 years at diagnosis the odds ratio was 1.2 (0.8 to 1.9) in highly contaminated areas compared with areas of low contamination. Dose-response analysis showed no correlation between the degree of contamination and the incidence of childhood leukaemia. CONCLUSION--There has been no significant increase in the incidence of acute childhood leukaemia in areas of Sweden contaminated after the Chernobyl reactor accident.