Mothers' perception of the quality of childhood sibling relationships affected by disability

The quality of the sibling relationship has an important role in the development of psychosocial skills throughout childhood. While the literature suggests that the significance of sibling relationships is heightened when one sibling has a disability, empirical findings about the quality of these relationships are few and inconsistent. The present study aimed to address this gap, by investigating mothers’ perspectives about the impact of disability on the quality of the childhood sibling relationship. Forty-one mothers with a child with disability, and 48 with no children with disability completed an online questionnaire that assessed the amount of perceived warmth/closeness and conflict in their children’s sibling relationship. It was found that while there were no differences in reported conflict between the two groups, mothers with a child with disability reported significantly lower warmth/closeness in their children’s sibling relationship than mothers without a child with disability. Demographic variables such as number of children, gender grouping, target gender, target age and age order did not moderate this result. Mothers overall reported significantly more warmth/closeness for younger rather than older children, and more conflict when the sibling was younger than the target child as opposed to older than them. Clinical implications for intervention are discussed.

Correction: Genome-wide association studies of asthma in population-based cohorts confirm known and suggested loci and identify an additional association near HLA

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Genome-Wide Association Studies of Asthma in Population-Based Cohorts Confirm Known and Suggested Loci and Identify an Additional Association near HLA

Rationale: Asthma has substantial morbidity and mortality and a strong genetic component, but identification of genetic risk factors is limited by availability of suitable studies. Objectives: To test if population-based cohorts with self-reported physician-diagnosed asthma and genome-wide association (GWA) data could be used to validate known associations with asthma and identify novel associations. Methods: The APCAT (Analysis in Population-based Cohorts of Asthma Traits) consortium consists of 1,716 individuals with asthma and 16,888 healthy controls from six European-descent population-based cohorts. We examined associations in APCAT of thirteen variants previously reported as genome-wide significant (P<5x10-8) and three variants reported as suggestive (P<5×10-7). We also searched for novel associations in APCAT (Stage 1) and followed-up the most promising variants in 4,035 asthmatics and 11,251 healthy controls (Stage 2). Finally, we conducted the first genome-wide screen for interactions with smoking or hay fever. Main Results: We observed association in the same direction for all thirteen previously reported variants and nominally replicated ten of them. One variant that was previously suggestive, rs11071559 in RORA, now reaches genome-wide significance when combined with our data (P = 2.4×10-9). We also identified two genome-wide significant associations: rs13408661 near IL1RL1/IL18R1 (PStage1+Stage2 = 1.1x10-9), which is correlated with a variant recently shown to be associated with asthma (rs3771180), and rs9268516 in the HLA region (PStage1+Stage2 = 1.1x10-8), which appears to be independent of previously reported associations in this locus. Finally, we found no strong evidence for gene-environment interactions with smoking or hay fever status. Conclusions: Population-based cohorts with simple asthma phenotypes represent a valuable and largely untapped resource for genetic studies of asthma. © 2012 Ramasamy et al.

Do human rhinovirus infections and food allergy modify grass pollen-induced asthma hospital admissions in children?

Asthma prevalence in children has remained relatively constant in many Western countries, but hospital admissions for younger age groups have increased over time.1 Although the role of outdoor aeroallergens as triggers for asthma exacerbations requiring hospitalization in children and adolescents is complex, there is evidence that increasing concentrations of grass pollen are associated with an increased risk of asthma exacerbations in children.2 Human rhinovirus (HRV) infections are implicated in most of the serious asthma exacerbations in school-age children.3 In previous research, HRV infections and aeroallergen exposure have usually been studied independently. To our knowledge, only 1 study has examined interactions between these 2 factors,4 but lack of power prevented any meaningful interpretation...

Altered immunoglobulin E diversity and regulation of allergic inflammation in asthma

The clinical efficacy of anti-immunoglobulin E (IgE) therapy indicates a central role for IgE in perpetuation of allergic inflammatory diseases. Omalizumab is now uti- lized in treatment of a wide variety of allergic conditions including severe asthma, allergic rhinitis, atopic dermati- tis, food allergy and urticaria either alone or adjunct with other therapies such as steroid administration or allergen- specific immunotherapy [1, 2]. Current research activity is focused on the cellular and molecular mechanisms by which IgE influences the immunopathogenesis of allergic disease [3]. Increased knowledge of how IgE exerts its effects will underpin effective clinical use of anti-IgE treatment. In this issue Kerzel et al. [4] investigate the effects of altered antibo dy repertoire on the outcomes of an experimental model of allergic asthma.

The effect of LRP5 polymorphisms on bone mineral density is apparent in childhood

Bone mass acquired during childhood is the primary determinant of adult bone mineral density (BMD) and osteoporosis risk. Bone accrual is subject to genetic influences. Activating and inactivating LRP5 gene mutations elicit extreme bone phenotypes, while more common LRP5 polymorphisms are associated with normal variation of BMD. Our aim was to test the hypothesis that LRP5 gene polymorphisms influence bone mass acquisition during childhood. The association between LRP5 gene polymorphisms and bone size and mineralization was examined in 819 unrelated British Caucasian children (n = 429 boys) aged 9 years. Height, weight, pubertal status (where available), total-body and spinal bone area, bone mineral content (BMC), BMD, and area-adjusted BMC (aBMC) were assessed. Dual-energy X-ray absorptiometry (DXA)-gene associations were assessed by linear regression, with adjustment for age, gender, pubertal status, and body size parameters. There were 140, 79, 12, and 2 girls who achieved Tanner stages I-IV, respectively, and 179 and 32 boys who achieved Tanner stages I and II, respectively. The rs2306862 (N740N) coding polymorphism in exon 10 of the LRP5 gene was associated with spinal BMD and aBMC (each P = 0.01) and total-body BMD and aBMC (P = 0.04 and 0.03, respectively). Adjusting for pubertal stage strengthened associations between this polymorphism and spinal BMD and aBMC (P = 0.01 and 0.002, respectively). Individuals homozygous for the T allele had greater spinal BMD and aBMC scores than those homozygous for the C allele. A dose effect was apparent as the mean spinal BMD and aBMC of heterozygous TC individuals were intermediate between those of their TT and CC counterparts. The N740N polymorphism in exon 10 of LRP5 was associated with spinal BMD and aBMC in pre- and early pubertal children. These results indicate that LRP5 influences volumetric bone density in childhood, possibly through effects on trabecular bone formation.

Associations between extreme precipitation and childhood hand, foot and mouth disease in urban and rural areas in Hefei, China

Background Understanding the relationship between extreme weather events and childhood hand, foot and mouth disease (HFMD) is important in the context of climate change. This study aimed to quantify the relationship between extreme precipitation and childhood HFMD in Hefei, China, and further, to explore whether the association varied across urban and rural areas. Methods Daily data on HFMD counts among children aged 0–14 years from 2010 January 1st to 2012 December 31st were retrieved from Hefei Center for Disease Control and Prevention. Daily data on mean temperature, relative humidity and precipitation during the same period were supplied by Hefei Bureau of Meteorology. We used a Poisson linear regression model combined with a distributed lag non-linear model to assess the association between extreme precipitation (≥ 90th precipitation) and childhood HFMD, controlling for mean temperature, humidity, day of week, and long-term trend. Results There was a statistically significant association between extreme precipitation and childhood HFMD. The effect of extreme precipitation on childhood HFMD was the greatest at six days lag, with a 5.12% (95% confident interval: 2.7–7.57%) increase of childhood HFMD for an extreme precipitation event versus no precipitation. Notably, urban children and children aged 0–4 years were particularly vulnerable to the effects of extreme precipitation. Conclusions Our findings indicate that extreme precipitation may increase the incidence of childhood HFMD in Hefei, highlighting the importance of protecting children from forthcoming extreme precipitation, particularly for those who are young and from urban areas.

Childhood sexual abuse and adult sexual dysfunction: Response to commentary by Rind and Tromovitch (2007)

Rind and Tromovitch (2007) raised four concerns relating to our article (Najman, Dunne, Purdie, Boyle, & Coxeter, 2005. Archives of Sexual Behavior, 34, 517-526.) which suggested a causal association between childhood sexual abuse (CSA) and adult sexual dysfunction. We consider each of these concerns: magnitude of effect, cause and effect, confounding, and measurement error. We suggest that, while the concerns they raise represent legitimate reservations about the validity of our findings, on balance the available evidence indicates an association between CSA and sexual dysfunction that is of "moderate" magnitude, probably causal, and unlikely to be a consequence of confounding or measurement error.

Adverse childhood experiences and the health of university students in eight provinces of Vietnam

Recent systematic reviews have emphasized the need for more research into the health and social impacts of adverse childhood experiences (ACEs) in the Asia-Pacific region. This cross-sectional study was conducted with 2099 young adult students in 8 medical universities throughout Vietnam. An anonymous, self-report questionnaire included the World Health Organization ACE-International Questionnaire and standardized measures of mental and physical health. Three quarters (76%) of the students reported at least one exposure to ACEs; 21% had 4 or more ACEs. The most commonly reported adversities were emotional abuse, physical abuse, and witnessing a household member being treated violently (42.3%, 39.9%, and 34.6%, respectively). Co-occurrence of ACEs had dose–response relationships with poor mental health, suicidal ideation, and low physical health–related quality of life. This first multisite study of ACEs among Vietnamese university students provided evidence that childhood adversity is common and is significantly linked with impaired health and well-being into the early adult years

Long-term effect of childhood liver transplantation on body cell mass

Malnutrition is common in end-stage liver disease, but a correction after transplantation is expected. Body cell mass (BCM) assessment using total body potassium (TBK) measurements is considered the gold standard for assessing nutritional status. The aim of this study was to examine the BCM and, therefore, nutritional status of long-term survivors after childhood liver transplantation. © 2014 American Association for the Study of Liver Diseases.

Long-term growth and anthropometry after childhood liver transplantation

Objectives: To describe longitudinal height, weight, and body mass index changes up to 15 years after childhood liver transplantation. Study design: Retrospective chart review of patients who underwent liver transplant from 1985-2004 was performed. Subjects were age <18 years at transplant, survived ≥5 years, with at least 2 recorded measurements, of which one was ≥5 years post-transplant. Measurements were recorded pre-transplant, 1, 5, 10, and 15 years later. Results: Height and weight data were available in 98 and 104 patients, respectively; 47% were age <2 years at transplant; 58% were Australian, and the rest were from Japan. Height recovery continued for at least 10 years to reach the 26th percentile (Z-score -0.67) 15 years after transplant. Australians had better growth recovery and attained 47th percentile (Z-score -0.06) at 15 years. Weight recovery was most marked in the first year and continued for 15 years even in well-nourished children. Growth impaired and malnourished children at transplant exhibited the best growth, but remained significantly shorter and lighter even 15 years later. No effect of sex or age at transplant was noted on height or weight recovery. Post-transplant factors significantly impact growth recovery and likely caused the dichotomous growth recovery between Australian and Japanese children; 9% (9/98) of patients were overweight on body mass index calculations at 10-15 years but none were obese. Conclusions: After liver transplant, children can expect ongoing height and weight recovery for at least 10-15 years. Growth impairment at transplant and post-transplant care significantly impact long-term growth recovery. Copyright © 2013 Mosby Inc. All rights reserved.

Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change

Parent-centred interventions for childhood obesity aim to improve parents' skills and confidence in managing children's dietary and activity patterns, and in promoting a healthy lifestyle in their family. However, few studies assess changes in parenting over the course of treatment. This study describes the evaluation of a lifestyle-specific parenting program (Group Lifestyle Triple P) on multiple child and parent outcomes. One-hundred-and-one families with overweight and obese 4- to 11-year-old children participated in an intervention or waitlist control condition. The 12-week intervention was associated with significant reductions in child BMI z score and weight-related problem behaviour. At the end of the intervention, parents reported increased confidence in managing children's weight-related behaviour, and less frequent use of inconsistent or coercive parenting practices. All short-term intervention effects were maintained at one-year follow-up assessment, with additional improvements in child body size. The results support the efficacy of Group Lifestyle Triple P and suggest that parenting influences treatment outcomes. Further research is needed to evaluate the long-term effectiveness of the intervention and to elucidate the mechanisms of change. © 2010 Elsevier Ltd.

Genome-wide association analysis identifies 11 risk variants associated with the asthma with hay fever phenotype

Background To date, no genome-wide association study (GWAS) has considered the combined phenotype of asthma with hay fever. Previous analyses of family data from the Tasmanian Longitudinal Health Study provide evidence that this phenotype has a stronger genetic cause than asthma without hay fever. Objective We sought to perform a GWAS of asthma with hay fever to identify variants associated with having both diseases. Methods We performed a meta-analysis of GWASs comparing persons with both physician-diagnosed asthma and hay fever (n = 6,685) with persons with neither disease (n = 14,091). Results At genome-wide significance, we identified 11 independent variants associated with the risk of having asthma with hay fever, including 2 associations reaching this level of significance with allergic disease for the first time: ZBTB10 (rs7009110; odds ratio [OR], 1.14; P = 4 × 10−9) and CLEC16A (rs62026376; OR, 1.17; P = 1 × 10−8). The rs62026376:C allele associated with increased asthma with hay fever risk has been found to be associated also with decreased expression of the nearby DEXI gene in monocytes. The 11 variants were associated with the risk of asthma and hay fever separately, but the estimated associations with the individual phenotypes were weaker than with the combined asthma with hay fever phenotype. A variant near LRRC32 was a stronger risk factor for hay fever than for asthma, whereas the reverse was observed for variants in/near GSDMA and TSLP. Single nucleotide polymorphisms with suggestive evidence for association with asthma with hay fever risk included rs41295115 near IL2RA (OR, 1.28; P = 5 × 10−7) and rs76043829 in TNS1 (OR, 1.23; P = 2 × 10−6). Conclusion By focusing on the combined phenotype of asthma with hay fever, variants associated with the risk of allergic disease can be identified with greater efficiency.

Rethinking Culture and Diversity in Early Childhood Preservice Teacher Education: Looking at Teaching and Learning Through an Interdisciplinary Lens

Early Childhood Education (ECE) has a long history of building foundations for children to achieve their full potential, enabling parents to participate in the economy while children are cared for, addressing poverty and disadvantage, and building individual, community and societal resources. In so doing, ECE has developed a set of cultural practices and ways of knowing that shape the field and the people who work within it. ECE, consequently, is frequently described as unique and special (Moss, 2006; Penn, 2011). This works to define and distinguish the field while, simultaneously, insulating it from other contexts, professions, and ideas. Recognising this dualism illuminates some of the risks and challenges of operating in an insular and isolated fashion. In the 21st century, there are new challenges for children, families and societies to which ECE must respond if it is to continue to be relevant. One major issue is how ECE contributes to transition towards more sustainable ways of living. Addressing this contemporary social problem is one from which Early Childhood teacher education has been largely absent (Davis & Elliott, 2014), despite the well recognised but often ignored role of education in contributing to sustainability. Because of its complexity, sustainability is sometimes referred to as a ‘wicked problem’ (Rittel & Webber, 1973; Australian Public Service Commission, 2007) requiring alternatives to ‘business as usual’ problem solving approaches. In this chapter, we propose that addressing such problems alongside disciplines other than Education enables the Early Childhood profession to have its eyes opened to new ways of thinking about our work, potentially liberating us from the limitations of our “unique” and idiosyncratic professional cultures. In our chapter, we focus on understandings of culture and diversity, looking to broaden these by exploring the different ‘cultures’ of the specialist fields of ECE and Design (in this project, we worked with students studying Architecture, Industrial Design, Landscape Architecture and Interior Design). We define culture not as it is typically represented, i.e. in relation to ideas and customs of particular ethnic and language groups, but to the ideas and practices of people working in different disciplines and professions. We assert that different specialisms have their own ‘cultural’ practices. Further, we propose that this kind of theoretical work helps us to reconsider ways in which ECE might be reframed and broadened to meet new challenges such as sustainability and as yet unknown future challenges and possibilities. We explore these matters by turning to preservice Early Childhood teacher education (in Australia) as a context in which traditional views of culture and diversity might be reconstructed. We are looking to push our specialist knowledge boundaries and to extend both preservice teachers and academics beyond their comfort zones by engaging in innovative interdisciplinary learning and teaching. We describe a case study of preservice Early Childhood teachers and designers working in collaborative teams, intersecting with a ‘real-world’ business partner. The joint learning task was the design of an early learning centre based on sustainable design principles and in which early Education for Sustainability (EfS) would be embedded Data were collected via focus group and individual interviews with students in ECE and Design. Our findings suggest that interdisciplinary teaching and learning holds considerable potential in dismantling taken-for-granted cultural practices, such that professional roles and identities might be reimagined and reconfigured. We conclude the chapter with provocations challenging the ways in which culture and diversity in the field of ECE might be reconsidered within teacher education.

A new regulatory variant in the interleukin-6 receptor gene associates with asthma risk

The main genetic determinant of soluble interleukin 6 receptor (sIL-6R) levels is the missense variant rs2228145 that maps to the cleavage site of IL-6R. For each Ala allele, sIL-6R serum levels increase by ∼20 ng ml -1 and asthma risk by 1.09-fold. However, this variant does not explain the total heritability for sIL-6R levels. Additional independent variants in IL6R may therefore contribute to variation in sIL-6R levels and influence asthma risk. We imputed 471 variants in IL6R and tested these for association with sIL-6R serum levels in 360 individuals. An intronic variant (rs12083537) was associated with sIL-6R levels independently of rs4129267 (P=0.0005), a proxy single-nucleotide polymorphism for rs2228145. A significant and consistent association for rs12083537 was observed in a replication panel of 354 individuals (P=0.033). Each rs12083537:A allele increased sIL-6R serum levels by 2.4 ng ml -1. Analysis of mRNA levels in two cohorts did not identify significant associations between rs12083537 and IL6R transcription levels. On the other hand, results from 16 705 asthmatics and 30 809 controls showed that the rs12083537:A allele increased asthma risk by 1.04-fold (P=0.0419). Genetic risk scores based on IL6R regulatory variants may prove useful in explaining variation in clinical response to tocilizumab, an anti-IL-6R monoclonal antibody.