Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis

OBJECTIVES: To determine age and gender differences in health-related quality of life (HRQOL) in children and adolescents across 12 European countries using a newly developed HRQOL measure (KIDSCREEN). METHODS: The KIDSCREEN-52 questionnaire was filled in by 21,590 children and adolescents aged 8-18 from 12 countries. We used multilevel regression analyses to model the hierarchical structure of the data. In addition, effect sizes were computed to test for gender differences within each age group. RESULTS: Children generally showed better HRQOL than adolescents (P < 0.001). While boys and girls had similar HRQOL at young age, girls' HRQOL declined more than boys' (P < 0.001) with increasing age, depending on the HRQOL scale. There was significant variation between countries both at the youngest age and for age trajectories. CONCLUSIONS: For the first time, gender and age differences in children's and adolescents' HRQOL across Europe were assessed using a comprehensive and standardised instrument. Gender and age differences exist for most HRQOL scales. Differences in HRQOL across Europe point to the importance of national contexts for youth's well-being.

Measles outbreak in Germany: clinical presentation and outcome of children hospitalized for measles in 2006

In 2006, 115 children hospitalized with measles in Germany were reported. Detailed information could be obtained for 96 cases from a pediatric hospital surveillance system. The most frequent symptoms and complications were pneumonia, respiratory insufficiency, other respiratory disorders, otitis media, feeding problems, and other gastrointestinal symptoms. Two children died of measles inclusion body encephalitis.

Integration of electrical neuroimaging with other functional imaging methods

Integrating evidence from different imaging modalities is important to overcome specific limitations of any given imaging method, such as insensitivity of the EEG to unsynchronized neural events, or the lack of fMRI sensitivity to events of low metabolic demand. Processes that are visible in one modality may be related in a nontrivial way to other processes visible in another modality and insight may only be obtained by integrating both methods through a common analysis. For example, brain activity at rest seems to be at least partly determined by an interaction of cortical rhythms (visible to EEG but not to fMRI) with sub-cortical activity (visible to fMRI, but usually not to EEG without averaging). A combination of EEG and fMRI data during rest may thus be more informative than the sum of two separate analyses in both modalities. Integration is also an important source of converging evidence about specific aspects and general principles of neural functions and their dysfunctions in certain pathologies. This is because not only electrical, but also energetic, biochemical, hemodynamic and metabolic processes characterize neural states and functions, and because brain structure provides crucial constraints upon neural functions. Focusing on multimodal integration of functional data should not distract from the privileged status of the electric field as the primary direct, noninvasive real-time measure of neural transmission. The preceding chapters illustrate how electrical neuroimaging has turned scalp EEG into an imaging modality which directly captures the full temporal dynamics of neural activity in the brain.

A 4-year study on clinical characteristics of children hospitalized with rotavirus gastroenteritis

Rotavirus (RV) is a frequent cause of severe gastroenteritis (GE) in children. With the licensure of new RV vaccines, data on the burden of disease are important regarding immunization strategies. We reviewed the medical records of children hospitalized with RV infection in our institution between July 2002 and March 2006. Relevant data were extracted in a standardized fashion from records of hospitalized children with a positive RV antigen test in a stool sample. Severity of disease was graded by the 20-point Vesikari score. Population data were obtained from the Federal Office of Statistics. Six hundred eighty-six RVGE were identified and records of 608 hospitalizations (in 607 children) were available. In 539 (89%) cases, RVGE was the primary reason for hospitalization and 69 (11%) were nosocomial infections; yearly peaks occurred between February and May. Cumulative incidence of RVGE was 26.7/1,000 children <3 years of age. Median age of 539 children (55.6% male) with primary RVGE was 1.4 years and median stay in the hospital for both community acquired and nosocomial RVGE was 4 days (interquartile range 3-5). Thirtypercent and 94% of RV hospitalizations were in children <1 and <3 years of age, respectively. Mean Vesikari score was 15 (range 6-20; 96% >11). Intravenous fluids were administered in 378 (70%) patients, 130 (24%) patients were rehydrated via nasogastral tube, and 31 (5.7%) received rehydration by mouth. RVGE causes a substantial burden in children with an estimated risk for hospitalization due to RVGE of one in 37 children <3 years of age.

Curricular Integration of Simulations in Neuroscience - Instructional and Technical Perspectives

In recent years interactive media and tools, like scientific simulations and simulation environments or dynamic data visualizations, became established methods in the neural and cognitive sciences. Hence, university teachers of neural and cognitive sciences are faced with the challenge to integrate these media into the neuroscientific curriculum. Especially simulations and dynamic visualizations offer great opportunities for teachers and learners, since they are both illustrative and explorable. However, simulations bear instructional problems: they are abstract, demand some computer skills and conceptual knowledge about what simulations intend to explain. By following two central questions this article provides an overview on possible approaches to be applied in neuroscience education and opens perspectives for their curricular integration: (i) How can complex scientific media be transformed for educational use in an efficient and (for students on all levels) comprehensible manner and (ii) by what technical infrastructure can this transformation be supported? Exemplified by educational simulations for the neurosciences and their application in courses, answers to these questions are proposed a) by introducing a specific educational simulation approach for the neurosciences b) by introducing an e-learning environment for simulations, and c) by providing examples of curricular integration on different levels which might help academic teachers to integrate newly created or existing interactive educational resources in their courses.

The Care and Shelter of Children and Adolescents in Brazil: Expressions of Social Issues

The future of Brazilian children who have the protection offered by familial bonds is threatened by social inequities that force them to seek shelter and grow up in shelters. According to the Institute of Applied Economic Research, an estimated 20,000 children and adolescents are served by institutions. The majority of these children are afro-descendent males between the ages of seven and fifteen years old. Of those researched, 87.6% have families (58.2% receive visits from their families, 22.7% are rarely visited by their families and 5.8 are legally prohibited from contacting or being by their families). The percentage of children and adolescents “without families” or with “missing families” is 11.3%. There is no information available for 2% of the children and adolescents residing in shelters. The principle factors that necessitate the placement of Brazilian children in institutions that provide care and shelter include poverty (including children forced to work, sell drugs or beg, for example); domestic violence; chemical dependence of parents or guardians; homelessness; death or parents or guardian; imprisonment of their parents; and sexual abuse committed by their parents or guardians. The issue of abandoned children and adolescents and their care and shelter in the Brazilian context expresses a perverse violation of Child and Adolescent Rights.

Integration of Truncated Distributions in Exponential Family with Simulation Models of Logistics and Supply Chain Management

Truncated distributions of the exponential family have great influence in the simulation models. This paper discusses the truncated Weibull distribution specifically. The truncation of the distribution is achieved by the Maximum Likelihood Estimation method or combined with the expectation and variance expressions. After the fitting of distribution, the goodness-of-fit tests (the Chi-Square test and the Kolmogorov-Smirnov test) are executed to rule out the rejected hypotheses. Finally the distributions are integrated in various simulation models, e. g. shipment consolidation model, to compare the influence of truncated and original versions of Weibull distribution on the model.

Development of a novel material flow simulation model for the integration of spatial and process relevant information

Simulation techniques are almost indispensable in the analysis of complex systems. Materials- and related information flow processes in logistics often possess such complexity. Further problem arise as the processes change over time and pose a Big Data problem as well. To cope with these issues adaptive simulations are more and more frequently used. This paper presents a few relevant advanced simulation models and intro-duces a novel model structure, which unifies modelling of geometrical relations and time processes. This way the process structure and their geometric relations can be handled in a well understandable and transparent way. Capabilities and applicability of the model is also presented via a demonstrational example.

Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations

OBJECTIVES This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. MATERIAL AND METHODS The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. RESULTS Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.

Enterprise Integration of Smart Objects using Semantic Service Descriptions

Integrating physical objects (smart objects) and enterprise IT systems is still a labor intensive, mainly manual task done by domain experts. On one hand, enterprise IT backend systems are based on service oriented architectures (SOA) and driven by business rule engines or business process execution engines. Smart objects on the other hand are often programmed at very low levels. In this paper we describe an approach that makes the integration of smart objects with such backends systems easier. We introduce semantic endpoint descriptions based on Linked USDL. Furthermore, we show how different communication patterns can be integrated into these endpoint descriptions. The strength of our endpoint descriptions is that they can be used to automatically create REST or SOAP endpoints for enterprise systems, even if which they are not able to talk to the smart objects directly. We evaluate our proposed solution with CoAP, UDP and 6LoWPAN, as we anticipate the industry converge towards these standards. Nonetheless, our approach also allows easy integration with backend systems, even if no standardized protocol is used.

Integration of Pasturing Systems for Cattle Finishing Programs—A Progress Report

This progress report is an introduction to a study to evaluate the incorporation of rotational pasturing systems into cattle finishing programs. Because the first year is still in progress and the first trial is not complete, few data are available. However, there is a suggestion that feeding an ionophore to young calves on pasture may result in improved daily gains.

Integration of Pasturing Systems for Cattle Finishing Programs

A 3-year study, using 84 fall-born and 28 spring-born calves of similar genotypes, was conducted to integrate pasturing systems with drylot feeding systems. Calves were started on test following weaning in May and October. Seven treatments were imposed: 1) fall-born calves directly into feedlot; 2 and 3) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of July; 4 and 5) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October; 6 and 7) spring-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October. A bromegrass pasture consisting of 16 paddocks, each 1.7 acre in size, was available. Each treatment group had access to 1 paddock at a time and was rotated at approximately 3-day intervals. In the feedlot, steers were provided an 82% concentrate diet containing whole-shelled corn, ground alfalfa hay, and a protein, vitamin and mineral supplement containing ionophore and molasses. As pens of cattle reached about 1150 lb. average live weight, they were processed and carcass traits were evaluated. Pasture daily gains were highest for cattle on pasture for the longest duration (P < .03), and overall daily gains were highest for drylot cattle (P < .01) and decreased with increased time spent on pasture. Although differences among treatments existed in numerical scores for yield and quality grades (P < .05 and P < .03, respectively), all treatments provided average yield grade scores of 2 and quality grades of low Choice or higher. Use of four production costs and pricing scenarios revealed that fall-born calves placed on pasture for varying lengths of time were the most profitable (P < .04) among the treatments. Furthermore, employing a 5% price sensitivity analysis, indicated that fed-cattle selling price had great impact on profit potential and was followed in importance by feeder purchase price and corn grain price. Overall, these findings should provide significant production alternatives for some segments of the cattle feeding industry and also lend substantial credence to the concept of sustainable agriculture.