Snoring and sleep apnea in children

Snoring is a primary and major clinical symptom of upper airway obstruction during sleep. Sleep-disordered breathing ranges from primary snoring to significant partial upper airway obstruction, and obstructive sleep apnea. Adult snoring and obstructive sleep apnea have been extensively studied, whereas less is known about these disorders in children. Snoring and more severe obstructive sleep apnea have been shown to have a harmful effect on the neurobehavioral development of children, but the mechanisms of this effect remains unknown. Furthermore, the correlation of this effect to objective sleep study parameters remains poor. This study evaluated the prevalence of snoring in preschool-aged children in Finland. Host and environmental risk factors, and neurobehavioral and neurocognitive symptoms of children suffering from snoring or obstructive sleep apnea were also investigated. The feasibility of acoustic rhinometry in young children was assessed. The prevalence and risk factors of snoring (I) were evaluated by a questionnaire. The random sample included 2100 children aged 1-6 years living in Helsinki. All 3- to 6-year-old children whose parents reported their child to snore always, often, or sometimes were categorized as snorers, and invited to participate to the clinical study (II-IV). Non-snoring children whose parents were willing to participate in the clinical study were invited to serve as controls. Children underwent a clinical ear-nose-throat examination. Emotional, behavioral, and cognitive performances were evaluated by Child Behavioral Checklist (CBCL), Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) and NEPSY-A Developmental Neuropsychological Assessment (NEPSY). Nasal volume was measured by acoustic rhinometry, and nasal resistance by rhinomanometry. Lateral and posteroanterior cephalometry were performed. A standard overnight ambulatory polysomnography was performed in the home environment. Twenty-six healthy children were tested in order to assess the feasibility of acoustic rhinometry in young children (V). Snoring was common in children; 6.3% of children snored always or often, whereas 81.3% snored never or occasionally. No differences were apparent between snorers and non-snorers regarding age, or gender. Pediatric snoring was associated with recurrent upper respiratory infections, otitis media, and allergic rhinitis. Exposure to parental tobacco smoke, especially maternal smoking, was more common among snorers. Rhinitis was more common among children who exposured to tobacco smoke. Overnight polysomnography (PSG) was performed on 87 children; 74% showed no signs of significant upper airway obstruction during sleep. Three children had obstructive apnea/hypopnea index (OAHI) greater than 5/h. Age, gender, or a previous adenoidectomy or tonsillectomy did not correlate with OAHI, whereas tonsillar size did correlate with OAHI. Relative body weight and obesity correlated with none of the PSG parameters. In cephalometry, no clear differences or correlations were found in PSG parameters or between snorers and non-snorers. No correlations were observed between acoustic rhinometry, rhinomanometry, and PSG parameters. Psychiatric symptoms were more frequent in the snoring group than in the nonsnoring group. In particular, anxious and depressed symptoms were more prevalent in the snoring group. Snoring children frequently scored lower in language functions. However, PSG parameters correlated poorly with neurocognitive test results in these children. This study and previous studies indicate that snoring without episodes of obstructive apnea or SpO2 desaturations may cause impairment in behavioral and neurocognitive functions. The mechanism of action remains unknown. Exposure to parental tobacco smoke is more common among snorers than non-snorers, emphasizing the importance of a smoke-free environment. Children tolerated acoustic rhinometry measurements well.

Jos olisin viisas niin siivoisin : Lasten luovat prosessit päiväkodissa

It has been found usually to talk in the early childhood education in connection with the creativity about arts and skills and about play. In this treatise, the creativity is approached besides play but also from the point of view of the creativity of the everyday. The starting point for the study is the view according to which the creativity is complex interaction between a creative person and an environment. The theoretical body of the study is the Componential theory of creativity of Amabile (1996). The process which is open and product which is new and suitable or acceptable were defined creative. In the opinion of many researchers, the creativity is a phenomenon that has determined in a certain time and place so the creativity is examined from the point of view of the social constructionism. As creative processes in the day nursery it has been defined pretend play, child´s involvement and children´s agentive perception which is based on the Children´s agentive perception theory of Reunamo (2007). The purpose of the study is to clarify how the child's personal factors and the social environment affect the creative processes of children in the day nursery. This Master's thesis is based on the Children' s agentive perception uncovered study led by Jyrki Reunamo (2010) which was carried out in the spring of 2010 in Keski-Uusimaa and in Hämeenlinna and Taiwan. From the study, a name has also been used "on the sources of Orientation", a research project and development project. The study includes the children's evaluation sector, the observation sector, the children's interview sector and the evaluation sector of the pedagogic environment. 891 Children 1-7 year-old by age participated in the study. All the sectors which belong to the study of Reunamo were utilized in this treatise and the Finnish day nurseries or preschool groups which had participated in the study were marked off as the target group. The main component analysis, sum variables, the correlation coefficients, Mann-Whitney s U-test and Kruskall-Wallas test were used for the statistical examination of the quantitative material. In this treatise it was noticed, both the personal properties of the child and a social environment, that they affected all the examined creative processes which also had a significant connection with each other statistically. The definition of creativity was filled best by the participative answers. However, the number of the participative answers was only 8% in the questions concerning adults. That raised the question whether an attempt should be made to have effect so that the children's better participation also in the interaction with the adults would be possible in the educational culture of the day nursery. In the further study, the conscious building of the social environment which supports the creativity from a social constructionism point of view could indeed be an interesting task. The treatise is suitable for an examination of the interaction between the child's person and a social environment especially from the point of view of the creativity.

The “Centre for Child Protection” of the Gregorian University/Rome. First experiences, results and reflections in setting up a global e-learning-program for the prevention of sexual abuse of minors

Resumen: El Centro para la Protección Infantil ha sido fundado en cooperación con el Instituto de Psicología de la Universidad Gregoriana (Roma, Italia), el Departamento para la Psiquiatría/Psicoterapia Infantil y Adolescente del Hospital de la Universidad de Ulm (Alemania) y la Arquidiócesis de Múnich (Alemania). Su tarea principal es la creación de un centro global de entrenamiento e-learning para profesiones de pastoral que respondan al abuso sexual de los menores, tomando en consideración asuntos multilingüísticos e interculturales. Dentro de tres años el Centro desarrollado e implementado un programa e-learning en cuatro lenguas. Ocho socios del proyecto internacional asumen un papel en el reclutamiento de participantes y en la evaluación en curso del programa. En esta fase, personas-test son incluidas en el desarrollo y la evaluación del programa, como parte de la formación (en curso) de sacerdotes y de otros coagentes de pastoral

Legal Aspects of the Use of Child Images in OERs

Considers the legal issues which arise in relation to the taking of or possession of images still and moving) of children for use in an Open Education Resource. JLL

Ikasgelan gauzatzen diren gatazkaz ohartuz

Laburpena: Bost urteko gela batean burututako ikerketa lan honen bidez, gure inguruko eskoletan ohikoa den egoera aztertu nahi da. Hots, eskoletan ematen diren gatazka egoerak, hain zuzen ere. Gainera, argi izan behar dugu hauek ondo bideratzen ez badira biolentzia edota agresibitate egoerak bilakatu daitezkeela. Gatazka hauek bi eratan ulertu daitezke: alde batetik, umearen jokabide negatibo gisa; edota, gaiaren inguruko hausnarketa sakona eginez gero, umeak ingurunea ulertzeko eta horrekin interakzioak egiteko erabiltzen dituen ikasketa mekanismo gisa. Argi dago beraz, gatazka hauen izaera parametro ezberdinek osatzen dutela: irakaslearen papera, eskainitako baliabideak, umearen garapena, etab. Ikuspuntu honetatik lanean ikasgelan bizi izandako gatazken ezaugarrien frekuentzia erregistroa egin da. Gatazka hauen interpretazioak haur hezkuntzako irakasleei hobetu ulertzen eta honekin batera, hauek era positibo batean bideratzen lagundu ahal dizkie.

Efetividade da aplicação semestral de verniz fluoretado no controle da cárie dentária em pré-escolares: resultados após 12 meses de acompanhamento

O presente estudo teve como objetivos avaliar se a aplicação de verniz fluoretado com periodicidade semestral em crianças pré-escolares reduz o número de crianças com lesões de cárie em dentina na dentição decídua, diminui a incidência de lesões de cárie em esmalte e dentina, está inversamente associado à ocorrência de dor e abscesso dentário e produz quaisquer efeitos adversos. A população de estudo consistiu de 200 crianças na faixa etária de 12 a 48 meses, recrutadas em uma unidade de saúde pública da cidade do Rio de Janeiro, as quais foram alocadas aleatoriamente nos grupos teste (verniz fluoretado Duraphat) e controle (verniz placebo). Para o registro da incidência de cárie, as crianças foram examinadas na linha de base e a cada seis meses, durante um ano, por dois odontopediatras previamente treinados e calibrados (Kappa=0,85). A ocorrência de dor, abscesso e efeitos adversos foi verificada a partir de entrevistas com os responsáveis. Os participantes, os seus responsáveis, os operadores e os examinadores desconheciam a qual grupo cada criança pertencia. No final do período de acompanhamento, 71 crianças do grupo teste e 77 do grupo controle foram avaliadas. Constatou-se que, nos grupos teste e controle, o número de crianças com novas lesões de cárie em dentina foi igual a 13 e 20 (teste Qui-quadrado, p=0,34) e que a média do incremento de cárie considerando apenas lesões em dentina (c3eos) foi de 1,1(dp=3,4) e de 1,4(dp=2,8), respectivamente (teste de Mann-Whitney, p=0,29). Uma criança apresentou dor de dente e abscesso dentário e outras duas crianças apresentaram apenas dor de dente. Todas pertenciam ao grupo teste. Com relação aos efeitos adversos, encontrou-se que uma criança pertencente ao grupo controle relatou ardência na cavidade bucal após a aplicação do placebo e que o responsável por um participante do grupo teste sentiu-se incomodado com a coloração amarelada dos dentes da criança após a aplicação do verniz fluoretado. Concluiu-se que a aplicação de verniz fluoretado com periodicidade semestral em crianças pré-escolares é segura e parece contribuir para o controle da progressão de cárie. Contudo, é necessário um período de acompanhamento mais longo para se obter evidência conclusiva a respeito da efetividade dessa intervenção. Não houve associação entre a ocorrência de dor e abscesso dentário e o uso profissional do verniz fluoretado.

Efetividade da aplicação semestral de verniz fluoretado na redução da incidência de cárie dentária em pré-escolares: resultados após 18 meses

O objetivo deste trabalho foi avaliar se, após 18 meses de acompanhamento, a aplicação semestral de verniz fluoretado em pré-escolares reduz a incidência de cárie na dentição decídua. Os possíveis efeitos adversos e a aceitabilidade da intervenção também foram investigados. Desenho do estudo: ensaio clínico controlado, randomizado, duplo-cego, com uso de placebo. Ingressaram no estudo 200 crianças na faixa etária de 12 a 48 meses, recrutadas em uma unidade da rede pública de saúde. Cem crianças foram alocadas no grupo teste (verniz fluoretado Duraphat, Colgate Oral Pharmaceuticals, New York, NY, USA) e 100 no grupo controle (verniz placebo, Colgate Oral Pharmaceuticals, New York, NY, USA). Os exames clínicos, seguidos das aplicações semestrais de verniz nos grupos teste e controle, foram realizados por duas odontopediatras treinadas (Kappa=0,85) que utilizaram o International Caries Detection and Assessment System II (ICDAS II) para registrar o índice ceo-s nos níveis c1 (lesão ativa em esmalte não cavitado, lesão em esmalte cavitada e lesão em dentina) e c3 (lesão em dentina) de detecção de doença. Verificou-se também a ocorrência de efeitos adversos e outras queixas por entrevistas telefônicas com os responsáveis 7 a 10 dias após a primeira aplicação de verniz. Como resultado aos 18 meses de acompanhamento, 85 crianças do grupo teste e 92 do grupo controle foram examinadas. As diferenças nos incrementos médios de cárie, entre os grupos teste e controle, foram -0,9 (IC95%: -2,4;0,4) no nível c1 e -0,8 (IC95%:-1,9;0,2) no nível c3. O risco de desenvolvimento de novas lesões de cárie em dentina foi 30% (RR=0,70; IC 95%:0,49;0,99) menor nas crianças do grupo teste em relação às do grupo controle. Foram feitas entrevistas com 183 responsáveis sobre os efeitos adversos e a aceitabilidade da intervenção. Um relatou que a sua criança sentiu ardência na cavidade bucal após a aplicação do placebo e outro ficou incomodado com a coloração amarelada dos dentes da criança imediatamente após a aplicação do verniz fluoretado. A aplicação semestral de verniz fluoretado na dentição decídua de pré-escolares reduz o risco de desenvolver lesão de cárie dentária em dentina. Além disso, essa intervenção é segura e bem aceita pelos pais e pelas crianças.

A obrigatoriedade da educação infantil: governamentalidade e refinamento das técnicas de governo

O presente trabalho coloca em análise a obrigatoriedade da educação infantil no Brasil com foco na institucionalização da criança desde a tenra idade, buscando correlacionar infância, educação, governamentalidade e o refinamento das técnicas de governo. Entendemos a infância não como fato natural, mas como acontecimento sócio e culturalmente produzido, organizado por regulações potentes que instituem maneiras de cuidar e educar a criança seja na família ou nos demais espaços, como a escola. De certo, as ações da educação infantil permanecem promovendo processos de subjetivação, seja ao determinar, enquadrar e controlar os comportamentos das crianças por meio de técnicas de dominação seja ao estimulá-las para que operem de acordo com os padrões estabelecidos, formando condutas resilientes, imobilizando-as em papéis, silenciando-as. Deste modo, imergirmos nas práticas que caminham pela vertente da institucionalização de crianças, a partir dos estudos de Michel Foucault, estabelecendo relações entre os campos de saber, tipos de normatividade e formas de subjetividade na educação infantil. Elegemos a análise genealógica proposta por Foucault e a análise institucional de acordo com Lourau, como metodologias para a compreensão dos processos em curso, tensionando as práticas diárias, dando visibilidade a diferentes formas do fazer cotidiano e percebendo as resistências como potência. Entendemos como desafio a criação de espaços de discussão, que não sejam construídos pelo sujeito da falta, mas que possam perceber como potência o que é visto como ausência no outro. Necessitamos desta forma, estabelecer regiões limítrofes de existência única, de experiência vivida, existência anárquica de qualquer criança e não só de espaços de capturas, ordenações e silenciamentos. Assim, linhas de fuga como proposto por Deleuze e Guattari insurgirão como possibilidade, tendo como horizonte uma vida não fascista, como convida Foucault, para os fazeres e saberes de e na educação infantil.

通过对心理学期刊的几项统计分析看我国十年来儿童发展教育心理学研究状况与动向

In this study, bibliometric method was usded in the investigation of 2274 papers concerning child developmental and educational psychology, which were published during the ten years of 1979-1988, in 14 psychological journals and 97 other scientific journals. According to the quantitative and qualitative analyses, the results are as follows: 1979-1988 saw the rapid development and prosperous period in China's child developmental and educational psychology, During which more papers were published and more fields couched than in the psvious thirty years. The number of literature publications increased and went to the peak in 1983 and 1984, and came down since 1985. The trend was found to result from the decrease in popular science introductions of psychology, which reflected that a heat of psychology had appeared in 1983 and started to cool in 1985. At the mean time, the number of research reports had been holding a steady increase by 1987 and decreased obviously in 1988, especially in the fields of cognitive and social development. There could be several possible explanations of this phenonemon: Piagetian studies are becoming fewer and the eakening of Piaget's influence might predict a period of standstill in the field of developmental psychology in China; As researches become more and more difficult, researchers have turned to be more cautious in lay out their reports; the cutdown of fees and staff could also be one of reasons for less publication in 1988. As the factors mentioned above still exist and their influences last, the number of papers are not expected to increase in the near future. The field of thinking and menory is closely connected with that of artificial intelligence. The downhill situations in these two fileds should be taken seriously. 2. The types of research work are divided on the bases of their problem raising. The trends show that the deepening studies, which represent a comaratively higher level of exploration, are waving fewer, while repeated studies and creative studies are becoming more as the years go along. This fact is worth being further analysed. Big progress could be seen from research methods. The methods currently used are mainly experiment, psychological measurement and assessment, and theoretical reasoning. There is a rapid increase of research by using scales. Wechsler Intelligence Scale for Children, Binet Scale and Baley Scale have been revised andstandardized. Chinese researchers have also developed several good scales of their own, some of which are valuable and need to be standardized. In the papers investigated, the amount of citation is significantly lower than the world average level as well as the average citation number of whole China's scientific literature. Among the papers cited, most are of Chinese and English languages, and only a small rate were published in resently five years. The renewal of literature cited seems to stay at a low level in the ten years. Tremendous work could be reflected by the number of subjects used the research work in those ten years: 362665. A lot of studies piled on the period of 4-16 year olds. Compared with the previous thirty years, the age range was much enlarged and there were quite a few studies about preschool, school and adolescent periods. The study of newborn of 0-3 has been a weak point so far and it is a field to which chinese developmental psychologists should pay more attention. The progress in using statistics is one of the most obvious part in the development in the research work of child developmental and educational psychology. The one tendency that should be awared and avoid is to put the cart before the horse: seeking for more sophisticated statistic method while neglecting the meanings of research problems. 3. Citation analysis was used in selecting scholars who had great influence in the field of child developmental and educational psychology. Among the often cited and famous scholars, 31 are Chinese researchers and 12 are Western psychologists. The authoritative journal for child developmental psychology and educational psychology is Acta Psychologica Sinica.

Voice Performance Evaluation of Street Children From Aracaju, Brazil Using Perceptual-Auditory and Acoustic Analyses

Objective. To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses.Methods. A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements.Results. A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. the SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. the maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG.Conclusion. Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.

Supporting the case for “progressive universalism” in health visiting: Scottish mothers and health visitors’ perspectives on targeting and rationing health visiting services, with a focus on the Lothian Child Concern Model.

Aims. To explore parents and professionals’ experience of family assessment in health visiting (public health nursing), with a focus on the Lothian Child Concern Model (LCCM). Background. Health visitors (HVs) currently assess families as requiring core, additional or intensive support, and offer support at a corresponding level. The majority of families are assessed as core and receive no pro-active support beyond the early days. Previous assessment tools, consisting of checklists, have been criticised as being ineffective in identifying a range of health needs and unacceptable to parents and HVs. The LCCM model was developed and introduced in the study area to promote a partnership approach with parents and assess strengths as well as difficulties in parents’ capacity to care for their child. Methods. Qualitative methods were used. Ten mothers and twelve HVs took part in individual semi-structured interviews. Results. Most mothers were aware of the assessment process but some felt that they were not involved in the decision making process. Explaining the assessment process to parents is problematic and not all HVs do so. The assessment process was stressful for some mothers. HVs find the model useful for structuring and documenting the assessment process. Many believe that most families benefit from some support, using public health approaches. Families are often assessed as core because there are insufficient resources to support all those who meet the criteria of the additional category, and managers assess caseloads in terms of families with child protection concerns. Conclusions. The study findings support the concept of “progressive universalism” which provides a continuum of intensity of support to families, depending on need. Mothers would like better partnership working with HVs. Relevance to clinical practice. The study endorses proposed policy changes to re-establish the public health role of HVs and to lower the threshold for families to qualify for support.

I am a Child. Hypothesis on Spectator Pedagogy

The paper consists of series of suggestions and historical references on the basis of which it would become possible to think and practice „spectator pedagogy” in performing arts. Contemporary performance practices can claim for new kind of political relevance by focusing on the way spectator´s corporeal experience changes during and through theatrical situation. Naive body produced by a performance is also most susceptible for thoroughgoing political and ecological change. This is the first outline by its author on this topic.