Community-based programs to promote care seat restraints in children 0-16 years - A systematic review

Study Objective: Community-based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing injury due to inadequate car seat restraint use in children 0-16 years of age. Methods: A comprehensive search of the literature was performed using the following study selection criteria: community-based intervention study: target population was children aged 0-16 years of age; outcome measure was either injury rates due to motor vehicle crashes or observed changes in child restraint use; and use of community control or historical control in the study design. Quality assessment and data abstraction was guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. Results: This review found eight studies, that met all the inclusion criteria. In the studies that measured injury outcomes, significant reductions in risk of motor vehicle occupant injury (33-55%) were reported in the study communities. For those studies reporting observed car seat restraint use the community-based programs were successful in increasing toddler restraint use in 1-5 year aged children by up to 11%; child booster seat use in 4-8 year aged children by up to 13%; rear restraint use in children aged 0-15 years by 8%; a 50% increase in restraint use in pre-school aged children in a high-risk community; and a 44% increase in children aged 5-11 years. Conclusion: While this review highlights that there is some evidence to support the effectiveness of community-based programs to promote car restraint use and/or motor vehicle occupant injury, limitations in the evaluation methodologies of the studies requires the results to be interpreted with caution. There is clearly a need for further high quality program evaluation research to develop an evidence base. (C) 2004 Elsevier Ltd. All rights reserved.

The effects of affective picture stimuli on blink modulation in adults and children

Two experiments examined blink modulation during viewing of pleasant, neutral and unpleasant picture stimuli in non-selected adults (N = 21) and children (N = 60) and children with anxiety disorders (N = 12). Blink reflexes were elicited by a white noise probe of 105 dB at lead stimulus intervals of 60, 240, 3500, and 5000 ms and during intertrial intervals. Blink modulation during unpleasant pictures was significantly different from blink modulation during neutral pictures at the 60 ms lead interval in children whereas adults showed no significant differences. Picture content had no differential effect on the extent of blink modulation for adults or children at the 240 ms lead interval. At the long lead intervals, blink modulation during unpleasant and pleasant pictures was significantly larger than during neutral pictures in adults. Picture valence did not differentially affect the extent of blink modulation at long lead intervals in children. Comparing the extent of blink modulation in anxious and non-selected children, blinks were significantly modulated during unpleasant pictures at the 60 ms lead interval for both groups. However, the extent of blink modulation was larger overall at this very short lead interval in anxious children. Children did not differ at other lead intervals. (C) 2004 Elsevier B.V. All rights reserved.

Evidence for retarded extinction of aversive learning in anxious children

The habituation to intense acoustic stimuli and the acquisition of differentially conditioned fear were assessed in 53 clinically anxious and 30 non-anxious control children and young adolescents. Anxious children tended to show larger electrodermal responses during habituation, but did not differ in blink startle latency or magnitude. After acquisition training, non-anxious children rated the CS + as more fear provoking and arousing than the CS- whereas the ratings of anxious children did not differ. However, anxious children rated the CS + as more fear provoking after extinction, a difference that was absent in non-anxious children. During extinction training, anxious children displayed larger blink magnitude facilitation during CS + and a trend towards larger electrodermal responses, a tendency not seen in nonanxious children. These data suggest that extinction of fear learning is retarded in anxious children. (c) 2005 Elsevier Ltd. All rights reserved.

Governmentality and 'fearless speech': framing the education of asylum seeker and refugee children in Australia

This paper considers the educational provision for, and general treatment of, refugee and asylum seeker children in Australia, using a framework of governmentality. The paper describes the regimes of practices which govern refugees and asylum seekers in Australia, including mandatory detention and a complex set of visa categorisations, and considers their consequences for the educational provision for children. It addresses three questions: How is it possible that the rights of children have been rendered invisible in and by a democratic state? How are repressive and even violent practices normalised in a liberal state, so that ordinary citizens show so little concern about them? And what should our response be as educators and intellectuals? In conclusion, it explores Foucault's notions of ethics and fearless speech (parrhesia) as a basis for an ethics of engagement in education.

Non-eating disorders psychopathology in children and adolescents with eating disorders: Implications for malnutrition and symptom severity

Objectives: To compare the general psychopathology in an eating disorders (ED) and a child mental health Outpatient sample and investigate the implications of comorbidity on psychological and physical measures of ED severity. Methods: One hundred thirty-six children and adolescents with a DSM-IV ED diagnosis were compared with age- and gender-matched controls. Measures included the Eating Disorders Examination and the Child Behavior Checklist. Results: The ED group had lower general and externalizing psychopathology scores and no difference in internalizing (anxiety-depression) symptoms. Of the anorexia nervosa group, 49% experienced comorbid psychopathology. This group had significantly higher ED psychopathology, longer duration of illness, and more gastrointestinal symptoms, but no difference in malnutrition status. Eating disorders not otherwise specified (EDNos) group measures were less influenced by comorbidity status. Conclusions: Anxiety-depressive symptoms are very common in children and adolescents with EDs. Comorbidity status influences illness severity, especially in the anorexia nervosa group. The management implications of these findings are discussed. (c) 2006 Elsevier Inc. All rights reserved.

Testing the protracted lexical restructuring hypothesis: The effects of position and acoustic-phonetic clarity on sensitivity to mispronunciations in children and adults

Although developmental increases in the size of the position effect within a mispronunciation detection task have been interpreted as consistent with a view of the lexical restructuring process as protracted, the position effect itself might not be reliable. The current research examined the effects of position and clarity of acoustic-phonetic information on sensitivity to mispronounced onsets in 5- and 6-year-olds and adults. Both children and adults showed a position effect only when mispronunciations also differed in the amount of relevant acoustic-phonetic information. Adults' sensitivity to mispronounced second-syllable onsets also reflected the availability of acoustic-phonetic information. The implications of these findings are discussed in relation to the lexical restructuring hypothesis. (c) 2006 Elsevier Inc. All rights reserved.

Towards evidence-based guidelines for wise use of computers by children

This paper argues for the systematic development and presentation of evidence-based guidelines for appropriate use of computers by children. The currently available guidelines are characterised and a proposed conceptual model presented. Five principles are presented as a foundation to the guidelines. The paper concludes with a framework for the guidelines, key evidence for and against guidelines, and gaps in the available evidence, with the aim of facilitating further discussion. Relevance to industry The current generation of children in affluent countries will typically have over 10 years of computer experience before they enter the workforce. Consequently, the primary prevention of computer-related health disorders and the development of good productivity skills for the next generation of workers needs to occur during childhood. (c) 2006 Elsevier B.V. All rights reserved.

Asymmetrical switch costs in children

Switching between tasks produces decreases in performance as compared to repeating the same task. Asymmetrical switch costs occur when switching between two tasks of unequal difficulty. This asymmetry occurs because the cost is greater when switching to the less difficult task than when switching to the more difficult task. Various theories about the origins of these asymmetrical switch costs have emerged from numerous and detailed experiments with adults. There is no documented evidence of asymmetrical switch costs in children. We conducted a series of studies that examined age-related changes in asymmetrical switch costs, within the same paradigm. Similarities in the patterns of asymmetrical switch costs between children and adults suggested that theoretical explanations of the cognitive mechanisms driving asymmetrical switch costs in adults could be applied to children. Age-related differences indicate that these theoretical explanations need to incorporate the relative contributions and interactions of developmental processes and task mastery. © 2006 Elsevier Inc. All rights reserved.

The Gilles de la Tourette Syndrome-Quality of Life Scale for children and adolescents (C&A-GTS-QOL):development and validation of the Italian version

BACKGROUND: Gilles de la Tourette syndrome (GTS) is a chronic childhood-onset neuropsychiatric disorder with a significant impact on patients' health-related quality of life (HR-QOL). Cavanna et al. (Neurology 2008; 71: 1410-1416) developed and validated the first disease-specific HR-QOL assessment tool for adults with GTS (Gilles de la Tourette Syndrome-Quality of Life Scale, GTS-QOL). This paper presents the translation, adaptation and validation of the GTS-QOL for young Italian patients with GTS. METHODS: A three-stage process involving 75 patients with GTS recruited through three Departments of Child and Adolescent Neuropsychiatry in Italy led to the development of a 27-item instrument (Gilles de la Tourette Syndrome-Quality of Life Scale in children and adolescents, C&A-GTS-QOL) for the assessment of HR-QOL through a clinician-rated interview for 6-12 year-olds and a self-report questionnaire for 13-18 year-olds. RESULTS: The C&A-GTS-QOL demonstrated satisfactory scaling assumptions and acceptability. Internal consistency reliability was high (Cronbach's alpha > 0.7) and validity was supported by interscale correlations (range 0.4-0.7), principal-component factor analysis and correlations with other rating scales and clinical variables. CONCLUSIONS: The present version of the C&A-GTS-QOL is the first disease-specific HR-QOL tool for Italian young patients with GTS, satisfying criteria for acceptability, reliability and validity. © 2013 - IOS Press and the authors. All rights reserved.

Experiencing an 'inclusive' education:parents and their children with 'special educational needs'

This paper focuses on the experiences of British parents who have children identified with ‘special education needs’ within mainstream education. Expectations of mainstream education can have a negative affect on parents when a child is unable to maintain his or her education within a mainstream school. In England and Wales, ‘inclusion’ within mainstream schools is implemented by the current government and promoted as anti-exclusionary. However, current research indicates that actual ‘inclusion’ (the child experiencing inclusion as well as being placed in a mainstream environment) is not necessarily occurring in practice. As it stands, the conflict is between desires to embrace difference based on a philosophy of ‘equal rights’ (‘inclusive’ education) and prioritising educational performance, structuring it in such a way that it leaves little room for difference and creativity due to the highly structured testing and examination culture. Qualitative analysis of parents who have children identified with special educational needs indicate that they have hopes and expectations for their children. These hopes and expectations are challenged recurrently.

Clinical significance of medication reconciliation in children admitted to a UK pediatric hospital:observational study of neurosurgical patients

Background: In December 2007, the National Institute for Health and Clinical Excellence and the National Patient Safety Agency in the UK (NICE-NPSA) published guidance that recommends all adults admitted to hospital receive medication reconciliation, usually by pharmacy staff. A costing and report tool was provided indicating a resource requirement of d12.9 million for England per year. Pediatric patients are excluded from this guidance. Objective: To determine the clinical significance of medication reconciliation in children on admission to hospital. Methods: A prospective observational study included pediatric patients admitted to a neurosurgical ward at Birmingham Childrens Hospital, Birmingham, England, between September 2006 and March 2007. Medication reconciliation was conducted by a pharmacist after the admission of each of 100 consecutive eligible patients aged 4 months to 16 years. The clinical significance of prescribing disparities between pre-admission medications and initial admission medication orders was determined by an expert multidisciplinary panel and quantified using an analog scale. The main outcome measure was the clinical signficance of unintentional variations between hospital admission medication orders and physician-prescribed pre-admission medication for repeat (continuing) medications. Results: Initial admission medication orders for children differed from prescribed pre-admission medication in 39%of cases. Half of all resulting prescribing variations in this setting had the potential to cause moderate or severe discomfort or clinical deterioration. These results mirror findings for adults. Conclusions: The introduction of medication reconciliation in children on admission to hospital has the potential to reduce discomfort or clinical deterioration by reducing unintentional changes to repeat prescribed medication. Consequently, there is no justification for the omission of children from the NICENPSA guidance concerning medication reconciliation in hospitals, and costing tools should include pediatric patients. © 2010 Adis Data Information BV. All rights reserved.

Under the ABC Umbrella: Orphanages, Rights, and Education in Mexico

The National System for the Integral Development of the Family (DIF) in Mexico assists children in orphanages. This paper provides an overview of its current practices, and advocates a holistic educational/social model for “alternative orphanages,” integrating Maslow’s Hierarchy of Needs and the rights-based approach. The model complements DIF’s social efforts.

Pharmacovigilance in children : detecting adverse drug reactions in routine electronic healthcare records. A systematic review

This article is protected by copyright. All rights reserved.

Pharmacovigilance in children : detecting adverse drug reactions in routine electronic healthcare records. A systematic review

This article is protected by copyright. All rights reserved.

Pharmacovigilance in children : detecting adverse drug reactions in routine electronic healthcare records. A systematic review

This article is protected by copyright. All rights reserved.