Study of the antibody response against Mycobacterium tuberculosis antigens in Warao Amerindian children in Venezuela

This study was aimed at investigating alternate methods for serodiagnosis of tuberculosis (TB), which are needed because bacteriologic diagnosis of childhood TB is difficult. A selection of 80 serum and saliva samples were tested from Warao indigenous children under 15 years of age; 34 high TB suspects (28 positive and 6 negative for the tuberculin skin test, TST) and 46 healthy contact children (32 positive and 14 negative for the TST). Several enzyme-linked immunosorbent assay (ELISA) serological tests were developed to test for Mycobacterium tuberculosis-specific antibodies, including serum IgA, IgG, IgE, and secretory IgA (sIgA) in saliva against 3 specific antigens (PPD, HSP60, 38 kDa). Of these, 2 antigens, PPD and 38 kDa, showed significantly higher reactivity. The sensitivity and specificity of these tests for diagnosis remained limited, between 26.5% and 38.2%, and 77.4% and 97%, respectively. Of all the samples studied and combinations realized between all isotypes and antigens combined with 3 isotypes (anti-PPD IgG, IgE, and anti-38kDa sIgA) managed to detect the largest number of patients, showing an improved sensitivity level of 64.7%, although specificity levels dropped to 81.8%. These results were compared with the Omega diagnostics commercial kit results. The commercial kits showed significantly lower reactivity (sensitivity of 20% and 13.33% to Myco G and Complex Plus, respectively) and a specificity of 100%. This study shows that in indigenous populations of Venezuela, where invasive procedures cannot be used to select samples but evaluation with a chest X-ray for radiological studies is available, the combination of 3 specific isotypes may be a useful tool to increase diagnostic accuracy with pulmonary TB in this population, when used together with clinical and epidemiological criteria.

REACH - Rethinking Eating and Activity for Children's Health

The aims of the REACH programme were to: - Provide a quality whole-family healthy lifestyle programme that is accessible and equitable to support children aged 4-7 and 8-11years who are above the healthy weight range in maintaining or achieving a healthy weight; - Target areas of poor health and high prevalence of childhood obesity; Contribute towards the prevention and reduction of obesity prevalence in South Gloucestershire; - Be a resource for other health professionals and services in South Gloucestershire. As this was a pilot of a child weight management programme being developed from scratch the objectives of REACH were to: Provide a high quality service which meets the needs of the local health community; - Improve childrens diet and nutritional intake and promote a healthy weight; Encourage exercise and physical activity participation; - Develop a range of skills with participants in order to increase their confidence and self esteem; - Be participant centred but also use a whole family approach to deliver healthy lifestyle messages; - Develop appropriate referral protocols, resources and course plans; - Advertise and promote the programme locally liaising with communications and the Public Health Team in NHS South Gloucestershire, GPs and staff working in the community such as School Health Nurses (SHNs); - Successfully recruit families on to the programme; Enable eligible new participants referred to the service to take part; - Encourage participants to complete the programme; - Deliver a service that helps to address health inequalities; - Monitor participants weight and lifestyle changes as part of a follow up programme; - Provide continuous professional development of service staff; - Ensure individuals and families are signposted and supported to access other services such as after school clubs, local sports clubs and leisure centres; - Provide equitable access to the service and ensure equitable outcomes are achieved by the service; Ensure continuous quality improvement;

Children and Family Weight Management

The Children and Family Weight Management Team aims to help overweight children and their families to achieve and maintain a healthy weight. Aimed primarily at children, the service offers a programme of advice and support to families who are committed to making healthy lifestyle changes. Adult family members who seek personal weight management support may be signposted to appropriate local services.

Building Children and Young People's Resilience in Schools

Evidence Review 2 - Building children and young people's resilience in schools Briefing 2 - Building children and young people's resilience in schools This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of schools in building children and young people’s resilience and capabilities. They provide a summary of evidence about the effect of resilience on health, the unequal distribution of resilience and its contribution to levels of health inequalities. The review outlines the potential actions that can be taken in schools in order to build resilience for all children and young people and reduce inequalities in resilience. Throughout, a social determinants approach to resilience is taken. Children and young people’s individual characteristics are seen as shaped by, and related to, inequities in power, money and resources, and the conditions in which they are born, grow, live, and in which they will work and age. Family and community resilience are highly significant and similarly shaped by wider social and economic factors. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Elevated energy expenditure and reduced energy intake in obese prepubertal children: paradox of poor dietary reliability in obesity?

The purpose of this study was to assess the validity of two common methods used to assess energy intake. A 3-day weighed dietary record and a dietary history were collected and compared with the total daily energy expenditure (TEE) assessed by the heart rate method in a group of 12 obese and 12 nonobese prepubertal children (mean age 9.3 +/- 1.1 years vs 9.3 +/- 0.4 years). The TEE value was higher in obese than in nonobese children (9.89 +/- 1.08 vs 8.13 +/- 1.39 MJ/day; p < 0.01). Energy intake assessed by the dietary record was significantly lower than TEE in the obese children (7.06 +/- 0.98 MJ/day; p < 0.001) but comparable to TEE in the nonobese children (8.03 +/- 0.99 MJ/day; p = not significant). Energy intake assessed by diet history was lower than TEE in the obese children (8.37 +/- 1.35 MJ/day, p < 0.05) but close to TEE in the nonobese children (8.64 +/- 1.54 MJ/day, p = not significant). These results suggest that obese children underreport food intake and that the dietary record and the diet history are not valid means of assessing energy intake in obese prepubertal children.

Naturally acquired immunity to Haemophilus influenzae type B in healthy Cuban children

We have evaluated the prevalence of antibody to immunogenicity of Haemophilus influenzae type b (Hib) in a group of 4 to 5 years old healthy children, who were too old to be included in the first vaccinated cohort when Hib vaccination begun in Cuba in 1999. Serum capsular polysaccharide specific IgG antibody concentrations were measured in 974 healthy children, between February and May 2002. The prevalence of Hib nasopharyngeal carriage was also estimated. The majority of children (99.7%) had more than 1 µg/ml of antibody. The preliminary report of the nasopharyngeal cultures was positive for H. influenzae in 16 children, but in only one was confirmed as Hib after serotyping (0.1% Hib nasopharyngeal carrier). These results provide evidence that in Cuba the natural active immunity to Hib can be acquired at an early age.

Pulmonary artery pressure and cardiac function in children and adolescents after rapid ascent to 3,450 m.

High-altitude destinations are visited by increasing numbers of children and adolescents. High-altitude hypoxia triggers pulmonary hypertension that in turn may have adverse effects on cardiac function and may induce life-threatening high-altitude pulmonary edema (HAPE), but there are limited data in this young population. We, therefore, assessed in 118 nonacclimatized healthy children and adolescents (mean ± SD; age: 11 ± 2 yr) the effects of rapid ascent to high altitude on pulmonary artery pressure and right and left ventricular function by echocardiography. Pulmonary artery pressure was estimated by measuring the systolic right ventricular to right atrial pressure gradient. The echocardiography was performed at low altitude and 40 h after rapid ascent to 3,450 m. Pulmonary artery pressure was more than twofold higher at high than at low altitude (35 ± 11 vs. 16 ± 3 mmHg; P < 0.0001), and there existed a wide variability of pulmonary artery pressure at high altitude with an estimated upper 95% limit of 52 mmHg. Moreover, pulmonary artery pressure and its altitude-induced increase were inversely related to age, resulting in an almost twofold larger increase in the 6- to 9- than in the 14- to 16-yr-old participants (24 ± 12 vs. 13 ± 8 mmHg; P = 0.004). Even in children with the most severe altitude-induced pulmonary hypertension, right ventricular systolic function did not decrease, but increased, and none of the children developed HAPE. HAPE appears to be a rare event in this young population after rapid ascent to this altitude at which major tourist destinations are located.

Young People's Health in Great Britain and Ireland: Findings from the Health Behaviour in School-Aged Children (HBSC)Survey, 2006.

This report presents data from the 2006 Health Behaviour in School-aged Children (HBSC) survey; a World Health Organization (WHO) collaborative cross-national study and focuses on data collected from young people in England, Ireland, Scotland and Wales. It expands on the findings from the international report Inequalities in Young People's Health (Currie et al, 2008), with additional variables and prevalence rates that allows more comprehensive and focussed comparisons to be made between the four countries.This resource was contributed by The National Documentation Centre on Drug Use.

Looked after children in Dublin and their mental health needs.

Children in care in Ireland have increased by 27% in the last decade. This population is recognized to be among the most vulnerable. This study aims to describe their placement histories, service use and mental health needs. Data was obtained on 174 children (56.5% of eligible sample) with a mean age of 10.83 (SD = 5.04). 114 (65.5%) were in care for three years or more. 29 (16.7%) did not have a SW and 49 (37.7%) had no GP. 50 (28.7%) were attending CAMHS. Long term care, frequent placement changes and residential setting were significantly related with poorer outcomes and increased MH contact. Given the increase in numbers in care and the overall decrease in resource allocation to health and social care, individual care planning and prioritizing of resources are essential.This resource was contributed by The National Documentation Centre on Drug Use.

Effect of malaria and fever on energy metabolism in Gambian children.

The aim of the present study was to measure the changes in resting energy expenditure (REE) induced by malaria and to assess to what extent they are related to fever and nutritional status. The REE of 19 Gambian children (mean age +/- SEM, 9 +/- 1 y; weight, 24 +/- 2 kg; expected weight for height 86 +/- 1%) were measured with a hood system at repeated intervals at the onset of malaria crisis (test A), 3 to 4 d after therapy (test B), and 14 to 21 d later (test C). Axillary temperature averaged 39.2 +/- 0.1, 36.6 +/- 0.1, and 36.7 +/- 0.1 degrees C in the tests A, B, and C, respectively. REE in test A was significantly higher than REE in test B (223 +/- 10 versus 174 +/- 8 kJ/kg.d, p less than 0.0001), but in test C (169 +/- 8 kJ/kg.d), it did not differ from that observed in test B. The percentage of increase in REE was significantly correlated with the difference in axillary temperature (r = 0.46, p less than 0.05); the slope of the regression line indicated an increase of 6.9% in REE/degree C of fever. Furthermore, the individual increase in REE/degree C was correlated to the percentage of weight for height of the children (r = 0.54, p less than 0.05), indicating that the child's nutritional status influences the magnitude of the hypermetabolism due to fever. We concluded that Gambian children suffering from an acute episode of malaria have an increase in REE averaging 30%; however, REE promptly returns to baseline value a few days after the beginning of therapy.

Conference 2012: Reaching Children's Outcomes: An All-Island Approach

Presentations from the inaugural conference of the Children's Research Network for Ireland and Northern Ireland, 26th September 2012.

CRNINI workshop: Ethics in Research with children

Guidance for ethical research projects   •Good practice in children’s research •Building on knowledge gained in GUI •Initiated by DCYA   •Produced by Working Group with research, legal, policy and child protection expertise   Patricia's presentation is an analysis of at data from the Growing Up in Ireland study:  The relationship between family tranisitions and children's well being.

Putting children first: The role of health psychology in applied child/youth research

Overview Part One • Background/context  – defining and thinking about health • The role of the health psychologist • Promoting the psychosocial well being of children and young people • Early intervention and prevention in Ireland • Intervening in the lives of children with emotional and behavioural difficulties   Part Two • Case-study  – The Incredible Years Ireland Study: theory, practice and research   Part Three • Some key considerations in intervention science for research, policy and practice with children and young people   Sinead McGilloway: Putting children first. The role of health psychology

FLYER: Ethics, Consent and Participation in Research With Children and Young People

  Date: Friday, 14 June 2013   Time:10:30 – 13.30 Location: G13, Western Gateway Building, University College Cork The children's Research Network for Ireland and Northern Ireland in conjunction with the Children and Young People Research Cluster at the Institute for Social Sciences in the 21st Century at UCC are holding a workshop on ethics, consent and participation in research with children and young people. The event will explore some of the complex ethical issues involved in conducting research with children and young people, from the perspectives of researchers, children, families and service-providers.  

Success and Failure for Children Born with Facial Clefts in Africa: A 15-Year Follow-up.

BACKGROUND: This study reviews the 15 year program of our Department of Pediatric Surgery for the treatment and follow-up of children born with a cleft in Benin and Togo. METHODS: We analyzed files of children born in Africa with a cleft. They were referred to us through a nongovernmental organization (NGO) between 1993 and 2008 and assessed in Africa by local pediatricians before and after surgery. Operations were performed by our team. RESULTS: Two hundred files were reviewed: 60 cases of unilateral cleft lip, seven of bilateral cleft lip, 44 of unilateral cleft lip palate (UCLP), 29 of bilateral cleft lip palate (BCLP), 53 of cleft palate (CP), three of bilateral oro-ocular cleft, one of unilateral and two of median clefts (Binder), and one of commissural cleft. Sixty-nine (35 %) of these cases were not operated in Africa: 25 (12.5 %) had not shown up, 28 (15 %) were considered unfit for surgery (Down's syndrome, HIV-positive, malnutrition, cardiac malformation), and 16 (7.5 %) were transferred to Switzerland. Palatal fistula occurred in 20 % of UCLP, 30 % of BCLP, and 16 % of CP. Evaluation of speech after palate surgery gave less than 50 % of socially acceptable speech. CONCLUSIONS: Our partnership with a NGO and a local team makes it possible to treat and subsequently follow children born with a cleft in West Africa. Surgery is performed under good conditions. If aesthetic results are a success, functional results after palate surgery need further improvement to promote integration in school and social life.