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This article examines, how two Russian-speaking children (ages 9 and 11) learn Finnish morpho-syntactic structures in interaction in a transitional classroom at primary school. It also discusses whether the influence of the mother tongue is observable in the learning process. The study focuses on the development of prototypical possessive structure and standard negation. The data consist of 15 lessons, video-recorded during one school year. The episodes, including the structures used by the children, are analysed by drawing on the principles of conversation analysis. The analyses show that for both children the possessive structure appears to be more complex to learn than the standard negation. However, the children’s acquisition of these structures follows different paths. At the end of the semester, the younger child’s possessive has not become established in Finnish, whereas the older child has begun to use it in accordance with the target language norms. The negation, however, follows the target language norms, in both children’s speech.

Recent developmental psychology studies conducted within the context of values and children’s value acquisition have shown that even during the early years of middle childhood, children’s value priorities can occur. Parents, who are the primary actors in the socialization process, play an important role in the value development of their children. In this study, the similarities between mother–child dyads in terms of the 10 value types of Schwartz were examined. For this aim, a total of 172 mothers and their children between ages 6–11 years attending 1st, 2nd, 3rd, and 4th grade in primary schools in Ankara were included in this study. The Portrait Value Questionnaire was used to assess mothers’ values, and the Picture-Based Value Survey was used to assess children’s values. The findings showed that mothers gave priority to the values of achievement, security, and self-direction and high-order values of self-enhancement and conservation. In contrast, it was found that children gave priority to the values of tradition, benevolence, and universality and higher order values of self-transcendence and conservation. Furthermore, it was seen that the values of the mother–child dyads had lower similarities, and the order of the priority of the value types differed from each other. In addition, our findings revealed that there were significant relationships among the mother’s education, total monthly income, and mother–child value similarity, which varied according to the age of the child. While the mothers’ education and total monthly income were not associated with the mother–younger child value similarity, these were negatively associated with the mother– older child value similarity. Similarly, it was observed that the relationship among the mothers’ education, total monthly income, and mother–child value similarity also varied according to the gender of the child. While the mothers’ education and total monthly income were not associated with the mother–son value similarity, these were negatively associated with the mother–daughter value similarity. In conclusion, it is thought that these findings can provide information about the intergenerational transfer of values and provide guiding clues for the regulation of curriculum related to value education in schools.

The purpose of this study was to describe exposure to within-household and community adverse childhood experiences (ACEs) and to identify child- and parent-level factors associated with exposure to different kinds of ACEs. This cross-sectional study used a clinical sample of 257 Black and Hispanic children ages 3–16 years and their caregivers who were seeking care at two federally qualified health centers in Chicago, Illinois and screened positive for a behavioral health problem. The sample had high levels of within-household ACEs (76% reported at least one) and community ACEs (71% reported at least one). Black children experienced more overall and within-household ACEs than Hispanic children, including forced separation from a caregiver and family member incarceration. Hispanic children experienced more bullying and violent media exposure. Significant associations to all categories of ACEs were observed for depression, child behavioral problems, and older child age. Tailored assessment of ACEs and interventions such as trauma-informed care are needed in pediatric clinical settings, including assessment of ACEs children in experience in communities.

Little is known regarding factors that influence parenting behaviors specific to the management of food allergies in elementary school-aged children. The aim of this study was to identify child characteristics and parent psychosocial factors associated with food allergy-related parenting practices. Participants included 182 parents of food allergic children aged between 5 and 11 years recruited from parent support groups. Data were collected using web-based questionnaires. Multiple regression analyses were conducted to identify predictors of food allergy-related parenting practices. Predictor variables examined included child demographic and allergy characteristics, parent perceived social support, and parenting self-efficacy (ie, parental beliefs specific to their ability to influence their child's behavior and development). The interaction between social support and parenting self-efficacy was examined to test for moderation. Having an older child and more social support were associated with significantly less parental monitoring (

Objectives:This study investigates (a) whether child heritage speakers produce more gender mismatches in Spanish ( un piedra “a-masc. stone-fem.”) than monolingual children, (b) whether older child heritage speakers mismatch more than younger ones, and (c) linguistic contexts in which mismatches occur.Methodology:3893 agreement forms were extracted from corpora of Spanish spoken by six monolingual children, ages 5–6 years, and three groups of US child heritage speakers: ten 5–6-year-olds, fifteen 7–8-year-olds, and twenty-one 9–11-year-olds.Data and analysis:Logistic regressions measured the impact of agreement form type, noun gender, noncanonical noun ending, and noun frequency on gender matching. One regression included 5–6-year-olds only (monolingual and heritage); the second included child heritage speakers only (5–11-year-olds).Findings:There were no significant differences between monolingual and heritage 5–6-year-olds; for these children, adjectives, direct object clitics, noncanonical nouns, and feminine nouns increased the likelihood of mismatches. Among the 5–11-year-old heritage speakers, direct object clitics referring to feminine nouns and noncanonical nouns increased the likelihood of mismatches. The 9–11-year-olds produced more gender mismatches referring to feminine nouns than the younger child heritage speakers, especially with direct object clitics.Originality:This corpus study provides evidence for high rates of gender matching and clarifies the contexts that increase the likelihood that children will mismatch.Implications:Gender matching remains an intact part of child heritage speakers’ Spanish grammars. The distribution of mismatches found provides evidence of a strong article–noun association and a weaker noun–direct object clitic association. The oldest child heritage speakers’ use of masculine clitic lo to refer to feminine nouns may reflect an association between English “it” and Spanish lo. More generally, the finding that mismatches tend to involve masculine forms referring to feminine nouns supports the idea that masculine is the default, unmarked form in Spanish.

Posterior urethral valves (PUVs) are the most common cause of congenital urethral obstruction. However, the diagnosis of a PUV is sometimes difficult. A 13-year-old Japanese boy and his mother visited our hospital, and his mother complained that he frequently strained to void although he had no complaint. Uroflowmetry revealed a plateau-shaped curve and a voiding cystourethrography (VCUG) revealed a PUV. Thus, we performed a transurethral incision of the PUV, and his voiding status improved. Because some patients with mild PUV may not notice their dysuria, we believe that VCUG should be performed without hesitation when a urethral lesion is suspected.

This research aims to analyze the role of income shocks, gender, and resource competition between siblings against the school's decision at the level of primary and senior secondary education during the economic crisis in Indonesia. Methods in this research were conducted in two phases, fixed effect and conditional logit. Results reveal that no evidence of households' transitory income affected children's education level, both for primary and senior secondary education. Meanwhile, compared to boys, girls have a higher probability of dropping out of school and have lower school enrollment rates in primary education. This paper indicated the existence of resource competition between the younger child and the older child for education, especially for senior secondary education.JEL Classification: I20, I24, I25, J16How to Cite:Kharisma, B., Hadiyanto, F., & Remi, S. S. (2020). Schooling Decision in Indonesia: a Lesson From Indonesian Crisis. Signifikan: Jurnal Ilmu Ekonomi, Vol. 9(1), 81-92. doi: http://dx.doi.org/10.15408/sjie.v9i1.12479.

Dropout from children's mental health services has negative impacts on children, families and service providers. To target interventions aimed to reduce dropout, it is essential to predict individuals who drop out. This study compares predictors of dropout using a novel need-based definition, to existing definitions of dropout. Children (N = 650; 61% male) aged 5-13 attended five children's mental health agencies in Ontario. A mixed effects logistic regression was used to model binary outcome variables (i.e., dropout or treatment completion), for each definition of dropout. Using the need-based definition, older child age, lower child problem presentation, higher child risk behaviors, higher caregiver needs, and more child strengths predicted an increased likelihood of dropout. The need-based definition results in different predictors of dropout than existing definitions in the literature. High caregiver needs was the only predictor of dropout across all definitions. Caregiver needs represent a prospective target when distributing interventions aimed to reduce dropout.

This review identifies key distinctive features of the anatomy and physiology of the neonatal airway that contribute to pathology. Additionally, it highlights the importance of a multidisciplinary approach to the evaluation of the airway in certain neonates with respiratory distress in the neonatal intensive care unit. Advancements in airway imaging aid in the evaluation of the neonatal airway. However, a comprehensive airway evaluation is often indicated. This requires a team of subspecialists including neonatologists, radiologists, pediatric otolaryngologists, pulmonologists, and anesthesiologists. Disorders of the airway are a common challenge in the neonatal intensive care unit. For reasons that relate to size, anatomy, and physiology, key differences exist between the neonatal airway and that of the older child or adult. A comprehensive multidisciplinary approach to the neonate with suspected airway pathology can improve timely diagnosis, facilitate early intervention, and potentially help avoid unnecessary additional procedures in the neonatal intensive care unit.

PURPOSE: Good vision during childhood is vital for visual, educational, and social development. Previous research highlights challenges in the accessibility of eye care for children. This study investigates the accessibility of primary eye care for young children with typical development and those with autism in England. METHODS: A telephone survey was conducted using four hypothetical scenarios (a child aged 1, 3, 5 years and a 13-year-old with autism). Four hundred community optometric practices (100 different practices for each scenario) were contacted to explore the availability of an eye examination. The caller acted as a parent, asking about the availability of an eye examination for their child and raising concerns regarding the child. Key barriers and enablers to the accessibility of primary eye care were identified through an analysis of qualitative information. RESULTS: Of the 400 practices, only three (

Foster care is intended to be a temporary placement option. Viewing permanency as central to child well-being, current U.S. policies aim to limit the length of time a child spends in out-of-home foster placements. There is little recent research, however, on predictors of length of time in out-of-home care. The purposes of this study were to test if more frequent contact with biological parents predicted less time in out-of-home care, and determine if more frequent contact with biological parents was associated with better mental health outcomes using three waves of data from the National Survey on Child and Adolescent Well-Being II, a U.S. nationally representative dataset of youth involved with the child welfare system. Findings revealed that more frequent contact with biological mothers was associated with fewer cumulative days in out-of-home care. Among covariates, older child age was related to longer stays in out-of-home care, and Black youth experienced more cumulative days in out-of-home care compared to White youth. Links between frequency of contact and youth mental health outcomes also were tested, and more frequent contact with both mothers and fathers was associated with lower mental health symptoms. Being separated from siblings also was associated with more mental health problems, and compared with foster care, being in kinship care was negatively associated with mental health problems. A discussion of the findings in light of U.S. polices and best-practices is included.

Prior research has examined associations between state adoption policies and assisted reproductive technology insurance coverage and foster care adoption rates, but knowledge of the relationships between state policies and contexts and foster care adoption is still limited. In this study, we test adoption subsidy policy, alternative means of family formation, and the demographic characteristics of potential adoptive parents and children as predictors of foster care adoption rates at the state-year level using data from the Adoption and Foster Care Analysis and Reporting System and other sources for 2005 to 2016. We use between-within models to obtain random effects estimates between states and fixed effects estimates within states. We find that states with higher average adoption subsidies have lower foster care adoption rates. Foster parent rates, international adoption rates, and mandated in vitro fertilization insurance coverage are positively associated with foster care adoption. States with higher median household incomes and more same-sex couples have higher foster care adoption rates, but states with more women of childbearing age have lower rates of older child adoption. These findings suggest some ways states may seek to increase adoptions from foster care.

Atypical teratoid/rhabdoid tumors (ATRTs) are malignant central nervous system tumors that affect early childhood (< 3 years), and mostly located in the infratentorial space. Owing to an infrequent occurrence, their radiological features have not been completely defined. Nevertheless, these are characteristically intra-axial except for few instances in the cerebellopontine angle region. We describe a case of a 10-year-old boy who harbored an extra-axial, dural-based ATRT in the right parietal region. The lesion was totally excised followed by adjuvant chemo-radiotherapy. At 10-month follow-up, he was well with no recurrence. The report intends to highlight an atypical imaging presentation of ATRT in an older child, and adds to the radiological spectrum. This uncommon pathology should be borne in mind, even in a supratentorial dural-based location.

In this chapter a father writes about supporting the language and literacy development of his English-dominant children before and after they were enrolled in a two-way Spanish/English bilingual primary school in a large Midwestern city. Both children struggled at first to understand, speak, read, and write in Spanish, but incrementally improved. The older child came to the school with age-level reading ability in English. The younger child struggled to learn to read and write in English as well. Framing the understanding of bilingual development with the work of Cummins and Thomas and Collier, the chapter describes the various ways the family attempted to support the children’s language and literacy development, including a nightly routine of reading and speaking in both English and Spanish at home. The author worked with the younger daughter first on reading English at night, asking the child to read aloud first with pre-primer books, as the school focused almost entirely on Spanish in the earliest grades. The differences in the children’s language development are theorized and recommendations are made.

Breastfeeding is a gold standard of feeding of newborns and infants. Tandem breastfeeding (TBF) is feeding two children of different ages at the same time. The knowledge about the composition of human milk in prolonged lactation is still scarce. Milk from tandem breastfeeding women and after weaning was examined. Milk samples were collected from 13 TBF mothers. A 24-h milk collection was done. Analyses of fat, protein, carbohydrate and energy content were performed using MIRIS. Sociodemographic characteristics of TBF mothers was done. Higher fat content, energy value and total protein concentration was found in TBFM milk during tandem breastfeeding, than in milk after weaning the older child. The carbohydrate content remained stable. The composition of breastmilk, in terms of macronutrients, changes after weaning, taking into account the nutritional requirements of the younger child. The milk of nursing mothers in tandem did not show diurnal variability in individual components. These findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children. The results may support the promotion of long breastfeeding, including tandem breastfeeding.

An increasing amount of empirical attention is focused on adrenocortical synchrony as an index of biobehavioral co-regulation between parent and child in the context of early child development. Working with an ethnically diverse community sample of children (N = 99, 50.5% male, ages 9-12), we collected saliva samples from mother-child dyads prior to and after a laboratory-based performance challenge task, and tested whether maternal overcontrol and child age moderated dyadic synchrony in cortisol. Results revealed that cortisol levels between mothers and children were significantly positively correlated at pretask for dyads with mean age and older children only, at 25-min post-task for all dyads, and at 45-min post-task for all dyads. Higher overcontrol/older child dyads exhibited a unique pattern of cortisol synchrony wherein at pretask, mother-child levels had the strongest positive correlation, whereas at 25 and 45 min, mother-child cortisol levels were significantly inversely correlated. These findings contribute to theory and research on parent-child relationships by examining parenting behavior, developmental stage, and adrenocortical synchrony in tandem.

Introduction Acquired skin-level strictures following posterior sagittal anorectoplasty (PSARP) and some rare cases of congenital anal stenosis can be managed using a Heineke–Mikulicz like anoplasty (HMA). We hypothesized that this procedure was an effective, safe, and durable outpatient procedure in select patients. Methods We retrospectively reviewed all patients who underwent HMA for skin level strictures following PSARP or for certain congenital anal stenoses from 2014 to 2017. Results Twenty-eight patients (19 males, 9 females) with a mean age of 5.8 years (range 0.5–24.4) underwent HMA. Twenty-six had a prior PSARP, of which 18 were redo, and 8 were primary procedures. Two patients had congenital skin level anal stenosis. The mean follow up was 1.0 years (range 0.4–2.9). The average preprocedure anal size was Hegar 8, which after HMA increased 8 Hegar sizes to 16 (95% CI 7–9, p Conclusion HMA is a safe procedure for skin-level anal strictures following PSARP (primary and redo) and can also be used in some rare cases of congenital anal stenosis. Long-term follow up to determine the restricture rate is ongoing. A plan to do an HMA if a stricture develops may offer an alternative to routine anal dilations, particularly after a redo PSARP in an older child. Type of study Case series. Level of evidence Level IV.

Manufacturers label their sleeping bags with a temperature rating to assist consumers in selecting a bag that will provide them with an acceptable level of thermal protection under the expected conditions of use. These temperature ratings are typically based on thermal manikin testing and whole-body heat loss models. Due to physical and physiological differences between children and adults, existing adult sleeping bag temperature rating models cannot be applied to children's bags. Therefore, a model for determining the temperature ratings of children's sleeping bags is proposed. Issues related to measuring the thermal insulation of children's sleeping bags are also discussed. The results of the model indicate that an older child has a higher temperature rating than a younger child for the same level of insulation. This is due to the higher sleeping metabolic rate of younger children.

Introduction: Tandem breastfeeding is a poorly understood concept. Mothers who tandem breastfeed are often faced with social stigma and poor support given by healthcare professionals. The purpose of the research was to study the knowledge on tandem breastfeeding among students of nursing.Methods: The research is based upon quantitative explorative-nonexperimental descriptive research design. Participants were random nursing (n = 66) and dietetics (n = 24) students. Data were gathered with a structured questionnaire (Cronbach α = 0.914). Descriptive statistics were used; a chi square test and singlefactor analysis of variance.Results: 50.7 % (n = 36) women and 84.2 % (n = 16) men (χ2 = 6.898, p = 0.009) considered it physiologically normal that if a woman stops breastfeeding the older child when she becomes pregnant again. 79.2 % (n = 19) dietetics students compared to 54.5 % (n = 36) nursing students (χ2 = 4.489, p = 0.034) knew that breastfeeding was the only form of nutrition in the first six months of an infant’s life. 86.3 % (n = 44) women in comparison to 13.7 % (n = 7) men recognized that the statement that infants who are tandem breastfed experience slower growth, was incorrect.Discussion and conclusion: Students participating in the research have demonstrated a lack of knowledge in both, breastfeeding and tandem breastfeeding. The study programme should contain more content on breastfeeding.

Introduction/Objective Wilms tumor (nephroblastoma), is a neoplasm that has a prevalence of 1 per 10,000 before the age of fifteen, with 50% occurring before age 3. WT1 (11p13) gene, a zinc finger transcription factor, is expressed in early urogenital system development and mutations here represent one of the primary pathways to the development of Wilms tumor. Although mouse model studies have shown that WT1 may be a transcriptional activator of erythropoietin (EPO) gene, increases in serum erythropoietin are rarely seen in patients with Wilms tumor. Concurrent polycythemia is a further rarity with only 11 such reports in literature. This is intriguing since WT1 mutations represent the most common mutation pathway in Wilms Tumor. Interestingly, other tumor types associated with elevated serum EPO and polycythemia (e.g. renal cell carcinoma and metanephric adenoma) are thought to do so through the generation of hypoxia inducible factor, and induction of VEGF. Methods/Case Report Here we present a case of Wilms tumor in a 7-year-old female who was establishing care after moving to Vermont. Physical examination showed possible splenomegaly ultimately discovered to be a large LUQ abdominal mass with a concurrent discovery of polycythemia. Subsequent serum EPO was 308 (Ref: 2.6-18.5 mIU/mL).). The mass was surgically removed with resolution of polycythemia. Histological evaluation showed a triphasic, blastema predominant Wilms tumor with favorable histology. Heterologous, vascular differentiation was seen in the stroma, positive for CD34 and CD31, and negative for D2-40. Results (if a Case Study enter NA) NA Conclusion Based on these findings, this phenomenon may be related to increased VEGF expression resulting in this patient’s increased serum EPO and polycythemia, and heterologous vascular differentiation within the tumor stroma. This is the first report of histology in a case of Wilms tumor associated with high serum EPO and polycythemia and may indicate an alternative pathway for the generation of EPO in Wilms tumor.

INTRODUCTION: This study aims to ascertain if there are any differences in supracondylar fractures between children under seven years of age and those above 7 years of age. MATERIALS AND METHODS: All cases of displaced humerus supracondylar fractures that required surgical stabilization were identified and retrospectively reviewed. Demographic data, mode of injury, associated neurovascular injuries and details of surgery performed were obtained from clinical records. The Gartland classification and the extent of comminution of fractures were also documented from review of radiographs. RESULTS: One hundred and twelve children were included in this study, of whom 61 (54.46%) were younger than seven years of age while 51 (45.5%) were aged seven years or older. Children aged seven or older had a greater incidence of associated neurological deficit at presentation (p=0.046). Of the six patients with nerve injury in the older age group, one patient (16.7%) had a radial nerve injury, two patients (33.3%) had ulnar nerve injuries while another two patients (33.3%) had median nerve injuries. There was one patient (16.7%) with both median and ulnar nerve injuries. Comminuted fractures were also more common in the older children (p=0.004). No significant differences were demonstrated between the groups with regard to age, gender and mechanism of injury, laterality, incidence of open fracture, vascular injuries and operative time. CONCLUSION: Children aged seven years or older who sustain supracondylar humeral fractures tend to get more comminuted fractures. There is also a higher incidence of associated neurological injury. These cases must be carefully examined for at presentation and parents need to be appropriately counselled about them.

The present study aims to estimate the relationship between child alcohol problems, sociodemographic characteristics, externalizing behavior, parental and peer alcohol use, and family violence by using a cross-sectional community sample of 320 Ukrainian children (9–16 years of age, 50% boys) and their parents. Participants answered questions from the Drinking and Drug History and Current Use Patterns Questionnaire, the Revised Conflict Tactics Scales, the Alabama Parenting Questionnaire, and the Child Behavior Checklist. Fifty-two percent of children reported alcohol use within the past year and 32% experienced alcohol-related problems. The average number of reported alcohol problems was 11.19 (SD = 63.65). Five robust regression models examined correlates of early problem drinking in Ukraine. The final model indicated older child age (β = 0.21, p

BACKGROUND The experience of children undergoing hematopoietic stem cell transplantation (HSCT), including the ways in which different participants (ie, children, parents, and nurses) contribute to the overall picture of a child's experience, is poorly characterized. This study evaluated parent, child, and nurse perspectives on the experience of children during HSCT and factors contributing to interrater differences. METHODS Participants were enrolled in a multicenter, prospective study evaluating child and parent health-related quality of life over the year after HSCT. Children (n = 165) and their parents and nurses completed the Behavioral, Affective, and Somatic Experiences Scale (BASES) at baseline (before/during conditioning), 7 days after the stem cell infusion (day+7), and 21 days after the stem cell infusion (day+21). The BASES domains included Somatic Distress, Mood Disturbance, Cooperation, and Getting Along. Higher scores indicated more distress/impairment. Repeated measures models by domain assessed differences by raters and changes over time and identified other factors associated with raters' scores. RESULTS Completion rates were high (≥73% across times and raters). Multivariate models revealed significant time-rater interactions, which varied by domain. For example, parent-rated Somatic Distress scores increased from baseline to day+7 and remained elevated at day+21 (P < .001); children's scores were lower than parents' scores across time points. Nurses' baseline scores were lower than parents' baseline scores, although by day+21 they were similar. Older child age was associated with higher Somatic Distress and Mood Disturbance scores. Worse parent emotional functioning was associated with lower scores across raters and domains except for Cooperation. CONCLUSIONS Multirater assessments are highly feasible during HSCT. Ratings differ by several factors; considering ratings in light of such factors may deepen our understanding of the child's experience. Cancer 2017;123:3159–66. © 2017 American Cancer Society.

Idiopathic facial aseptic granuloma (IFAG) is an uncommon, benign lesion that presents in the pediatric population. The diagnosis is classically associated with preschool-aged children. Herein, we present a case of IFAG in a pre-adolescent boy, emphasizing the importance of diagnostic consideration in older children.

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

Background Medical child abuse is a challenging diagnosis to make, particularly in older children with unusual presenting symptoms. Case A 7-year-old child with complex medical history presented with anogenital bleeding of unknown origin. Extensive laboratory testing, imaging studies, and diagnostic procedures were negative for any etiology. Forensic testing confirmed the blood in her underwear was a genetic match to the patient. Trial separation from the mother was diagnostic and therapeutic in this case. Summary and Conclusion Older children who are victims of medical child abuse might present in a variety of ways, and might even collaborate with the perpetrator in falsifying symptoms. It is important to keep medical child abuse on the differential when the patient's symptoms and work-up do not match.

Accurate and reproducible measurements related to the paediatric hip and pelvis can be challenging. A standardised radiograph requires close attention to positioning of the infant or child to ensure that it is neither rotated nor inclined. Even a minor degree of obliquity can result in great variability of measurement. In the young child several bony landmarks are not yet established and difficulty can be encountered in determining the appropriate point of measurement. Awareness of these issues allows one to employ the best and most readily reproducible measurement at a particular age or stage of development. Although ultrasound plays an important role in evaluation of paediatric hip dysplasia, this is mainly in infants and radiography continues to play an important role in the older child and adult. There are a wide range of measurements available for different clinical scenarios. These will be addressed in this chapter.

This chapter discusses taking a developmental and autism-focused history and acknowledging that developmental and behavioral problems are stories that unfold over time. Going back to infancy is critical to this process, and questions to ask regarding infancy, toddlerhood, and childhood are included. Your history may be complicated by the broader autism phenotype, the tendency of close relatives of the child to have some language and social differences. There is a cautionary warning regarding an invalid way for nonverbal children to communicate. For the verbal older child and adolescent with ASD, using their very special interests can give insight into how a child views their world. Important communication and social milestones are discussed.

We look at children who might have other or additional diagnoses to explain their symptoms; as the autism spectrum expands, it includes other, possibly related conditions. First we explore the differential diagnosis for ASD (section “Differential Diagnostic Conditions”) and then children who are diagnosed later (section “The Older Child: Late Diagnosis and Primary Behavioral Concerns”).

The use of point of care ultrasound (POCUS) in the assessment of the acutely shocked adult patient has been well established for over a decade. Comparatively, its use in paediatrics has been limited, but this is starting to change with the recent introduction of Children’s Acute Ultrasound training. This article highlights the pathophysiology of shock in children and demonstrates how bedside ultrasound can be used to assist decision making in the clinical assessment of the neonate, infant or older child presenting with undifferentiated shock. We discuss a structured protocol to use when performing the POCUS examination and explain how this could lead to a more rapid correlation of the ultrasound findings with the underlying cause of shock.

The state of malnutrition can be considered as a predominant issue for a developing nation like Bangladesh. Since today's children are the future's workforce, it explicitly impacts to the economic improvement of Bangladesh. So, prevention of child malnutrition is the most foremost investigation at this stage. The study aims to classify malnutrition based on deep learning approach of predictive modeling on significant malnutrition features to predict malnutrition status of a 0–59 months' older child. To do so an Artificial Neural Network (ANN) approach is applied to Bangladesh Demographic and Health Survey 2014 (BDHS) children data. This study clarifies how a predictive model classifies the malnutrition condition. ANN approach shows the best accuracy with wasting, underweight, and stunting. In conclusion, determining the malnutrition status using deep learning approach is the most scientific way to deal with it both for policymakers and clinicians.

Aims Previous research has shown that young children from lower-income countries who play on soil contaminated with faecal bacteria may have an increased risk of diarrhoea. We describe the directly observed activities of young children in rural Gambia and assess whether exposure to the ground outside and factors such as who cares for the child are associated with the child’s risk of diarrhoea. Methods This was a cross-sectional analysis of secondary data from 735 randomly selected households with a child aged 6–36 months from 30 rural villages in The Gambia. Fieldworkers observed the children’s activities and the presence of livestock in the compound, and caregivers reported diarrhoea in the children over the past week. The predictors of diarrhoea were assessed by using a mixed effects multivariate logistic regression model, adjusted for demographic, socio-economic and behavioural factors. Results The majority (87.1%) of children were observed on the ground outside and 84.4% of children were in compounds that contained livestock. Some children (15.6%) were observed on the ground on multiple occasions but the longest period the children were observed on the ground was a median (IQR) of 93 (46–195) minutes. For every hour a child spent on the ground outside during the longest observed period, their risk of diarrhoea increased by 12.4% (adjusted OR=1.124, 95% CI=1.000–1.264, p=0.049). Having an older child, compared to an adult supervising the child reduced the risk of diarrhoea by nearly half (adjusted OR=0.523, 95% CI=0.344–0.794, p=0.002). Conclusion This is the first study from rural Gambia to explore the activities of young children and quantify their exposure to soil on the ground and nearby livestock. The length of the longest period the child spent on the ground outside was positively associated with the risk of diarrhoea. This study highlights the need for interventions that will reduce young children’s exposure to contaminated soil in compounds and suggests that older children as carers could play a part.

Acute pain management in the neonatal period remains a challenge for the clinician. Responses to pain and analgesic intervention are developmentally influenced and cannot be not directly extrapolated from the older child. Successful and safe intervention will minimize acute physiological and behavioural distress, reduce pain scores and potentially improve short- and long-term outcomes. This requires an understanding of the physiology and pharmacology in this age group alongside a multi-modal approach to treatment using both pharmacological and non-pharmacological interventions.

Introduction Sunburns during childhood increase melanoma risk. Children of melanoma survivors are at higher risk, but little is known about their sunburn and sun protection. One study showed that almost half of melanoma survivors' children experienced sunburn in the past year. This study evaluated sunburn and sun protection in melanoma survivors' children, and relevant survivor characteristics from Social Cognitive Theory and the Health Belief Model. Methods Melanoma survivors (N=340) were recruited from a comprehensive cancer center. Survivors completed a baseline questionnaire administered by telephone to report on the behavior of their children (N=340) as part of an RCT of a sun protection intervention. Data were collected in 2008 and analyzed in 2015. Results In the prior 6 months, 28% of children experienced sunburn. "Always" or "frequent" sun protection varied by behavior: sunscreen, 69%; lip balm, 15%; wide-brimmed hats, 9%; sleeved shirts, 28%; pants, 48%; sunglasses, 10%; shade, 33%; and limiting time outdoors, 45%. Survivors' sunburn and sun protection were positively associated with these outcomes in children. Correlates of sunburn also included older child age and higher risk perceptions. Correlates of sun protection behaviors included younger child age; stronger intentions, higher self-efficacy, and more positive outcome expectations about sun protection; and greater number of melanomas in survivors. Conclusions Melanoma survivors may have a heightened awareness of the importance of their children's sun protection, but their children are not routinely protected. Correlates of children's sunburn and sun protection suggest subgroups of survivors to target with interventions to improve sun protection.

El presente trabajo se propone analizar los recursos evaluativos (Labov, 1972) empleados por niños de 4 años de poblaciones urbanas marginadas cuando cuentan un relato de ficción en distintos contextos de producción: en interacción con un niño mayor, en interacción con un par y de formaindividual. El corpus está conformado por 99 narrativas solicitadas a 33 niños y niñas de 4 años a partir de una secuencia de imágenes en las tres condiciones mencionadas. Las narrativas fueron filmadas en video. Se empleó un procedimiento cualitativo, el Método Comparativo Constante(Strauss & Corbin, 1990), con el objetivo de elaborar inductivamente un sistema de categorías que permitió dar cuenta de los recursos evaluativos empleados por los niños. Luego se analizó la distribución cuantitativa de estas categorías y se emplearon procedimientos estadísticos (ANOVA yChi cuadrado) para evaluar la significatividad de las diferencias. Por último, se analizaron de forma cualitativa las narrativas producidas por una misma niña en las tres condiciones consideradas. Los resultados mostraron que los niños empleaban mayor cantidad de recursos evaluativos cuando interactuaban con un par que en las otras dos condiciones. El análisis cualitativo de las narrativas producidas por una misma niña en las tres condiciones permite comprender esta diferencia en función del modo particular que adopta la interacción con un niño de igual edad. Estos resultados,que se discuten atendiendo a investigaciones psicolingüísticas y del análisis conversacional,permiten ponderar la relevancia de las interacciones entre pares en la producción de narrativas y su potencial uso en el diseño de estrategias pedagógicas.Palabras clave: evaluación, narrativas de ficción, interacciones entre niños, niños pequeños,poblaciones urbano marginadas. This work aims to analyze the evaluative resources (Labov, 1972) that 4-year-old children from marginalized urban populations employ when they tell a fictional account in different contexts of production: interaction with a same age child, interaction with an older child and individual performance. The corpus is made up of 99 narratives elicited from a sequence of images to 33 4-year-old children in the three conditions mention. The narratives were videotaped and transcribed. A qualitative method was employed, the Constant Comparative Method, in order to create a system of categories that allowed to analyzed the evaluative resources employed by the children. The quantitative distribution of these categories was then analyzed, and statistics procedures were employed in order to evaluate the significance of the differences. Last, we analyzed qualitatively the narratives produced by the same girl in the three conditions. Results show that the children employed more evaluative resources when they interacted with a peer than in the other two conditions. The qualitative analysis of the narratives produced by one child in the three conditions allowed understand this difference due to the characteristics of the interaction with a same age child. These results, which are discussed in response to psycholinguistic and conversational analysis previous research, allow weigh the importance of peer interactions in the production of narratives and their potential use in designing teaching strategies. Le présent travail se propose d’analyser les ressources évaluatives (Labov, 1972) employées par des enfants de 4 ans issus de populations défavorisées, au moment de raconter un événement fictif produit dans différents contextes : et ce durant l’interaction avec un enfant plus grand, puis avec un enfant de leur âge, et enfin de manière individuelle. Le corpus est conformé par 99 narrations sollicitées à 33 enfants de 4 ans, à partir d’une séquence d’images présentée dans les trois conditions mentionnées ci-dessus. Les narrations ont été filmées et transcrites. Nous avons employé une procédure qualitative, la Méthode Comparative Constante (Strauss & Corbin, 1990), afin de construire de manière inductive un système des catégories nous permettant de comprendre les ressources évaluatives employées par les enfants. Ensuite, nous avons analysé la distribution quantitative de ces catégories, et nous avons employé des procédures statistiques afin d’évaluer la significativité des différences. Finalement, nous avons analysé de façon qualitative les récits produits par la même petite fille, pendant les trois scénarios déjà mentionnés. Les résultats ont démontré que les enfants employaient une quantité de ressources évaluatives plus large lorsqu’ils échangeaient avec des enfants de leur âge, que dans les autres contextes. L’analyse qualitative des récits produits par la même petite fille dans les trois conditions, permet de comprendre cette différence en fonction de la particularité dont l’enfant du même âge adopte l’interaction. Ces résultats, qui sont discutés en réponse à des travaux de recherche psycholinguistiques et d’analyse conversationnelle, permettent de peser l’importance des interactions entre pairs dans la production de récits et leur utilisation potentielle dans la conception de stratégies d’enseignement. Fil: Alam, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; Argentina Fil: Rosemberg, Celia Renata. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; Argentina

This mixed-method study examined parents’ experiences of their children’s influence on parent’s continuing adult development. Mothers and fathers from 30 families were separately interviewed regarding two of their children who were between 8 and 14 years old. Parents reported on recent events when their younger and older child successfully requested that parents change their preferences, attitudes, and personal behaviors. Mothers reported more direct child influence than fathers, and both parents reported that they were more receptive to influence from their older children. Thematic analyses revealed that parents were generally comfortable with child influence and constructed their children as actors and agents. Parents attributed their receptivity to agentic qualities of children’s requests, goals for empowering children, and maintaining their mutual relationship. The findings provided insight into the transactional and relational nature of children’s influence and the direct and indirect impact of children on the adult development of parents.

Children in late latency through early adolescence can join in a partnership with their analyst to explore their dreams as important communications about themselves. The child is the bearer of the dream, the analyst the receiver, and their shared attention to something new presenting itself to each of them offers a unique opportunity to seek meaning together. This article provides clinical illustrations of work with the dreams of children in different phases of analysis and during developmental transitions. Technical approaches that invite a child’s interest in dreams are demonstrated.

Anatomically corrected malposition of great arteries constitutes a rare form of congenital cardiac malformation where aorta and pulmonary artery arise from respective ventricles but the alignment of the great vessels does not conform to that of a normal heart. It often poses a diagnostic challenge due to a close resemblance to other great vessel malposition defects. The majority of the patients with this disorder are physiologically corrected and present due to associated lesions, most commonly ventricular septal defects. In this review, we present two children of anatomically corrected malposition who presented with hemodynamically significant ventricular septal defects. The older child had a restrictive defect and was successfully managed by percutaneous closure in-spite of associated septal malalignment. The younger child had a larger defect and underwent surgical closure for the same. None of the children had any associated outflow tract obstructions. Closure of ventricular septal defect with such an anatomy either surgically or by percutaneous route has its own set of challenges. Although the risks of conduction abnormalities are not increased, there is a potential for future development of outflow tract obstruction requiring periodic follow-up. Detailed echocardiography and proper understanding of the unique anatomy forms the basis of successful management of associated lesions in anatomically corrected malposition of great arteries.

Background We examined the correlation between initial Pirani and Dimeglio scores and their individual components to the number of casts for older clubfoot children. Methods Twenty seven patients (39 feet) aged 2–11 years with idiopathic clubfeet were treated using the Ponseti technique and correlation with number of corrective casts calculated. The number of cast required was counted from application of primary cast to the time of initiation of the foot abduction orthosis. Results Average 8.45 ± 2.31 (range, 4–13) casts were used for treatment. A low correlation (r = 0.203) was identified when total Dimeglio score was compared with the number of casts. No correlation was identified for Pirani score (r = 0.023). Among individual components, only cavus deformity had a significant positive correlation to cast numbers. Conclusions The Pirani and Dimeglio classifications still remain the most widely practiced clubfoot severity grading systems for the older clubfoot child. However, their prognostic value to predict the total cast duration from initial severity remains questionable.

Posterior urethral valves (PUVs) present clinically across a varied spectrum, ranging from severe obstruction with massive distension of the bladder and upper urinary tracts in the fetus, to a much more indolent course with minor secondary changes in the young or older child. Type III (diaphragm) PUVs are relatively uncommon, and are associated with difficulty in passing a transurethral catheter into the bladder as well as smooth dilation of the bladder. The following case examines the unusual experiences of both diagnosing PUVs in a teenager, and capturing visual evidence of type III valves during cystourethroscopy.

Cor triatriatum is a rare, congenital heart defect. When diagnosis does not occur in infancy, primary symptoms in an older patient may mimic reactive airway disease. We report a case of cor triatriatum in an older child, previously diagnosed with asthma, presenting to an emergency department with a chief complaint of wheezing. Initial treatment with bronchodilators and corticosteroids was unsuccessful, prompting thorough evaluation. Subsequent imaging diagnosed cor triatriatum sinister. When presentations consistent with common conditions, such as asthma, do not respond appropriately to classic intervention, emergency physicians must be prepared to consider alternative and rare diagnosis.

We evaluated predictors of micronutrient powder (MNP) sachet coverage and recent intake using data from a cross-sectional survey representative of children aged 12-23 months in Amuria district, Uganda. In June/July 2016, caregivers were interviewed 12 months after implementation of an integrated MNP and infant and young child feeding pilot (N = 761). Logistic regression described predictors of (a) high-MNP sachet coverage (received at least 60 sachets/6 months) and (b) recent intake (consumed MNP during the 2 weeks preceding the survey) among children who had ever received MNP and had complete data (N = 683). Fifty-nine percent (95% Confidence Interval [CI] [53.8, 64.2]) of children had high-MNP sachet coverage, and 65.4% (95% CI [61.0, 69.9]) had recent intake. MNP ration cards (Adjusted Odds Ratio [AOR] 2.67, 95% CI [1.15, 6.23]), organoleptic changes to foods cooked with soda ash (AOR 1.52, 95% CI [1.08, 2.14]), having heard of anaemia (AOR 1.59, 95% CI [1.11, 2.26]), knowledge of correct MNP preparation (AOR 1.89, 95% CI [1.11, 3.19]), and current breastfeeding (AOR 2.04, 95% CI [1.36, 3.08]) were positively associated with MNP coverage whereas older child age (18-23 vs. 12-17 months) was inversely associated with coverage (AOR 0.32, 95% CI [0.23, 0.50]). MNP ration cards (AOR 2.86, 95% CI [1.34, 6.09]), having heard an MNP radio jingle (AOR 1.40, 95% CI [1.01, 1.94]), knowledge of correct MNP preparation (AOR 1.88, 95% CI [1.04, 3.39]), and the child not disliking MNP (AOR 1.90, 95% CI [1.13, 3.22]) were positively associated with recent intake. Interventions that increase caregiver knowledge and skills and focus on older children could improve MNP coverage and recent intake.

Cultural factors, such as food taboos, negatively influence the promotion of breastfeeding, resulting in early weaning. The aim of this study was to investigate differences in eating habits of a group of mothers in relation to breastfeeding. Cross-sectional study consisting of mothers of children under two years old enrolled in the Child Care Program of two Basic Health Units of Guarapuava-PR. One located in the peripheral region (US 1) and the other in the central area (US 2) to detect differences in eating habits of this population. The study included 96 mothers with mean age 25,11 years, of which 86.5% said they believed that some food would undermine breastfeeding. The main foods to be avoided, according to the mothers, were acidic foods, alcohol, chocolate and soft drinks. Mothers of units 1 and 2 have made mention consumption of foods derived from corn, and only two mentioned in the U.S. 2 beer consumption as food lactogenic black. No differences were found between the health U.S. 1 and U.S. 2. In relation to dietary restrictions were not found relevant data related to the taboos of the interviewees. Highlights the importance of orientation to promote breastfeeding and encourage mothers to solve any doubts, avoiding early weaning and continued breastfeeding until two years of age or older child.

An 11-year-old boy presented with fever and abdominal pain, and was diagnosed with retroperitoneal lymphadenitis. At the same time, a painless right scrotal mass was observed. On imaging the testis and the epididymal mass both had abundant blood flow, although tumor markers were negative. Although the right testis had shrunk after antibiotic treatment, swelling was persistent and incisional biopsy was therefore performed, resulting in diagnosis of granulomatous orchitis (GO). No recurrence was found. In cases of scrotal swelling in both the testis and the epididymis of an older child, it is necessary to consider the possibility of inflammatory GO, and orchiectomy should not be performed without careful consideration.

Mentalization normally comes about through the child’s experience of his mental states being reflected on, prototypically through secure play with a parent or older child, which facilitates integration of the pretend and psychic equivalence modes. Adults with a history of childhood attachment trauma often seem unable to understand how others think or feel. We have hypothesized that childhood maltreatment undermines mentalization. The collapse of mentalization in the face of trauma entails a loss of awareness of the relationship between internal and external reality. Attachment is normally the ideal ‘training ground’ for the development of mentalization because it is safe and non-competitive. The impact of trauma on mentalization is intermittent. A therapist needs to maintain a mentalizing stance in order to help a patient develop a capacity to mentalize. Mentalization involves both a self- reflective and an interpersonal component.

Jaundice is an important sign of acute and chronic liver diseases in older children and adolescents. The differential diagnosis is extensive and differs from neonatal liver disease. Jaundice may be a late feature in chronic liver disease while acute onset jaundice may be a sign of severe liver disease or acute liver failure. Prompt diagnosis and evaluation of liver synthetic function is essential in making the diagnosis (Box 6.1).

The examination of a child is a challenge as the specifics will vary with the child’s age. In addition, children often do not wish to be examined, and they tend to be shy, apprehensive, and noncooperative. Therefore, it is important to make the child comfortable, and, to reach a precise diagnosis, you must develop your own technique and style for the examination, adapted always to the situation and the child’s age. This chapter provides tips to conduct a successful pediatric examination, focusing on the examination of different organ systems in older children. At the beginning of each organ system examination, the information is summarized in an “Examination Station” to help you to readily memorize the examination steps and their sequence. This information should be particularly helpful in an objective structured clinical examination (OSCE).

Brian Young continues his journey by examining the child at school developing as an autonomous consumer (with a little help from the Bank of Mum) and how strands of socialisation shape children’s understanding of money and brands. Being able to control and manage behaviour is key to serious development. These recent developments in children’s development of their executive control in different situations are summarised and the updated review of work on advertising to children and the child’s understanding of brands is essential reading.