Children's response to hospitalization at the University Hospital of the West Indies

The results of this study indicated that patients aged 3-13 years who had a history of previous hospitalization appeared to be significantly more distressed than patients without such previous history (p<0.05). Previously hospitalized children were more uncooperative and displayed anxious, immature behaviour patterns. Children who were hospitalized for more than a month were also interviewed about their concerns and response to hospitalization. The study highlighted the need for hospitalized children to be better prepared for hospitalization, to have greater parental involvement in the management of their behaviour and to have efficiently run programmes geared at addressing their educational and emotional needs.(Au)

Evaluation of school feeding programs: some Jamaican examples

It is hypothesized that giving children a daily breakfast at school may improve their scholastic achievement through several mechanisms: increasing the time spent in school, improving certain cognitive functions and attention to tasks, and, perhaps indirectly, improving nutritional status. Two Jamaican studies showed that providing breakfast to students at school improved some cognitive functions, particularly in undernourished children. However, changes in classroom behavior varied depending on the quality of ths school. Children in better-organised schools concentrated on tasks for longer periods and made fewer undesirable movements, whereas in poorly organized schools the children's behavior deteriorated. Studies to date have provided insufficient evidence to determine whether children's long-term scholastic achievement is imporved by eating breakfast daily. Well-designed, randomized, controlled. long-term trials are essential for determining public policy on the implementation of schools feeding programme(AU)

Behaviour and emotional problems of clinic referred children of the African diaspora

Several factors determine behaviour problem types children exhibit, and actions adults (eg, parents) subsequently take. Factors include children's sociocultural background and clinicians' professional training. Cross-national research on children of similar heritage (eg, the African Diaspora) living in different cultures can address sociocultural issues associated with child psychopathology, but few cross-cultural studies focus on children of African descent. This study begins addressing these issues by surveying clinic records of 696 African American and Jamaican children aged 4-18 years. Trained recorders reviewed clinic records and recorded youngsters' presenting problems. By matching youngsters' problem to the widely used Child Behavior Checklist (CBCL) items, recorders coded and summed problems according to eight CBCL syndromes, internalising, externalising problems, other CBCL-, and non-CBCL problems. Stepwise regression revealed that African American youngsters scored higher on the Somatization syndrome only, a child problem type the Jamaican culture seems to tolerate.(AU)

An evaluation of the effects of breakfast on classroom behaviours in Jamaican schoolchildren - abstract

Children's behaviours may be affected by short-term food deprivation, and this may hinder their ability to learn in class. However, there are few adequate evaluations of the effect of nutrition on classroom behaviour in Jamaica. We evaluated the effects of giving breakfast on the classroom behaviours of 50 undernourished and 60 adequately nourished children aged 8-11 years, selected from 4 poor rural schools. The children were observed twice, once after receiving breakfast and once after a placebo. The behaviours were observed in teaching and set task situations and included attention to task, talking to another child, gross motor behaviour and responding to teacher. A time sampling method was used. This technique estimates the number of times actual behaviours occur. The test retest reliabilities ranged from 0.6 to 0.9 (Spearman-Brown coefficient). The undernourished children moved around the classroom more than the adequately nourished children. The impact of breakfast varied among the schools but not between nutritional groups. In the school which was better equipped and organized, the children were more attentive (p<0.01) and moved less (p<0.05) when they received breakfast. In the poorer schools there was no improvement and, in one, the children's attention to task was less when given breakfast (p<0.02). School breakfasts may therefore only benefit children's behaviours in the presence of satisfactory classroom infrastructure (AU)

Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study

OBJECTIVE. To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. DESIGN. Ethnographic field studies and standardized neuro-behavior assessments during the neonatal period. SETTING. Rural Jamaica in heavy-marijuana-using population. PARTICIPANTS. Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed mnonnates were compare at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-refulation and were judged to be more rewarding for caregivers. CONCLUSIONS. The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development (AU)

Knowledge, attitudes and practices of boys and girls aged 8-9 years with regard to their sexual behaviour and risk of acquiring HIV/AID

The apparent increase in the prevalence of STDs and the new epidemic HIV/AIDS are definite causes for public concern. This study compares the knowledge, attitudes and practises of boys and girls aged 8-9 years with regard to their sexual behaviour and their risk of acquiring AIDS. Sixty five students (34 boys, 31 girls) with the age range 8-9 years were selected from grades 2, 3, and 4 at August Town Primary School. Personal interviews with a standard questionnaire were conducted at the school with the consent of the parents. The girls scored marginally higher on the questionnaire than the boys, but there were no statistically significant differences. Parents were rated second to radio and television by their children as a first source of information about sex. Sexual approaches were experienced by 65 percent of the sample, with 15 percent actually becoming involved sexually. There were more boys (18 percent) than girls (13 percent) involved in such activity. The risk of acquiring HIV/AIDS through sexual involvement is possible as 15 percent of those who were approached for sexual relationships responded. Insufficient knowledge and negative attitudes towards HIV/AIDS victims by some of the 8-9 years old can be considered risk factors of acquiring the disease. (AU)

The long-term effects of early kwashiorkor compared with marasmus. IV. Performance on the national high school entrance examination

This one of a series of studies on the long-term effects of early childhood malnutrition in Barbadian school children. This is the first report of the relationship between early malnutrition and later performance on a national examination administered to all 11-y-old children in Barbados to assign high school seats. We compared scores achieved on 11-plus examination by 103 boys and girls with histories of marasmus or kwashiorkor with those obtained by 63 healthy comparison children and also with scores obtained by the total island population of children during the same years. We report that children with histories of either type of malnutrition confined to infancy had significantly lower scores on the national high school examination than health comparison children. Reduced 11-plus scores were closely associated with teacher reports of attention deficits in the classroom documented when the children were as young as 5 to 8 y of age and also with IQ and academic performance. Early malnutrition had independent effects on performance on the 11-plus examination even when home environmental conditions were controlled for. These findings have important implications for future opportunities available to children with histories of infantile malnutrition. (AU)

Nutritional deficiencies and children's behaviour and mental development

There is an increasing amount of evidence that all the nutritional deficiencies reviewed here detrimentally affect children's concurrent mental functions. In the case of 1 and probably severe PEM in poor environments, long term effects have also been demonstrated. It is likely that Fe deficiency, and mild to moderate undernutrition, if allowed to persist for long periods may lead to developmental lags which are difficult to reverse. The long-term effects of recurrent short-term food deprivation are unknown. Considering the high prevalence of these conditions the public health implications are enormous (AU)

The effects of undernutrition on mental development

Studies on the effects of iodine and iron deficiency, and early childhood malnutrition on mental development and behaviour are discussed. Foetal iodine deficiency causes structural changes to the brain and permanent behavioural changes whereas moderate iron deficiency appears to have transient effects on behaviour. Problems in interpreting findings from studies of malnutrition are extensively examined. (AU)

Chronic undernutrition and cognitive abilities

This review attempts to summarize recent developments in our understanding of the relationship between childhood malnutrition and cognitive abilities. The first questions briefly discussed relate to methods: the definition of malnutrition and the selection of suitable methods of measuring cognitive abilities. Next are considered the effects on mental development of undernutrition, social background and the behavioural patterns of mothers. The consequences of an episode of severe malnutrition in infancy and of confinement in hospital represent a special but important case. The review ends with a discussion of the factors that influence recovery and of strategies for intervention which might be included in a health care programme.(AU)

Early maternal-child contact: effects on later behaviour

Fifty normal, healthy, full-term infants were allowed 45 minutes contact with their mothers immediately after birth at Victoria Jubilee Hospital, Kingston, Jamaica. The behavior of these infants and their mothers was compared with matched controls at six and 12 weeks in a hospital follow-up interview. More early-contact mothers solely breast-fed their infants than did control mothers. Early-contact infants were less likely than controls to be restless or crying during the interviews. At 12 weeks, early-contact mothers were more likely than control mothers to rise and follow when their babies were taken from them, gazed more frequently at their infants, and were more likely to vocalise to their infants during the interview. These diferences indicate that early contact promotes a closer relationship between a woman and her infant. Given the importance of breast-feeding as protection against gastro-enteritis and malnutrition, this closer relationship may be especially valuable in developing countries where such diseases are common (AU)

Long term behavioural consequences of severe protein-calorie malnutrition - abstract

A study of the long term behavioural consequences of severe nutritional marasmus was undertaken in Barbados, West Indies. The index cases were boys (n=60) and girls (n=36) who had been hospitalized with malnutrition in the first year of life and followed longitudinally by the National Nutrition Centre. At the time of the current study, their ages ranged from four to eleven years. Each index child was matched by age, gender and handedness with a control child from the same school or parish as the index child. Descriptions of the child's behaviour were obtained by interviewing the primary caretaker of each child. Information concerning the social, physical and biological ecology was also gathered since these factors may independently influence behavioural development. Index children had more behavioural problems than their matched controls. Multiple regression analyses were performed to partial out the contribution of nutritional history of the child and economic conditions of the family, which differed in the two groups. These analyses confirmed that the behavioural deficits present among the index children were a consequence of malnutrition and not economic factors. Behavioural deficits persisted even in the older children as compared with their controls. In contrast with the behavioural results, anthropometric measures failed to distinguish between the two groups by ten years of age (AU)

Parent-child separation as a determinant of psychopathology in children: A Jamaican study

A large proportion (33.8) of children attending the Child Psychiarty Clinic (UHWI) were separated during their early childhood from parents or parent-figure. Separated children tended to be emotionally labile and anti-social. The largest number of children attending the clinic for treatment were within the 8-15 year age group. It is suggested that these children at risk be helped by means of social and psychological intervention. (AU)

Growth, behaviour, and educational achievement of Jamaican children with sickle cell trait

A longitudinal study of the mental and physical development of 200 children with normal haemoglobin and 21 with the sickle-cell trait was carried out in a small rural community in Jamaica. At about 2 and 10 years of age heights and weights showed no significant differences. At about 10 years of age classroom behaviour, sociability, and educational achievement were similar. The results suggest that the sickle-cell trait does not affect growth and mental development.(Summary)