Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study.

Haemolytic uraemic syndrome (HUS) caused by infection with Shiga toxin-producing Escherichia coli (STEC) is a relatively rare but potentially fatal multisystem syndrome clinically characterised by acute kidney injury. This study aimed to provide robust estimates of paediatric HUS incidence in England, Wales, Northern Ireland, and the Republic of Ireland by using data linkage and case reconciliation with existing surveillance systems, and to describe the characteristics of the condition. Between 2011 and 2014, 288 HUS patients were included in the study, of which 256 (89.5%) were diagnosed as typical HUS. The crude incidence of paediatric typical HUS was 0.78 per 100,000 person-years, although this varied by country, age, gender, and ethnicity. The majority of typical HUS cases were 1 to 4 years old (53.7%) and female (54.0%). Clinical symptoms included diarrhoea (96.5%) and/or bloody diarrhoea (71.9%), abdominal pain (68.4%), and fever (41.4%). Where STEC was isolated (59.3%), 92.8% of strains were STEC O157 and 7.2% were STEC O26. Comparison of the HUS case ascertainment to existing STEC surveillance data indicated an additional 166 HUS cases were captured during this study, highlighting the limitations of the current surveillance system for STEC for monitoring the clinical burden of STEC and capturing HUS cases.

Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study.

BACKGROUND: Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions. AIMS: To estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition. METHOD: Surveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires. RESULTS: Questionnaire response was 79% at baseline and 82% at follow-up. For those aged 17-19, incident rate (range adjusted for non-response) of transition need was 202-511 per 100 000 people aged 17-19 per year, with successful transition of 38-96 per 100 000 people aged 17-19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria. CONCLUSIONS: As inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.

How to measure the need for transition to adult services among young people with Attention Deficit Hyperactivity Disorder (ADHD): a comparison of surveillance versus case note review methods.

BACKGROUND: Health services have not provided adequate support for young people with long term health conditions to transfer from child to adult services. National Institute of Health and Care (NICE) guidance on transition has been issued to address these gaps. However, data are often sparse about the number of young adults who might need to transition. Using Attention Deficit Hyperactivity Disorder (ADHD) as an exemplar, this study used an existing surveillance system and a case note review to capture the incidence of the transition process, and compared and contrasted the findings. METHODS: The Child and Adolescent Psychiatry Surveillance System (CAPSS) was used to estimate the incident transition of young people with Attention Deficit Hyperactivity Disorder (ADHD) from child to adult services. This involves consultant child and adolescent psychiatrists from the United Kingdom (UK) and Republic of Ireland (ROI) reporting relevant young people as they are seen in clinics. In parallel, a case note review was conducted using the Maudsley Biomedical Research Centre (BRC) Clinical Records Interactive Search (CRIS). The study period ran for twelve months with a nine month follow up to see how the transition proceeded. RESULTS: CRIS identified 76 cases in the study period, compared to 18 identified using surveillance via CAPSS. Methodological issues were experienced using both methods. Surveillance issues; eligibility criteria confusion, reporting errors, incomplete questionnaires, difficulties contacting clinicians, and surveillance systems do not cover non-doctors and psychiatrists who are not consultants. Case note review issues using CRIS included the need for researchers to interpret clinical notes, the availability and completeness of data in the notes, and data limited to the catchment of one particular mental health trust. CONCLUSIONS: Both methods demonstrate strengths and weaknesses; the combination of both methods in the absence of strong routinely collected data, allowed a more robust estimate of the level of need for service planning and commissioning.

GENDER DIFFERENCES IN INTELLIGENCE OF 5- TO 11-YEAR-OLDS ON THE COLOURED PROGRESSIVE MATRICES IN EGYPT.

This study was based on data for a sample of 1756 Egyptian primary school children (863 boys and 893 girls) aged 5-11 years assessed for intelligence with Raven's Coloured Progressive Matrices (CPM). The results showed that boys obtained a slightly higher IQ than girls and had greater variance.

A STUDY OF THE HERITABILITY OF INTELLIGENCE IN SUDAN.

Intelligence was assessed using the Standard Progressive Matrices in 316 MZ and 550 same-sex DZ twins with a mean age of 10 years in Sudan. Heritability was estimated at 0.172 and shared environmental influences at 0.596.

Treatment adherence and BMI reduction are key predictors of HbA1c 1 year after diagnosis of childhood type 2 diabetes in the United Kingdom.

BACKGROUND/OBJECTIVE: Type 2 Diabetes (T2DM) is increasing in childhood especially among females and South-Asians. Our objective was to report outcomes from a national cohort of children and adolescents with T2DM 1 year following diagnosis. METHODS: Clinician reported, 1-year follow-up of a cohort of children (<17 years) diagnosed with T2DM reported through the British Paediatric Surveillance Unit (BPSU) (April 2015-April 2016). RESULTS: One hundred (94%) of 106 baseline cases were available for review. Of these, five were lost to follow up and one had a revised diagnosis. Mean age at follow up was 15.3 years. Median BMI standard deviation scores (SDS) was 2.81 with a decrease of 0.13 SDS over a year. HbA1c <48 mmol/mol (UK target) was achieved in 38.8%. logHbA1c was predicted by clinician reported compliance and attendance concerns (ß = 0.12, P = <0.0001) and change in body mass index (BMI) SDS at 1-year (ß = 0.13, P=0.007). In over 50%, clinicians reported issues with compliance and attendance. Mean clinic attendance was 75%. Metformin was the most frequently used treatment at baseline (77%) and follow-up (87%). Microalbuminuria prevalence at 1-year was 16.4% compared to 4.2% at baseline and was associated with a higher HbA1c compared to those without microalbuminuria (60 vs 49 mmol/mol, P = 0.03). CONCLUSIONS: Adherence to treatment and a reduction in BMI appear key to better outcomes a year after T2DM diagnosis. Retention and clinic attendance are concerning. The prevalence of microalbuminuria has increased 4-fold in the year following diagnosis and was associated with higher HbA1c.

Are greenhouse gas emissions and cognitive skills related? Cross-country evidence.

Are greenhouse gas emissions (GHG) and cognitive skills (CS) related? We attempt to answer this question by exploring this relationship, using cross-country data for 150 countries, for the period 1997-2012. After controlling for the level of economic development, quality of political regimes, population size and a number of other controls, we document that CS robustly predict GHG. In particular, when CS at a national level increase by one standard deviation, the average annual rate of air pollution changes by nearly 1.7% (slightly less than one half of a standard deviation). This significance holds for a number of robustness checks.

Classification of childhood onset eating disorders: A latent class analysis.

This study tested the hypothesis that latent class analysis (LCA) would successfully classify eating disorder (ED) symptoms in children into categories that mapped onto DSM-5 diagnoses and that these categories would be consistent across countries. Childhood onset ED cases were ascertained through prospective active surveillance by the Australian Paediatric Surveillance Unit, the Canadian Paediatric Surveillance Program, and the British Paediatric Surveillance Unit for 36, 24, and 14 months, respectively. Pediatricians and child psychiatrists reported symptoms of any child aged ≤ 12 years with a newly diagnosed restrictive ED. Descriptive analyses and LCA were performed separately for all three countries and compared. Four hundred and thirty-six children were included in the analysis (Australia n = 70; Canada n = 160; United Kingdom n = 206). In each country, LCA revealed two distinct clusters, both of which presented with food avoidance. Cluster 1 (75%, 71%, 66% of the Australian, Canadian, and United Kingdom populations, respectively) presented with symptoms of greater weight preoccupation, fear of being fat, body image distortion, and over exercising, while Cluster 2 did not (all p < .05). Cluster 1 was older, had greater mean weight loss and was more likely to have been admitted to an inpatient unit and have unstable vital signs (all p < .01). Cluster 2 was more likely to present with a comorbid psychiatric disorder (p < .01). Clusters 1 and 2 closely resembled the DSM-5 criteria for anorexia nervosa and avoidant/restrictive food intake disorder, respectively. Symptomatology and distribution were remarkably similar among countries, which lends support to two separate and distinct restrictive ED diagnoses.

CORRELATIONS BETWEEN INTELLIGENCE, HEAD CIRCUMFERENCE AND HEIGHT: EVIDENCE FROM TWO SAMPLES IN SAUDI ARABIA.

This study was based on two independent studies which in total consisted of 1812 school pupils aged 6-12 years in Saudi Arabia. Study I consisted of 1591 school pupils (609 boys and 982 girls) attending state schools, and Study II consisted of 211 boys with learning disabilities. Intelligence (measured using the Standard Progressive Matrices Plus for Study I and the Standard Progressive Matrices for Study II), head size and height were measured for the two samples. The results showed that intelligence was statistically significantly correlated with head circumference (r=0.350, p<0.001 for Study I and r=0.168, p<0.05 for Study II) and height (r=0.271, p<0.001 for Study I and r=0.178, p<0.05 for Study II).

SEX DIFFERENCES ON THE WISC-III AMONG CHILDREN IN SUDAN AND THE UNITED STATES.

The sex differences on the WISC-III are reported for the thirteen subtests, the Verbal and Performance IQs, the four Index IQs and the Full Scale IQs in Sudan and the United States. The sex differences are closely similar in the two samples with a correlation of 0.878 (p<0.001) for the thirteen subtests. Males obtained significantly higher Full Scale IQs in the two samples of 0.23d and 0.11d, respectively.

Chinese sex differences in intelligence: Some new evidence.

Sex differences on the WISC-R in Chinese children were examined in a sample of 788 aged 12 years. Boys obtained a higher mean full scale IQ than girls of 3.75 IQ points, a higher performance IQ of 4.20 IQ points, and a higher verbal IQ of 2.40 IQ points. Boys obtained significantly higher means on the information, picture arrangement, picture completion, block design, and object assembly subtests, while girls obtained a significantly higher mean on coding. The results were in general similar to the sex differences in the United States standardisation sample of the WISC-R. Boys showed greater variability than girls.

THREE STUDIES OF THE STANDARD PROGRESSIVE MATRICES IN MOROCCO (.).

Results are given for three studies of samples tested with the Standard Progressive Matrices (SPM) in Morocco. The first consisted of 85 children (boys, girls; M age = 8.5 yr.) in the town of Kenitra and obtained a British IQ of 74. The second consisted of 202 adults (92 men, 110 women; M age = 26 yr.) in four cities and obtained a British IQ of 81. The third consisted of 1,177 secondary school children (723 boys, 454 girls; ages 12-17 yr.) in a rural area and obtained a British IQ of 73.3. It is proposed that the best estimate of the Moroccan IQ can be obtained as the average of the three results, giving an IQ of 76.

SEX DIFFERENCES ON THE WECHSLER INTELLIGENCE SCALE FOR CHILDREN-III IN BAHRAIN AND THE UNITED STATES.

Sex differences on the Wechsler Intelligence Scale for Children-III (WISC-III) are reported for children in Bahrain and the United States. The results for the two samples were consistent in showing no significant differences in Verbal, Performance, and Full Scale IQs, higher average scores by boys on the Block design and Mazes subtests of spatial ability, and higher average scores by girls on Coding. There was also greater variability in boys than in girls.

A note on a new study of intelligence in Egypt.

Three studies of intelligence in Egypt published between 1957 and 1989 and based on small samples gave British IQs between 77 and 83. The present paper reports the results of a recent study based on a much larger sample in order to examine how far the results of the older studies can be replicated. The Coloured Progressive Matrices was standardized in Egypt in 2011-2013 on a sample of 11,284 children aged 5.6 to 10.5 years. The sample obtained a British IQ of 84.2 and provides a satisfactory replication of the earlier studies.

A study of intelligence in Jordan .

The Raven's Standard Progressive Matrices test was standardized in Jordan in 2004 on a sample of 1,015 school students ages 12 to 17 yr. The sample obtained a British IQ of 82.6.

A study of intelligence in Oman.

There have been two studies of the Coloured Progressive Matrices and the Standard Progressive Matrices in Oman, giving British IQs of 87 and 81, respectively. The present paper reports results for the Advanced Progressive Matrices to ascertain how far these are consistent with the previous studies. The Advanced Progressive Matrices was standardized in Oman in 2009-10 on a sample of 2,467 Grade 11 and 12 students (M age = 17.13 yr., SD = 1.01, range = 16-18). The sample obtained a mean score of 12.2, equivalent to a British IQ of 88, consistent with the results of the two previous studies.

Subtypes of avoidant/restrictive food intake disorder in children and adolescents: a latent class analysis.

Background: The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) describes three primary avoidant/restrictive food intake disorder (ARFID) subtypes including sensory sensitivity, lack of interest in food or eating, and fear of aversive consequences. Studies exploring these subtypes have yielded varying results. We used latent class analysis (LCA) based on the psychopathology of ARFID in a sample of children and adolescents to empirically identify classes. Methods: We carried out a surveillance study of ARFID in collaboration with the British Paediatric Surveillance Unit (BPSU) and the Child and Adolescent Psychiatry Surveillance System (CAPSS) in the United Kingdom and the Republic of Ireland from 1st of March 2021 to 31st of March 2022. Paediatricians and child and adolescent psychiatrists were contacted monthly to report newly diagnosed cases of ARFID electronically and complete a detailed clinical questionnaire. Cases aged 5-18 years were included. LCA was performed specifying 1-6 classes and likelihood-based tests for model selection. The Bayesian Information Criterion (BIC), the Akaike Information Criterion (AIC) and the Sample-Size Adjusted BIC were used to determine the most parsimonious model. Analysis of variance (ANOVA) and χ2 tests were used to compare the characteristics of the identified classes. A multinomial logistic regression (MLR) was performed to investigate predicting factors for the latent classes. Findings: We identified 319 children and adolescents with ARFID. LCA revealed four distinct classes which were labelled as Fear subtype, Lack of Interest subtype, Sensory subtype, and Combined subtype. The probability of being classified as these were 7.2% (n = 23), 25.1% (n = 80), 29.5% (n = 94) and 38.2% (n = 122), respectively. Age at diagnosis, sex, weight loss, distress associated with eating, and autism spectrum disorder diagnosis were identified as predictors of class membership. Interpretation: LCA identified four different classes in a sample of children and adolescents with ARFID. The Combined Subtype, a mixed presentation was the most common. The other three classes resembled the subtypes described in the literature. Clinicians should be aware of these different presentations of ARFID as they may benefit from different clinical interventions. Funding: This study was funded by the Former EMS Ltd (charity number 1098725, registered October 9th 2017).

Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland.

BACKGROUND: Little is known about conversion disorder in childhood. AIMS: To document clinical incidence, features, management and 12-month outcome of non-transient conversion disorder in under 16-year-olds in the U.K. and Ireland. METHOD: Surveillance through the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System. RESULTS: In total, 204 cases (age range 7-15 years) were reported, giving a 12-month incidence of 1.30/100 000 (95% CI 1.11-1.52). The most common symptoms were motor weakness and abnormal movements. Presentation with multiple symptoms was the norm. Antecedent stressors were reported for 80.8%, most commonly bullying in school. Most children required in-patient admission with frequent medical investigations. Follow-up at 12 months was available for 147 children, when all conversion disorder symptoms were reported as improved. Most families (91%) accepted a non-medical explanation of the symptoms either fully or partially. CONCLUSIONS: Childhood conversion disorder represents an infrequent but significant clinical burden in the UK and Ireland.

Twin-singleton differences in cognitive abilities in a sample of Africans in Nigeria.

Recent studies comparing cognitive abilities between contemporary twins and singletons in developed countries have suggested that twin deficits in cognitive abilities no longer exist. We examined cognitive abilities in a sample of twins and singletons born recently in Nigeria to determine whether recent findings can be replicated in developing countries. Our sample consisted of 413 pairs of twins and 280 singletons collected from over 45 public schools in Abuja and its neighboring states in Nigeria. The ages of twins and singletons ranged from 9 to 20 years with a mean (SD) of 14.6 years (2.2 years) for twins and 16.1 years (1.8 years) for singletons. Zygosity of the same-sex twins was determined by analysis of 16 deoxyribonucleic acid markers. We asked participants to complete a questionnaire booklet that included Standard Progressive Matrices-Plus Version (SPM+), Mill-Hill Vocabulary Scale (MHV), Family Assets Questionnaire, and demographic questions. The data were corrected for sex and age and then analyzed using maximum likelihood model-fitting analysis. Although twins and singletons were comparable in family social class indicators, singletons did better than twins across all the tests (d = 0.10 to 0.35). The average of d for SPM+ total [0.32; equivalent to 4.8 Intelligence Quotient (IQ) points] and d for MHV (0.24; equivalent to 3.6 IQ points) was 0.28 (equivalent to 4.2 IQ points), similar to the twin-singleton gap found in old cohorts in developed countries. We speculate that malnutrition, poor health, and educational systems in Nigeria may explain the persistence of twin deficits in cognitive abilities found in our sample.

An Increase of Intelligence in China 1986-2012.

The Flynn effect has been widely researched in Western and European nations, while it has been comparatively understudied in Asian countries. This study examines possible Flynn effects in China from 1985-86 and to 2011-12. Results are reported for an IQ increase among 12 year olds on the Full Scale IQ WISC-R (Wechsler Intelligence Scale for Children- Revised) of 6.19 IQ points, a gain on the Performance IQ of 6.55 IQ points, and a gain on the Verbal IQ of 1.91 IQ points.