Compliance with the 24-hour movement behaviour guidelines among children and adolescents with disabilities: a systematic review and meta-analysis.

BACKGROUND: Compliance with the 24-Hour Movement Guidelines (24-HMG: physical activity (PA), screen time (ST), and sleep) has been associated with numerous beneficial health outcomes among children and adolescents. However, there is a lack of consensus on the overall compliance with the 24-HMG specifically among children and adolescents with disabilities. Therefore, this systematic review and meta-analysis aimed to examine the extent to which children and adolescents with disabilities adhere to the 24-HMG globally. METHOD: Quantitative studies published in English until May 2023 were sought by searching seven electronic databases: Web of Science, PubMed, SPORTDiscus, CINAHL, MEDLINE, Scopus, Psychology and Behavioural Sciences Collection. This review included studies that identified participants as individuals with disabilities and reported the overall (non) compliance with the 24-HMG among children and adolescents with disabilities. RESULTS: A total of 13 studies, involving 21,101 individuals (65.95% males), aged 6 to 21 years from 9 countries, were included in the analysis. In general, 7% (95%CI: 0.05-0.09, p < 0.01) of children and adolescents with disabilities met all three 24-HMG, while 16% (95%CI: 0.13-020, p < 0.01) did not meet any of the three recommendations. Regarding adherence to individual 24-hour movement behaviour, the rates of compliance were 22% (95%CI: 0.18-0.25, p < 0.01) for PA, 49% (95%CI: 0.41-0.56, p < 0.01) for ST, and 59% (95%CI: 0.56-0.61, p < 0.01) sleep. In relation to numbers of those meeting the 24-HMG, 43% (95%CI: 0.41-0.45, p < 0.01) met one guideline, while 32% (95%CI: 0.28-0.36, p < 0.01) met two guidelines. CONCLUSION: There is a notable percentage of children and adolescents with disabilities who do not meet the recommended the 24-HMG, which encompasses PA, ST, and sleep. This underscores the pressing requirement to create and execute evidence-based strategies that effectively encourage and assist these individuals with disabilities in adopting and maintaining these movement behaviours.

The effect of conflict on child and adolescent health in Amhara region, Ethiopia: Cross-Sectional Study.

BACKGROUND: Currently, conflict become common phenomenon in the world affecting the lives of millions of children. Due the continued conflict in Ethiopia millions of children are suffering from extreme levels of violence, lack of basic humanitarian needs, and lack of health services. OBJECTIVE: This study was designed to assess the effect of conflict on child and adolescent health in Amhara region, September 2022. METHODS: A community-based cross-sectional study was employed among children agedd < 18 years in conflict affected areas of Amhara region. The sample size was determined using a single population proportion formula. Data was collected through face-to-face interviews of children or child legal guardians. Data was cleaned, verified, and entered into EpiData version 3.1 and analysis was done using SPSS version 24 statistical software. RESULT: Seven hundred and ninety-eight children agedd less than 18 years were involved with a response rate of 94.33 percent. More than one thirds (276, 34.59%) of children were displaced due to the conflict. Three hundred and thirty one (41.48%) children get diseased with the majority didn't receive treatment. More than two thirds (557, 69.80%) of children had experienced violence of different types. One hundred and thirty four (41.23%) children had acute malnutrition with two third (66.42%) of them had severe acute malnutrition. CONCLUSION: Conflict had deadly impacts on the lives of children and adolescents. It causes massive displacement, lack of basic humanitarian needs, extreme level of violence, hunger and malnutrition, and lack of health services. The government and other national and international humanitarian aids should give special attention to children living in war zone of Amhara region. In addition, rehabilitation services and resilience training should be designed and provided to children affected by the conflict.

Eating disorders in young patients with neurofibromatosis type 1.

AIM: We describe the association of neurofibromatosis type 1 (NF1) and feeding and eating disorders (FED) in five patients admitted to our third level centre for both FED and NF1. METHODS: Case series of five adolescent females with NF1 treated for FED. RESULTS: We collected data from five patients with NF1 aged between 14 and 22 years, all females. The onset of eating disorder symptoms occurred between 13 and 19 years of age and was characterised by food intake restriction, associated with physical hyperactivity in three out of five cases. One patient also reported self-injurious acts and episodic binges. Patients received diagnoses of anorexia nervosa (AN, n = 2), atypical AN (n = 1), bulimia nervosa (n = 1), unspecified feeding and eating disorder (n = 1). CONCLUSION: The current literature reports a single case of an adult with NF1 and comorbid AN, focusing on the dermatological features of NF1. Our article describes a case series of five patients in developmental age affected by NF1 and FED. Clinical and psychological features of NF1 may play a role in the pathogenesis of FED when these two conditions co-occur. The dermatological alterations of NF1 may contribute to body image distortion that characterises AN. Further research is required to systematically screen populations of patients with NF1 for the presence of FED.

Danish translation and cultural adaptation of the 'What do you think of hospital' patient reported experience measure for children and adolescents in outpatient settings.

PURPOSE: The aim of this study was to translate the patient reported experience measure (PREM) questionnaire"What do you think of the hospital? Help us to get better!" into Danish used in outpatient clinics and to explore its face and content validity. DESIGN AND METHODS: The translation process followed WHO recommendations and included forward translation, expert panel evaluation, back translation, pre-testing and cognitive interviews with 23 children and adolescents. RESULTS: Children and adolescents were positive to using PREM as a way to express their experiences. The layout of the questionnaire was important as use of colours was more appealing and the topics of the questionnaire were better visualised. The concepts in the original questionnaire related to distinguishing between different rooms for examination and conversation are not used in a Danish context. Otherwise, only minor translation adjustments were needed to match the Danish target group. CONCLUSION: Children and adolescents found that the Danish version of the PREM questionnaire tool was easy to read and understand, and the layout emphasised that they are the target group. After pre-testing among 23 children and adolescents, the questionnaire is now ready for pilottest in a larger group. PRACTICE IMPLICATIONS: The present study provides a tool to generate knowledge and evaluate the experiences of children and adolescents in an outpatient clinic. Using the questionnaire, healthcare staff may monitor the quality of the experiences of children and adolescents and collect data for research purposes. Likewise, it will be possible to compare hospitals and organizations nationally.

[Serum Uric Acid Level and Its Influencing Factors in Patients with Diabetes Insipidus].

Objective To investigate the level of serum uric acid in patients with diabetes insipidus (DI),summarize the clinical characteristics of central diabetes insipidus (CDI) patients with hyperuricemia (HUA),and analyze the factors affecting the level of serum uric acid in the patients with CDI. Methods The clinical data of DI patients admitted to Peking Union Medical College Hospital from 2018 to 2021 were retrospectively analyzed.The patients were assigned into a child and adolescent group (≤ 18 years old) and an adult group (>18 years old) according to their ages.The demographic and biochemical data between two groups of patients with and without HUA were compared.Spearman correlation analysis and multiple linear regression analysis were performed to analyze the correlations between serum uric acid level and other factors. Results Among the 420 DI patients,411 patients had CDI (97.9%),including 189 patients with HUA (46.0%).Thirteen (6.9%) out of the 189 CDI patients with HUA presented the disappearance of thirst.The prevalence of HUA in children and adolescents was higher than that in adults (χ2=4.193,P=0.041).The level of serum uric acid in the CDI patients with HUA and disappearance of thirst was higher than those without disappearance of thirst (U=2.593,P=0.010).The multiple linear regression predicted serum creatinine (ß=0.472,95%CI=2.451-4.381,P<0.001) and body mass index (ß=0.387,95%CI=6.18-12.874,P<0.001) as the independent risk factors of serum uric acid level increment in children and adolescents,while serum creatinine (ß=0.361,95%CI=1.016-1.785,P<0.001),body mass index (ß=0.208,95%CI=2.321-6.702,P<0.001),triglyceride (ß=0.268,95%CI=12.936-28.840,P<0.001),and total cholesterol (ß=0.129,95%CI=2.708-22.250,P=0.013) were the independent risk factors in adults. Conclusions The patients with CDI were more likely to have HUA,and the prevalence of HUA in children and adolescents was higher than that in adults.Body mass index,serum creatinine,triglyceride,total cholesterol,and disappearance of thirst were the risk factors for the increased level of serum uric acid in CDI patients.

Effect of screen time intervention on obesity among children and adolescent: A meta-analysis of randomized controlled studies.

Several studies have investigated the effect of screen time interventions on obesity in children and adolescents, but the existing results were controversial. This study aimed to analyze the effect of screen time intervention on obesity in children and adolescents. PubMed, Cochrane, Web of Science, Embase databases were searched through December 2020 to identify publications meeting a priori inclusion criteria and references in the published articles were also reviewed. Finally, 14 randomized controlled trials and 1894 subjects were included in this meta-analysis. The results showed that interventions targeting screen time are effective in reducing total screen time (MD: -6.90 h/week, 95% CI: [-9.19 to -4.60], p < 0.001) and television time (MD: -6.17 h/week, 95% CI: [-10.70 to -1.65], p < 0.001) in children and adolescents. However, there was no significant difference between the intervention and control groups in body mass index and body mass index-z score. In conclusion, there is no evidence that screen time interventions alone can decrease obesity risk in children and adolescents, though they can effectively reduce screen time.

Effectiveness of emotion focused skills training for parents: study protocol for a randomized controlled trial in specialist mental health care.

BACKGROUND: Emotion-Focused Skills Training (EFST) is a newly developed manualized skill training program for parents to strengthen emotional bonds between parents and children and improve mental health outcomes in children. Results from several preliminary trials indicate that EFST can be quite effective, but more rigorous methods are needed to affirm the evidence of the program. The primary objective of this study is to compare the effectiveness of EFST to treatment as usual (TAU) in a Norwegian outpatient clinic for child and adolescent mental health. Additionally, the study will examine the basic theoretical assumption underlying EFST that increased parental emotional functioning predicts a decline in children's mental health symptoms.  METHOD : 120 patients will be randomly assigned to either EFST or TAU. The main outcome measure is the semi-structured diagnostic interview Schedule for Affective Disorders and Schizophrenia, present and lifetime version (K-SADS-PL) scored by trained assessors administered at pretreatment and repeated after 3 months. The secondary outcome measure is the DSM-IV version of the Strength and Difficulties Questionnaire (SDQ) administered at pretreatment as well as 3, 6, and 12 months after the intervention. To examine the efficacy question, effect sizes and reliable change for each of the treatment arms will be assessed as well as symptom differences between the conditions. To examine the second aim of the study, we will examine (1) how parents relate to emotions in their children assessed by the Emotion-Related Parenting Styles (ERPS), (2) the parents' emotion regulation capacity assessed by the Difficulties in Emotion Regulation Scale, short-form (DERS-SF), and (3) parents' sense of self-efficacy and the strength of their relationship with the child will be assessed by the relationship with child scale (RWC) of the systemic inventory of change. DISCUSSION: This study will provide insights into the effectiveness of EFST in improving children's mental health and the mechanisms of change responsible for the program's effectiveness. Impotently, this study may provide information regarding whether children's mental health issues can be alleviated through therapeutic work provided to the parents alone. TRIAL REGISTRATION: Clinical trials.gov Identifier: NCT04885036 . First Posted on May 13, 2021. TRIAL STATUS: In recruitment.

Mental health literacy in children and adolescents in low- and middle-income countries: a mixed studies systematic review and narrative synthesis.

Mental illnesses are the leading cause of disease burden among children and young people (CYP) globally. Low- and middle-income countries (LMIC) are disproportionately affected. Enhancing mental health literacy (MHL) is one way to combat low levels of help-seeking and effective treatment receipt. We aimed to synthesis evidence about knowledge, beliefs and attitudes of CYP in LMICs about mental illnesses, their treatments and outcomes, evaluating factors that can enhance or impede help-seeking to inform context-specific and developmentally appropriate understandings of MHL. Eight bibliographic databases were searched from inception to July 2020: PsycInfo, EMBASE, Medline (OVID), Scopus, ASSIA (ProQuest), SSCI, SCI (Web of Science) CINAHL PLUS, Social Sciences full text (EBSCO). 58 papers (41 quantitative, 13 qualitative, 4 mixed methods) representing 52 separate studies comprising 36,429 participants with a mean age of 15.3 [10.4-17.4], were appraised and synthesized using narrative synthesis methods. Low levels of recognition and knowledge about mental health problems and illnesses, pervasive levels of stigma and low confidence in professional healthcare services, even when considered a valid treatment option were dominant themes. CYP cited the value of traditional healers and social networks for seeking help. Several important areas were under-researched including the link between specific stigma types and active help-seeking and research is needed to understand more fully the interplay between knowledge, beliefs and attitudes across varied cultural settings. Greater exploration of social networks and the value of collaboration with traditional healers is consistent with promising, yet understudied, areas of community-based MHL interventions combining education and social contact.

Success rate of radioactive iodine treatment for children and adolescent with hyperthyroidism.

PURPOSE: To assess the success rate of first dose radioiodine for treatment of hyperthyroidism in children and adolescent. METHODS: This is a retrospective data analysis of children and adolescent with hyperthyroidism who received radioiodine (RAI) therapy from January 2013 to December 2017. Age, gender, family history of hyperthyroidism, duration of anti-thyriod drugs (ATDs) treatment, rapid turnover status, 2 h and 24 h I-131 radioiodine uptake (RAIU), thyroid volume, and treatment dose were also analyzed. The goal of RAI therapy was to achieve hypothyroidism within 3-6 months after treatment. Treatment result was evaluated at 6 months after treatment and divided into 2 groups: treatment success (hypothyroid and euthyroid) and treatment failure (hyperthyroid). The same parameters were compared between both groups. RESULTS: 32 hyperthyroid patients, 26 female with mean age at treatment of 13.84 ± 1.83 years. All patients had prior treatment with ATDs, with a median treatment duration of 32.5 months (range 2-108). The median estimated thyroid gland size was 24.62 g, range 9.29-72.8. RAI doses ranged from 4.1 to 29.9 mCi (median dose = 7.54 mCi). Significant difference in 24-h I-131 uptake and RI status was demonstrated. Successful treatment rate after single dose of therapeutic I-131 was 65.63%. CONCLUSION: With the I-131 dose of 220 µCi/g of thyroid tissue, successful treatment rate after single dose of therapeutic I-131 was 65.63%. RAI therapy with I-131 dose of 250-400 µCi/g of thyroid tissue might be suitable in patients with medical failure from ATDs. Possible role of RI as the predictor for RAI therapy failure are needed to investigate in both adult and children clinical settings.

Bacteriology of pediatric breast abscesses beyond the neonatal period.

BACKGROUND: Limited data exist regarding the presentation and bacteriology of nonneonatal pediatric breast abscess. OBJECTIVE: To determine the bacteriology and characteristic presentation of pediatric breast abscesses in a tertiary care center. METHODS: Cross-sectional study of patients age 1 month to 21 years admitted to a pediatric Emergency Department (ED) between 1996 and 2018 with a breast abscess. Patients with pre-existing conditions were excluded. Records were reviewed to determine demographics, history, physical exam findings, wound culture results, imaging and ED disposition. We used descriptive statistics to describe prevalence of different bacteria. RESULTS: We identified 210 patients who met study criteria. Median age was 13.6 years [IQR 6.6, 17.4], and 91% (191/210) were females. Ninety-two patients (43.8%) were 'pre-treated' with antibiotics prior to ED visit, and 33/210 (16%) were febrile. Ultrasound was obtained in 85 patients (40.5%), 69 patients had a single abscess and 16 had multiple abscesses. Most patients were treated with antibiotics and 100 had a surgical intervention, of these 89 had I&D and 11 a needle aspiration. Admission rate was 45%. Culture results were available for 75 (75%). Thirty-three (44%) had a negative culture, or grew non-aureus staphylococci or other skin flora. Culture were positive for MSSA 21 (28%), MRSA 13 (17%), Proteus mirabilis 2 (2.6%), Serratia 1 (1.3%). Other organisms include Gram-negative bacilli, group A Streptococcus and enterococcus. CONCLUSIONS: Non-neonatal pediatric breast abscess bacteriology is no different than data published on other skin abscesses. MRSA coverage should be considered based on local prevalence in skin infections.

Associations between family-level adversity and society-level trauma with emotional and behavioural problems amongst children of West Papuan refugees.

Few studies have examined associations between family-level parental factors, society-level violence, and the emotional and behavioral status of children of refugee populations. Our study used cross-sectional epidemiological data to test a theoretical model of these key associations amongst a community sample of children (n = 162) of West Papuan refugees living in remote town in Papua New Guinea (PNG), a setting of endemic violence and poverty. Culturally adapted instruments were used to assess three types of intra-familial factors (adverse parenting, physical and/or sexual abuse and emotional abuse) and three types of society-level violence and stressors (exposure to systematic violence, peer violence, living difficulties). Emotional and behavioural problems were assessed using the Youth Self-Report Checklist. Path analysis was used to test theoretical associations. Key findings include direct associations between both family-level physical and/or sexual abuse (ß = .43; p < .001) and adverse parenting (ß = .40; p < .001) with emotional and behavioural problems amongst children. In the broader social domain, peer violence (ß = .29; p < .001) had a direct association with children's emotional and behavioural problems. Several indirect paths demonstrated a chain of relationships involving family- and society-level factors and emotional and behavioural problems in children. Only longitudinal data can provide further support for veridical causal pathways linking family and social factors with adverse emotional and behavioural outcomes in offspring of refugees, thereby supporting mechanisms leading to a transgenerational transmission of adverse mental health outcomes in refugee populations. Such data would give further support for a multisectoral approach to dealing with at risk families in refugee populations, in which attention should focus on supporting parents, and promoting the protection of children from abuse in the family and in the wider society.

Fluoxetine in the Management of Major Depressive Disorder in Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Fluoxetine is a serotonin-specific reuptake inhibitor antidepressant and is the only approved pharmacological treatment for major depressive disorder (MDD) in children and adolescent. METHODS: We searched the published randomized controlled-trials to review fluoxetine efficacy and tolerability using the databases PubMed, EudraCT, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials for fluoxetine role in managing MDD in children and adolescents. A meta-analysis was conducted using the identified 7 clinical trials to assess efficacy using the outcomes: Children's Depression Rating Scale-Revised (CDRS-R), Clinical Global Impressions-Severity of Illness (CGI-S) and Clinical Global Impressions-Improvement (CGI-I) response rate. The risk of discontinuation due to adverse effects and common side effects were examined. RESULTS: The mean difference in change from baseline for CDRS-R was -2.72 (95% confidence interval [CI], -3.96, -1.48) favoring fluoxetine treatment (P < .001). Similarly, mean difference for CGI-S was -0.21 (95% CI, -0.36, -0.06). The risk ratio (RR) of discontinuing due to adverse events was 0.98 (95% CI, 0.54, 1.83), with RR for headache side effects 1.34 (95% CI, 1.03, 1.74) and rash 2.6 (95% CI, 1.32, 5.14). CONCLUSION: Fluoxetine demonstrates significant improvements in symptom intensity control in young patients suffering from MDD and is considered well tolerated with similar rates of trials discontinuation; however, fluoxetine was associated with a higher risk of headache and rash side effects. These findings will guide psychiatrists and pharmacists in their clinical role for supporting the care of young mental health patients.

Comparison common equations for LDL-C calculation with direct assay and developing a novel formula in Iranian children and adolescents: the CASPIAN V study.

BACKGROUND: Hypercholesterolemia is a common dyslipidemia that leads to atherosclerosis. It is proved that early stages of atherosclerosis begins in early stages of life. In several studies, widespread prevalence of dyslipidemia in children is reported. So, assessment of lipid profile in children and adolescence is necessary for early diagnosis of dyslipidemia. Laboratory methods for measuring LDL are not available and economical. So, in some laboratories Friedwald method is used to determine LDL level. But, the preciseness of this method is not acceptable. Further, the preciseness of this method was not assayed in children and adolescence. So, it seems that assaying the preciseness of different methods is necessary. METHODS: The methodology of this work is on the basis of findings of the Caspian V study. This study was conducted in 30 provinces of Iran during 2015. The population of this work was rural and urban students aged 7-18 years old. The level of total cholesterol (TC), HDL, LDL, and TG were measured using laboratory methods. The average and variances values were determined for each group of data using SPSS. Further, LDL values were calculated with a new formula introduced in this work. A comparison was made between the new formula and the other methods. RESULTS: In the present study, we found that compare to four common formulas, Friedwald was the best equation to estimate LDL-C concentrations in Iranian children and adolescents and the new formula was the next accurate equation. The strongest correlation between Friedwald and the new equation was found for those with 15-18 years old. CONCLUSION: Considering the cut-off points of TG (100 mg/dL), we observed the strongest correlation between Friedwald equation and direct assay and the weakest one was for Ahmadi formula in subjects with either greater or lower TG concentrations. Furthermore, we found that Anandraja equation had the most sensitivity (89.5%), while the most specificity was dedicated to the new formula (98.9%).

Did the extended coverage policy contribute to alleviating socioeconomic inequality in untreated dental caries of both children and adolescents in South Korea?

BACKGROUND: Dental sealants have been covered by the National Health Insurance Service (NHIS) since December 2009 in South Korea. This study aims to determine whether the socioeconomic inequality in untreated dental caries decreased after implementing the extended coverage policy for dental sealant. METHODS: The data were derived from the fourth (2007-2009) and sixth (2013-2015) waves of the Korean National Health and Nutrition Examination Survey (KNHANES) conducted by the Korea Centers for Disease Control and Prevention (KCDC). Dental caries and sealant experience by income quartiles were tested using the Rao-Scott chi-squared test. In order to examine socioeconomic inequalities and their trends over time, the prevalence ratios (PRs), slope index of inequality (SII), and relative index of inequality (RII) were estimated for each wave and age group. All analyses were conducted using SAS version 9.3. RESULTS: The adjusted PRs of untreated dental caries and sealants in the poorest in the aged 6-11 group were significantly higher and lower, respectively, compared to the most affluent quartile group for the fourth wave; however, all significant differences disappeared for the sixth wave, after the sealant coverage. The gap between the lowest and the highest was similar for the aged 12-18 group but it widened in the untreated dental caries even after the sealant coverage. The statistical significance of the PRs was maintained at the sixth wave for both caries and sealants. Children showed decreases in both SII and RII over time so its significance disappeared. The SII among adolescents decreased over time but the RII of untreated dental caries increased. CONCLUSIONS: This study found that the NHIS coverage expansion of dental care had a positive effect on overall status in dental health among children and adolescents. However, younger children benefited more in terms of inequalities. Our findings indicate that strategies to enhance access to preventive dental services should consider the differential effects for the vulnerable population in terms of socioeconomic status and age from the beginning stage of the policy.

Effect of passive exposure to cigarette smoke on blood pressure in children and adolescents: a meta-analysis of epidemiologic studies.

BACKGROUND: Hypertension is an emerging disease in children and adolescents resulting in future morbidities. Cigarette smoking is one of the most studied contributing factors in this regard; however, there are contradictory results among different studies. Therefore, the present meta-analysis tends to assess the relationship between passive exposure to cigarette smoke and blood pressure in children and adolescents. METHOD: Medline, Embase, Scopus, EBSCO, and Web of Sciences were systematically reviewed for observational studies up to May, 2017, in which the relationship between cigarette smoking and hypertension were assessed in children and adolescents. The meta-analysis was performed with a fixed effect or random effects model according to the heterogeneity. RESULTS: Twenty-nine studies were included in present meta-analysis incorporating 192,067 children and adolescents. Active smoking (pooled OR = 0.92; 95% CI: 0.79 to 1.05) or passive exposure to cigarette smoke (pooled OR = 1.01; 95% CI: 0.93 to 1.10) were not associated with developing hypertension in the study population. Despite the fact that active cigarette smoking did not significantly affect absolute level of systolic and diastolic blood pressure, it was shown that passive exposure to cigarette smoke leads to a significant increase in absolute level of systolic blood pressure (pooled coefficient = 0.26; 95% CI: 0.12 to 0.39). CONCLUSION: Both active and passive cigarette smoking were not associated with developing hypertension in children and adolescents. However, passive cigarette smoke was associated with higher level of systolic blood pressure in children and adolescents.

Emotional and behavioral problems and associated factors among children and adolescents on highly active anti-retroviral therapy in public hospitals of West Gojjam zone, Amhara regional state of Ethiopia, 2018: a cross-sectional study.

BACKGROUND: Children and adolescents with HIV/AIDS are more likely to have emotional and behavioral problems than the general population. This can result in a continuing negative influence on the quality of life, school performance, immunity and co-morbidity of children and adolescents with HIV/AIDS. OBJECTIVE: To assess the prevalence and associated factors of Emotional and Behavioral Problems among children and adolescents on Highly Active Anti-Retroviral Therapy in the public hospitals of West Gojjam Zone, Amhara regional state of Ethiopia. METHODS: An institutional based cross sectional study was conducted by screening 411 children and adolescents for emotional and behavioral problems using Pediatric Symptomatology Check List (PSCL). Systematic random sampling technique was used to select the study participants. Data analysis was done using SPSS version 23. Bivariable and multivariable logistic regression analysis were fitted to identify factors associated with Emotional and Behavioral Problems. Odds ratio (OR) with 95% confidence interval (CI) was computed to determine the level of significance. RESULT: Out of the total 411 participants, 43.6% were screened positive for Emotional and Behavioral Problems. Lower age (AOR = 5.33, 95%CI: 2.56-11.04), having non-kin care giver (AOR = 4.64, 95%CI: 1.20-17.90), parental loss (AOR = 2.15, 95%CI: 1.03-4.49), non self -disclosure of HIV sero status (AOR = 1.99, 95% CI: 1.16-3.41) and having distressed care giver (AOR = 1.64, 95%CI: 1.04-2.57) had statistically significant association with EBPs. CONCLUSION: The prevalence of Emotional and Behavioral Problems is high among children and adolescents on HAART. Lower age, care giver's mental distress, non-self disclosure status, having non-kin care giver and parental loss were variables significantly associated with EBPs. This demonstrates a need for the integration of Mental Health and Psycho Social Support (MHPSS) service with HIV/AIDS care.

[Insomnia and Hypersomnia among Children and Adolescents with Psychiatric Disorders]. / Insomnie und Hypersomnie bei Kindern und Jugendlichen mit psychiatrischen Störungen.

Insomnia and Hypersomnia among Children and Adolescents with Psychiatric Disorders The common symptom of sleep disorders is non-restorative sleep, which results in daytime sleepiness. Therefore in clinical practice simultaneous complaints of "not enough" and "too much" sleep are very frequent. For the investigation and treatment of organic sleep disorders, available instruments, guidelines and specialised institutions (sleep centres or sleep laboratories) are more advanced than for non-organic sleep disorders. Especially in the child and adolescent psychiatric and psychotherapeutic field this complicates an appropriate treatment. In addition multiple psychiatric, neurological and other somatic diseases can disrupt nighttime sleep and cause impairments during the day too. There are various instruments and methods to cover disturbed nocturnal sleep, some of which have already found widespread use in clinical practice (e. g. sleep diaries or specific questionnaires and interviews). For the examination of daytime sleepiness instruments and methods are available too, which by now seem to be less widely used. Against this background an overview of definitions, distinctive features and clinical instruments as well as guidelines for dealing with "too much and too little sleep" during the day or at night shall be presented.

Differential item functioning by language on the PROMIS® physical functioning items for children and adolescents.

PURPOSE: To assess the equivalence of self-reports of physical functioning between pediatric respondents to the English- and Spanish-language patient-reported outcomes measurement information system (PROMIS®) physical functioning item banks. METHODS: The PROMIS pediatric physical functioning item banks include 29 upper extremity items and 23 mobility items. A sample of 5091 children and adolescents (mean age = 12 years, range 8-17; 49% male) completed the English-language version of the items. A sample of 605 children and adolescents (mean age = 12 years, range 8-17; 55% male; 96% Hispanic) completed the Spanish-language version of the items. RESULTS: We found language (English versus Spanish) differential item functioning (DIF) for 4 upper extremity items and 7 mobility items. Product-moment correlations between estimated upper extremity and mobility scores using the English versus the equated Spanish item parameters for Spanish-language respondents were 0.98 and 0.99, respectively. After excluding cases with significant person misfit, we found DIF for the same 4 upper extremity items that had DIF in the full sample and for 12 mobility items (including the same 7 mobility items that had DIF in the full sample). The identification of DIF items between English- and Spanish-language respondents was affected slightly by excluding respondents displaying person misfit. CONCLUSIONS: The results of this study provide support for measurement equivalence of self-reports of physical functioning by children and adolescents who completed the English- and Spanish-language surveys. Future analyses are needed to replicate the results of this study in other samples.

Evaluation of Youth Enjoyment Toward Physical Activity and Sedentary Behavior.

PURPOSE: The consensus is that physical activity (PA) and sedentary behavior (SB) are independent behaviors, but past findings suggest that they may be influenced by common underlying factors. To clarify this issue, we examined associations between enjoyment of PA and participation in both PA and SB in a large sample of 4th- to 12th-grade US youth. METHODS: A total of 18,930 students from 187 schools completed the youth activity profile, a self-report 15-item survey that assesses time spent in PA and SB in school and home settings. Two additional items captured enjoyment of PA and physical education. Two-way (gender × enjoyment and grade × enjoyment) mixed analysis of variances were conducted. RESULTS: Pearson correlation results revealed a positive relationship between enjoyment and PA (r = .38, P < .05) and an inverse correlation between enjoyment and SB (r = -.23, P < .05). Statistically significant main effects of enjoyment were found in the 2-way analysis of variance for both PA and SB. The simple main effect from analysis of variance indicated students with high enjoyment of PA reported higher levels of PA and lower levels of SB compared with students reporting moderate or low levels of enjoyment. CONCLUSION: The results provide new insights related to the relevance of enjoyment as a common underlying variable influencing both PA and SB across gender and grade levels.

[Treatment of femoral shaft fractures in children and adolescents ≥50 kg : A retrospective multicenter trial]. / Behandlung der Femurschaftfraktur bei Kindern und Jugendlichen mit einem Körpergewicht ≥50 kg : Eine retrospektive multizentrische Erhebung.

BACKGROUND: Operative treatment of diaphyseal fractures of the femur in older children and adolescents remains controversial due to multiple surgical options and higher complication rates in single-center studies compared to younger children. This retrospective multicenter study aimed to register early and late complications in day-by-day treatment. MATERIAL AND METHODS: Sixteen hospitals with particular expertise in pediatric orthopedic trauma participated in this study. Patients with diaphyseal femur fractures, a body weight ≥50 kg (aged 10-16 years) and treated between 2008 and 2012 were included. Age, weight, fracture type, and choice of operative treatment were correlated to complication rate and type. Patients with pathologic fractures and/or metabolic bone disorders were excluded. RESULTS: Fifty-three children (15 females and 38 males; mean age: 14.2 y [SD 1.4 y]; mean body weight: 60.5 kg [max. 95 kg]) with 54 fractures were included. Elastic stable intramedullary nailing (ESIN) was the treatment of choice in 31 of 42 fractures with open growth plates. In the subgroup with two nails, 7 of 12 patients experienced revision surgery due to instability or shortening. Three patients with ESIN and end caps had no complications. In the subgroup with three inserted nails (11 patients), one patient was converted to external fixation. Nine patients received primary or secondary plate osteosyntheses. Within this group, two patients had deep infections; one implant failure, and one peri-implant fracture were recorded. Adolescent lateral femoral nailing (ALFN), when used as the primary treatment option in two patients, was free of complications. When used as a secondary treatment option in three patients, one patient had a pseudarthrosis and one an infection. Both were treated in further operative procedures. In a group of eight patients with closed physes, regular intramedullary nailing as primary or secondary treatment of choice resulted in one locking screw change. As late complications, leg length discrepancy (LLD) over 15 mm (n = 2) and loss of range of motion (ROM) (n = 4; two knee and three hip) were noted in patients receiving multiple revisions or serious postoperative complication. CONCLUSIONS: Children older than 10 years of age with a body weight ≥50 kg and open physes are prone to complications regardless of treatment choice. A smaller revision rate occurred in patients treated with ESIN and end caps or a third nail compared to the other treatment options. When physes are closed, rigid intramedullary nailing is the treatment of choice.