Child_Health RSS : Gourt

FUNdamentally important: humour and fun as caring and practice

'I didn't really like it, but it sounded exciting': Admission to hospital for surgery from the perspectives of children

It is a mark of respect for children that their views around their healthcare are listened to and considered. To date, too little attention has been paid to children’s views and experiences of admission to hospital for surgery. This paper presents findings from a constructivist grounded theory study of children’s experiences of admission to hospital for surgery (from their perspectives). Age appropriate data collection techniques were used and included interviews with children and their drawings and stories. Ten children, aged 6–12 years, who were admitted to hospital for surgery participated in the research. The children were able to clearly articulate aspects of their experience, including their fears and anxieties, the things they enjoyed and the things that assisted them to cope with their experience. The substantive theory developed was ‘children’s reframing of their sense of selves to incorporate the experiences of hospitalization and surgery’. Children require information and support to alleviate their anxieties around the time of their surgery. With pressures on children’s services, increased day surgery rates and shorter admissions, nurses who care for children around this time are challenged to find ways of knowing each child’s story and the fears that they have.

When food is neither good nor bad: Children's evaluations of transformed and combined food products

This study examined children’s subjective perceptions of ‘good’ and ‘bad’ foods. Four interactive focus groups were conducted with 27 children aged 5–9 in South Australia. Each focus group was engaged in a food picture sorting activity. Whilst most children were able to discriminate good and bad whole foods or ingredients, they were less able to agree at a group level on the categorization of combined and transformed food products with which they are most likely to be presented in their ‘everyday’ lives. We discuss this confusion using Mary Douglas’s (1966) theory of ‘matter out of place’. Accordingly, health promotion messages should cultivate the skills required to reconcile the co-presence of ‘good’ and ‘bad’ ingredients in one product or meal.

Parents' attitudes to smoking and passive smoking and their experience of the tobacco preventive work in child health care

The purpose of this study was to describe parents’ attitudes to smoking and their experience of the tobacco preventive work in antenatal care and in Child Health Care (CHC) in Sweden. A population based survey in which 62 percent of 3000 randomly selected parents with 1- and 3-year-old children answered a questionnaire. Fifty-six percent stated that smoking was registered in the health record of the child yet no further discussion regarding passive smoking took place. The parents’ educational level and smoking status was related to the attitudes and experiences of the tobacco preventive work. The results indicated that the dialogue with parents regarding children and environmental tobacco smoke (ETS) exposure has to be redesigned and intensified in order to meet the needs of parents with different backgrounds.

Weight loss surgery for morbidly obese adolescents: A review

Obesity is common among adolescents resulting in substantial comorbidities and reduced life expectancy. Conservative treatments normally fail to ensure significant and sustained weight loss and suitable adolescents should be offered weight loss surgery. Laparoscopic Adjustable Gastric Banding and Roux-en-Y Gastric Bypass are commonly used in adolescents. Complications in RYGB tend to be more severe, but the procedure leads to more immediate results. LAGB complications are often device-related and less severe. Dietary adherence, eating behaviour and unrealistic patient expectations often cause problems. Significant and sustained weight loss of 50–70 per cent of excess weight is achievable, comorbidities and psychological problems improve. Meticulous patient selection and preparation and good post-operative care are vital for successful weight loss surgery. Weight loss surgery is safe, effective and economically viable with nurses playing a vital role at all stages of its application.

Polyunsaturated fatty acids, cognition and literacy in children with ADHD with and without learning difficulties

Suboptimal omega-3 polyunsaturated fatty acid (n-3 PUFA) levels may contribute to attention deficit hyperactivity disorder (ADHD) and related developmental problems. Associations between n-3 and omega-6 (n-6) PUFA levels in red blood cells (erythrocytes) and learning and behaviour were investigated in 75 children aged 7–12 with ADHD. Children provided blood samples and underwent cognitive assessments. Parents completed questionnaires and Conners’ Rating Scales. Controlling for covariates, higher n-3 PUFA predicted lower anxiety/shyness (β = -.27), higher docosahexaenoic acid (DHA) better word reading (β = .22), and higher n-6 PUFA poorer reading (β = -.34), vocabulary (β = .-.26), spelling (β = -.30) and attention (β = -.30). Thirty-six per cent of the sample with learning difficulties had lower DHA than those without (M = 3.26 ± 0.54 vs M = 3.68 ± 0.76, p = .02). This study is the first to compare erythrocyte PUFAs (a measure of PUFA status) in children who have ADHD with and without learning difficulties, and supports emerging indications that the former may be more likely responders to n-3 PUFAs.

Children's participation in decision-making: Balancing protection with shared decision-making using a situational perspective

Children’s participation in decision-making in the health care setting is complex because parents and health professionals tend to take a protective stance towards children to act in their best interest. Children prefer to be protected in some situations and to share decision-making in others. Adults in the health care setting need to consider children as individuals, rather than as a homogenous group, and take into account that a child’s competence and preferences will depend on the circumstances in every situation. This article argues for a situational perspective of children’s participation to act in the child’s best interest and to balance protection with shared decision-making, according to children’s rights and desires.

Birth outcomes among booked and unbooked women at a secondary health facility in southwest Nigeria: Implications for strengthening perinatal health services

A case-controlled analytic study involving 406 singleton unbooked and 396 singleton booked births was conducted. Unbooked births constituted 16.6% of all births during the study. Booked births were half as likely to preterm than unbooked births (43, 10.9% vs 81, 20.0%; p<0.001). Unbooked births were seven times more likely to be stillbirth than booked births (80, 17.7% vs 13, 3.3%; p< 0.001). Booked births were a third as likely to have a low birth weight as unbooked births (36, 9.1% vs 104, 25.6%; p< 0.001). Unbooked births had a significantly lower mean birth weight of 2.95 ± 0.53 kg than 3.08 ± 0.45 kg of booked births (p< 0.001). Unbooked births had a significantly lower mean Apgar score at 1 minute and 5 minutes than booked births (6.64 ± 1.42 vs 7.08 ± 1.12 and 9.16 ± 1.40 vs 9.64 ± 1.00; p< 0.001) respectively.Unbooked births are common and their birth outcomes may result in high morbidity and disability, thereby contributing to the high child mortality in developing countries. Strengthening perinatal health services through professional skilled care at birth and providing quality services for all unbooked births may lead to improved birth outcomes.

Acute scrotal pain in boys at a single paediatric centre with a questionnaire to assess patient awareness of the acute scrotum

Paediatric surgeons commonly evaluate acute scrotal pain. Previous peer review articles have suggested that boys should be educated to ensure early medical assessment thereby avoiding potential testicular loss. In this study we sought to ascertain a contemporary view of educational awareness of testicular pain in boys presenting to our service. A prospective 11 month study of boys attending our unit with acute scrotal pain was undertaken. Additionally, 30 consecutive patients completed a standardised questionnaire to ascertain their educational awareness of testicular pain. A total of 84 boys were referred to our service for evaluation of acute scrotal pain; 36 required operative interventions. Nine patients (25%) had testicular torsion; 19 patients (52.8%) had torted appendages; 6 patients (16.7%) had epididymitis and 2 patients (5.5%) had alternative diagnoses. There was one case of testicular loss in the older age group. Most boys were unaware of testicular problems but felt an education regarding scrotal problems would be useful. Our study shows that an unawareness of testicular pain exists in both children and their carers. We envisage that including basic educational aspects into the school curriculum may help avoid possible testicular loss in the future.

Understanding the private worlds of physicians, nurses, and parents: A study of life-sustaining treatment decisions in Italian paediatric critical care

This study’s aim was to describe: (a) How life-sustaining treatment (LST) decisions are made for critically ill children in Italy; and (b) How these decisional processes are experienced by physicians, nurses and parents. Focus groups with 16 physicians and 26 nurses, and individual interviews with 9 parents were conducted. Findings uncovered the ‘private worlds’ of paediatric intensive care unit (PICU) physicians, nurses and parents; they all suffer tremendously and privately. Physicians struggle with the weight of responsibility and solitude in making LST decisions. Nurses struggle with feelings of exclusion from decisions regarding patients and families that they care for. Physicians and nurses are distressed by legal barriers to LST withdrawal. Parents struggle with their dependence on physicians and nurses to provide care for their child and strive to understand what is happening to their child. Features of helpful and unhelpful communication with parents are highlighted, which should be considered in educational and practice changes.

Health-related quality of life (HRQOL) in Latino families experiencing pediatric asthma

The purpose of the present study was to examine health-related quality of life (HRQOL) in Latino children with asthma and their parents. Twenty-six parents completed the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ), the Health Status and Activities Questionnaire for Children with Asthma (HSAQ) and four subscales from the Family Environment Scale. The results indicated that, overall, neither children with asthma nor their parents showed significant impairments in their HRQOL, though higher illness severity was associated with lower child quality of life and lower parent quality of life related to activity limitations. Other child and family variables, including dimensions of family functioning, did not correlate significantly with HRQOL. However, child and parent HRQOL were significantly associated with each other. This study provides additional context for understanding the experiences of Latino families dealing with pediatric asthma.

Socio-demographic disparities of childhood asthma

Childhood asthma is particularly prevalent among disadvantaged children and is associated with greater functional consequences. This study described factors associated with childhood asthma in a sample of Latino and non-Latino children. Data were from baseline measures of 791 parent and child dyads involved in a childhood obesity prevention study. Parents completed a self-administered survey assessing childhood factors, demographics, acculturation and child asthma diagnosis. Multivariate mixed effects logistic regression analyses tested for correlates of child asthma and ethnicity interactions. Children were 4–10 years old, half were female, 86.0 percent were US-born and 45.7 percent were overweight or obese. The prevalence of childhood asthma was 11.5 percent. In multivariate analyses, the odds of childhood asthma were greater among children of non-Latino descent (OR = 4.1, CI: 1.8, 9.2), who had health insurance (OR = 11.1, CI: 2.7, 46.4), were male (OR = 1.8; CI: 1.1, 3.1) and born pre-term (OR = 3.0, CI: 1.4, 6.3). This study supports socio-demographic disparities in childhood asthma and evidence of their independent effects.

Convergence at the surface; divergence beneath: Cross-agency working within a small-scale, schools-based project

In the UK school system social remits – requiring schools to work towards improved social as well as educational outcomes for children – have become significant over the last decade. This study focuses upon the inter-professional issues in the running of one small-scale intervention involving parents and their babies based in schools in an urban setting in the UK. The programme, run over the school year 2007/08, provided a professional framework in which parents from the local community surrounding a school brought their babies into classroom settings to talk about aspects of baby care and development. This professional framework included classroom teachers, one senior cross-school education manager, family health visitors and one senior children’s health nurse. Despite agreement about the benefits of the programme there were also clear differences of priority. This paper describes the different perceptions that each of these two sets of professionals – from health and from education – had of the programme, and highlights some critical perspectives that tended to come more from health professionals. It also maps out potential solutions which draw upon recent literature that is similarly focused upon inter-professional and inter-agency service delivery. In so doing it offers valuable insights to professionals working in inter-agency collaborations in schools.

Parents' experience of giving consent for their child to undergo surgery

This study considered the experiences of parents giving consent for their children to undergo surgery at a regional centre for paediatric surgery. Eighteen purposively selected parents whose children had undergone surgery were interviewed for this qualitative study. All parents wanted to receive understandable but comprehensive information, they expected opportunities to ask questions and wanted to be given sufficient time to make their decision. Their reactions to being given the information varied, with some parents’ anxiety levels increasing, while others felt re-assured. Most parents were willing to give their consent only once they had been convinced of the need for surgery. On the other hand, two parents wanted the surgeon to decide for them. Many parents also wanted to share the responsibility and give consent together. The main outcome of this study was that the parents’ decisions and decision-making was more individualised than previously thought.

Children's weight status and maternal and paternal feeding practices

Child obesity has become a major concern of health researchers. This study explores the association between parental feeding practices and children’s weight status. The study also examines whether maternal and paternal feeding practices lead to significantly different children’s weight outcomes. By analyzing samples of 312 children (aged 9–11 and 13–15) and their parents, randomly selected from the Houston Metropolitan Statistical Area, the results show that parental feeding practices are linked to children’s weight status. The finding that maternal and paternal feeding practices do not have significantly different effects on children’s weight highlights an equivalent role of maternal and paternal feeding practices in shaping children’s weight status.

Food insecurity among Australian children: Potential determinants, health and developmental consequences

Children in food-insecure households may be at risk of poor health, developmental or behavioural problems. This study investigated the associations between food insecurity, potential determinants and health and developmental outcomes among children. Data on household food security, socio-demographic characteristics and children’s weight, health and behaviour were collected from households with children aged 3–17 years in socioeconomically disadvantaged suburbs by mail survey using proxy-parental reports (185 households). Data were analysed using logistic regression. Approximately one-in-three households (34%) were food insecure. Low household income was associated with an increased risk of food insecurity [odds ratio (OR), 16.20; 95% confidence interval (CI), 3.52–74.47]. Children with a parent born outside of Australia were less likely to experience food insecurity (OR, 0.42; 95% CI, 0.19–0.93). Children in food-insecure households were more likely to miss days from school or activities (OR, 3.52; 95% CI, 1.46–8.54) and were more likely to have borderline or atypical emotional symptoms (OR, 2.44; 95% CI, 1.11–5.38) or behavioural difficulties (OR, 2.35; 95% CI, 1.04–5.33). Food insecurity may be prevalent among socioeconomically disadvantaged households with children. The potential developmental consequences of food insecurity during childhood may result in serious adverse health and social implications.

Ending Violence Sparked By Baby's Cry

About 300 babies die each year after being hospitalized for serious injuries, according to a new report. Researchers are testing ways to help parents cope with the anger and frustration that can be triggered by a crying baby.

Secondhand Smoke An Unwelcome Passenger In Cars With Kids

About 1 in 5 nonsmoking kids in middle and high school reported sharing a car with a smoker. The researcher say the survey, which included responses from thousands of students, give an accurate snapshot of what's happening across the country.

Many Hits, Rather Than A Big One, Pose Greatest Concussion Risk

High school football players experienced brain changes long before they had symptoms of concussion. The findings suggest that concussions come from cumulative damage, researchers say.

Computerized Tests For Concussions May Be Unreliable

Computerized testing of athletes for concussion isn't a reliable gauge of their brain health or fitness to return to play, according to new research. The computerized tests are used in the NFL and NHL, and in many colleges and high schools.

Parents Cheat On Booster Seats, Despite Safety Risks

Parents don't always use booster seats for children, even though they're required in 47 states. Only half insisted their child use a booster when riding in the family car with boosterless friends.

Santorum Family's Trisomy 18 Saga Casts Spotlight On Sad Condition

News of Bella Santorum's health problems led to rare news media and Internet interest in the congenital condition known as Trisomy 18, casting a spotlight on a fairly tragic condition.

Blood Doctors Call Foul On NCAA's Screening For Sickle Cell

The leading group of doctors specializing in blood disorders says it opposes the NCAA's screening program for sickle cell trait in college athletes. The doctors say it overlooks other, more common factors in exercise-related deaths and is not a comprehensive solution.

Home Births Grow More Popular In U.S.

Advocates of home births applaud the trend, but some doctors caution there are risks when deliveries come with complications. The federal data suggest the trend appears to be driven primarily by the choices of older, white women.

Alice Waters: Picture Perfect As The Constant Gardener

A portrait of the Chez Panisse chef was recently unveiled at the National Portrait Gallery. If Waters could have her way, she says kids would grow their own food and cook it for breakfast, lunch and snacks all year round.

USDA To Require Healthier Meals In Schools With Updated Nutrition Standards

Less salt and fat. More whole grains, fruit, veggies and low-fat dairy. This is what kids can expect in the school lunchroom soon, according to new standards for school meals announced by the U.S. Department of Agriculture and first lady Michelle Obama.

Common Chemicals Could Make Kids' Vaccines Less Effective

Researchers found that children whose blood contained high levels of chemicals used in nonstick coatings and stain-resistant fabrics were less responsive to vaccination. The finding suggests, but doesn't prove, that these chemicals may make some children more vulnerable to infectious diseases.

Listen Up, Walkers: Watch Out For Traffic When Wearing Headphones

A study of accidents involving pedestrians wearing headphones suggests a real risk from the audio distraction. Fumbling with or listening to music players can divert attention from dangers. The audio can also drown out sounds of trouble.

Gains In Afghan Health: Too Good To Be True?

A U.S.-sponsored mortality survey released last year found huge improvements in health across Afghanistan. But the improvements are so dramatic that experts, including several involved in the survey, question the findings.

A Doctor Tells All in 'Confessions Of A Surgeon'

In a new book, surgeon Paul Ruggieri reveals the "good, the bad, and the complicated" about being a surgeon, and operating on patients. From cutting into a man who just killed his wife, to the headaches of running a small business, Ruggieri candidly discusses his career.

Researchers Say 3 Embryos Is Too Many For IVF

British researchers say the time has come to buckle down on the number of embryos used during in-vitro fertilization. Three or more is entirely too many, they concluded after looking at data on more than 124,000 IVF treatments.