Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.
The purpose of this study was to define a one portion size of food frequently consumed by Korean children aged 6-11 for convenient use in food selection, diet planning, nutritional evaluation, and nutrition education. We analyzed using the original data on 889 persons (9.96%) aged 6-11 years among 8,930 persons to whom NHANES 2005 and selected food items consumed by the intake frequency of 10 or higher among the 500 most frequently consumed food items. A total of 172 varieties of food items of regular use were selected. Also the portion size of food items was set on the basis of the median (50 percentile) of the portion size for a single intake by a single person was analyzed. The portion size of cereals was 5 g for prosomillet to 120 g for hamburger. As for vegetables, it posted 1 g for red pepper to 50 g for nabakkimchi. The portion size of meats and products was 15 g for luncheon meat to 120 g for beef feet soup. In comparison of children's portion size with adults', the children's portion sizes of every food groups, with the exception of meats and eggs, were lower than those of adults. The portion size of the regular food items of children in this study will be conveniently and effectively used by children, children's diet planners and researchers in selecting food items for a nutritionally balanced diet and in assessing the children's diet intake.
Purpose: The study was done to identify adjustment to hospital life of school aged children. This research was designed as a descriptive study. Method: A convenience sample of 186 patients who were hospitalized children, 6~12 years old. The instrument in this study were developed by researcher and constructed to include 5 sub categories about adjustment to hospital life. They ask children to rate each item on 5 Likert scale. The data were analyzed by SPSS Win Program. Result: The mean average score of adjustment to hospital life was 91.75(SD 11.22); the social support revealed the highest value, followed by self-esteem, stress on disease, stress on hospitalization, and defense strategies. There was differences on bibliographic data; hospital date, disease type. The relationship between adjustment and sub categories was significant, especially in the stress on hospitalization and disease, social support and self-esteem. The relationship between coping strategies and stress on diseases was reversed. Conclusion: These results suggest that pediatric nurses need to be aware of the adjustment to hospital life. A development of nursing intervention program may be useful and critical for hospitalized school aged children.
The purpose of this study was to determine biochemical parameters related to protein and immunity. Subjects were 125 preschool children(M:69, F:56) residing in low income area of Seoul. Mean serum total protein of the children aged 6 was 7.3g/dl which was significantly higher than 6.6g/dl of the group aged 3. The mean serum albumin was 4.7g/dl for 3, 4, 5 age group, and 4.9g/dl for 6 age group and there was no significant difference. Serum retinol binding protein(RBP) is used as a sensitive indicatior of protein, because it tends to fall rapidly in response to protein status and respond to quickly dietary treatment. Mean RBP for each group(3, 4, 5 and 6 age group) were $2.5\mu{g}$/dl, $2.9\mu{g}$/dl, $2.7\mu{g}$/dl, $3.0\mu{g}$/dl. The Proportion of children whose RBP was than $2.6\mu{g}$/dl was 15.9%, 19.2%, 24.3% and 16.7%, respectively. The 24-hour urinary excretion of hydroxyproline was 7.9mg, 14.6mg, 11.7mg and 11.8mg for each group and the mean excretion of all children was 12.2mg/day. Children aged 3 were excreting significantly lower amount of hydroxprolinc per day than the children aged 4. The mean hydroxyproline index were 2.18, 2.39, 2.52, 2.80 for each age group and the mean of a group aged 6 was significantly higher than that of the group aged 3. The proportion of children assessed as malnourished and impaired growth(hydroxyproline index <2.0) was 18.8%, 4.9%, 2.5% and 4.3%, respectively. The nutrients which showed significant relationship with protein and immunity parameters were niacin, vitamin C and calcium. Vitamin C showed significant positive relationship(p<0.05-p<0.01) with serum RBP, total protein and globulin. The triceps skinfold thickness was significantly and positively correlated with serum globulin. Serum IgG showed significant positive relationship with height, weight, girth of chest and midarm circumference(p<0.05-p<0.01).
This study was conducted to investigate the dietary habits and assess the dietary intake of preschool children. Food habit, preference and nutritional supplement status were investigated using a questionnaire answered by the mothers of 453 subjects aged 3 to 6 years old. Also, a dietary intake survey using a 24-hour recall method was performed by mothers of the children. It was found that 81.2% of subjects had milk, dairy products, cookies, fruit and bread between meals once or twice per day. As well, 60.3% of subjects had an unbalanced diet and 20.7% had an overeating habit. Thus, unbalanced diet was a serious problem for many of the subjects. Due to weight controls, digestion problems and allergies, 11.7% of subjects had special dietary consideration. And 26.4% of subjects were using nutritional supplements. From the 24-recall survey, it was found that all nutrient intakes were higher than the Korean RDA except calcium and vitamin A. Nutrient intakes for protein, calcium, phosphorus and vitamin B2 were significantly different by sex, and also increased with age but not significantly. Children received 35% of daily energy, 44% of daily fat and 52% of daily calcium from snacks, so snacks clearly play an important role in dietary intake. The average number of foods consumed per day by subjects was 17.6 and that dishes was 11.0. Most children consumed 4 or 5 food groups per day. In conclusion, the dietary intake of children aged 3 to 6 were deemed adequate judging from nutrient intake and dietary diversity. More attention should be paid to the nutritional value of snacks in this age group.
Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.
Marshall, Sarah K;Monarrez-Espino, Joel;Eriksson, Anneli
Nutrition Research and Practice
/
v.13
no.3
/
pp.247-255
/
2019
BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.
Purpose: The spontaneous seroconversion rate of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) virus infection in children is lower than that in adults. However, few studies have investigated the rate of transition from the immune-tolerant to the early immune-clearance phase in children. Methods: From February 2000 to August 2011, we enrolled 133 children aged <18 years who had visited the Department of Pediatrics, Kyungpook National University Hospital. All subjects were in the immune-tolerant phase of HBeAg-positive CHB virus infection. The estimated transition rate into the early immune-clearance phase was calculated using the Kaplan-Meier method. Results: Among the 133 enrolled pediatric CHB virus infection patients in the HBeAg-positive immune-tolerant phase, only 21 children (15.8%) had converted to the early immune-clearance phase. The average age at entry into active hepatitis was $10.6{\pm}4.8$ years. The incidence of transition from the immune-tolerant to the early immune-clearance phase in these children was 1.7 episodes/100 patient-years. When analyzed by age, the estimated transition rate was 4.6%, 7.1%, and 28.0% for patients aged <6, 6-12, >12 years, respectively. Conclusion: In children with CHB virus infection, the estimated rate of entry into the early immune-clearance phase was 28.0% for patients aged 12-18 years, which was significantly higher than that observed for children aged <12 years (11.7%; p=0.001).
This study was performed to investigate the biochemical status of iron, zinc and copper for 125 preschool children (Males : 69, Females : 56) residing in a low-income area of Seoul. The number of subjects aged, 3, 4, 5 and 6 were 19, 41, 41 and 24, respectively. The hemoglobin level of the children aged 3 was 11.8 g/dl and was lower thant hat of the other groups(p<0.05). Similar results were found for hematocrit and serum zinc. The percentage of children with an iron deficiency assessed by Hb(3-5) years : <11.0g/dl, 6 years: <11.5g/dl), Hct(3-6 years : 33%, 6 years : <35%), serum transferrin(<16%) and serum ferritin(<10ng/ml) were 4.3%, 9.5%, 8.2% and 17.7%, respectively. The mean serum zinc was 67.9$\mu\textrm{g}$/dl and urinary zinc was 0.1300mg/day. Low serum zinc (61.0$\mu\textrm{g}$/dl) occurred in 28.0% of the children. The mean serum copper was 110.5$\mu\textrm{g}$/dl and urinary copper was 0.0126mg/day. The prevalence of children with elevated serum copper($\geq$ 130$\mu\textrm{g}$/dl) was 54.8%, which was higher than 7.4%, the prevalence of low serum copper(<70$\mu\textrm{g}$/dl). Children with higher status, more weight, larger girth of chest, or larger midarm circumference showed higher values of Hb. The height and weight of children also showed a positive crrelation with serum zinc(P<0.001-P<0.05).
The purpose of this study was to develop a "Happiness Scale for School-aged Korean Children" (HSSKC). Participants consisted of 2,528 children who were chosen from six places, namely: Seoul, Gyeonggi, Chungnam, Jeonnam, Gyeongnam, and Gangwon. The province of Jeju-do was not included. The study assessed children's perception of happiness in six areas of life. For data analysis, the study employed the following methods: descriptive statistics, factor analysis, correlation, and Cronbach's $\alpha$. Initially, the study used an original scale composed of 32 items, but these were later reduced to 29 through exploratory factor analysis. The study identified six factors which influenced the happiness of school-aged children: (1) self-esteem, (2) parent-child relationship, (3) school life, (4) after-school activities, (5) general living environment, and (6) satisfaction of needs. Validity was determined through correlating the sub-factors. Using Cronbach' $\alpha$ to measure the reliability of factors, the result ranged from .60 to 81.
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