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Colt S, Miller CD, Edielu A, Webb EL, Mawa PA, Wu HW, Nakyesige R, Muheki E, Kabatereine N, Bustinduy AL, Friedman JF. Relationships Between Schistosoma mansoni Infection Intensity and Nutritional Status and Anemia Among Preschool-aged Children in Uganda. Clin Infect Dis 2024; 78:90-93. [PMID: 37585653 PMCID: PMC10810701 DOI: 10.1093/cid/ciad470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023] Open
Abstract
In a cross-sectional analysis of 354 Ugandan children (age 12-48 months) infected with Schistosoma mansoni, we assessed relationships between infection intensity and nutritional morbidities. Higher intensity was associated with an increased risk for anemia (RR = 1.05, 95% confidence interval [CI] 1.01-1.10) yet not associated with risk for underweight, stunting, or wasting.
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Affiliation(s)
- Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cole D Miller
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Andrew Edielu
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Emily L Webb
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Patrice A Mawa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Hannah W Wu
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Racheal Nakyesige
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Edridah Muheki
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | | | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Pereira T, Ramalho AM, Valente ARS, Couto PS, Lousada M. The Effects of the Pragmatic Intervention Programme in Children with Autism Spectrum Disorder and Developmental Language Disorder. Brain Sci 2022; 12:brainsci12121640. [PMID: 36552100 PMCID: PMC9775383 DOI: 10.3390/brainsci12121640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Children with Autism Spectrum Disorder (ASD) and Developmental Language Disorder (DLD) frequently face pragmatic impairments which may result in learning, socialization, and mental health difficulties, therefore early intervention is crucial. In Portugal, the Pragmatic Intervention Programme (PICP) has been recently developed and validated, but its effects are unknown. This study aims to determine the effects of the PICP on preschool-age children with ASD or DLD with pragmatic impairments. METHODS A non-randomized controlled trial has been conducted. The children (n = 20) were assigned to the intervention (n = 11) or the control group (waiting list) (n = 9). Each child attended 24 PICP-based intervention sessions provided by a Speech and Language Therapist in kindergarten. The primary outcome measure was a Goal Attainment Scale (GAS) rated by parents and kindergarten teachers. Secondary outcomes include parent/teacher-reported communication skills (Escala de Avaliação de Competências Comunicativas) and an assessment of the child's general language ability (Teste de Linguagem-Avaliação da Linguagem Pré-Escolar). RESULTS GAS results show that all the children in the intervention group made progress. Statistically significant differences between pre- and post-intervention assessments were found for all secondary outcomes. CONCLUSIONS The main findings suggest that the PICP improves language in preschool-age children with ASD and DLD with pragmatic difficulties. Further research is needed to analyse the effects of the PICP for each neurodevelopmental disorder individually. These results are crucial and will contribute to future research and evidence-based practice.
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Affiliation(s)
- Tatiana Pereira
- CINTESIS.UA@RISE, University of Aveiro, 3810 Aveiro, Portugal
- Center of Linguistics, University of Lisbon (CLUL), 1600 Lisbon, Portugal
- Correspondence:
| | | | - Ana Rita S. Valente
- Institute of Electronics and Informatics Engineering of Aveiro, Department of Electronics, Telecommunications and Informatics, University of Aveiro, 3810 Aveiro, Portugal
| | - Pedro Sá Couto
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics, University of Aveiro, 3810 Aveiro, Portugal
| | - Marisa Lousada
- CINTESIS.UA@RISE, University of Aveiro, 3810 Aveiro, Portugal
- Center of Linguistics, University of Lisbon (CLUL), 1600 Lisbon, Portugal
- School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
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Andreyeva T, Sun X, Cannon M, Kenney EL. The Child and Adult Care Food Program: Barriers to Participation and Financial Implications of Underuse. J Nutr Educ Behav 2022; 54:327-334. [PMID: 34865970 DOI: 10.1016/j.jneb.2021.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To assess facilitators and barriers to participation in the Child and Adult Care Food Program (CACFP) and estimate foregone federal funds because of CACFP underuse. METHODS An online survey of food service practices and experiences with CACFP among Connecticut-based licensed child care centers (n = 231). RESULTS Serving meals and the center's nonprofit status predicted CACFP participation. The most common challenge among participants was collecting family income eligibility. Streamlining paperwork (mentioned by 44% of respondents) and funding for nonfood, administrative costs (40%) were recommended facilitators to increase CACFP uptake. Nonparticipating centers had limited knowledge about the program and its eligibility. Foregone federal funding due to CACFP underuse among eligible Connecticut centers was estimated at $30.7 million in 2019, suggesting that 20,300 young children from low-income areas missed out on CACFP-subsidized food. CONCLUSIONS AND IMPLICATIONS Improving knowledge about CACFP and reducing participation burdens through additional funding and technical assistance can help expand the program to support child nutrition.
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Affiliation(s)
- Tatiana Andreyeva
- Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT.
| | - Xiaohan Sun
- The Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY
| | - Mackenzie Cannon
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT
| | - Erica L Kenney
- Prevention Research Center on Nutrition and Physical Activity, Harvard T.H. Chan School of Public Health, Boston, MA
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Jongstra R, Hossain MM, Galetti V, Hall AG, Holt RR, Cercamondi CI, Rashid SF, Zimmermann MB, Mridha MK, Wegmueller R. The effect of zinc-biofortified rice on zinc status of Bangladeshi preschool children: a randomized, double-masked, household-based, controlled trial. Am J Clin Nutr 2021; 115:724-737. [PMID: 34792094 PMCID: PMC8895213 DOI: 10.1093/ajcn/nqab379] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Zinc biofortification of rice could sustainably improve zinc status in countries where zinc deficiency is common and rice is a staple, but its efficacy has not been tested. Fatty acid desaturases (FADS) are putative new zinc status biomarkers. OBJECTIVES Our objective was to test the efficacy of zinc-biofortified rice (BFR) in preschool-aged children with zinc deficiency. Our hypothesis was that consumption of BFR would increase plasma zinc concentration (PZC). METHODS We conducted a 9-mo, double-masked intervention trial in 12-36-mo-old rural Bangladeshi children, most of whom were zinc-deficient (PZC <70 µg/dL) and stunted (n = 520). The children were randomly assigned to receive either control rice (CR) or BFR provided in cooked portions to their households daily, with compliance monitoring. The primary outcome was PZC. Secondary outcomes were zinc deficiency, linear growth, infection-related morbidity, FADS activity indices, intestinal fatty acid binding protein (I-FABP) and fecal calprotectin. We applied sparse serial sampling for midpoint measures and analyzed data by intention-to-treat using mixed-effects models. RESULTS At baseline, median (IQR) PZC was 60.4 (56.3-64.3) µg/dL, 78.1% of children were zinc deficient, and 59.7% were stunted. Mean ± SD daily zinc intakes from the CR and BFR during the trial were 1.20 ± 0.34 and 2.22 ± 0.47 mg/d, respectively (P < 0.001). There were no significant time-by-treatment effects on PZC, zinc deficiency prevalence, FADS activity, I-FABP, or fecal calprotectin (all P > 0.05). There was a time-treatment interaction for height-for-age z-scores (P < 0.001) favoring the BFR group. The morbidity longitudinal prevalence ratio was 1.08 (95% CI: 1.05, 1.12) comparing the BFR and CR groups, due to more upper respiratory tract illness in the BFR group. CONCLUSIONS Consumption of BFR for 9 mo providing ∼1 mg of additional zinc daily to Bangladeshi children did not significantly affect PZC, prevalence of zinc deficiency, or FADS activity.The trial was registered at clinicaltrials.gov as NCT03079583.
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Affiliation(s)
- Roelinda Jongstra
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - Md Mokbul Hossain
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Valeria Galetti
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - Andrew G Hall
- Department of Nutrition, University of California, Davis, CA, USA
| | - Roberta R Holt
- Department of Nutrition, University of California, Davis, CA, USA
| | - Colin I Cercamondi
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
| | - Sabina F Rashid
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Malay K Mridha
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Rita Wegmueller
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland,GroundWork, Fläsch, Switzerland
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Gober HJ, Li KH, Yan K, Bailey AJ, Carleton BC. Hydroxyzine Use in Preschool Children and Its Effect on Neurodevelopment: A Population-Based Longitudinal Study. Front Psychiatry 2021; 12:721875. [PMID: 35153845 PMCID: PMC8832122 DOI: 10.3389/fpsyt.2021.721875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
We identified the first-generation antihistamine hydroxyzine as the earliest and most frequently prescribed drug affecting the central nervous system in children under the age of 5 years in the province of British Columbia, Canada (1. 1% prevalence). Whereas, the antagonism of H1-receptors exerts anti-pruritic effects in atopic dermatitis and diaper rash, animal studies suggest an adverse association between reduced neurotransmission of histamine and psychomotor behavior. In order to investigate hydroxyzine safety, we characterized the longitudinal patterns of hydroxyzine use in children under the age of 5 years and determined mental- and psychomotor disorders up to the age of 10 years. We found significantly higher rates of ICD-9 and ICD-10 codes for disorders such as tics (307), anxiety (300) and disturbance of conduct (312) in frequent users of hydroxyzine. Specifically, repeat prescriptions of hydroxyzine compared to a single prescription show an increase in tic disorder, anxiety and disturbance of conduct by odds ratios of: 1.55 (95%CI: 1.23-1.96); 1.34 (95%CI: 1.05-1.70); and 1.34 (95%CI: 1.08-1.66) respectively in children up to the age of 10 years. Furthermore, a non-significant increased trend was found for ADHD (314) and disturbance of emotions (313). This is the first study reporting an association between long-term neurodevelopmental adverse effects and early use of hydroxyzine. Controlled studies are required in order to prove a causal relationship and to confirm the safety of hydroxyzine in the pediatric population. For the time being, we suggest the shortest possible duration for hydroxyzine use in preschool-age children.
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Affiliation(s)
- Hans J Gober
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pharmacy, Kepler University Hospital, Linz, Austria
| | - Kathy H Li
- Therapeutic Evaluation Unit, Provincial Health Services Authority, Vancouver, BC, Canada.,Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, BC, Canada
| | - Kevin Yan
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anthony J Bailey
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bruce C Carleton
- Division of Translational Therapeutics, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Therapeutic Evaluation Unit, Provincial Health Services Authority, Vancouver, BC, Canada.,Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Zhao L, Stinnett SS, Prakalapakorn SG. Visual Acuity Assessment and Vision Screening Using a Novel Smartphone Application. J Pediatr 2019; 213:203-210.e1. [PMID: 31326117 DOI: 10.1016/j.jpeds.2019.06.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate a smartphone-based application's (Peek Acuity) ability to assess visual acuity and screen for ocular conditions in children, we compared visual acuity assessment between Peek Acuity and the pediatric ophthalmology examination and evaluated Peek Acuity's ability to identify children with referable ocular conditions. STUDY DESIGN We prospectively recruited 111 children age 3-17 years, presenting to a pediatric ophthalmology clinic, who could follow instructions. Monocular visual acuity assessments by Peek Acuity and standard clinical methods were performed in randomized order. We compared visual acuity assessments between methods using intraclass correlation coefficient (ICC) and evaluated Peek Acuity's ability to identify children with referable ocular conditions. RESULTS ICC comparing visual acuity assessed between methods was 0.88 (95% CI 0.83-0.92) for first and 0.85 (95% CI 0.78-0.89) for second eyes examined. ICC among 3 to 5-year-olds (preschool-age children) was 0.88 (95% CI 0.77-0.94) for first and 0.45 (95% CI 0.13-0.68) for second eyes examined. Peek Acuity had a sensitivity of 83%-86% for decreased vision and 69%-83% for referable ocular disease. Sensitivity was highest among 3 to 5-year-olds with decreased vision, 93%-100%. CONCLUSIONS Overall, Peek Acuity visual acuity assessment correlated well with visual acuity assessed by standard clinical methods, though preschool-age children appeared more susceptible to examination fatigue. Peek Acuity performed adequately as a screening tool and had the greatest sensitivity among those with decreased vision and preschool-age children. TRIAL REGISTRATION ClinicalTrials.gov: NCT03212222.
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Affiliation(s)
- Lloyd Zhao
- School of Medicine, Duke University, Durham, NC
| | - Sandra S Stinnett
- Department of Ophthalmology, Duke University, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC
| | - S Grace Prakalapakorn
- Department of Ophthalmology, Duke University, Durham, NC; Department of Pediatrics, Duke University, Durham, NC.
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Abstract
BACKGROUND The Child and Adult Care Food Program (CACFP) sets nutrition standards for foods served in participating settings. Licensing regulations in many states, including Connecticut (CT), extend these rules to nonparticipating facilities. This study evaluates the food environment for preschool-age children in CT child care centers and describes center-reported adherence to the CACFP nutrition regulations. METHODS We surveyed directors of licensed CACFP-participating and non-CACFP centers that served meals and/or snacks. Food served, caregiver feeding behavior, nutrition practices and policies, and CACFP knowledge were reported by 256 non-CACFP and 87 CACFP centers. We conducted bivariate analyses to describe adherence to the CACFP regulations as reported by CACFP and nonparticipating centers. Data were collected in 2015-2016 and analyzed in 2017. RESULTS CACFP centers reported more engagement in recommended feeding and nutrition practices than non-CACFP centers, including serving more fresh fruit and whole grains at snack time, serving low-fat milk for meals/snacks, and use of family style dining and positive caregiver behaviors. No center reported serving soda, only a few had fruit drinks, and the majority prohibited parents from sending in sugary drinks. Despite the licensing regulations about compliance with the CACFP nutrition standards, 52% of non-CACFP centers had never heard of CACFP and only 21% received information about following the CACFP standards and practices. CONCLUSIONS CACFP participation is associated with better center-reported adherence to the CACFP nutrition standards and feeding practices. Poor awareness about CACFP among nonparticipating centers needs to be addressed to improve compliance with the CACFP nutrition standards.
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Affiliation(s)
- Tatiana Andreyeva
- 1 Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Obesity University of Connecticut , Hartford, CT
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Davis DW, Feygin Y, Creel L, Williams PG, Lohr WD, Jones VF, Le J, Pasquenza N, Ghosal S, Jawad K, Yan X, Liu G, McKinley S. Longitudinal Trends in the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Stimulant Use in Preschool Children on Medicaid. J Pediatr 2019; 207:185-191.e1. [PMID: 30545564 DOI: 10.1016/j.jpeds.2018.10.062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 08/31/2018] [Accepted: 10/26/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To describe trends in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescribing of stimulants in preschool-age children receiving Medicaid and to identify factors associated with the receipt of psychosocial care. STUDY DESIGN Data were extracted from 2012-2016 Kentucky Medicaid claims for children aged <6 years. ADHD was identified using International Classification of Diseases, Tenth Revision codes F90.0, F90.1, F90.2, F90.8, and F90.9. Psychosocial therapy was defined as having at least 1 relevant Current Procedural Terminology code in a claim within the year. A generalized linear model with a logit link and binomial distribution was used to assess factors associated with receipt of psychosocial treatment in 2016. RESULTS More than 2500 (1.24%) preschool-aged children receiving Medicaid had a diagnosis of ADHD in 2016, with 988 (38.2%) of those receiving a stimulant medication. Children in foster care were diagnosed with and/or treated for ADHD 4 times more often than other Medicaid recipients. Of the 1091 preschoolers receiving stimulants, 99 (9%) did not have a diagnosis of ADHD. There were no significant differences in diagnoses by race/ethnicity, but children reported to be black, Hispanic, or other race/ethnicity received stimulants at a lower rate than white children. Positive predictors for receiving psychosocial therapy in 2016 included having the diagnosis but not receiving a stimulant, having at least 1 prescription written by a psychiatrist, having comorbidities, and age. The use of stimulants in children aged <6 years declined from 0.9% in 2012 to 0.5% in 2016. CONCLUSIONS Promising trends demonstrate a decreasing use of stimulants in preschoolers; however, continued vigilance is needed to promote the optimal use of psychosocial interventions.
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Affiliation(s)
- Deborah Winders Davis
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA.
| | - Yana Feygin
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Liza Creel
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Health Management & Systems Science, Louisville, KY, USA
| | - P Gail Williams
- University of Louisville School of Medicine, Department of Pediatrics, Weisskopf Child Evaluation Center, Louisville, KY, USA
| | - W David Lohr
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA
| | - V Faye Jones
- University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA
| | - Jennifer Le
- University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA
| | - Natalie Pasquenza
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Soutik Ghosal
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Bioinformatics and Biostatistics, Louisville, KY, USA
| | - Kahir Jawad
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA
| | - Xiaofang Yan
- University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Bioinformatics and Biostatistics, Louisville, KY, USA
| | - Gil Liu
- University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA; Kentucky Department of Medicaid Services, Frankfort, KY, USA
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Vaughn BE, Posada G, Veríssimo M, Lu T, Nichols OI. Assessing and quantifying the secure base script from narratives produced by preschool age children: justification and validation tests. Attach Hum Dev 2019; 21:225-237. [PMID: 30729889 DOI: 10.1080/14616734.2019.1575546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Building on aframework presented by Bretherton and associates, Waters and associates argued that interaction sequences relevant to children's access to and use of asecure base for exploration during infancy/toddlerhood become internalized as script-like representations. For adults, these scripted representations are readily assessed using word-prompt lists d to elicit attachment relevant narratives. However, this method is not appropriate during early childhood. Waters and associates used stories from Bretherton's Attachment Story Completion Task for this purpose. However, the method they used to score secure base script use is not efficient for larger samples (e.g. over 50), and new approaches for scoring have been designed. We describe two approaches to story selection and scoring for access to and use of the secure base script. The two scoring methods show substantial and significant overlap and also have significant associations with other methods of measuring attachment security during early childhood.
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Affiliation(s)
- Brian E Vaughn
- a Human Development and Family Studies , Auburn University , Auburn , AL , USA
| | - German Posada
- b Human Development and Family Studies , Purdue University , West Lafayette , IN , USA
| | - Manuela Veríssimo
- c William James Center for Research , ISPA-Instituto Universitário , Lisbon , Portugal
| | - Ting Lu
- a Human Development and Family Studies , Auburn University , Auburn , AL , USA
| | - Olivia I Nichols
- a Human Development and Family Studies , Auburn University , Auburn , AL , USA
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Lindsay AC, Moura Arruda CA, Tavares Machado MM, De Andrade GP, Greaney ML. Exploring Brazilian Immigrant Mothers' Beliefs, Attitudes, and Practices Related to Their Preschool-Age Children's Sleep and Bedtime Routines: A Qualitative Study Conducted in the United States. Int J Environ Res Public Health 2018; 15:E1923. [PMID: 30181465 PMCID: PMC6165127 DOI: 10.3390/ijerph15091923] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/23/2018] [Accepted: 09/01/2018] [Indexed: 12/26/2022]
Abstract
In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at increased risk of childhood obesity. Mounting evidence documents that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children. The number of Brazilian immigrants in the US is increasing, yet no existing research, to our knowledge, has examined factors affecting sleep and bedtime routines of children of Brazilian immigrant families. Therefore, the purpose of this qualitative study was to explore Brazilian immigrant mothers' beliefs, attitudes, and practices related to sleep and bedtime routines among preschool-aged children. Seven focus group discussions (FGDs) were conducted with 37 Brazilian immigrant mothers of preschool-age children living in the US. The audio-recordings of the FGDs were transcribed verbatim in Portuguese without identifiers and analyzed using thematic analyses. Mothers also completed a brief questionnaire assessing socio-demographic and acculturation. Analyses revealed that most mothers were aware of the importance of sleep and sleep duration for their children's healthy growth and development. Mothers also spoke of children needing consistent bedtime routines. Nevertheless, many mothers reported inconsistent and suboptimal bedtime routines (e.g., lack of predictable and orderly bedtime activities such as bath, reading, etc. and use of electronics in bed). These suboptimal routines appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families' lives such as parents' work schedule, living with extended family, living in multi-family housing, neighborhood noise, etc. Analyses identified several modifiable parenting practices related to young children's sleep and bedtime routines (e.g., irregular bedtime, late bedtime, inconsistent bedtime routines, use of electronics in bed, etc.) that can be addressed in parenting- and family-based obesity prevention interventions. Interventions should consider the social context of the home/family (e.g., parents' work schedules) and the environment (e.g., multi-family housing; neighborhood noise, etc.) faced by Brazilian immigrant families when developing health promotion messages and parenting interventions tailored to this ethnic group.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | | | - Márcia M Tavares Machado
- Department of Community Health, Federal University of Ceará, Fortaleza, Ceará 62010-560, Brazil.
| | - Gabriela P De Andrade
- Department of Exercise and Health Sciences, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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Smith K, Reinman L, Schatz J, Roberts CW. Parent Perspectives on Pain Management in Preschool-Age Children With Sickle Cell Disease. J Pediatr Oncol Nurs 2017; 35:16-24. [PMID: 29094643 DOI: 10.1177/1043454217735829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pain episodes occur for many preschoolers with sickle cell disease (SCD), but little is known about parent perceptions of managing pain episodes in young children. We surveyed parents of young children with SCD who had managed pain episodes in the past year to assess their management and satisfaction with their strategies, challenges of pain management, and interest in additional education. Parents were recruited from health maintenance visits at a SCD specialty clinic. Forty-two of 51 parents (82%) of 2- to-6-year-olds reported managing pain over the past year. Parents who had managed pain primarily reported using medications. These parents reported at least moderate satisfaction with current management strategies and resources. At least one-third of parents found each facet of pain management queried as at least somewhat challenging. Identifying when their child was in pain, encouraging functional activities, and managing irritable behavior were reported as most challenging. Parents of young children with SCD reported interest in additional pain management education, which could promote better parent and child coping skills.
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Affiliation(s)
- Kelsey Smith
- 1 University of South Carolina, Barnwell College, Columbia, SC, USA
| | - Laura Reinman
- 1 University of South Carolina, Barnwell College, Columbia, SC, USA
| | - Jeffrey Schatz
- 1 University of South Carolina, Barnwell College, Columbia, SC, USA
| | - Carla W Roberts
- 2 University of South Carolina Medical School, Columbia, SC, USA
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Lindsay AC, Greaney ML, Wallington SF, Mesa T, Salas CF. A review of early influences on physical activity and sedentary behaviors of preschool-age children in high-income countries. J SPEC PEDIATR NURS 2017; 22. [PMID: 28407367 DOI: 10.1111/jspn.12182] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 03/09/2017] [Accepted: 03/11/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Promoting physical activity (PA) is a key component of preventing and controlling childhood obesity. Despite well-documented benefits of PA, globally, rates of PA among young children have declined over the past decades, and most children are not accruing sufficient PA daily. Helping children develop the foundation for PA habits early in life is critical for the promotion of health in childhood and prevention of chronic diseases later in life, and will ultimately promote longer and healthier lives for individuals and the general population. The purpose of this review is to provide a synthesis of current evidence on influences on PA and sedentary behaviors of preschool-age children in high-income countries. DESIGN AND METHODS A systematic review of three databases was performed. Studies conducted in high-income countries and published from 2000 onward that addressed influences on PA and sedentary behaviors of preschool-age children were identified and reviewed. Additionally, reference lists of identified articles and relevant published reviews were reviewed. Studies that met the following inclusion criteria were considered: (a) sample included preschoolers (age ≤5 years); (b) PA and/or sedentary behaviors or factors associated with PA and/or sedentary behaviors was assessed; (c) published in English; (d) used either quantitative or qualitative methods; and (e) conducted in a high-income country. Data were extracted from selected studies to identify influences on PA and sedentary behaviors of preschool-age children and organized using the social-ecological model according to multiple levels of influence. RESULTS Results from included studies identify multiple factors that influence PA and sedentary behaviors of young children in high-income countries at the various levels of the social-ecological model including intrapersonal, interpersonal, environmental, organizational, and policy. PRACTICE IMPLICATIONS Given pediatric nurses' role as primary care providers, and their frequent and continued contact with parents and their children throughout childhood through well-child visits, immunization, and minor acute illnesses, they are well positioned to promote and support the development of early healthful PA habits of children starting in early childhood.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
- Health Studies & Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Mary L Greaney
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Sherrie F Wallington
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Tatiana Mesa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Carlos F Salas
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Mei Z, Namaste SML, Serdula M, Suchdev PS, Rohner F, Flores-Ayala R, Addo OY, Raiten DJ. Adjusting total body iron for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Am J Clin Nutr 2017; 106:383S-389S. [PMID: 28615255 PMCID: PMC5490648 DOI: 10.3945/ajcn.116.142307] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Total body iron (TBI) that is calculated from ferritin and soluble transferrin receptor (sTfR) allows for the evaluation of the full range of iron status from deficiency to excess. However, both ferritin and sTfR are affected by inflammation and malaria, which may require a statistical adjustment. TBI has been used to assess iron status in the United States, but its use worldwide and in settings with inflammation has been limited.Objective: We examine whether inflammation-adjusted ferritin and sTfR concentrations affect TBI values and the prevalence of low TBI (<0 mg/kg) in preschool children (PSC) (age range: 6-59 mo) and women of reproductive age (WRA) (age range: 15-49 y).Design: Cross-sectional data for PSC (8 surveys; n = 8413) and WRA (4 surveys; n = 4258) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed individually and combined. TBI and the prevalence of low TBI were compared following 3 adjustment approaches for ferritin and sTfR: 1) the exclusion of individuals with inflammation (C-reactive protein concentration >5 mg/L or α-1-acid glycoprotein concentration >1 g/L), 2) the application of arithmetic correction factors, and 3) the use of regression correction.Results: Regardless of the method that was used to adjust ferritin and sTfR for inflammation, the adjusted mean TBI decreased in both PSC and WRA compared with unadjusted values. Subsequently, inflammation-adjusted TBI increased the prevalence of low TBI by a median of 4-14 percentage points (pps) in PSC and 1-3 pps in WRA compared with unadjusted TBI. The regression approach resulted in a greater median increase than was achieved with the exclusion or correction-factor approaches, and accounting for malaria in addition to inflammation did not have an added effect on the prevalence estimates.Conclusion: The prevalence of low TBI is underestimated if it is not adjusted by inflammation, particularly in children living in areas with a high prevalence of inflammation.
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Affiliation(s)
| | - Sorrel ML Namaste
- Strengthening Partnerships, Results, and Innovations in Nutrition Globally, Arlington, VA;,Helen Keller International, Washington, DC
| | | | | | | | | | | | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD
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Abstract
BACKGROUND Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child's pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children. METHODS Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG-carbohydrate entry-insulin bolus delivered. RESULTS Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children's mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed. CONCLUSIONS Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.
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Affiliation(s)
- Susana R. Patton
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
- Susana R. Patton, PhD, CDE, University of Kansas Medical Center, Department of Pediatrics, 3901 Rainbow Blvd, MS 4004, Kansas City, KS 66160, USA.
| | - Kimberly A. Driscoll
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mark A. Clements
- Division of Endocrinology, Children’s Mercy Hospital and Clinics, Kansas City, MO, USA
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Metcalfe LA, Harvey EA, Laws HB. The Longitudinal Relation Between Academic/Cognitive Skills and Externalizing Behavior Problems in Preschool Children. J Educ Psychol 2013; 105:881-894. [PMID: 24039280 DOI: 10.1037/a0032624] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Existing research suggests that there is a relation between academic/cognitive deficits and externalizing behavior in young children, but the direction of this relation is unclear. The present study tested competing models of the relation between academic/cognitive functioning and behavior problems during early childhood. METHOD Participants were 221 children (120 boys, 101 girls) who participated in a longitudinal study from age 3 to 6. RESULTS A reciprocal relation (Model 3) was observed only between inattention and academic achievement; this relation remained controlling for SES and family stress. The relation between inattention and cognitive ability was consistent with Model 1 (cognitive skills predicting later inattention) with controls. For hyperactivity and aggression, there was some support for Model 2 (early behavior predicting later academic/cognitive ability), but this model was no longer supported when controlling for family functioning. CONCLUSION These results suggest that the relation between academic achievement/cognitive ability and externalizing problems may be driven primarily by inattention. These results also suggest that this relation is evident early in development, highlighting the need for early assessment and intervention.
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Reid GJ, Stewart M, Vingilis E, Dozois DJA, Wetmore S, Jordan J, Dickie G, Osmun WE, Wade TJ, Brown JB, Zaric GS. Randomized trial of distance-based treatment for young children with discipline problems seen in primary health care. Fam Pract 2013; 30:14-24. [PMID: 22948337 PMCID: PMC3552315 DOI: 10.1093/fampra/cms051] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Many parents of preschool-age children have concerns about how to discipline their child but few receive help. We examined the effects of a brief treatment along with usual care, compared with receiving usual care alone. Patients. Parents (N = 178) with concerns about their 2- to 5-year olds' discipline were recruited when they visited their family physician at 1 of 24 practices. METHODS After completing mailed baseline measures, parents were randomly assigned to receive usual care or the Parenting Matters intervention along with usual care. Parenting Matters combined a self-help booklet with two calls from a telephone coach during a 6-week treatment period. Follow-up assessments were completed at 7 weeks post-randomization, and 3 and 6 months later. RESULTS Behaviour problems (Eyberg Child Behaviour Inventory) decreased significantly more in the Parenting Matters condition compared with Usual Care alone, based on a significant time by treatment group effect in intent-to-treat, growth curve analyses (P = 0.033). The Parenting Matters group also demonstrated greater and more rapid improvement than in usual care alone in terms of overall psychopathology (Child Behaviour Checklist, P = 0.02), but there were no group differences in parenting. The overall magnitude of group differences was small (d = 0.15 or less). CONCLUSION A brief early intervention combining a self-help booklet and telephone coaching is an effective way to treat mild behaviour problems among young children. This minimal-contact approach addresses the need for interventions in primary health care settings and may be a useful component in step-care models of mental health.
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Affiliation(s)
- Graham J Reid
- Department of Psychology, Western University, London, Canada.
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Murphy JM, Pagano ME, Ramirez A, Yolanda Anaya A, Nowlin C, Jellinek MS. Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS). J Child Fam Stud 1999; 8:343-356. [PMID: 22323892 PMCID: PMC3273861 DOI: 10.1023/a:1022071430660] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Efforts to determine the prevalence of serious emotional disturbance in preschool-aged children have been hampered by the lack of a validated measure. The Preschool and Early Childhood Functional Assessment Scale (PECFAS) is a multi-dimensional measure that assesses the psychosocial functioning of children aged 3-7 years. The concurrent validity and reliability of the PECFAS were assessed in a sample of 30 preschool-aged children in a large Head Start program in Ventura, California. PECFAS ratings based on in-depth interviews were significantly related to parental ratings that the children had mental health problems, psychiatric diagnoses, teacher ratings of the child's need for mental health evaluations, teacher ratings of behavior problems on a standardized screening inventory (DIAL-R), and actual referrals for mental health evaluations. Interrater reliability for the total PECFAS score was high (r = .90) as was internal consistency of the five subscales (alpha = .86). Using the PECFAS scores as a standard, the weighted prevalence of serious emotional disturbance in this West Coast Head Start program was 17%, at the lower end of the current estimated rate of SED for older children in low income samples (18-26%).
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Affiliation(s)
- J. Michael Murphy
- Staff Psychologist, Department of Child Psychiatry, Massachusetts General Hospital/Assistant Professor of Psychology, Harvard Medical School, Boston, Massachusetts
| | - Maria E. Pagano
- Doctoral Candidate, Department of Human Development, Northwestern University, Evanston, IL
| | - Alicia Ramirez
- Head Start Program Manager, Child Development Resources of Ventura County, California
| | - A.A. Yolanda Anaya
- Family Service Specialist Supervisor, Child Development Resources of Ventura County, California
| | - Creda Nowlin
- Family Service Specialist Supervisor, Child Development Resources of Ventura County, California
| | - Michael S. Jellinek
- Chief of Child Psychiatry, Massachusetts General Hospital, and Professor of Psychiatry and Pediatrics, Harvard Medical School, Boston, Massachusetts
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