Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

Author(s):  
P J Clamp ◽  
K De-Loyde ◽  
A R Maw ◽  
S Gregory ◽  
J Golding ◽  
...  

Abstract Objective This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. Method This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. Results Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.

2021 ◽  
Author(s):  
Dana Barr ◽  
Nancy Fiedler ◽  
Tippawan Prapamontol ◽  
Panrapee Suttiwan ◽  
Warangkana Naksen ◽  
...  

BACKGROUND Prenatal exposure to pesticides have been linked to adverse neurodevelopmental outcomes. Gaps exist in the current literature about the timing and magnitude of exposures that result in these adverse outcomes. OBJECTIVE The Study of Asian Women and their Offspring’s Development and Environmental Exposures (SAWASDEE) Cohort was established to investigate the impact of prenatal exposure to pesticides on neurodevelopment during infancy and early childhood in northern Thailand. METHODS Recruitment of this prospective, longitudinal birth cohort began in July 2017 and was completed in June 2019 in Chom Thong and Fang, two farming districts in Chiang Mai Province in northern Thailand. Follow up of the study participants is on-going. During pregnancy, seven questionnaires were administered. Time-resolved biospecimen samples were collected monthly (for urine) and during each trimester (for blood) at antenatal care visits. Medical records were abstracted. Infants were administered the NICU Network Neurobehavioral Scale (NNNS) test at one month of age. We will complete a number of additional exposure related analyses. RESULTS A total of 1298 women were screened and of those 394 women were enrolled. The mean gestational age at enrollment was 9.9 weeks (STD = 2.6). Differences in literacy were observed between Chom Thong and Fang participants. In Fang about 51% reported being able to read in Thai compared to about 95% in Chom Thong. The percentages were comparable for reporting to be able to write in Thai. A total of 322 mother-child pairs completed the NNNS. CONCLUSIONS This longitudinal birth cohort study will inform risk assessment standards for pregnant women in Thailand and other countries. Building awareness of how insecticide exposure during specific windows of pregnancy affects the neurodevelopmental trajectories of children in developing countries is a specific need recognized by the World Health Organization.


2021 ◽  
pp. 1-9
Author(s):  
Rebecca J. Bennett ◽  
Erin Kosovich ◽  
Steff Cohen ◽  
Cara Lo ◽  
Kevin Logan ◽  
...  

Purpose This study aimed to (a) identify participant factors associated with hearing aid review (HAR) appointment attendance, (b) investigate whether the completion of self-report survey identifying hearing aid–related problems affects HAR appointment attendance, and (c) investigate whether hearing aid problems and hearing aid management deficiencies are adequately addressed during HAR appointments. Method A prospective cohort study of adult hearing aid owners recruited from a single hearing clinic in Western Australia. Potential participants were invited to an annual HAR appointment via postal letter. The invitation included a paper-based self-report survey evaluating either (a) hearing aid problems, (b) hearing aid management skills, or (c) hearing aid outcomes, depending on which intervention/control group the potential participants were assigned to, and a reply paid addressed envelope. Two months later, potential participants were sent all three paper-based self-report surveys, irrespective of whether they had attended or not attended an HAR appointment. Results (a) There was no significant difference in gender or source of funding for hearing services between HAR appointment attendees and nonattendees. HAR nonattendees lived a greater distance from their clinic and were younger than attendees. (b) Survey completion did not influence HAR appointment attendance rates. (c) A significant reduction in individuals' self-reported hearing aid problems was recorded following the attendance at the HAR appointment. No significant changes in hearing aid management skills or overall hearing aid outcomes were detected. Conclusions Long travel distances may be a barrier to attendance at review appointments. HAR appointments appear to be effective in improving hearing aid problems.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Narendar Manohar ◽  
Andrew Hayen ◽  
Loc Do ◽  
Jane Scott ◽  
Sameer Bhole ◽  
...  

Abstract Background Early childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes. Methods Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on ‘weekly frequency of core and discretionary foods intake’ using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for ‘core’ and ‘discretionary’ foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. Results The intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27–0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47–0.91) and having a single mother (RR: 0.40, 95%CI: 0.18–0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01–1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00–1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47–4.70), low maternal education (RR 3.01, 95%CI: 1.61–5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31–5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97–0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15–0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood. Conclusion Children’s frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.


2020 ◽  
pp. 182-188
Author(s):  
V. D. Lunkov ◽  
M. V. Maevskaya ◽  
V. T. Ivashkin

Objective of the study. prove the effectiveness of brief psychological intervention (BPI) conducted by an internist in achieving and maintaining abstinence in patients with alcoholic liver disease (ALD).Materials and methods. A total of 65 patients were included in the study: 29 patients in the BPI group and 36 in the historical control group. A comparative analysis of the frequency of achievement and maintenance of abstinence and analysis of factors associated with these parameters were conducted.Results of the study. The frequency of achieving abstinence was significantly higher in the BPI group compared with the control group after 6, 9, 12 and 24 months from the date of inclusion in the study (p <0.001, p = 0.002, p = 0.001, p = 0.017, respectively; criterion χ2). The frequency of failures to achieve abstinence in the CPC group was significantly lower than in the control group after 6 months and in general for the entire observation period (p = 0.004, p = 0.005, respectively; criterion χ2). Provision of BPIs for 12 months after alcohol-induced decompensation serves as a factor that is reliably associated with achieving total abstinence within 24 months (p = 0.001, criterion χ2). Decompensated cirrhosis of the liver serves as factors independently associated with failures to achieve abstinence within 24 months after alcohol-induced illness (OS: 10.72 [95% CI 2.17–52.81]; p = 0.004) and the absence of BPI after discharge from the hospital (OSH BPI: 0.80 [95% CI 0.14–0.479]; p = 0.006)Conclusion. BPIs provided by an internist to the patients with ABD for 12 months after alcohol-induced decompensation leads to a higher rate of achieving total abstinence and decrease in the frequency of failures to achieve abstinence within 24 months after discharge from the hospital.


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