Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

2018 ◽  
Vol 128 (05) ◽  
pp. 325-331 ◽  
Author(s):  
Marie Auzanneau ◽  
Barbara Bohn ◽  
Ralf Schiel ◽  
Rainer Stachow ◽  
Sibylle Koch ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Diabetes Care ◽  
Secondary Data ◽  
Inpatient Rehabilitation ◽  
Age Group ◽  
Pension Insurance ◽  
Comprehensive Overview ◽  
Therapeutic Concept ◽  
Pediatric Diabetes

Abstract Introduction In Germany, inpatient rehabilitation is a well-established additive option in the therapeutic concept for children and adolescents with diabetes. However, its contribution in pediatric diabetes care is not known exactly. Our objective was to analyze inpatient rehabilitation in pediatric diabetes over eight years in Germany. Methods We requested secondary data from the German Statutory Pension Insurance Scheme to evaluate all completed inpatient rehabilitations for children and adolescents with diabetes (ICD-code E10-14) reimbursed by this institution between 2006 and 2013. For each type of diabetes, we analyzed the distribution of admissions by year, age-group, sex, nationality, and other documented diagnoses. All analyses were conducted via remote computing with IBM SPSS Version 24. Results Between 2006 and 2013, 5,403 admissions to inpatient rehabilitation for 4,746 children and adolescents with diabetes were documented. For type 1 diabetes (T1D; 88.5% of admissions), the number of yearly admissions increased from 458 in 2006 to 688 in 2013 (p=0.013), especially for age-group>5-10. The increase for type 2 diabetes (T2D) was not significant. Admissions were more frequent for girls (53.6%, p≤0.001), age>10-15 years (42.8%, p=0.001), and German nationality (98.5%). Obesity (T1D: 11.1%; T2D: 87.9%) and mental disorders (T1D: 11.6%; T2D: 27.4%) were the most frequent documented diagnoses in addition to diabetes. Conclusion This study provides a comprehensive overview of inpatient rehabilitation for children and adolescents with diabetes over many years in Germany. Until 2013, inpatient rehabilitation remained important in pediatric diabetes care, especially for children with mental disorders or obesity.

ANALYSIS OF ACTIVITIES IN THE FIELD OF HEALTH PROMOTION, PROPHYLAXIS AND PREVENTION OF MENTAL DISORDERS AMONG CHILDREN AND ADOLESCENTS IN POLAND AND WORLDWIDE

2021 ◽  
Vol 8 (1) ◽  
pp. 23-26
Author(s):  
Monika Serkowska ◽  
Katarzyna Pogorzelczyk ◽  
Marlena Robakowska ◽  
Marta Gallas ◽  
Sylwia Jałtuszewska ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Preventive Measures ◽  
Current Situation ◽  
Mental Health Promotion ◽  
Health Protection ◽  
Age Group ◽  
Methods Of Operation

Aim: The study aims to compare Polish methods of health promotion and prevention (prophylaxis) of mental disorders among children and adolescents with solutions have their effect in other countries when assessing the effectiveness (in both groups). Material and methods: Based on legal acts concerning mental health protection and data on preventive programs conducted both in Poland and in other countries, not only the methods of operation and the differences between them were compared but also recommendations were made regarding making possible changes to the current activities in Poland. Results: In territorial self-government units, where help is offered mainly to teenagers, introducing the intervention may be too late. Besides, due to the limited number of places offering such aid, incl. municipal programs, the issue emerges – concerning the ensuring of appropriate preventive measures – which results in the deterioration of the situation in this age group category and eventuate in the escalation of the current situation. Conclusions: To prevent the widespreadness of the disorders mentioned above, it is necessary to modify and extend the scope of preventive measures and activities regarding mental health promotion in Poland.

Nutrition Status of School Children in Punjab, India: Findings from School Health Surveys

2020 ◽  
Author(s):  
Madhur Verma ◽  
Priyanka Sharma ◽  
Poonam Khanna ◽  
Rachana Srivastava ◽  
Soumya Swaroop Sahoo
Keyword(s):  
Data Analysis ◽  
Nutritional Status ◽  
Children And Adolescents ◽  
Middle Childhood ◽  
Secondary Data ◽  
Nutrition Status ◽  
Age Group ◽  
Nutrition Interventions ◽  
Intergenerational Cycle ◽  
High Level

Abstract Background School-going children and adolescents are rarely targeted in nutrition surveys, despite the significant impact of nutritional status on their health, cognition, educational achievements and future economic productivity. The present secondary data analysis evaluated the nutritional status of children and adolescents in the 5–18 years age group. Materials and methods The anthropometric measurements of children and adolescents studying in the government and government-aided schools were collected under the ‘Rashtriya Bal Swasthya Karyakram’ in the District Fatehgarh Sahib of Punjab, India between March and August 2018. It was analyzed using SPSS version 21. Mean and standard deviation for weight-for-age, height-for-age, body mass index (BMI) for age z-scores were calculated using World Health Organization’s Anthro-plus software. Results A total of 897 children’s data were included in the study. Out of 352 children in 5–9 years age group, mean weight, height and BMI were 15.7 ± 3.8 kg, 110.7 ± 10.6 cm and 12.7 ± 2.1 kg/m2. About 58.8%, 37.4% and 31.8% of the children were categorized as severely underweight, stunted and thin, respectively. In the 10–18 years age group, mean weight, height and BMI were 30.5 ± 9.5 kg, 140 ± 13.4 cm and 15.2 ± 2.6 kg/m2. Severe stunting was present in 19.4% of adolescents, while 26.9% were severely thin. Conclusion Our study depicts a high level of undernutrition in school-going children and adolescents. There is a need to strengthen the nutrition interventions for middle childhood and adolescence period that can help in a healthy transition from childhood to adulthood and break the intergenerational cycle of malnutrition. Lay summary National and state-level health-priorities focus mainly on improving the nutrition status of under-5-year children, while the school-going children and adolescents are usually neglected. The present secondary data analysis estimates the burden of malnutrition in school-going children and adolescents. These data were collected under one of India's national health programs that intend to tackle childhood illnesses. Our study depicts a high level of undernutrition in school-going children and adolescents. We found that girls were affected more by malnutrition in middle childhood, i.e. during 5–9 years (both by stunting and thinness) compared to boys. But in middle and late adolescence, males were more stunted and thin compared to females. Programs to support adolescents' nutrition interventions could provide an opportunity for a healthy transition from childhood to adulthood and could be an essential step in breaking the intergenerational cycle of malnutrition.

scholarly journals PANDEMIA KORONAWIRUSA - ZMIANA W ŚWIECIE. ZAGROŻENIA DLA ZDROWIA PSYCHICZNEGO I SZANSE ROZWOJOWE

2021 ◽  
pp. 101-113
Author(s):  
Agnieszka Wojtczuk
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Chronic Stress ◽  
Current Situation ◽  
Mental Condition ◽  
Age Group ◽  
Development Opportunity ◽  
The Family

This pandemic may result in another pandemic of chronic stress-related mental disorders. Even before the outbreak of the epidemic, reports on the mental condition of the society were alarming, the current situation may worsen this condition. There is an alarming increase in the incidence of mental disorders among children and adolescents, the number of suicides in this age group is also growing. The article focuses on the causes of the deteriorating mental health of children and adolescents, emphasizes the role of the family and school in the prevention of disorders. It draws attention to the need for systemic changes in the area of helping people in crisis. The article also deals with the issue of psychological resistance and the use of crisis as a development opportunity.

Sibling relationships of children and adolescents with mental disorders–Resource or risk factor?

2020 ◽  
Vol 34 (8) ◽  
pp. 918-926 ◽  
Author(s):  
Sabine Bojanowski ◽  
Emma G. Gotti ◽  
Nora Wanowski ◽  
Joel Nisslein ◽  
Ulrike Lehmkuhl
Keyword(s):  
Risk Factor ◽  
Mental Disorders ◽  
Children And Adolescents ◽  
Sibling Relationships

scholarly journals POS1309 PREVALENCE AND CORRELATES OF UNDERWEIGHT, OVERWEIGHT AND OBESITY AMONG PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA): EVIDENCE FROM THE NATIONAL PAEDIATRIC RHEUMATOLOGIC DATABASE (NPRD)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 936.2-937
Author(s):  
F. Milatz ◽  
J. Klotsche ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
D. Windschall ◽  
...  
Keyword(s):  
Physical Activity ◽  
Juvenile Idiopathic Arthritis ◽  
General Population ◽  
Children And Adolescents ◽  
Treatment Response ◽  
Weight Status ◽  
Overweight And Obesity ◽  
Age Group ◽  
Group 3 ◽  
Obesity In Children

Background:In patients with JIA, growth impairment and variance in body composition are well-known long-term complications that may be associated with prolonged drug therapy (e.g. glucocorticoids) as well as impaired physical and psychosocial well-being. An increased accumulation of body fat represents a significant risk factor for metabolic abnormalities and a modifiable variable for a number of comorbidities. Recently, evidence has emerged in favour of the potential negative influence of overweight on the course of the disease and treatment response [1].Objectives:The study aimed a) to estimate the prevalence of underweight, overweight and obesity in children and adolescents with JIA compared to the general population, and b) to investigate correlates of patients’ weight status.Methods:A cross-sectional analysis of physicians’ recorded body weights and heights of patients with JIA enrolled in the NPRD in the year 2019 was performed. Underweight (BMI <10th), overweight (BMI >90th) and obesity (BMI >97th) were defined according to age- and sex-specific percentiles used in the German reference system. For comparison with data from the general population [2], sex- and age-matched pairs of 3-17-year-old patients and controls were generated. A multinomial logistic regression analysis was performed to examine the association between weight status and patients’ clinical and self-reported outcomes.Results:In total, data from 6.515 children and adolescents with JIA (age 11.2 ± 4.1 years, disease duration 4.9 ± 3.8 years, 67% girls, 40% persistent oligoarthritis) were included. Of these, 3.334 (age 5.9 ± 2.1 years, 52.5% girls) could be considered for matched-pair analysis. Compared with the general population, patients underweight, overweight and obesity rates were 10.6% (vs. 8.1%), 8.8% (vs. 8.5%) and 6.1% (vs. 5.7%), respectively. No significant sex differences were found in either group. Largest difference in prevalence was registered for underweight, specifically in the age group 3-6 years (12.9% patients vs. 5.9% controls). Similar to the general population, higher rates of overweight were observed in adolescent patients than in affected children (19.1% age group 11-13 vs. 8.4% age group 3-6). While the highest underweight prevalence was registered in patients with RF+ polyarthritis (16%), patients with Enthesitis-related arthritis (22%), psoriatic arthritis (21%) and systemic JIA (20%) showed the highest overweight rates (including obesity). Younger age (OR = 0.51, 95% CI = 0.31-0.83), more frequent physical activity (OR = 0.92, 95% CI = 0.85-0.99) and high parental vocational education (OR = 0.39, 95% CI = 0.18-0.80) were independently associated with a lower likelihood of being overweight/obese.Conclusion:The overall prevalence of underweight, overweight and obesity in children and adolescents with JIA is comparable to that found in the general population. Behavioural health promotion, including regular physical activity, as part of the treatment strategy in JIA should preventively already begin at preschool age and necessarily be made accessible to patients of all educational levels.References:[1]Giani T et al. The influence of overweight and obesity on treatment response in juvenile idiopathic arthritis. Front Pharmacol 2019;10:637.[2]Schienkiewitz A et al. BMI among children and adolescents: prevalences and distribution considering underweight and extreme obesity. Bundesgesundheitsbl 2019;62:1225–1234.Acknowledgements:The National Paediatric Rheumatological Database has been funded by AbbVie, Chugai, Novartis and GSK.Disclosure of Interests:Florian Milatz: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Daniel Windschall: None declared, Frank Weller-Heinemann Speakers bureau: Pfizer, AbbVie, SOBI, Roche and Novartis., Frank Dressler: None declared, Rainer Berendes: None declared, Johannes-Peter Haas: None declared, Gerd Horneff: None declared, Kirsten Minden Speakers bureau: Pfizer, AbbVie, Consultant of: Novartis

scholarly journals Nutritional factors associated with femoral neck bone mineral density in children and adolescents

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Guo-Hau Gou ◽  
Feng-Jen Tseng ◽  
Sheng-Hao Wang ◽  
Pao-Ju Chen ◽  
Jia-Fwu Shyu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Femoral Neck ◽  
Children And Adolescents ◽  
Bone Mineral ◽  
Age Group ◽  
Mineral Density ◽  
Nutrient Intakes ◽  
Nutritional Factors ◽  
Daily Total

Abstract Background Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents. Methods Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD. Results Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 ×  10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification. Conclusion The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.

Prospects for the classification of mental disorders of children and adolescents

2008 ◽  
Vol 23 (7) ◽  
pp. 481-485 ◽  
Author(s):  
M.H. Schmidt ◽  
J. Sinzig
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Classification Systems ◽  
General Question ◽  
Specific Information ◽  
Specific Symptom ◽  
Trade Offs ◽  
Dimensional Classification ◽  
Dsm V

AbstractSuggestions for classification of mental disorders of children and adolescents in DSM-V and ICD-11 have been made, which differ strongly from the current descriptive approach of dimensional classification.These suggestions even comprise a dichotomized system for health care as well as for scientific purposes.Nevertheless it is obvious that we are far behind an “etiological” classification, so that trade-offs have necessarily to be made in DSM-V and ICD-11.Appropriate proposals concern the strict separation of disorders that are typical for children and adolescents as well as for adults.Furthermore a differentiation of diagnosis for infants, toddlers and preschool children is required in both classification systems. As far as it is relevant for treatment, combined diagnosis in DSM-V and subthreshold diagnosis as well as coding-possibilities for findings in molecular biology should be permitted.As personality disorders should only be diagnosed after the age of 16, it is recommended to dimensionally classify personality traits that are pathognomonic for specific symptom patterns and of prognostic relevance.DSM-V and ICD-11 should allow age-specific information on axis-IV. The article discusses the general question of how relational disorders respectively disturbances should be classified and include furthermore special recommendations concerning ICD and DSM categories.

scholarly journals TERT rs2736100 and TERC rs16847897 genotypes moderate the association between internalizing mental disorders and accelerated telomere length attrition among HIV+ children and adolescents in Uganda

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Allan Kalungi ◽  
Eugene Kinyanda ◽  
Jacqueline S. Womersley ◽  
Moses L. Joloba ◽  
Wilber Ssembajjwe ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Telomere Length ◽  
Cellular Aging ◽  
Nucleotide Polymorphisms ◽  
Moderating Effects ◽  
Post Traumatic Stress ◽  
Single Nucleotide ◽  
Post Traumatic ◽  
Component Gene

Abstract Background Internalizing mental disorders (IMDs) (depression, anxiety and post-traumatic stress disorder) have been associated with accelerated telomere length (TL) attrition; however, this association has not been investigated in the context of genetic variation that has been found to influence TL. We have previously reported an association between IMDs and accelerated TL attrition among Ugandan HIV+ children and adolescents. This study investigated the moderating effects of selected single nucleotide polymorphisms in the telomerase reverse transcriptase gene (TERT) (rs2736100, rs7726159, rs10069690 and rs2853669) and the telomerase RNA component gene (TERC) (rs12696304, rs16847897 and rs10936599) on the association between IMDs and TL, among Ugandan HIV+ children (aged 5–11 years) and adolescents (aged 12–17 years). Results We found no significant interaction between IMDs as a group and any of the selected SNPs on TL at baseline. We observed significant interactions of IMDs with TERT rs2736100 (p = 0.007) and TERC rs16847897 (p = 0.012), respectively, on TL at 12 months. Conclusions TERT rs2736100 and TERC rs16847897 moderate the association between IMDs and TL among Ugandan HIV+ children and adolescents at 12 months. Understanding the nature of this association may shed light on the pathophysiological mechanisms underlying advanced cellular aging in IMDs.

The Occurrence of High Levels of Acute Behavioral Distress in Children and Adolescents Undergoing Routine Venipunctures

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 87-91 ◽  
Author(s):  
G. Bennett Humphrey ◽  
Chris M. J. Boon ◽  
G. F. E. Chiquit van Linden van den Heuvell ◽  
Harry B. M. van de Wiel
Keyword(s):  
Children And Adolescents ◽  
Age Group ◽  
Loss Of Control ◽  
Strong Relation ◽  
And Gender ◽  
Trained Observers ◽  
Distress Scale ◽  
Insight Into

While there is no question that children dislike needles, there are very little data available on the occurrence of high levels of distress experienced by children undergoing routine venipunctures. To provide some insight into this problem, trained observers evaluated distress in 223 different children and adolescents undergoing this procedure. An observational distress scale of 1 to 5 was developed; 1 = calm, 2 = timid/nervous, 3 = serious distress, but still under control, 4 = serious distress with loss of control, and 5 = panic. We observed a strong relation between distress and age but not between distress and gender. During the actual venipuncture. half the subjects (113/223) were scored as having high levels of distress (3 or more). Our subjects were also grouped into three age ranges: toddlers; 2½ to 6 years, N = 70; preadolescents; 7 to 12 years, N = 55; and adolescents; 12 years and older, N = 98. The percent of subjects experiencing high levels of distress for each age group were: 83%, 51%, and 28%, respectively. We conclude that for venipunctures: 1) high levels of distress are common, and 2) age and not gender correlates with distress. Other correlations are discussed. Toddlers and pre-adolescents should be the targets for new interventions to reduce distress.

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