Sleep-related difficulties in healthy children and adolescents

Abstract Background As sleep-related difficulties are a growing public health concern, it is important to gain an overview of the specific difficulty areas of the most vulnerable individuals: children. The current descriptive study presents the prevalence of sleep-related difficulties in two large samples of healthy children and adolescents and outlines the effects of age, gender, and socioeconomic status (SES) on various sleep-related difficulties. Methods Participants were 855 4–9 year-old children (child sample) and 1,047 10–17 year-old adolescents (adolescent sample) participating 2011–2015 in the LIFE Child study, a population-based cohort study in Germany. Parents of the child participants completed the Children’s Sleep Habits Questionnaire (CSHQ), whereas adolescents self-administered the Sleep Self Report (SSR). Familial SES was determined by a composite score considering parental education, occupational status, and income. Multiple regression analyses were carried out to address the research question. Results Among 4−9 year-old children, the mean bedtime was reported to be 8 p.m., the mean wake-up time 7 a.m., and sleep duration decreased by 14 min/year of age. 22.6 % of the children and 20.0 % of the adolescents showed problematic amounts of sleep-related difficulties. In the child sample, bedtime resistance, sleep onset delay, sleep-related anxiety, night waking, and parasomnia were more frequent in younger than older children. In the adolescent sample, difficulties at bedtime were more frequent among the younger adolescents, whereas daytime sleepiness was more prominent in the older than the younger adolescents. Considering gender differences, sleep-related difficulties were more frequent among boys in the child sample and among girls in the adolescent sample. Lower SES was associated with increased sleep-related difficulties in the adolescent, but not the child sample. Conclusions The present results report sleep-related difficulties throughout both childhood and adolescence. Gender differences can already be observed in early childhood, while effects of SES emerge only later in adolescence. The awareness for this circumstance is of great importance for pediatric clinicians who ought to early identify sleep-related difficulties in particularly vulnerable individuals.

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Foot Arch Posture Development in Children and Adolescents aged 6 to 19 Years: A Cross-sectional Descriptive Study

10.21203/rs.3.rs-121786/v1 ◽

2020 ◽

Author(s):

Yousef Mahmoudzadeh ◽

Roghayyeh Alipour

Keyword(s):

Children And Adolescents ◽

Normative Values ◽

Childhood And Adolescence ◽

Healthy Children ◽

Arch Height ◽

Cross Sectional ◽

Foot Length ◽

Foot Posture ◽

Foot Arch ◽

The Mean

Abstract Background: The arch height index (AHI) is a commonly used method for measuring foot arch posture. However, there are little studies have investigated the natural growth and normative values of the foot arch using the AHI. The objective of this study was to establish normative and cut-off values for foot arch posture and to identify factors influencing foot arch posture across childhood and adolescence. Methods: In this cross-sectional study, a sample of 3532 healthy children and adolescents (1804 boys, 1728 girls; aged 6 to 19 years) was recruited for the navicular height (NH) and AHI measurements and anthropometry assessment (weight, height, BMI and foot length). Data were explored descriptively and graphically, comparisons between groups used t-tests or ANOVA model as appropriate and a multiple regressions was conducted. The 95% and 68% prediction intervals were used as cut-off values. Results : approximately 69% had a normal AHI range, 12% low arched foot, 3% severely low arched, 14% high arched and 1.8% severely high arched foot. The mean (SD) AHI was 15.16 (2.61). Very little gender bias was found for AHI values, being higher in males 15.32 (2.54) than in females 15.0 (2.68) ( p = .019). Regression showed approximately 3%, 0.3% and 2% of the AHI change was explained by age, BMI and foot length, respectively. The mean NH significantly increased from the age of 6 (2.62 cm) to 19 (4.20 cm). Conclusions: This study confirms that the ‘flexible flatfoot’ or low arched foot decreases with age. Simultaneously, increase of high arched foot type and shift in foot posture towards more normal foot type are also confirmed. BMI does not seem to be an important determinant of children foot arch posture. Keywords: Foot posture, Navicular height, Arch height index, Normative values, Medial longitudinal arch, Foot arch development, Children, Adolescents

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Abstract 170: Re-evaluation of Carotid Intima-Media Thickness by Z-score in Children and Adolescents After Kawasaki Disease

Circulation ◽

10.1161/circ.131.suppl_2.170 ◽

2015 ◽

Vol 131 (suppl_2) ◽

Author(s):

Nobutaka Noto ◽

Masataka Kato ◽

Yuriko Abe ◽

Hiroshi Kamiyama ◽

Kensuke Karasawa ◽

...

Keyword(s):

Kawasaki Disease ◽

Children And Adolescents ◽

Reference Values ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Specific Reference ◽

Healthy Children ◽

Media Thickness ◽

Z Scores ◽

The Mean

Objectives: The carotid intima-media thickness (CIMT) is a reliable screening method for vascular alterations even in a pediatric cohort; however, reference values of CIMT established recently by LMS methods for childhood and adolescence are limited when comparing patients after Kawasaki disease (KD) and controls. We tested the hypothesis that there are significant differences between the values of CIMT expressed as absolute values and z-scores in children and adolescents after KD and controls. Methods: We reviewed 12 published articles regarding CIMT on patients after KD and controls. Absolute values (Ab) of the mean±1 SD of CIMT in patients after KD and controls were transformed to z-scores (Zs) using age-specific reference values established by Jourdan et al. (J: 247 Caucasian subjects aged 10-20 years) and our own data (O: 175 Asian subjects aged 6-20 years), and the results were compared between the two references. In this study, the mean age of the study population derived from each article was designated the representative age for transformation. Results: In either reference (J) or (O), there was no significant sex difference in CIMT at any given age. The mean CIMT of (Ab) and (Zs) transformed by (J) or (O) were significantly different between patients after KD and controls, at 41.6% (Ab), 66.6% (Zs) by (J), and 83.3% (Zs) by (O) among 12 articles, respectively. Therefore, patients after KD had significantly higher (Zs) by (O) than those of controls (0.66±0.71 vs. 0.03±0.68, p=0.006, respectively). Compared with reference values, the controls of (O) were within the normal range. However, there were no significant differences in (Zs) by (J) between the two groups (1.72±0.77 vs. 1.23±0.83, p=0.116, respectively). When we assessed 9 articles dealing with Asian subjects, the difference of (Zs) between the two groups remained significant only by (O) (p=0.015). In contrast, when we assessed 3 articles dealing with mainly Caucasian subjects, there was no significant difference in (Zs) between the two groups with both (J) and (O). Conclusions: These results indicate that age and race-specific reference values for CIMT are mandatory for performing an accurate assessment of the vascular status in healthy children and adolescents and particularly in those after KD.

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Age and sex relationship with flow-mediated dilation in healthy children and adolescents

Journal of Applied Physiology ◽

10.1152/japplphysiol.01113.2014 ◽

2015 ◽

Vol 119 (8) ◽

pp. 926-933 ◽

Cited By ~ 7

Author(s):

Nicola D. Hopkins ◽

Donald R. Dengel ◽

Gareth Stratton ◽

Aaron S. Kelly ◽

Julia Steinberger ◽

...

Keyword(s):

Sex Differences ◽

Children And Adolescents ◽

Brachial Artery ◽

Vascular Function ◽

Growth Patterns ◽

Childhood And Adolescence ◽

Flow Mediated Dilation ◽

Healthy Children ◽

Asymptomatic Children ◽

Age And Sex

Flow-mediated dilation (FMD) is a noninvasive technique used to measure conduit artery vascular function. Limited information is available on normative FMD values in healthy children and adolescents. The objective of this study was to assess relationships between age and sex with FMD across childhood and adolescence. Nine hundred and seventy-eight asymptomatic children (12 ± 3 yr, range 6–18 yr, 530 male) underwent ultrasonic brachial artery assessment before and after 5 min of forearm ischemia. Sex differences in FMD and baseline artery diameter were assessed using mixed linear models. Baseline artery diameter was smaller in females than males [2.96 mm (95% CI: 2.92–3.00) vs. 3.24 mm (3.19–3.28), P < 0.001] and increased with age across the cohort ( P < 0.001). Diameter increased between ages 6 and 17 yr in males [from 2.81 mm (2.63, 3.00) to 3.91 mm (3.68, 4.14)] but plateaued at age 12 yr in females. Males had a lower FMD [7.62% (7.33–7.91) vs. 8.31% (7.95–8.66), P = 0.024], specifically at ages 17 and 18 yr. There was a significant effect of age on FMD ( P = 0.023), with a reduction in FMD apparent postpuberty in males. In conclusion, the brachial artery increases structurally with age in both sexes; however, there are sex differences in the timing and rate of growth, in line with typical sex-specific adolescent growth patterns. Males have a lower FMD than females, and FMD appears to decline with age; however, these findings are driven by reductions in FMD as males near maturity. The use of age- and sex-specific FMD data may therefore not be pertinent in childhood and adolescence.

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PERCEIVED PARENTING STYLES AND SCHOOL ANXIETY IN PREADOLESCENTS

CBU International Conference Proceedings ◽

10.12955/cbup.v4.801 ◽

2016 ◽

Vol 4 ◽

pp. 483-488

Author(s):

Simona Butnaru

Keyword(s):

Gender Differences ◽

Parenting Styles ◽

Rural Areas ◽

Parental Education ◽

School Failure ◽

Self Report ◽

Social Evaluation ◽

Perceived Parenting ◽

School Anxiety ◽

The Relationship

The goal of this study was to test the relationship between perceived authoritative, authoritarian and permissive parenting styles and school anxiety (anxiety about aggression, about social evaluation and about school failure). A Romanian sample of 182 students (93 girls), enrolled in 5th to 8th grade in two secondary schools from rural areas, completed self-report measures assessing school anxiety and perception of parenting styles. Results indicated a predominance of authoritative parenting style and a moderate level of school anxiety. The highest mean score in school anxiety was in school failure. Gender differences were found in school anxiety, but not in parenting styles. Grade level differences were found in anxiety about school failure and in perceived parenting styles. Preadolescents whose parents expressed prevailing authoritarian and permissive styles had higher levels of school anxiety. Gender differences were found for the relationship between parenting styles and school anxiety. Implications of results in parental education field are discussed.

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Rates of physical development as a marker of the quality of metabolic control in children and adolescents with diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl12181 ◽

1994 ◽

Vol 40 (6) ◽

pp. 10-12

Author(s):

N. B. Lebedev

Keyword(s):

Diabetes Mellitus ◽

Growth Rate ◽

Children And Adolescents ◽

Insulin Dependent Diabetes Mellitus ◽

Physical Development ◽

Dependent Diabetes Mellitus ◽

Childhood And Adolescence ◽

Insulin Dependent ◽

The Mean

Physical development of 710 children and adolescents with insulin-dependent diabetes mellitus (IDDM) was studied over time. The patients were divided into 3 groups: with growth rate above the 25th percentile of the age norm, with growth rate below the 10th percentile of the norm, and with growth rales between the 10th and 25th percentiles of age norm. Analysis showed that (a) the presence of manifest decompensation higher than 12 %, frequent ketoacidosis episodes is a factor of high risk of reduction of physical development rate in children and adolescents with IDDM; (b) the mean statistical rates of diabetic adolescents growth are characterized by delayed (by 1 to 2 years vs. the norm) pubertal growth skip, and this growth skip in the patients is more levelled and stretched in time, and in some cases is virtually nor manifest; (c) if good compensation is attained and maintained after previous prolonged decompensation, compensating growth rates may develop in patients of both sexes both in childhood and adolescence.

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Vitamin D Status and Its Determinants in a Paediatric Population in Norway

Nutrients ◽

10.3390/nu12051385 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1385

Author(s):

Mads N Holten-Andersen ◽

Johanne Haugen ◽

Ingvild Oma ◽

Tor A Strand

Keyword(s):

Vitamin D ◽

Seasonal Variation ◽

Children And Adolescents ◽

Parental Education ◽

Sun Exposure ◽

Late Summer ◽

Paediatric Population ◽

Vitamin D Supplementation ◽

Healthy Children ◽

Vitamin D Levels

Recommendations for sufficient vitamin D intake in children were recently revised in Norway. However, optimal levels of vitamin D are still debated and knowledge on supplementation and vitamin D levels in healthy children in Norway is scarce. Therefore, we measured the plasma-concentration of 25-hydroxyvitamin D (25(OH)D) in children and adolescents attending the outpatient paediatric clinics in Innlandet Hospital Trust, Norway during two consecutive years (2015–2017). We recruited 301 children and adolescents aged 5 months to 18 years (mean 7.8, SD 4.4 years) for the study and obtained sample material for 25(OH)D measurements from 295 (98%). Information on diet, vitamin D supplementation, sun exposure, ethnicity, parental education and general health was collected by questionnaire. 25(OH)D levels were analysed and determinants for 25(OH)D were estimated by linear regression. 1.0% of the children had deficient levels (25(OH)D < 25 nmol/L) and 21.0% had insufficient levels (25–50 nmol/L). 25(OH)D levels ranging from 50 to 75 nmol/L were found among 38.3%, while 39.7% had levels above 75 nmol/L. The mean 25(OH)D level was 70.0 nmol/L (SD 23.4, range 17–142 nmol/L) with a significant seasonal variation with lowest levels in mid-winter and highest in late summer. In addition to seasonal variation independent determinants for 25(OH)D-levels were age of the child, parental ethnicity, vitamin D supplementation and soda consumption. Along with parental ethnicity other than Nordic, age was the strongest determinant of 25(OH)D, with adolescents having the lowest levels.

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Internalizing Problems in Children and Adolescents With Math Disability

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000207 ◽

2015 ◽

Vol 223 (2) ◽

pp. 93-101 ◽

Cited By ~ 3

Author(s):

Johanna Graefen ◽

Juliane Kohn ◽

Anne Wyschkon ◽

Günter Esser

Keyword(s):

Gender Differences ◽

Learning Disabilities ◽

Children And Adolescents ◽

Internalizing Problems ◽

Internalizing Symptoms ◽

Math Achievement ◽

Self Report ◽

Math Disability ◽

Internalizing Symptomatology ◽

Internalizing Problem

Research has shown that learning disabilities are associated with internalizing problems in (pre)adolescents. In order to examine this relationship for math disability (MD), math achievement and internalizing problem scores were measured in a representative group of 1,436 (pre)adolescents. MD was defined by a discrepancy between math achievement and IQ. Internalizing problems were measured through a multi-informant (parents, teachers, self-report) approach. The results revealed that MD puts (pre)adolescents at a higher risk for internalizing problems. External and self-ratings differed between boys and girls, indicating that either they show distinct internalizing symptoms or they are being perceived differently by parents and teachers. Results emphasize the importance of both a multi-informant approach and the consideration of gender differences when measuring internalizing symptomatology of children with MD. For an optimal treatment of MD, depressive and anxious symptoms need to be considered.

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GROWTH OF THE HEART RELATED TO BODILY GROWTH DURING CHILDHOOD AND ADOLESCENCE

PEDIATRICS ◽

10.1542/peds.2.4.382 ◽

1948 ◽

Vol 2 (4) ◽

pp. 382-404

Author(s):

MARION M. MARESH

Keyword(s):

Internal Diameter ◽

Childhood And Adolescence ◽

Transverse Diameter ◽

Healthy Children ◽

Mean Values ◽

Wide Range ◽

The Mean ◽

The Individual ◽

Range Of Variation ◽

Medium Weight

As part of a longitudinal study of healthy children by the staff of the Child Research Council, roentgenograms of the chest have been made at frequent intervals. Three cardiac diameters (transverse, long, and broad) and the internal diameter of the chest were measured on each of 3205 of these roentgenograms, taken of 128 subjects over a period of years. The size and shape of the heart are illustrated and discussed with emphasis on the range of variation that is seen in healthy individuals and on the inadequacy of one set of "normal standards" for evaluating the cardiac silhouette. In spite of fluctuations in the growth curves for the cardiac diameters, a general pattern of agreement was found in the increases in the cardiac diameters and the increases in body height and weight during childhood and adolescence. It would seem that periods of rapid growth such as are usually seen in adolescence are frequently coincident with fairly rapid increases in the cardiac diameters, suggesting that cardiac demands are greater during such growth spurts. The mean values for transverse diameter of the heart showed the same type of sex differentiation that is found in the mean values for height and weight in boys and girls. It seems logical to assume that changing cardiac size should be considered as part of the growth process rather than as an isolated physical and physiologic process. The relations that seem apparent between transverse diameter of the heart and height, weight, and internal diameter of the chest could not be proved statistically by calculated coefficients of correlation. However, it was possible to show differences in the mean values for cardiac transverse diameter in three groups, classified as to height-weight relationships into overweight, medium-weight, and underweight individuals. The mean values were greatest for the fat group, least for the thin group and intermediate for the group that was of medium weight for height. Body build may therefore be a factor in determining cardiac size during childhood as well as during adolescence and adult life. Since the width of the chest is increasing during childhood and adolescence in much the same manner that the transverse diameter of the heart is increasing, cardiothoracic ratios do not become progressively greater with advancing age. In fact, the successive ratios on the same individual show little regularity toward either increase or decrease although mean values for the different ages do decrease from a high of 0.44 at four years of age to a low of 0.40 in the post-adolescent age groups. Each individual showed considerable fluctuation in the cardio-thoracic ratios but no one person fluctuated as much as the range for the whole group. No ratios were found above 0.50 or below 0.32. No sex differences were found nor was there any significant difference in the cardio-thoracic ratios for the groups of different height-weight proportions. In evaluating the heart size of an individual from a single film, the cardio-thoracic ratio is probably as satisfactory as any other measurement if one recognizes the wide range of healthy variation. An increase in the cardio-thoracic ratio on successive roentgenograms might be more significant clinically than cardiac measurements which did not take into consideration the growth of the individual. The nomogram constructed by Ungerleider based on height and weight for prediction of transverse diameter of the heart on teleoroentgenograms of adults was tested for its applicability to the later childhood, adolescent and early adult periods. Nearly half the predicted cardiac transverse diameters exceeded the measured values by 10% or more. This study would seem to indicate, therefore, that one should not be discouraged by the range of variation or the fluctuations in cardiac measurements from routine roentgenograms of the chest. Valuable information regarding the significance of the size of the heart can be obtained from such roentgenograms if one relates those data to the basic process of growth and maturation of the individual.

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Gender differences in the relationship between cognition and corpus callosum in healthy children and adolescents

NeuroImage ◽

10.1016/s1053-8119(01)91727-6 ◽

2001 ◽

Vol 13 (6) ◽

pp. 384 ◽

Cited By ~ 1

Author(s):

Jonathan Blumenthal ◽

Elizabeth Molloy ◽

Hong Liu ◽

Neal O. Jeffries ◽

A. Zijdenbos ◽

...

Keyword(s):

Gender Differences ◽

Corpus Callosum ◽

Children And Adolescents ◽

Healthy Children ◽

The Relationship

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Health-related quality of life in children and adolescents with cerebral palsy

Slovenian Journal of Public Health ◽

10.1515/sjph-2017-0001 ◽

2017 ◽

Vol 56 (1) ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Anja Radsel ◽

Damjan Osredkar ◽

David Neubauer

Keyword(s):

Quality Of Life ◽

Cerebral Palsy ◽

Children And Adolescents ◽

Social Inclusion ◽

Self Report ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Mean

Abstract Introduction In a cross-sectional cohort study, health-related quality of life of Slovenian children and adolescents with cerebral palsy was examined, and factors associated with it have been identified. Methods Caregivers of 122 children and adolescents with cerebral palsy were addressed to fill out proxy versions of HRQoL questionnaires (DISABKIDS generic and cerebral palsy module). Children and adolescents without cognitive deficit were asked to fill out the self-report versions. Results Ninety-one families of 43 children (the mean age is 10 years, 6 months, SD 1.2; 26 males and 17 females) and 48 adolescents (the mean age is 14 years, SD 0.9; 23 males and 25 females) completed proxyreports. Forty-eight individuals were able to self-report (26 children and 22 adolescents). Health-related quality of life was perceived as good. Self-reporting participants scored higher than their caregivers (mean score 75.6, SD 15.9 versus mean 72.3, SD 17.9; p=0.048). Adolescents scored lower than children in all domains (mean score 69.4, SD 19.4 versus mean 80.8, SD 10.0; p=0.01). Higher age (p<0.001), pain (p<0.001) and disturbed sleep (p=0.002) were strong predictors of worse health-related quality of life. Social Inclusion and Independence domains received the lowest scores. Conclusions Slovenian children and adolescents with cerebral palsy have a good health-related quality of life, with Social Inclusion and Independence being the weakest domains. Children reported higher scores than adolescents or their caretakers. Pain was the strongest predictor of poor health-related quality of life.

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