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International Journal of Child Health and Nutrition

The Relative Value of Measures of Omega-3 Index, Perceived Stress, Cortisol and Sleep Time in Identifying Depression Among a Cohort of Australian Adolescents
Pages 40-49
Ross Grant, Ayse Bilgin, Jade Guest, Margaret J. Morris, Manohar Garg and Robyn Pearce

DOI: http://dx.doi.org/10.6000/1929-4247.2015.04.01.4

Published: 26 February 2015


Abstract: Objective: To assess the relative prognostic value of 11 variables including, omega-3, perceived stress, cortisol and sleep duration, in predicting adolescent depression.

Design, Setting and Participants: A cross-sectional study of 444 healthy adolescents aged 16-18 years, from 10 schools within the Northern Sydney and Central Coast regions of New South Wales, Australia. Participants provided blood and saliva samples and completed questionnaires. Statistical classification methods were used to model the relationships between the predictors and depression.

Main Outcome Measures: relative predictive value of each variable in correctly classifying depression.

Results: 6% of boys and 9% of girls were categorised as experiencing severe to extremely severe depression. 4% of boys and 10% of girls were categorised as experiencing severe to extremely severe stress. The mean AM:PM cortisol for boys, 22±101, was higher than that of girls, 11±10. The average omega-3 index for boys, 10.5±3.7, was also higher than that of girls, 7.7±2.6. The average sleep duration of 7.8±1.1 hrs showed no gender differences.

The best classification model identified perceived stress as the most significant predictor of depression followed by BMI and omega-3 index. Cortisol ratio was a significant discriminator for boys but not girls. When stress was excluded, shorter sleep duration became a significant discriminator in both boys and girls with waist to hip ratio providing further discrimination in girls only.

Conclusion: The strongest predictor of depression in adolescents was perceived stress followed by higher BMI and lower omega-3 levels. These findings provide a rational basis for establishing program priorities for the prevention and treatment of adolescent depression.

Keywords: Child, depression, adolescent, omega-3, sleep, BMI, cortisol.

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International Journal of Child Health and Nutrition

Maternal Employment, Child’s Caring Practices and Nutritional Status in Northern Ghana
Pages 54-60
Sixtus Aguree, Juventus B. Ziem, Amos Issah, Theophilus Akrugu and Ali Joseph

DOI: http://dx.doi.org/10.6000/1929-4247.2015.04.01.6

Published: 26 February 2015

 


Abstract: Mothers as caregivers exert strong influence over child feeding and caring practices. Maternal employment may influence child caring practices thus affecting the child’s nutritional status. The purpose of this study was to examine the effect of maternal employment status, on child caring practices and the nutritional status of children under-5 in Savelugu, Northern Ghana. This was a cross-sectional survey involving 400 mothers and their children under-5 years old. Data collection took place between February and May, 2013 through a house-to-house visit using a structured questionnaire designed for the study. Information collected included employment status, occupation type and mothers working hours away from home, feeding and caring practices and anthropometric measurements of their children. About 85.8% of respondents were employed. Together farmers and traders made approximately 76% of the respondents. Approximately 55% of Mothers had at least primary education. Around 85.1% of the employed mothers look after their children whiles carrying out their daily work. Employed mothers spent between 5 to 6 hours/day away from home without their children but unemployed mothers were mostly with their children. Occupation status has a significant effect on child caring practices with those unemployed being better (P<0.05). About 72.0% and 70.3% respectively of unemployed and employed mothers indicated they introduced complementary feeding at 6months. Child caring practices were better among unemployed mothers compared to employed mothers among the study population. Stunting and wasting rates were high among children of both employed and unemployed mothers.

Keywords: Stunting, northern Ghana, maternal employment, and feeding practices.

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International Journal of Child Health and Nutrition

Assessment of Nutritional Status Based on STRONGkids Tool in Iranian Hospitalized Children
Pages 61-66
Zahra Gholampour, Mina Hosseininasab, Gholamreza Khademi, Majid Sezavar, Nooshin Abdollahpour and Bahareh Imani

DOI: http://dx.doi.org/10.6000/1929-4247.2015.04.01.7

Published: 26 February 2015

 


Abstract: Background & Objective: Malnutrition is very common in hospitalized children and is associated with related clinical consequences such as increased risk of infections, increased muscle loss, impaired wound healing, longer hospital stay and higher morbidity and mortality. The estimated prevalence of acute malnutrition in hospitalized children varies from 6.1 to 40.9% in different countries. The current study was conducted with the aim of evaluating the efficiency of STRONGkids (Screening Tool for Risk On Nutritional Status and Growth) tool for assessing malnutrition in hospitalized children in Iran.

Methods: All children older than 28 days admitted to the pediatric hospital (Dr. Sheikh, Mashhad, Iran) were enrolled in this study and the screening tool named STRONGkids was applied for them. The anthropometric measurements were measured by a trained operator using standard methods and equipments. The children were classified in three groups of being at high risk, moderate risk and low risk of malnutrition.

Results: According to STRONGkids score; 17% of children were classified as low risk, 75% as moderate risk and 8% as high risk group. According to WFH, HFA and WFA z-scores31.4%, 19.2% and 28% of children were identified as moderately and severely malnourished respectively. According to MUAC cut-offs, 3.4% of children were classified as having moderate malnutrition and there was no child with severe malnutrition.

Conclusion: It is very important to recognize the nutritional status of the children as early as possible because of its effects on children’s growth. Therefore, evaluating the nutritional status of the hospitalized children is an essential step in clinical assessment. We suggest to apply the STRONGkids score aside with other clinical and anthropometric data.

Keywords: Nutritional screening, Hospitalized children, Iran, STRONGkids.

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International Journal of Child Health and Nutrition

Eating Disorders: Assessment of Knowledge on a Dentist’s Sample
Pages 50-53
Aurea Lumbau, Giovanni Spano, Silvio Mario Meloni, Francesca Sanna and Pietrina Francesca Lugliè

DOI: http://dx.doi.org/10.6000/1929-4247.2015.04.01.5

Published: 26 February 2015

 


Abstract:  Aim: To analyze the knowledge and experience of dentists with private practices in the Sassari district with regard to eating disorders and clinical stomatology manifestations.

Methods: A questionnaire to investigate dentists’ knowledge and experience was created and submitted to a random sample of dentists. Data were collected and analysed using the Stata SE 10 software.

Results: In total, 150 dentists were enrolled (a representative sample). After questionnaire evaluation, the following results were obtained: 80.7% (121) of the participants had a degree in dentistry and 19.3% (29) had degrees in medicine with a dentistry master of science diploma, 46% (69) were males and 54% (81) were females, their age range was 25-62 (mean, 36.1) years, and the average work experience was 11.5 (range, 1-36) years. More than 90% of the participants defined eating disorders only as bulimia and anorexia.

Of the dentists, 77.3% (116) correctly identified Western populations as the most affected, whereas 52.7% identified only whites as the most affected people. In total, 80% of the dentists recognised dental erosion and abrasion as typical oral manifestations. Only 62% stated that salivary pH decreases in these conditions, and 63% did not recognise parotid gland tumefaction as a clinical sign.

Regarding operator experience, 60.7% (91 dentists) had clinical experience of patients with eating disorders: 43.9% of them had made diagnoses from oral manifestations, 51.3% (77) were not able to treat these patients, and 69.3% (104) would refer patients to specialized centres for treatment. Moreover, 119 (79.3%) considered that a dental hygienist was a valid collaborator for the treatment of oral cavity manifestations.

Regarding prophylaxis, 16.7% (25) suggested fluoride prophylaxis and 21.3% (32) oral hygiene education. Only 1.3% indicated the use of bicarbonate to change salivary pH values, suggested conservative or prosthetic restorations, suggested the use of saliva substitutes, or the sealing of permanent teeth.

Difficulties in clinically treating these patients were related to a lack of knowledge for 72% (108) of participants. Of them, 36.7% (55) had studied the clinical aspects of this pathology while attending dental school and 24.7% (37) after their degree. In total, 94.7% (142) expressed the need for further information and only 2% (3) considered they had sufficient clinical knowledge.

Conclusions: It is evident that there is a lack of knowledge regarding the problem and there would seem to be an urgent need to provide more training programs and to establish guidelines for the diagnosis and treatment of eating disorders among dentists. In our opinion, the acquisition of such knowledge will change the approach to related pathology, improving clinical skills, and subsequently diagnosis and treatment.

Keywords: Eating disorders, dentists, oral manifestations, knoledge, oral pathology.

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