The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Nocturnal enuresis is an important problem among young children living in Turkey. The purpose of this study was to determine the possible differences in the prevalence of enuresis between children in boarding school and daytime school and the association of enuresis with sociodemographic factors.</p> <p>Methods</p> <p>This was a cross-sectional survey. A total of 562 self-administered questionnaires were distrubuted to parents from two different types of schools. One of them was a day-time school and the other was a boarding school. To describe enuresis the ICD-10 definition of at least one wet night per month for three consecutive months was used. Chi-square test and a logistic regression model was used to identify significant predictive factors for enuresis.</p> <p>Results</p> <p>The overall prevalence of nocturnal enuresis was 14.9%. The prevalence of nocturnal enuresis declined with age. Of the 6 year old children 33.3% still wetted their beds, while the ratio was 2.6% for 15 years-olds. There was no significant difference in prevalence of nocturnal enuresis between boys and girls (14.3% versus 16. 8%). Enuresis was reported as 18.5% among children attending day time school and among those 11.5% attending boarding school (p < 0.05). Prevalence of enuresis was increased in children living in villages, with low income and with positive family history (p < 0.05). After multivariate analysis, history of urinary tract infection (OR = 2.02), age (OR = 1.28), low monthly income (OR = 2.86) and family history of enuresis (OR = 3.64) were factors associated with enuresis. 46.4% of parents and 57.1% of enuretic children were significantly concerned about the impact of enuresis.</p> <p>Conclusion</p> <p>Enuresis was more frequent among children attending daytime school when compared to boarding school. Our findings suggest that nocturnal enuresis is a common problem among school children, especially with low income, smaller age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative.</p

Gene-Gene and Gene-Environmental Interactions of Childhood Asthma: A Multifactor Dimension Reduction Approach

Background: The importance of gene-gene and gene-environment interactions on asthma is well documented in literature, but a systematic analysis on the interaction between various genetic and environmental factors is still lacking. Methodology/Principal Findings: We conducted a population-based, case-control study comprised of seventh-grade children from 14 Taiwanese communities. A total of 235 asthmatic cases and 1,310 non-asthmatic controls were selected for DNA collection and genotyping. We examined the gene-gene and gene-environment interactions between 17 singlenucleotide polymorphisms in antioxidative, inflammatory and obesity-related genes, and childhood asthma. Environmental exposures and disease status were obtained from parental questionnaires. The model-free and non-parametrical multifactor dimensionality reduction (MDR) method was used for the analysis. A three-way gene-gene interaction was elucidated between the gene coding glutathione S-transferase P (GSTP1), the gene coding interleukin-4 receptor alpha chain (IL4Ra) and the gene coding insulin induced gene 2 (INSIG2) on the risk of lifetime asthma. The testing-balanced accuracy on asthma was 57.83 % with a cross-validation consistency of 10 out of 10. The interaction of preterm birth and indoor dampness had the highest training-balanced accuracy at 59.09%. Indoor dampness also interacted with many genes, including IL13, beta-2 adrenergic receptor (ADRB2), signal transducer and activator of transcription 6 (STAT6). We also used likelihood ratio tests for interaction and chi-square tests to validate our results and all tests showed statistical significance

Lichamelijke beperkingen en andere gezondheidsproblemen bij kinderen in het speciaal onderwijs in vergelijking met het regulier onderwijs [Physical limitation and other health problems in children who go to schools for special education compared with mainstream education]

Many children with developmental problems, especially with problems in cognition or in social and emotional functioning, go to schools for special education. Whether pupils in special education have more physical limitations, handicaps and other health problems than pupils in mainstream education has not been documented recently. Therefore, child health doctors and nurses collected data regarding limitations on 2630 children in special education and on 5515 children in mainstream education, in the age-range 4-15. Results show that the prevalence of 'serious physical limitations', for example in speaking or walking, is higher in children in special education than in children in mainstream education (20.0 and 4.1%, respectively) and that the same applies for 'any physical limitation' (49.3 and 19.8%, respectively). These limitations frequently interfere with daily life and children in special education experience significantly more handicaps too. Moreover, they have other health problems more frequently, and have a higher use of health care. We conclude that the need for medical care of children in special education is great. Healthcare providers, especially in paediatrics, will have relatively many of these children among their patients but should also realise that many of these children will not seek a paediatric diagnosis and treatment. The studies as described have been performed some years ago. It can be expected that the health problems among pupils in special educations have increased since then, because current policies aim at the integration of children with developmental problems in mainstream education. Therefore, morbidity is likely to increase among those remaining in special education, but paradoxically also in mainstream education

Childhood nocturnal enuresis in the Netherlands

Objectives. To assess the prevalence of nocturnal enuresis in school children aged 5 to 15 years, and to investigate the association of bedwetting with ethnicity, the educational level of the parents, and the type of education (mainstream or special) received by the child. Methods. Data were obtained for 5360 children in mainstream education and 2571 children in special education. The data were weighted to calculate estimates representative of the Dutch population. Nocturnal enuresis was examined in children 5 or 6 years of age who wet their bed at least twice in the 4 weeks previous to questioning, and in children 7 years of age and older who did so at least once in the previous 4 weeks. Results. The prevalence of nocturnal enuresis was 6%; 15% in the 5 to 6-year-age group and 1% in the 13 to 15- year age group. Marked enuresis (at least twice a week) was reported in 4%. Nocturnal enuresis was more common in Turkish/Moroccan (14%) than in Dutch children (6%). The educational level of the parents was not significantly related to nocturnal enuresis. Children in special education more frequently reported nocturnal enuresis than children in mainstream education (14% and 6%, respectively). This was especially true for children in schools for the mentally retarded as compared to children in mainstream education (odds ratio [OR] in boys 3.21 (99% confidence interval [CI] 2.26 to 4.55) and OR in girls 4.25 [99% CI 2.61 to 6.92]). Conclusions. Nocturnal enuresis occurs most frequently among mentally retarded children. Children attending special education schools for reasons other than mental retardation are also at a higher risk of experiencing nocturnal enuresis than children attending mainstream education schools. Nocturnal enuresis is more prevalent in Turkish/Moroccan children than in Dutch children

Gevolgen van vroeggeboorte : Veel medische consumptie en lichamelijke beperkingen; enquete onder ouders van 10-jarigen [Sequelae of preterm birth : Much medical consumption and physical handicaps; enquiry among parents of children at age 10]

Objective. To determine health and disabilities of preterm infants at age 10. Design. Prospective follow-up study. Setting. TNO Preventie en Gezondheid, sector Jeugd, Leiden, the Netherlands. Method. A questionnaire on medical consumption and physical disabilities was sent to the parents of a Dutch cohort of infants born alive in 1983 with a gestational age < 32 weeks and (or) a birth weight < 1500 g. The data were compared with outcomes at 5 years of age and with a peer group in mainstream education (data collected in a representative sample from the school health care system). Results. Questionnaires on 75% of the egilible children were returned. Almost 40% of the preterm children had been admitted to hospital after the age of 5. Children in special education were significantly more often treated by a physiotherapist and (or) speech therapist. Overall 45% of the children suffered from a physical disability. This was six times as frequent as in a peer group from the school health survey. Although the assessment of physical disabilities was based on a paediatric examination at age 5 and on a parental questionnaire at age 10, differences were small. Conclusion. Mild developmental problems and learning disabilities are frequent in preterm infants. Research of preventive methods and timely interventions are needed and should be incorporated in the facilities for neonatal intensive care

Obesity: a growing problem

Obesity, defined as a body mass index (BMI) of 30 kg/m2 or more, is common in many parts of the world, especially in the established market economies, the former socialist economies of Europe, Latin America, the Caribbean and the Middle Eastern Crescent. As many as 250 million people worldwide may be obese (7% of the adult population) and two to three times as many may be considered overweight. The prevalence of obesity seems to be increasing in most parts of the world, even where it used to be rare. Increased fatness, measured by a high BMI, a large waist circumference or a high waist/hip circumference ratio, is associated with many chronic diseases as well as with poor physical functioning. Assessments of the prevalence of obesity, and trends in this prevalence over time, are more difficult in children than adults, due to the lack of international criteria for classifying individuals as overweight or obese. The World Health Organization has now recommended the use of BMI-for-age percentiles, but the reference curves are still under development. France. The Netherlands, the UK and the USA are among the countries that have reported recent increases in the prevalence of obesity in children and adolescents. Although there are no accurate estimates of the components of energy balance and their changes over time, the available evidence suggests that the trends in obesity rates are related more to a reduction in energy expenditure than to an increase in caloric intake. Prevention of obesity through the promotion of a healthy lifestyle is among the important challenges for the new millennium, and should start in childhood