Contribution of respiratory tract infections to child deaths: a data linkage study

Background: Respiratory tract infections (RTIs) are an important cause of death in children, and often contribute to the terminal decline in children with chronic conditions. RTIs are often underrecorded as the underlying cause of death; therefore the overall contribution of RTIs to child deaths and the potential preventability of RTI-related deaths have not been adequately quantified. Methods: We analysed deaths in children resident in England who died of non-injury causes aged 28 days to 18 years between 2001 and 2010 using death certificates linked to a longitudinal hospital admission database. We defined deaths as RTI-related if RTIs or other respiratory conditions were recorded on death certificates or linked hospital records up to 30 days before death. We examined trends in mortality by age group, year and season (winter or summer) and determined the winter excess of RTI-related deaths using rate differencing techniques. We estimated the proportion of RTI-related deaths in children with chronic conditions. Results: 22.4% (5039/22509) of child deaths were RTI-related. RTI-related deaths declined by 2.3% per year in infants aged 28 to 364 days between 2001 and 2010. No decline was observed for older children. On average there were 161 winter excess RTI-related deaths annually, accounting for 32% of all RTI-related deaths. 89.0% of children with RTI-related deaths had at least one chronic condition; neurological conditions were the most prevalent. Conclusions: RTI-related deaths have not declined in the last decade except in infants. Targeted strategies to prevent the winter excess of RTIs and to treat RTIs in children, particularly children with chronic conditions, may reduce RTI-related deaths

Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study

Background: Chronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood. The purpose of the study was to build a biopsychosocial profile of children and adolescents with CNSMSP. Methods: CNSMSP subjects (n = 30, 18 females, age 7-18) were compared with age matched pain free controls across a number of biopsychosocial domains. Results: In the psychosocial domain CNSMSP subjects had increased levels of anxiety and depression, and had more somatic pain complaints. In the lifestyle domain CNSMSP subjects had lower physical activity levels, but no difference in television or computer use compared to pain free subjects. Physically, CNSMSP subjects tended to sit with a more slumped spinal posture, had reduced back muscle endurance, increased presence of joint hypermobility and poorer gross motor skills. Conclusion: These findings support the notion that CNSMSP is a multidimensional biopsychosocial disorder. Further research is needed to increase understanding of how the psychosocial, lifestyle and physical factors develop and interact in CNSMSP

Promoting human health through forests: overview and major challenges

This review aims to contribute to the ongoing discussion about human health, global change, and biodiversity by concentrating on the relationships between forests and human health. This review gives a short overview of the most important health benefits that forests provide to humans, and the risks that forests may pose to human health. Furthermore, it discusses the future challenges for the research on the links between forests and human health, and for delivering health through forests in practice. Forests provide enormous possibilities to improve human health conditions. The results of a vast amount of research show that forest visits promote both physical and mental health by reducing stress. Forests represent rich natural pharmacies by virtue of being enormous sources of plant and microbial material with known or potential medicinal or nutritional value. Forest food offers a safety net for the most vulnerable population groups in developing countries, and healthy forest ecosystems may also help in regulation of infectious diseases. Utilizing forests effectively in health promotion could reduce public health care budgets and create new sources of income. Main challenges to delivering health through forests are due to ecosystem and biodiversity degradation, deforestation, and climate change. In addition, major implementation of research results into practice is still lacking. Inadequate implementation is partly caused by insufficient evidence base and partly due to the lack of policy-makers’ and practitioners’ awareness of the potential of forests for improving human health. This calls for strong cooperation among researchers, policy-makers, and practitioners as well as between different sectors, especially between health and environmental professionals

An ecological and lifespan approach of social influences on childhood pain experiences

Pediatric pain is a common experience that not only impacts the child but also their social environment (e.g., parents, peers, school functioning). Several models have been formulated to gain a better understanding of the social context interwoven with pediatric pain, with the Social Communications Model the most well-known and comprehensive model. More recent model development has focused on providing an explanation of specific pathways to adaptive or maladaptive pain-related functioning in children (e.g., Interpersonal Fear-Avoidance Model, Ecological Resilience-Risk Model). The purpose of the current chapter is to provide an overview of both the Interpersonal Fear-Avoidance Model and the Ecological Resilience-Risk Model, followed by a critical evaluation of their merit in furthering our understanding of pediatric chronic pain across development and within the broader social context (e.g., peers and school environment). The chapter will conclude with directions for future research, model development and clinical practice