Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and COVID-19- its associated disease in humans- appears to cause more severe morbidity and mortality in older adults and geriatric patients than in children and young adults. There is growing recognition of the association between both race and obesity and disease severity in hospitalized patients with COVID-19.However, the impact of age, race, and other major comorbidities on COVID-19 course in children and younger adults is not as well understood. We conducted a retrospective analysis of 2656 patients under the age of 36 years with COVID-19 between March 1, 2020 and August 6, 2020 as reported to HEALTHeLINK, a regional health information system for western New York State. Subjects were split into pediatric (0-19 years) and young adult (20- 36 years) datasets. We evaluated the association between candidate risk factors (age, sex, race, calculated BMI/BMI percentile, smoking status, diabetes, pre-existing respiratory disease, hypertension, and sickle cell disease) using recursive partitioning and linear regression. The primary outcome was hospital admission, with length of stay being the secondary outcome There were 2129 young adults and 527 pediatric patients who tested positive for COVID-19 during our study period. In our young adult population, race was the most significant predictor of admission, followed by BMI. African Americans with a BMI > 23 had the highest rate of admission (66%, p<0.001). Interestingly, Asian race was a strong predictor of outpatient management, regardless of BMI. Smoking status and hypertension were less significant predictors of admission, whereas sex, diabetes, preexisting respiratory conditions, and sickle cell disease were not significant. For our pediatric population, race was also the most significant predictor of admission, with African Americans being admitted at higher rates than Whites and Asians. In the pediatric population, however, BMI percentile for age was not a predictor of admission. In regards to the secondary outcome, admitted young adult with COVID-19 had an average length of stay of 1.4 days (SD ±2) while the admitted pediatric COVID-19 patients had an average length of stay of 1 day (SD ±1.1). African American race was associated with longer length of stay in both populations however, BMI was only significant in the young adult population. In a regional population of young adult and pediatric patients with COVID-19, race was strongly predictive of admission and length of stay. African American patients were most likely to be admitted, while Asian race was a strong predictor of outpatient management. For African American young adults, a BMI > 23 was the strongest additional predictor of admission. For younger patients with COVID-19 a simple decision tree that incorporates age, race, and BMI can help identify those patients least likely to need inpatient management.
The study’s objectives were to gain school personnel’s (1) perceptions on diet, physical activity, body size, and obesity, (2) description of school food and physical activity practices, and (3) recommendations for programs to prevent adolescent obesity. The study took place in six junior secondary schools of varying socioeconomic status in Gaborone, Botswana. Using a qualitative descriptive design, semistructured interviews were conducted with key school personnel. Directed content analysis was used to summarize the findings. School personnel believed that obesity was an important problem. They felt that school food was unhealthy and that physical activity was provided insufficiently. Participants shared enthusiasm for a school-based health-promoting intervention that must be fun and include active engagement and education on healthy lifestyles for all students. Participants supported on-site food shop inventory changes and physical activity programs. Potential barriers listed were schools’ financial resources, interest of students, and time limitations of all involved.
Non-inflammatory joint pain referrals to pediatric rheumatologists are common. The underlying etiologies include trauma, overuse and hypermobility [1-3] With the current obesity epidemic, 16.9 percent of United States (U.S.) children and adolescents are obese and joint pain is more prevalent in obese than healthy weight children [4-6]. One mechanism of obesity related joint pain is that greater load bearing causes micro injury. However little is known about other factors that alter joint loads and possibly cause micro injury among obese children, such as hypermobility.
OBJECTIVE: To assess associations of the number of parent stressors and parent-perceived stress with obesity and related behaviors in their children. METHODS: This cross-sectional analysis used data from the 2006 Southeastern Pennsylvania Household Health Survey in which 2119 parents/caregivers answered questions about themselves and their children (ages 3–17 years). Survey data were used to assess the main exposure variables: the number of stressors (measured using a stressor index) and parent-perceived stress (the response to a general stress question); child covariates (age, race/ethnicity, health quality, and gender); adult covariates (education, BMI, gender, poor sleep quality) and study outcomes (child obesity, fast-food consumption, fruit and vegetable consumption, and physical activity). To account for developmental differences, analyses were also stratified by age group (3–5, 6–8, 9–12, and 13–17 years). Analyses used multiple logistic regression, with results expressed as odds ratios and 95% confidence intervals. RESULTS: The number of parent stressors was related to child obesity in unadjusted (1.12, 1.03–1.22, P = .007) and adjusted models (1.12, 1.03–1.23, P = .010). Parent-perceived stress was related to fast-food consumption in unadjusted (1.07, 1.03–1.10, P < .001) and adjusted (1.06, 1.02–1.10, P < .001) models. CONCLUSIONS: The number of parent stressors was directly related to child obesity. Parent-perceived stress was directly related to child fast-food consumption, an important behavioral indicator of obesity risk. Clinical care models and future research that address child obesity should explore the potential benefits of addressing parent stressors and parent-perceived stress.
In Brief Purpose: We sought to characterize the physical activity, health, and dietary patterns of middle school children and examine associations between these factors. Parent−child relationships also were examined. Methods: Thirty-eight children and parents participated and completed a three-day physical activity recall and 24-hour dietary recall. The Child Health Questionnaire was used to assess child health. Percentage overweight was determined for each participant. Results: Forty-four percent of children did not meet the current recommendation for physical activity. Fat and sodium consumption exceeded recommendations, and intake of key nutrients was inadequate. Youth who spent more time in sedentary activity had poorer general health. There were positive associations between parent and child percentage overweight and physical activity. Parent physical activity explained an additional 46.2% of the variance in child physical activity. Conclusions: Increasing physical activity and reducing sedentary behaviors through strategies that incorporate parents is an important component of a physical therapy program for school children. The authors studied physical activity, health, and dietary patterns of children. They report parent physical activity explained more than 45% of the variance in child physical activity and describe roles for physical therapists in preventing obesity.
The purpose of this study was to investigate the outcome of an education- and exercise-based intervention for children who are overweight.Forty-one children with a mean age of 10.5 years participated in the study. The eight-week intervention, scheduled twice weekly, included education and exercise components. Outcome measures included body mass index (BMI), waist and hip girth, blood pressure (BP), resting heart rate (RHR), immediate postexercise heart rate (HRfinish), five-minute recovery heart rate (5minHR), and distance walked in six minutes. Using a repeated-measures design, data were collected twice prior to intervention to determine baseline and once upon completion of the intervention.No significant difference existed between pretest I and II measures for each dependent variable, indicating a stable baseline. An intervention effect was established as evidenced by significant improvement in BMI, waist and hip girth, BP, RHR, HRfinish, and 5minHR at posttest.Children who are overweight and participate in an eight week exercise and educational program demonstrate improved morphology and physical conditioning.
Abstract Objective This study aimed to examine the impact of different antibiotic treatments on necrotizing enterocolitis (NEC) outcomes. Study Design Patient outcomes, including total parenteral nutrition and hospitalization durations, abdominal surgeries, intestinal strictures, and mortality data, were analyzed and compared by various antibiotic groups and treatment durations for 160 NEC patients managed at the Women and Children's Hospital of Buffalo between 2008 and 2016. Results Fourteen different antibiotics were used for NEC, most commonly ampicillin, gentamicin, and metronidazole (AGM). Medical (vs. surgical) NEC patients more likely received AGM (37 vs. 6%, p < 0.001). Surgical (vs. medical) NEC patients more likely received vancomycin (80 vs. 30%, p < 0.001) and antipseudomonal agents (69 vs. 15%, p < 0.001). For medical NEC there were no outcome differences between patients receiving only AGM versus those receiving other treatments; in patients receiving AGM, there were no outcome differences in durations of ≤10 days versus longer courses. Conclusion Antibiotic use for NEC varies substantially without definite outcome differences. Particularly with medical NEC, AGM for ≤10 days had comparable outcomes to other treatments. In light of growing concern for short and longer term adverse effects with early-life antibiotic exposure, narrow-spectrum and shorter course NEC treatment may be preferred.
