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Biomedical subjects

M Wake

Publications and source records attributed to M Wake.

At least 19 recordsLinked to original sources
PubMed2003

Health status of Australian children with mild to severe cerebral palsy: cross-sectional survey using the Child Health Questionnaire.

The aim of this study was to describe child health and well-being across the spectrum of cerebral palsy (CP) and to report on psychometric properties of the Child Health Questionnaire (CHQ) in this population. Parents of 80 individuals (45 males, 35 females; mean age 11 years 4 months, SD 3 years 6 months; range 5 to 18 years) attending a CP clinic in Victoria, Australia were surveyed. Measures included the CHQ PF-50, a 50-item parent-reported heath status measure; severity of CP, based on the Gross Motor Function Classification System; and cognitive status and presence of epilepsy. CHQ data were compared with normative data collected in Victoria two years earlier. The CHQ demonstrated good psychometric properties for children with CP. Children with CP had markedly poorer health on every CHQ scale than those in the normative sample. Health status did not vary by cognitive status or epilepsy. Children with severe CP had the poorest physical health, but psychosocial health and emotional impact on parents were similar for mild and severe CP showing that these should not be assumed to be less prevalent when CP is mild.

Adolescent↗
PubMed2003

Endoscopic repair of nasal septal perforation with acellular human dermal allograft and an inferior turbinate flap.

Nasal septal perforations present a distinct challenge to the otolaryngologist and a significant cause of symptoms to affected patients. Many surgical techniques for the repair of septal perforations have been described. Connective tissue autografts are commonly used as interpositional grafts between the septal flaps. Recently acellular human dermal allograft has been used with success. In total, 17 patients with symptomatic anterior nasal septal perforations that had failed conservative treatment underwent a closed endoscopic repair of their perforations with acellular human dermal allograft (alloderm) and an anteriorly based inferior turbinate flap; 13 patients had a successful closure of the perforation, two patients, despite initial success, re-perforated as a result of persistent crust picking and, in two patients, the graft failed. With appropriate patient selection and stringent postoperative care the authors consider this technique offers a good surgical outcome for the closure of septal perforations.

Adult↗
PubMed2003

Television, computer use and body mass index in Australian primary school children.

OBJECTIVE: To investigate relationships between children's body mass index (BMI) and parent reports of children's television and video game/computer habits, controlling for other potential risk factors for paediatric obesity. METHODS: Child BMI was calculated from measured height and weight collected in 1997 as part of a large, representative, cross-sectional study of children in Victoria, Australia. Parents reported the amount of time children watched television and used video games/computers, children's eating and activity habits, parental BMI and sociodemographic details. RESULTS: A total of 2862 children aged 5-13 years participated. Child mean BMI z-score was significantly related to television (F = 10.23, P < 0.001) but not video game/computer time (F = 2.23, P = 0.09), but accounted for only 1 and 0.2% of total BMI variance, respectively. When parental BMI, parental education, number of siblings, food intake, organized exercise and general activity level were included, television ceased to be independently significantly related to child BMI. Using adjusted logistic regression, the odds of being overweight and obese generally increased with increasing television viewing. No relationship was found for video game/computer use. CONCLUSIONS: A small proportion of variance in child BMI was related to television, but not video game/computer time. This was far outweighed by the influence of other variables. Causal pathways are likely to be complex and interrelated.

Adolescent↗
PubMed2003

Six month impact of false positives in an Australian infant hearing screening programme.

AIMS: To assess short and longer term parent reported impacts of false positive referrals in the Victorian Infant Hearing Screening Program (VIHSP). METHODS: Mailed retrospective case-control survey of infants consecutively referred to VIHSP between December 1998 and April 1999 for whom audiology did not confirm permanent hearing loss, comprising 137 infants screened with a neonatal risk factor questionnaire and 148 older infants screened with two consecutive behavioural (distraction) tests. The two control groups comprised non-referred screened infants matched by domicile, age, and gender. Main outcome measures were parent reported emotions experienced before and after child's audiology test, parent estimated impact of hearing loss, the Child Vulnerability Scale, audiology assessment satisfaction questionnaire, and questions relating to their child's hearing and language development. RESULTS: Final sample: at risk cases (AR) 108 (79% response), at risk controls 64 (51%); distraction test cases (DT) 103 (70%), distraction test controls 53 (41%). Parents across all groups believed that hearing loss would have major effects on a child's language (91-96%), schooling (81-91%), and employment opportunities (67-75%). Before audiology, 71% (AR) and 72% (DT) of case parents were anxious/worried, falling to 4% and 15% afterwards. After the test 82% (AR) and 79% (DT) reported relief, but 19% and 18% continued to feel worried. Ongoing concerns about hearing, language, development, and general health were comparable for AR cases compared to controls, and for DT cases compared to controls. CONCLUSIONS: Hearing screening tests are generally well received. Parents are realistic about the impact of childhood hearing loss and report a range of negative emotions when a false positive hearing screen requires referral. Although most are reassured by a normal test, a substantial number report continuing concern.

Adult↗
PubMed2002

Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood.

OBJECTIVE: To compare the effect of a behavioural sleep intervention with written information about normal sleep on infant sleep problems and maternal depression. DESIGN: Randomised controlled trial. SETTING: Well child clinics, Melbourne, Australia. PARTICIPANTS: 156 mothers of infants aged 6-12 months with severe sleep problems according to the parents. MAIN OUTCOME MEASURES: Maternal report of infant sleep problem; scores on Edinburgh postnatal depression scale at two and four months. INTERVENTION: Discussion on behavioural infant sleep intervention (controlled crying) delivered over three consultations. RESULTS: At two months more sleep problems had resolved in the intervention group than in the control group (53/76 v 36/76, P=0.005). Overall depression scores fell further in the intervention group than in the control group (mean change -3.7, 95% confidence interval -4.7 to -2.7, v -2.5, -1.7 to -3.4, P=0.06). For the subgroup of mothers with depression scores of 10 and over more sleep problems had resolved in the intervention group than in the control group (26/33 v 13/33, P=0.001). In this subgroup depression scores also fell further for intervention mothers than control mothers at two months (-6.0, -7.5 to -4.0, v -3.7, -4.9 to -2.6, P=0.01) and at four months (-6.5, -7.9 to 5.1 v -4.2, -5.9 to -2.5, P=0.04). By four months, changes in sleep problems and depression scores were similar. CONCLUSIONS: Behavioural intervention significantly reduces infant sleep problems at two but not four months. Maternal report of symptoms of depression decreased significantly at two months, and this was sustained at four months for mothers with high depression scores.

Adult↗
PubMed2002

Parent-reported health status of overweight and obese Australian primary school children: a cross-sectional population survey.

INTRODUCTION: Childhood overweight/obesity is associated with poor physical and psychosocial health in clinical samples. However, there is little information on the health status of overweight and obese children in the community, who now represent a large proportion of the child population. We examined parent-reported child health and well-being and parent concern about child weight by body mass index (BMI) category in a population sample of primary school children. DESIGN: A stratified two-stage random cluster sample of 24 primary schools representative of the state of Victoria, Australia. MEASURES: BMI (weight/height(2)) transformed to normalised Z-scores using the 1990 UK Growth Reference; the Child Health Questionnaire (CHQ), a 13-scale 50-item parent-completed measure of health and well-being; parent self-reported height and weight; parent concern about child's weight. RESULTS: Data were available for 2863 children aged 5-13 y (50.5% male), of whom 17% were overweight and 5.7% obese. Using logistic regression analyses with 'normal weight' as the referent category, obese boys were at greater risk of poor health (ie <15th centile) on seven of the 12 CHQ scales: Physical Functioning (odds ratio (OR) 2.8), Bodily Pain (OR 1.8), General Health (OR 3.5), Mental Health (OR 2.8), Self Esteem (OR 1.8), Parent Impact-Emotional (OR 1.7) and Parent Impact-Time (OR 1.9). Obese girls were at greater risk of poor health on only two scales: General Health (OR 2.1) and Self Esteem (OR 1.8). Forty-two percent of parents with obese children and 81% with overweight children did not report concern about their child's weight. Parents were more likely to report concern if the child was obese (OR 21.3), overweight (OR 3.5) or underweight (OR 5.4) than normal weight (P<0.05). Concern was not related to child gender, parental BMI or parental education after controlling for child BMI. Perceived health and well-being of overweight/obese children varied little by weight category of the reporting parent (overweight vs non-overweight). CONCLUSIONS: Parents were more likely to report poorer health and well-being for overweight and obese children (particularly obese boys). Parental concern about their child's weight was strongly associated with their child's actual BMI. Despite this, most parents of overweight and obese children did not report poor health or well-being, and a high proportion did not report concern. This has implications for the early identification of such children and the success of prevention and intervention efforts. DOI:10.1038/sj/ijo/0801974

Adolescent↗
PubMed2002

Six year effectiveness of a population based two tier infant hearing screening programme.

AIMS: To determine whether a two tier universal infant hearing screening programme (population based risk factor ascertainment and universal distraction testing) lowered median age of diagnosis of bilateral congenital hearing impairment (CHI) >40 dB HL in Victoria, Australia. METHODS: Comparison of whole population birth cohorts pre and post introduction of the Victorian Infant Hearing Screening Program (VIHSP). All babies surviving the neonatal period born in Victoria in 1989 (pre-VIHSP) and 1993 (post-VIHSP) were studied. (1) Pre-1992: distraction test at 7-9 months. (2) Post-1992: infants with risk factors for CHI referred for auditory brain stem evoked response (ABR) assessment; all others screened by modified distraction test at 7-9 months. RESULTS: Of the 1989 cohort (n = 63 454), 1.65/1000 were fitted with hearing aids for CHI by end 1995, compared with 2.09/1000 of the 1993 cohort (n = 64 116) by end 1999. Of these, 79 cases from the 1989 cohort (1.24/1000) and 72 cases from the 1993 cohort (1.12/1000) had CHI >40 dB HL. Median age at diagnosis of CHI >40 dB HL for the 1989 birth cohort was 20.3 months, and for the 1993 cohort was 14.2 months. Median age at diagnosis fell significantly for severe CHI but not for moderate or profound CHI. Significantly more babies with CHI >40 dB HL were diagnosed by 6 months of age in 1993 than in 1989 (21.7% v 6.3%). Compared to the six years pre-VIHSP, numbers aided by six months were consistently higher in the six years post-VIHSP (1.05 per 100 000 births versus 13.4 per 100 000 births per year). CONCLUSIONS: VIHSP resulted in very early diagnosis for more infants and lowered median age of diagnosis of severe CHI. However, overall results were disappointing.

Age of Onset↗
PubMed2001

The health and well-being of adolescents: a school-based population study of the self-report Child Health Questionnaire.

PURPOSE: To evaluate a new generic measure of adolescent health status, the self-report version of the Child Health Questionnaire (CHQ), and provide population-based data. Furthermore, we aimed to examine the impact of common adolescent illness and health concerns on their health and well-being. METHODS: A stratified, two-stage, random cluster sampling design was used to obtain a cross-sectional sample of subjects through schools. A written questionnaire included the 80-item 12-scale self-report CHQ and items measuring health concerns, illnesses/health conditions, and sociodemographics. RESULTS: A total of 2361 adolescents participated (response rate of 70%). Reliability was high: Tests of internal consistency and discriminant validity reported 90% of item-scale correlations >.4; all scales had Cronbach alpha coefficients >.7. Adolescents with illnesses/conditions or health concerns reported lower scores and larger differences for content-related scales, supporting content and construct validity. Statistically significant age and gender trends were observed for Mental Health, Self-Esteem, General Health, and Family Cohesion scales. Health status worsened as health concerns increased (X(2) linear trend, p =.00) with deterioration in health of 5-20% on all scales for emotional health concerns (40% of sample). CONCLUSIONS: The self-report CHQ is a reliable and seemingly valid measure of health and well-being for adolescent health research, although additional measures may be required where scales have high ceiling values. The significantly lower scores reported by adolescents with illness and/or health concerns lend support to the use of standardized health measures and longitudinal research to further examine the impact of adolescent comorbidities and their causal determinants.

Adolescent↗
PubMed2001

The epidemiology of overweight and obesity among Australian children and adolescents, 1995-97.

OBJECTIVES: To determine the population prevalence of overweight and obesity among Australian children and adolescents, based on measured body mass index (BMI). To determine if overweight and obesity are distributed differentially across the population of young Australians. METHODS: Data from three independent surveys were analysed. In each, height and weight were measured by trained surveyors using valid, comparable methods. BMI (kg/m2) was used as the index of adiposity and recently published international BMI cut-off values used to categorise each subject as non-overweight, overweight or obese. RESULTS: The population prevalence and distribution of overweight, obesity and overweight/obesity combined were generally consistent across datasets. The ranges of the prevalence of non-overweight, overweight, obesity and overweight/obesity combined were 79-81%, 14-16%, 5% and 19-21% (boys) respectively and 76-79%, 16-18%, 5-6% and 21-24% (girls). There were no consistent relationships between the prevalence of overweight/obesity and sex, age or SES. Their prevalence was up to 4% higher in urban than rural areas among boys, but there were no differences between urban and rural girls. The data suggest a higher prevalence of overweight/ obesity among students from European or Middle-Eastern cultural backgrounds. CONCLUSIONS: Some 19-23% of Australian children and adolescents are either overweight or obese. Although urban/rural, SES and cultural background differentials were noted, only the last warrants a targeted health promotion response. IMPLICATIONS: Overweight/obesity is a prevalent health risk factor among Australian children and adolescents. More information is needed to understand whether targeted approaches are required for specific ethnic groups in addition to broad, population-based approaches.

Adolescent↗
PubMed2001

Infant sleep problems and postnatal depression: a community-based study.

OBJECTIVES: To describe infant sleep patterns and investigate relationships between infant sleep problems and maternal well-being in the community setting. DESIGN: Cross-sectional community survey. Setting. Maternal and Child Health Centers in 3 middle-class local government areas in Melbourne, Australia. PARTICIPANTS: Mothers of infants 6 to 12 months of age. MAIN OUTCOME MEASURES: Maternal well-being (Edinburgh Postnatal Depression Scale) and infant sleep problems (standardized maternal questionnaire). RESULTS: The survey was completed by 738 mothers (94% response rate), of whom 46% reported their infant's sleep as a problem. In the univariate analyses, sleep patterns characterizing a sleep problem included the infant sleeping in the parent's bed, being nursed to sleep, taking longer to fall asleep, waking more often and for longer periods overnight, and taking shorter naps. The same sleep patterns were associated with high depression scores and tended to increase as depression scores increased. Because of positive skew, the Edinburgh Postnatal Depression Score was analyzed in 3 categories (<10, 10-12, and >12) using validated cutoff scores from community and clinical studies. Fifteen percent of mothers scored above 12 on the depression scale, indicating probable clinical depression, and 18% scored between 10 and 12, indicating possible clinical depression. After adjusting for potential confounders and factors significant in the univariate analyses, maternal report of an infant sleep problem remained a significant predictor of a depression score >12 (odds ratio: 2.13; 95% confidence interval: 1.27,3.56) and >10 (odds ratio: 2.88; 95% confidence interval: 1.93,4.31). However, mothers reporting good sleep quality, despite an infant sleep problem, were not more likely to suffer depression. CONCLUSIONS: Maternal report of infant sleep problems and depression symptoms are common in middle-class Australian communities. There is a strong association between the 2, even when known depression risk factors are taken into account. Maternal report of good sleep quality attenuates this relationship. Appropriate anticipatory guidance addressing infant sleep could potentially decrease maternal report of depressive symptoms.

Adult↗
PubMed2000

Public health and preventive healthcare in children: current practices of Victorian GPs and barriers to participation.

OBJECTIVES: To assess general practitioners' attitudes to and involvement in child public health activities and identify barriers affecting their participation. DESIGN: Cross-sectional written questionnaire survey of a representative sample of actively practising GPs. SETTING: General practices in the State of Victoria. PARTICIPANTS: 840 GPs returned questionnaires (65% response rate), and, of these, 792 (94%) saw children 0-12 years. MAIN OUTCOME MEASURES: Attitudes to and involvement in public health promotion; predictive factors for GPs' involvement. RESULTS: The odds of GPs' involvement in child public health issues were increased by being female (odds ratio [OR], 1.88), receiving basic medical qualifications outside Australia (OR, 1.55), attending continuing education and postgraduate training (OR, 1.60), and having confidence in dealing with newborns and infants (OR, 1.93) and preschool children (OR, 2.94) (both P < 0.05). Older GPs, compared with younger GPs, had significantly lower odds of involvement (P < 0.01). After adjustment, GPs had higher odds of involvement if they agreed it was important for them to take part in health promotion, or in screening and surveillance (OR, 2.76 and 1.94, respectively; P < or = 0.05); and lower odds if they agreed that screening and surveillance should be mainly done by maternal and child health nurses (OR, 0.60). The most common barriers to involvement were insufficient time, inadequate financial reimbursement for long consultations, inappropriateness of raising these issues in children presenting with illness, and lack of community resources. CONCLUSIONS: Increasing GPs' involvement in child public health will require attention to barriers (time, remuneration and perceived appropriateness), continuing education and changes in workforce composition and patterns.

Adult↗
PubMed2000

Change in body mass index in Australian primary school children, 1985-1997.

BACKGROUND: Childhood obesity is an important, potentially modifiable risk factor for a range of concurrent and later morbidities. Despite concerns about recent increases in children's body mass index (BMI), supporting data in Australia (as elsewhere) are scant. OBJECTIVE: To seek anthropometric evidence of a recent secular increase in BMI in primary school children in Victoria, Australia. DESIGN: Data from two cross-sectional population-based surveys of primary school children (the Victorian subsample of the 1985 Australian Health and Fitness Survey and the 1997 Health of Young Victorians Study) were compared. Similar stratified random sampling and standardized measurement methods were employed in the two studies. Subjects were all children aged 7-12 y with complete height and weight data. Body mass index (BMI (weight/height2)) was used as the index of relative adiposity. Non-parametric and parametric methods were used to examine the pattern and magnitude of change in BMI over the 12 y interval. RESULTS: Data for 1421 children (50% male, 68% response) from the 1985 survey and 2277 children (51% male, 75% response) from the 1997 survey were analysed. At all ages, mean height and median weight were greater in 1997 than 1985 for both boys and girls. Median BMI was significantly higher in the 1997 sample for all but 12 y-old girls and for boys aged 7, 8 and 10 y (Mann-Whitney U test). The magnitude of the overall increase in BMI was estimated using analysis of covariance for log-transformed BMI adjusted for exact age, which indicated an increase of 1.03 kg/m2 for boys and 1.04 kg/m2 for girls (both P<0. 001). Plots of BMI against BMI percentile clearly showed a pattern of higher BMI at any given percentile, especially at the upper percentiles, for all ages and both genders. CONCLUSIONS: Primary school children in Victoria have become more obese over the last decade. Increases in BMI are most marked at the heavier end of the distribution. Lesser increases in median and mean BMI (confirmed by both parametric and non-parametric statistical models) may also have major public health implications.

Adipose Tissue↗
PubMed2000

The Child Health Questionnaire in children with diabetes: cross-sectional survey of parent and adolescent-reported functional health status.

AIMS: To study parent and adolescent-reported physical, psychosocial and family wellbeing in children aged 5-18 years with diabetes. METHODS SUBJECTS: 5-18-year-olds attending a diabetes clinic at a tertiary children's hospital. MEASURES: (1) Child Health Questionnaire (CHQ) PF-50, a functional heath status measure for children aged 5-18 years (parents); (2) CHQ CF-80, a similar self-report measure (adolescents aged 12-18 years); (3) 11 study-designed questions related to diabetes-specific concerns (parents); (4) global ratings of physical and psychosocial health (clinicians); (5) HbA1c level (all subjects). CHQ data were compared with Australian normative data collected six months earlier. RESULTS: Reports were obtained from 128 parents and 71 adolescents (90 and 92% response). The CHQ demonstrated good psychometric properties in this sample of children with diabetes. Parents reported children with diabetes to have generally poorer health than children in the normative sample, especially on psychosocial and parent/family scales. Psychosocial health was markedly lower in 5-11-year-olds with HbA1c > 8.8%, but not in 12-18-year-olds. Presence of diabetes-related symptoms and concerns correlated with lower physical and psychosocial functioning. Parents and clinicians concurred in their ratings of health for 12-18-year-olds but not 5-11-year-olds. Adolescents reported their own health similarly to adolescents in the normative sample. CONCLUSIONS: Parents report children aged 5-18 years with diabetes to have poorer health than children in the normative sample across all domains. Clinicians may underrate the impact of diabetes for younger children, with possible therapeutic implications. In providing an overall description of health, instruments like the CHQ may add another dimension to the care of children with diabetes and can feasibly be used within clinical settings.

Adolescent↗
PubMed2000

The parent-form Child Health Questionnaire in Australia: comparison of reliability, validity, structure, and norms.

OBJECTIVE: To improve the ability to describe and compare child health within and between countries, using standardized multidimensional child health measures. METHODS: Data on population-specific psychometrics, the measurement structure, and norms are a vital prerequisite. These properties for the Child Health Questionnaire (CHQ) were examined for an Australian population and compared with the originating U.S. data. The CHQ 50-item parent-report was completed by 5,414 parents of children aged 5-18 years. Multi-item/multi-trait analysis tested convergent and discriminatory validity. Construct validity, test-retest reliability, comparative population mean scale scores, and the summary score factor structure were examined. RESULTS: Item and scale internal consistency and item discriminant validity results were good to excellent, and construct (concurrent) validity was supported. Australian children had higher scores than U.S. children except for Family Activities and Physical Functioning. The factor structure of the two summary scores for American children was not replicated in the normative sample but held for a subsample of children with one or more health conditions. CONCLUSIONS: The CHQ PF50 performed well in Australia at item and scale level. However, the physical and psychosocial summary scores are not supported for population-level analyses but may be of value for sub-groups of children with health problems.

Adolescent↗
PubMed2000

The Child Health Questionnaire in Australia: reliability, validity and population means.

OBJECTIVE: To provide reliability, validity and population means for the Australian Authorized Adaptation of the parent-report Child Health Questionnaire (CHQ). METHOD: We surveyed a representative sample of Australian parents of school-aged children (5-18 years) in Victoria between July and December 1997, using a school-based cluster sample design stratified by educational sector and age. RESULTS: Some 5,414 parents responded (72%). Good psychometric performance was observed for the CHQ in Australia. Population means demonstrated differences in health on domains of functioning and well-being by age and gender. This population-derived sample demonstrated high ceiling values on Physical Functioning and Social Role scales. IMPLICATIONS: The CHQ appears to be a reliable and valid measure of child and adolescent functional health and well-being for the Australian population. Child health outcomes of children and adolescents with particular conditions or within population subgroups can be compared with these age and gender benchmarks. Appropriate uses for the CHQ may be to discriminate between children who are generally healthy and children with health problems, or in population surveys partnered with measures that extend the range of physical functioning and social functioning.

Activities of Daily Living↗
PubMed2000

Does height influence progression through primary school grades?

AIM: To examine the relation between a child's height and grade progression in primary school. METHODS: Height was measured in a representative cross sectional sample of children from 24 primary schools in Victoria in late 1997. Height measurements were transformed to standardised scores using Cole's "LMS" method to allow for comparison across ages and genders. Children within each grade were divided into three equal groups based on age (youngest third, middle third, oldest third), again to allow for cross age comparison. RESULTS: A total of 2848 children aged 5-12 years (51% male) were included, with approximately 400 children in each of the seven grades from preparatory to grade 6. Analysis of variance showed a significant relation overall between age and height, with a sequential decrease in height from the youngest to the oldest third. When genders were considered separately, the relation remained significant for boys but not for girls. A total of 133 children (66% male) repeated a grade in primary school. When this group of grade repeaters was removed from the sample, analysis of variance showed no significant relation between standardised height score and age tertile for boys. Although birth weight category and maternal education were independent predictors of height scores overall, they did not appear to influence decisions to retain pupils in grades. CONCLUSIONS: Older boys within grades, notably those who have repeated a grade, are shorter than their peers. Decisions to retain pupils, particularly boys who are experiencing school difficulties, may be influenced by their height.

Analysis of Variance↗
PubMed2000

Teething and tooth eruption in infants: A cohort study.

OBJECTIVE: Many symptoms are attributed to teething in infants. There is little evidence to support these beliefs, despite their implications for clinical management. We investigated relationships between tooth eruption, fever, and teething symptoms. METHODS: Prospective cohort study. PARTICIPANTS: Twenty-one children 6 to 24 months old attending 3 suburban long-day care centers >/=3 days/week. Measures. 1) Daily temperature recording and examination of alveolar ridges for tooth eruption (dental therapist). 2) Daily questionnaires-symptoms over preceding 24 hours (staff and parents independently). 3) Final questionnaire-beliefs/experiences related to teething (parents). Definitions. Eruption day-the first day a tooth could be seen or felt. Non-toothdays-more than 28 days clear of any eruption day. Toothdays-the 5 days preceding eruption days. RESULTS: Data were collected for 236 toothdays and 895 non-toothdays pertaining to 90 teeth. Child temperatures were similar on toothdays and non-toothdays (36.21 vs 36.18, paired t test). Logistic regression adjusted for age did not show an association between toothdays and temperature (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 0.80, 2.27 for high fever; OR = 1.34, 95% CI = 0.48, 3.77 for low fever). Logistic regression models allowing for within-child cluster effects and age were fitted to daily staff and parent reports of mood, wellness/illness, drooling/dribbling, sleep, diarrhea, strong diapers, red cheeks, and rashes/flushing. Only parent-reported (but not staff-reported) loose stools were significantly associated with tooth eruption (OR = 1.86, 95% CI = 1. 26, 2.73). When the toothday definition was varied to 10 days preceding or 5 days surrounding tooth eruption, this single significant association was no longer apparent (OR = 1.42, 95% CI = 0.98, 2.05 and OR = 1.47, 95% CI = 0.97, 2.21, respectively). All parents retrospectively reported that their own children had suffered a range of teething symptoms. CONCLUSIONS: This study did not confirm the expected strong associations between tooth eruption and a range of teething symptoms in children 6 to 30 months old, although we cannot rule out the possibility that weak associations may exist (Type II error). These findings contrast with strong parent and professional beliefs to the contrary. Such beliefs may preclude optimal management of common patterns of illness and behavior in young children.teething, infants, symptoms, tooth eruption, illness.

Adult↗