Nutritional implications of selective eating in a child with autism spectrum disorder.

A 4-year-old boy attending the autism assessment service was identified to have a restricted diet. His food diary documented that he ate a narrow range of foods and consumed excessive quantities of carrot juice (excess 2.5 L daily). Physical examination showed that the boy had a florid orange discolouration of his skin, growth parameters were <91st centile for weight, >50th centile for height and head circumference. Blood investigations showed a raised serum carotene level and vitamin D deficiency. He was referred for urgent specialist input from dietetics and the other disciplines within the autism intervention team.

Adherence to antiepileptic medicines in children: a multiple-methods assessment involving dried blood spot sampling.

PURPOSE: To evaluate adherence to prescribed antiepileptic drugs (AEDs) in children with epilepsy using a combination of adherence-assessment methods. METHODS: A total of 100 children with epilepsy (≤17 years old) were recruited. Medication adherence was determined via parental and child self-reporting (≥9 years old), medication refill data from general practitioner (GP) prescribing records, and via AED concentrations in dried blood spot (DBS) samples obtained from children at the clinic and via self- or parental-led sampling in children's own homes. The latter were assessed using population pharmacokinetic modeling. Patients were deemed nonadherent if any of these measures were indicative of nonadherence with the prescribed treatment. In addition, beliefs about medicines, parental confidence in seizure management, and the presence of depressed mood in parents were evaluated to examine their association with nonadherence in the participating children. KEY FINDINGS: The overall rate of nonadherence in children with epilepsy was 33%. Logistic regression analysis indicated that children with generalized epilepsy (vs. focal epilepsy) were more likely (odds ratio [OR] 4.7, 95% confidence interval [CI] 1.37-15.81) to be classified as nonadherent as were children whose parents have depressed mood (OR 3.6, 95% CI 1.16-11.41). SIGNIFICANCE: This is the first study to apply the novel methodology of determining adherence via AED concentrations in clinic and home DBS samples. The present findings show that the latter, with further development, could be a useful approach to adherence assessment when combined with other measures including parent and child self-reporting. Seizure type and parental depressed mood were strongly predictive of nonadherence.

Home heating and respiratory symptoms among children in Belfast, Northern Ireland.

In this study, the authors assessed whether home heating with a glass-fronted solid fuel fire (GFF) affected the respiratory health of children in Belfast, Northern Ireland. Questionnaires were mailed to 2,480 households within 4 medical general practice areas of the city. Respiratory symptoms, tobacco exposure, socioeconomic status, and crowding were studied. The authors found statistically significant relationships (p < 0.001) between GFF heating and wheeze, cough, and asthma diagnosis (odds ratios [ORs] = 3.23, 2.91, and 1.83, respectively). After controlling for tobacco exposure, social deprivation, and crowding, GFF heating remained associated with wheeze, cough, and asthma diagnosis (ORs = 2.47, 2.20, and 1.81, respectively). Respiratory symptoms were triggered 6 times more often when GFF heating was turned on, compared with when it was off. A pilot environmental study of 19 homes determined that levels of particulate matter with diameters < or = 10 microm (PM10) were significantly higher when GFF heating was on. Home heating with GFF is associated with respiratory symptoms in children; in fact, PM10 levels may be the causal link.