Third-grade school performance in children with special healthcare needs: a prospective cohort study.

Objective: Children with special healthcare needs (SHCN) due to a chronic health condition perform more poorly at school compared with their classmates. We aimed to estimate the effects of past, current, transient, emerging and persistent SHCN on school performance in primary school children.

Methods: Data from the German population-based prospective cohort study ikidS were used.

School well-being in primary school children with chronic illness. A prospective cohort study.

Background: Children with chronic illness perform poorer at school, and school well-being (SWB) may mediate this association. We investigated the association between chronic illness and three domains of SWB in children in first grade.

Methods: Data from a German population-based prospective cohort study were used.

Grandmaternal pre-pregnancy body mass index and infant birthweight: a mediation analysis of maternal pre-pregnancy body mass index.

The objectives of this study were to examine the total effect of grandmaternal [G0] pre-pregnancy body mass index (BMI) on infant [G2] birthweight z-score and to quantify the mediation role of maternal [G1] pre-pregnancy BMI. Data were extracted from the Nova Scotia 3G Multigenerational Cohort. The association between G0 pre-pregnancy BMI and G2 birthweight z-score and the mediated effect by G1 pre-pregnancy BMI were estimated using g-computation with adjustment for confounders identified using a directed acyclic graph and accounting for intermediate confounding.

Teachers reported that children with special health care needs displayed more attention problems.

Aim: Children with special health care needs (SHCN) perform more poorly at school compared to their classmates. Specific causal pathways have not yet been extensively studied. Therefore, we investigated teacher-rated global attention, an important prerequisite for educational attainment, in children with SHCN.

Building a better model: abandon kitchen sink regression.

This paper critically examines 'kitchen sink regression', a practice characterised by the manual or automated selection of variables for a multivariable regression model based on p values or model-based information criteria. We highlight the pitfalls of this method, using examples from perinatal/neonatal medicine, and propose more robust alternatives. The concept of directed acyclic graphs (DAGs) is introduced as a tool for describing and analysing causal relationships.

Prophylactic cyclo-oxygenase inhibitor drugs for the prevention of morbidity and mortality in extremely preterm infants: a clinical practice guideline incorporating family values and preferences.

ImportanceProphylactic cyclo-oxygenase inhibitors (COX-Is) such as indomethacin, ibuprofen and acetaminophen may prevent morbidity and mortality in extremely preterm infants (born ≤28 weeks' gestation). However, there is controversy around which COX-I, if any, is the most effective and safest, which has resulted in considerable variability in clinical practice.  Our objective was to develop rigorous and transparent clinical practice guideline recommendations for the prophylactic use of COX-I drugs for the prevention of mortality and morbidity in extremely preterm infants.

School absenteeism in children with special health care needs. Results from the prospective cohort study ikidS.

Objective: Children with special health care needs (SHCN) due to a chronic health condition perform more poorly at school compared to their classmates. There is still little knowledge on the causal pathways and which factors could be targeted by interventions. We, therefore, investigated school absenteeism in children with SHCN compared to their peers.

Risk factors for mechanical complications of peripherally inserted central catheters in children.

Objective: To determine risk factors for mechanical (noninfectious) complications in peripherally inserted central catheters (PICCs) in children.

Design: Retrospective cohort study.

Setting: Pediatric tertiary-care center in Nova Scotia, Canada.

Health Care Utilization in the First 7 Years in Children with Fetal Growth Abnormalities: A Retrospective Cohort Study.

Objective: To investigate the relationship between birth weight for gestational age and health care utilization of term offspring from birth to 7 years.

Study Design: We used a population-based retrospective cohort study of infants (≥37 weeks' gestational age) born between 2003 and 2007 in the Canadian province of Nova Scotia (n = 42 050). Perinatal records were linked to provincial administrative health data from birth to age 7 years.

Prophylactic cyclo-oxygenase inhibitor drugs for the prevention of morbidity and mortality in preterm infants: a network meta-analysis.

Background: Patent ductus arteriosus (PDA) is associated with significant morbidity and mortality in preterm infants. Cyclooxygenase inhibitors (COX-I) may prevent PDA-related complications. Controversy exists on which COX-I drug is the most effective and has the best safety profile in preterm infants.

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke.

Introduction: Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia's rural and remote populations in accessing EVT, but improved access can be facilitated by a 'drip and ship' approach.

Maternal cannabis use during pregnancy and maternal and neonatal outcomes: A retrospective cohort study.

Objective: To examine the relationship between reported prenatal cannabis use and neonatal and maternal outcomes and whether the legalisation of cannabis in Canada affected the rates of reported use or the association with maternal and neonatal outcomes.

Design: Population-based retrospective cohort study.

Setting: Routinely collected data in a real-world setting.

Understanding Coordinator Roles in Acute Stroke Care: A National Survey.

Objectives: Coordinators contribute to stroke care quality. Evidence on the scope of practice of coordinator roles for stroke is lacking. We aimed to survey Australian stroke coordinators and describe their responsibilities and characteristics, and compare these based on perceived competency.

Urinary phthalates and body mass index in preschool children: The MIREC Child Development Plus study.

Childhood exposure to phthalates, a class of chemicals with known reproductive and developmental effects, has been hypothesized to increase the risk of obesity, but this association is not well understood in preschool children. We examined the association between urinary concentrations of phthalate metabolites and concurrently measured body mass index (BMI) and skinfolds among children between the ages of two and five years. We collected anthropometric measures and biomonitoring data on approximately 200 children enrolled in the Maternal-Infant Research on Environmental Chemicals Child Development Plus study.

School quality of life: Cross-national comparison of students' perspectives.

Background: Cross-national comparisons of students' school quality of life (QoL) can support our understanding of factors that may affect students' health and well-being at school.

Objective: To compare Canadian and Israeli students' perception of their school QoL.

Methods: The Quality of Life at School Questionnaire (QoLS) was administered to 1231 students in 4th to 6th grades from Canada (n = 629) and Israel (n = 602), measuring: Physical Environment, Positive Attitudes, Student-Teacher Relationship, and Psychosocial.

Canadians Reporting Sport-Related Concussions: Increasing and Now Stabilizing.

Background: Canada is currently engaged in a national harmonization of strategies to prevent and manage sport-related concussions.

Objective: To examine the annual incidence rates of reported sport-related concussions or other brain injuries by participants in the Canadian Community Health Survey, a national public health survey which provides nearly 2 decades of serial data using consistent methodology.

Design: Serial cross-sectional survey.

The Association Between Caesarean Section and Inflammatory Bowel Disease in Childhood and Young Adulthood: Findings From 2 Retrospective Cohort Studies.

Objective: The aim of the study was to examine the association of Caesarean section (CS) with inflammatory bowel disease (IBD) in Nova Scotian children.

Methods: The study consisted of 2 retrospective cohorts in the Canadian province of Nova Scotia: all births between 1988 and 2014 (n = 262,729) linked with a clinical registry of all children diagnosed with IBD at the IWK Health Centre, Halifax (Clinical Cohort) and all births from 1989 to 1993 (n = 42,999) linked with provincial administrative health data (Administrative Cohort). The primary outcome was a diagnosis of IBD; the outcome in the Administrative Cohort was ascertained using a previously validated algorithm.

Birth by Caesarean section and otitis media in childhood: a retrospective cohort study.

The objective of the present study was to examine the association between birth by Caesarean section (CS) and otitis media (OM) in childhood. We assembled a retrospective cohort of children born between 2003 and 2007 in Nova Scotia and followed them through to 2014. The cohort was derived through a linkage of the Nova Scotia Atlee Perinatal Database with provincial administrative health data.

The 3G Multigenerational Cohort of Nova Scotian women and their mothers and offspring.

Background: The negative impact of exposures such as maternal obesity, excessive gestational weight gain, and hypertension in pregnancy on the health of the next generation has been well studied. Evidence from animal studies suggests that the effects of in utero exposures may persist into the second generation, but the epidemiological literature on the influence of pregnancy-related exposures across three generations in humans is sparse.

Objectives: This cohort was established to investigate associations between antenatal and perinatal exposures and health outcomes in women and their offspring.

Anti-inflammatory medications for obstructive sleep apnoea in children.

Background: Obstructive sleep apnoea (OSA) is characterised by partial or complete upper airway obstruction during sleep. Approximately 1% to 4% of children are affected by OSA, with adenotonsillar hypertrophy being the most common underlying risk factor. Surgical removal of enlarged adenoids or tonsils is the currently recommended first-line treatment for OSA due to adenotonsillar hypertrophy.

An examination of sex differences in associations between cord blood adipokines and childhood adiposity.

Background: Though the physiological roles of adipokines in metabolism, insulin resistance and satiety are clear, literature regarding associations between cord blood adipokine levels and childhood adiposity is equivocal.

Objectives: To determine whether cord blood levels of leptin and adiponectin are associated with adiposity in children 2 to 5 years of age, and whether such associations are modified by sex.

Methods: Leptin and adiponectin levels were measured in cord blood and anthropometric measures were completed on 550 children enrolled in the Maternal-Infant Research on Environmental Chemicals Child Development Plus study (MIREC-CD Plus).

Blood metal levels and early childhood anthropometric measures in a cohort of Canadian children.

Fetal exposure to some toxic metals has been associated with reduced fetal growth, but the impact of contemporary, low-level metals on anthropometric measures in childhood is not well understood. Our primary objective was to quantify associations between childhood levels of toxic metals and concurrently measured body mass index (BMI) in a population of Canadian preschool-aged children. We collected biomonitoring data and anthropometric measures on 480 children between the ages of two and five years in the Maternal-Infant Research on Environmental Chemicals (MIREC) Child Development Plus study.

Cesarean Delivery and Healthcare Utilization and Costs in the Offspring: A Retrospective Cohort Study.

Objective: To examine the association between cesarean delivery and healthcare utilization and costs in offspring from birth until age 7 years.

Study Design: A retrospective cohort study of singleton term births in the Canadian province of Nova Scotia between 2003 and 2007 followed until age 7 years was conducted using data from the Nova Scotia Atlee Perinatal Database and administrative health data. The main exposure was mode of delivery (cesarean delivery vs vaginal birth); the outcome was healthcare utilization and costs during the first 7 years of life.