Background.Pediatric patients' self-report of health-related quality of life (HRQOL) has emerged as an important patient-based health outcome. A practical, validated generic measure of HRQOL facilitates assessing risk, tracking health status, and measuring treatment outcomes in pediatric populations

The PedsQL: measurement model for the pediatric quality of life inventory.

Background When thyroid deficiency occurs simultaneously in a pregnant woman and her fetus, the child's neuropsychological development is adversely affected. Whether developmental problems occur when only the mother has hypothyroidism during pregnancy is not known. Methods In 1996 and 1997, we measured thyrotropin in stored serum samples collected from 25,216 pregnant women between January 1987 and March 1990. We then located 47 women with serum thyrotropin concentrations at or above the 99.7th percentile of the values for all the pregnant women, 15 women with values between the 98th and 99.6th percentiles, inclusive, in combination with low thyroxine levels, and 124 matched women with normal values. Their seven-to-nine-year-old children, none of whom had hypothyroidism as newborns, underwent 15 tests relating to intelligence, attention, language, reading ability, school performance, and visual–motor performance. Results The children of the 62 women with high serum thyrotropin concentrations performed sli...

https://www.nejm.org/doi/pdf/10.1056/NEJM199908193410801

Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child.

Objective. Childhood obesity has contributed to an increased incidence of type 2 diabetes mellitus and metabolic syndrome (MS) among children. Intrauterine exposure to diabetes and size at birth are risk factors for type 2 diabetes mellitus, but their association with MS in childhood has not been demonstrated. We examined the development of MS among large-for-gestational-age (LGA) and appropriate-for-gestational age (AGA) children. Study Design. The major components of MS (obesity, hypertension, dyslipidemia, and glucose intolerance) were evaluated in a longitudinal cohort study of children at age 6, 7, 9, and 11 years who were LGA ( n = 84) or AGA ( n = 95) offspring of mothers with or without gestational diabetes mellitus (GDM). The cohort consisted of 4 groups, ie, LGA offspring of control mothers, LGA offspring of mothers with GDM, AGA offspring of control mothers, and AGA offspring of mothers with GDM. Biometric and anthropometric measurements were obtained at 6, 7, 9, and 11 years. Biochemical testing included measurements of postprandial glucose and insulin levels and high-density lipoprotein (HDL) cholesterol levels at 6 and 7 years and of fasting glucose, insulin, triglyceride, and HDL cholesterol levels at 9 and 11 years. We defined the components of MS as (1) obesity (BMI >85th percentile for age), (2) diastolic or systolic blood pressure >95th percentile for age, (3) postprandial glucose level >140 mg/dL or fasting glucose level >110 mg/dL, (4) triglyceride level >95th percentile for age, and (5) HDL level Results. There were no differences in baseline characteristics (gender, race, socioeconomic status, and maternal weight gain during pregnancy) for the 4 groups except for birth weight, but there was a trend toward a higher prevalence of maternal obesity before pregnancy in the LGA/GDM group. Obesity (BMI >85th percentile) at 11 years was present in 25% to 35% of the children, but rates were not different between LGA and AGA offspring. There was a trend toward a higher incidence of insulin resistance, defined as a fasting glucose/insulin ratio of Conclusions. We showed that LGA offspring of diabetic mothers were at significant risk of developing MS in childhood. The prevalence of MS in the other groups was similar to the prevalence (4.8%) among white adolescents in the 1988–1994 National Health and Nutrition Examination Survey. This effect of LGA with maternal GDM on childhood MS was previously demonstrated for Pima Indian children but not the general population. We also found that children exposed to maternal obesity were at increased risk of developing MS, which suggests that obese mothers who do not fulfill the clinical criteria for GDM may still have metabolic factors that affect fetal growth and postnatal outcomes. Children who are LGA at birth and exposed to an intrauterine environment of either diabetes or maternal obesity are at increased risk of developing MS. Given the increased obesity prevalence, these findings have implications for perpetuating the cycle of obesity, insulin resistance, and their consequences in subsequent generations.

Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus

The present study investigated the relationship of traits from the 5factor model of personality (often termed the "Big Five") and general mental ability with career success. Career success was argued to be comprised of intrinsic success (job satisfaction) and extrinsic success (income and occupational status) dimensions. Data were obtained from the Intergenerational Studies, a set of 3 studies that followed participants from early childhood to retirement. The most general findings were that conscientiousness positively predicted intrinsic and extrinsic career success, neuroticism negatively predicted extrinsic success, and general mental ability positively predicted extrinsic career success. Personality was related to career success controlling for general mental ability and, though adulthood measures of the Big Five traits were more strongly related to career success than were childhood measures, both contributed unique variance in explaining career success. Considerable evidence has accumulated regarding the antecedents of career success. A recent review of the career success literature (Tharenou, 1997) identified several categories of influences on career success. The most commonly investigated influences were human capital attributes (training, work experience, education) and demographic factors (age, sex, marital status, number of children). Although these classes of influences have provided important insights into the determinants of career success, there is room for further development. Specifically, little research has entertained the idea that career success may have dispositional causes. There have been a few exceptions, such as Howard and Bray's (1988, 1994) study of the career advancement of AT&T managers. However, as Tharenou noted, few studies have taken a more comprehensive, personological approach to career success.

/pdf/the-big-five-personality-traits-general-mental-ability-and-3ahyip1el0.pdf

The big five personality traits, general mental ability, and career success across the life span

One in 7 US children and adolescents is obese, yet little is known about their health-related quality of life (QOL) This study was a cross-sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years, who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002 Children and adolescents had a mean (SD) body mass index (BMI) of 347 (93) The main outcome measures were child self-report and parent proxy report using a pediatric QOL inventory generic core scale (range, 0-100) The inventory was administered by an interviewer for children aged 5 through 7 years Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer Compared with healthy children and adolescents, obese children and adolescents reported significantly lower health-related QOL in all domains  Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents and were similar to children and adolescents diagnosed as having cancer Children and adolescents with obstructive sleep apnea reported a significantly lower health-related QOL total score than obese children and adolescents without obstructive sleep apnea Overall it is clear that physicians, parents, and teachers need to be informed of the risk for impaired health-related QOL among obese children and adolescents to target interventions that could enhance health outcomes

http://web.mit.edu/kilroi/Public/text/jama-obese-children.pdf

Roi Paschou

Papers

Four Factor Index of Social Status