Acta Paediatrica

Publisher: Blackwell Publishing

Description

  • Impact factor
    1.97
  • 5-year impact
    2.06
  • Cited half-life
    8.70
  • Immediacy index
    0.41
  • Eigenfactor
    0.02
  • Article influence
    0.67
  • Other titles
    Acta pædiatrica (Oslo, Norway: 1992: Online), Acta paediatrica
  • ISSN
    1651-2227
  • OCLC
    37664034
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

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    • See Wiley-Blackwell entry for articles after February 2007
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    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley-Blackwell'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: AimThis study examined the prevalence, symptom expression and risk factors for food hypersensitivity among Swedish schoolchildren.Methods Parents of 2,585 (96% of invited) children aged seven to eight years completed a questionnaire regarding food hypersensitivity and allergic diseases. A random sample of 1,700 children (90% of invited) also participated in skin-prick-testing with ten airborne allergens.ResultsThe overall prevalence of reported food hypersensitivity to milk, egg, fish, wheat, soy, fruits and, or, nuts was 21%, with symptoms caused by milk (9%) being the most common. The most frequently reported symptoms were oral symptoms (47.4%), mainly caused by fruit, and gastrointestinal symptoms (45.7%), mainly caused by milk. Factors associated with any food hypersensitivity were female sex, allergic heredity and a positive skin prick test. Eczema was consistently associated with symptoms caused by milk, egg, fish, wheat, soy, fruits and nuts. Rhinitis was associated to the same foods, except milk.Conclusion Reported food hypersensitivity was common among Swedish schoolchildren. The most frequent symptom expressions were oral symptoms triggered by fruits and gastrointestinal symptoms triggered by milk. The high prevalence of reported symptoms should be validated by clinical examinations to provide a diagnosis.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimHospitalised children have higher rates of under-nutrition. Early detection of at risk patients could lead to prompt preventative or corrective interventions. Several nutritional risk screening tools are available for screening hospitalised children including the STRONGkids tool. This study was designed to assess the usefulness of STRONGkids when applied by nurses rather than a paediatrician.Methods The STRONGkids questionnaire was simplified to enhance clarity with nursing staff. Trained nursing staff were asked to apply the tool to children, aged one month to 17 years, admitted to the Christchurch Hospital, New Zealand. Each patient was also assessed by a paediatrician. In addition, the current nutritional state of each patient was defined by measuring their weight and height.ResultsOf the 162 children enrolled, 11.7% were under-nourished and 13% over-nourished. STRONGkids recognised 84% of under-nourished children when the tool was applied by nurses and 90% when the tool was applied by a paediatrician, indicating substantial agreement (kappa=0.65). A minor simplification to the questionnaire improved its utility.ConclusionSTRONGkids successfully recognised at risk children, when applied by either nurses or a paediatrician. It was suitable and feasible for nursing staff to use it to screen for children at risk of nutritional deterioration.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThis study investigated breast milk and maternal serum concentrations of biochemical markers of bone resorption, which may be implicated in both maternal and neonatal bone metabolism.Methods Tests were carried out on 85 parturients three to four days after they gave birth. We measured their breast milk and serum concentrations for soluble receptor activator of nuclear factor kappaB ligand (sRANKL) and cross-linked N-telopeptide of type I collagen (NTx). The sRANKL and NTx concentrations were associated with several perinatal parameters.ResultssRANKL was detectable in breast milk at considerably lower concentrations than in maternal serum (p<0.001) and these breast milk sRANKL concentrations were decreased in maternal diabetes (b=-0.366, 95% CI -0.622-[-0.110], p=0.006). Breast milk NTx concentrations were higher in exclusive lactation (b=0.269, 95% CI 0.014-0.524, p=0.039), but lower in Caesarean sections (b=-0.224, 95% CI -0.428-[-0.019], p=0.032).ConclusionsRANKL is downregulated in breast milk, particularly in the case of diabetes. Breast milk NTx upregulation characterises exclusive lactation and its downregulation characterises Caesarean section deliveries. Nutritional interventions in fetal life and early infancy may programme adult bone health and ameliorate diseases with developmental origins, such as osteoporosis.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimCritically ill children can develop withdrawal syndrome after prolonged analgesia and sedation in a paediatric intensive care unit (PICU), when treatment is stopped abruptly or reduced quickly. The aim of this study was to evaluate the incidence of withdrawal syndrome in patients after three or more days of analgesic or sedative drug therapy, using a validated scale. We also analysed the association between withdrawal syndrome and the patients’ outcome and factors related to analgesia and sedation treatment.Methods This prospective observational study analysed 89 periods of weaning from analgesia and sedation in 60 children between October 2010 and October 2011. Of these, 65% were less than six-months-old and 45% were admitted to the PICU after heart surgery. Withdrawal syndrome was assessed using the Withdrawal Assessment Tool-1 (WAT-1) scale.ResultsThe incidence of withdrawal syndrome was 37% and the only variable that predicted its presence was the highest administered dose of benzodiazepine. The duration of weaning, Sophia Observational Withdrawal Symptom scale score and nurse judgment were also associated with positive WAT-1 scores.Conclusion Withdrawal syndrome should be considered after three or more days of analgesic or sedative treatment. A high dose of benzodiazepine increases the risk of developing withdrawal symptoms.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe commonest mode of catheter colonisation is via the extraluminal route with skin bacteria. Catheter-related sepsis causes significant mortality and morbidity in neonates. Our aim was to study the relationships between culture-positive catheter exit site skin swabs, percutaneous central venous catheter segments and blood to determine the magnitude of associations between exit site skin colonisation, catheter colonisation and catheter-related sepsis.Methods In a prospective study, an exit site skin swab and three formerly in-vivo catheter segments (proximal, middle, and tip) were taken for culture at catheter removal. In those neonates who were clinically unwell at catheter removal a peripheral blood culture was also collected. Univariate and multivariate analyses were used to study associations.ResultsSkin swabs were culture-positive in 39 (21%) of 187 catheter removals. With a culture-positive skin swab the risk of associated catheter colonisation was nearly eight times higher (OR: 7.84, 95% CI: 3.59 to 17.15) and the risk of definite catheter-related sepsis with the same organism was nearly 10 times higher (OR 9.86, 95% CI: 3.13 to 31.00).Conclusion Culture-positive skin swabs from the catheter exit site were strongly associated with catheter colonisation and with definite catheter-related sepsis with the same organism. These data provide further evidence supporting catheter colonisation via the extraluminal route and highlight the importance of optimising skin disinfection before catheter insertion.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe aim of this study was to analyse the sedation subscale of the Neonatal Pain, Agitation and Sedation Scale (N-PASS), because the N-PASS has only been validated for the assessment of acute and prolonged pain.Methods The nurses’ expert opinion regarding the level of sedation of the study patients was used as reference scale. Paired assessments of both the N-PASS sedation subscale and the nurses’ expert opinion were performed in 50 sedated neonates from 23 to 44 weeks of postmenstrual age.ResultsA total set of 503 paired observations was included into analysis. The median N-PASS sedation subscale scores were significantly different for the three nurses’ expert opinion categories, with minus eight for over-sedation, minus two for adequate sedation and zero for under-sedation (p<0.0001). Inter-observer agreement for the N-PASS sedation subscale was excellent - linearly weighted Cohen's Kappa was 0.93 - as was the internal consistency of 0.88, estimated by a Cronbach's alpha. The internal consistency increased to 0.90 if the vital sign item of the subscale was deleted.Conclusion The N-PASS sedation subscale reliably detected over-sedation, but failed to differentiate between adequate and under-sedation. We therefore recommend using additional methods to ensure adequate assessment of sedation in neonates.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe aim of this analysis was to examine the association between asthma and general and abdominal weight status, defined by age-specific and sex-specific cut-offs for body mass index (BMI) and waist circumference (WC) in adolescents.Methods Participants aged 12-19 years in the Young-HUNT (YH) Study (YH1 1995-1997: N=8,222; YH3 2006-2008: N=7,403) completed self-administered questionnaires in school as part of a series of cross-sectional, population-based studies conducted in Nord-Trøndelag, Norway. Weight, height, and WC were measured. Adjusted odds ratios (ORs) for asthma, defined by self-reported physician-diagnosis, were calculated. Potential effect modifiers evaluated included sex and pubertal development status (PDS).ResultsAsthma was reported by 11.8% of the adolescents in YH1 and 17.0% in YH3. Asthma odds significantly increased for adolescents with general (OR=1.33), but not abdominal, overweight and increased for adolescents with general (OR=1.34) or abdominal obesity (OR=1.36). Underweight had no association with asthma regardless of weight assessment type and PDS did not meaningfully influence the associations between asthma and weight.Conclusion Overweight and obesity both increased the odds of asthma in 12-19 year-old Norwegians. WC did not add further information to that already provided by BMI to improve our understanding of the association between asthma and weight.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimIFN-γ, an essential cytokine in the viral cell-mediated immune response, has been associated with the pathogenesis of respiratory syncytial virus (RSV) bronchiolitis and to the severity of the infection. The aim of this study was to investigate whether IFN-γ CA microsatellite (rs3138557) polymorphism was associated with susceptibility to RSV in Chinese Han children and with the severity of the infection.Methods The IFN-γ CA microsatellite was tested in 218 RSV bronchiolitis inpatients and 303 healthy controls and the severity of the RSV bronchiolitis was evaluated using a standardised respiratory scoring system.ResultsThe frequencies of CA12+/CA12+, CA12+/CA12- and CA12-/CA12- in the 218 RSV bronchiolitis patients and 303 controls were approximately 11% versus 19%, 55% versus 53% and 34% versus 28% respectively. The gene polymorphism of IFN-γ CA repeats between the two groups was statistically different. The clinical respiratory scores of RSV bronchiolitis cases with CA12+/CA12+ and CA12+/CA12- were 2.84±0.40(SD) and 2.95±0.44(SD), respectively, and these were significantly lower than the 3.1±0.36 (SD) score for those with CA12-/CA12-.ConclusionIFN-γ CA microsatellite polymorphism was associated with the susceptibility of Chinese Han children to RSV and the severity of the infection.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe aim of this study was to follow the five-year prevalence of overweight, obesity and thinness in seven- to nine-year-old children in West Sweden, and to investigate whether trends differed according to gender and socioeconomic status.Methods Cross-sectional anthropometric measurements of three cohorts in grades one and two were performed in 3,492 seven- to nine-year-old children in 2008, 2010 and 2013. For body mass index classification, the IOTF/Cole- and WHO-2007-references were used. Percentage of inhabitants with high education in the school area was used for socioeconomic classification.ResultsBetween 2008, 2010 and 2013, the overall time-trends in overweight 17.7%, 19.3% and 18.8%, obesity 3.2%, 3.3% and 3.1%, and thinness 6.5%, 4.7% and 6.9%, respectively, were fairly stable using the IOTF/Cole-references. Thinness defined by the Cole-reference increased in girls. The socioeconomic gradient for overweight and obesity was clear by both references, but using the IOTF-reference, the gap increased for obesity among girls (p=0.024). No significant trends were observed with the WHO-reference.Conclusions The overall prevalence of overweight and obesity was stable over five years, but we detected growing inequality in obesity and increasing prevalence of thinness in girls. With these regionally representative data, we can draw conclusions about West Sweden, despite an absence of continued national surveillance.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimFew studies have focused on cardiac ventricular diastolic function in preterm neonates in the immediate postnatal period. This study evaluated Doppler-derived parameters of diastolic ventricular function in infants with birth weights of less than 1,250 grams during the transitional period.Methods This was a prospective observational study conducted in the Coombe Women and Infants University Hospital in Dublin, Ireland. Flow patterns on the mitral and tricuspid valve, isovolumic relaxation time, left and right ventricular output and superior vena cava flow were measured in 22 infants with a birth weight of below 1, 250 grams at six, 12, 24 and 48-hours-of-age.ResultsEarly filling peak velocity of the left and right ventricle increased significantly from 30.3 to 39.5 cm/s and 26.6 to 32.1 cm/s, respectively. Isovolumic relaxation time of the right ventricle decreased from 70 to 57 ms and there was a non significant decrease in isovolumic relaxation time of the left ventricle from 61.6 to 54 ms over the first 48 hours.Conclusion We have demonstrated that parameters of diastolic ventricular function change significantly over the first 48-hours-of-life in preterm infants less than 1,250 grams and that these changes may represent early diastolic dysfunction during the transitional period.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
  • Acta Paediatrica 08/2014; 103(8).
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    ABSTRACT: AimIt is important to identify speech and language difficulties in children as early as possible. This study investigated the validity of observing babbling structure and consonant articulation.Methods We focused on the language capabilities of children, with and without cleft palates, at 12-months-of-age (n=29) and 18-months-of-age (n=38), comparing observations made by speech and language pathologists on babbling structure and consonant articulation to audio recordings phonetically transcribed by experts blinded to the aim of the study. Descriptive crosstabs, sensitivity, specificity and predictive values were analysed to investigate the validity of agreement between the methods.ResultsWe found high mean agreement between the two methods (94%) and within the observation (100%) and transcription (88.5%) teams when it came to canonical babbling, high-pressure/oral stop consonants and anterior placement of bilabial and dental/alveolar consonants. The observations had high specificity and negative predictive values (0.90-1) at both ages, with low to moderate sensitivity (0-0.86). However, there was low agreement, between and within the groups, on the number of consonant types and the unproven predictive variable glottal place of articulation.Conclusion Previously suggested predictive measures of babbling were shown to be valid and observation is a reliable method of identifying children who need further support.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThis study compared the efficacy of intravenous magnesium sulfate, terbutaline and aminophylline for children with acute, severe asthma poorly responsive to standard initial treatment.Methods We enrolled 100children, aged one to 12 years, who had failed to respond to initial standard treatment for acute, severe asthma, in this randomised controlled trial. They received either intravenous magnesium sulfate, terbutaline or aminophylline. Responses were monitored using a modified Clinical Asthma Severity (CAS) score. The primary outcome was treatment success, defined as a reduction in the CAS of four points or more one hour after starting the intervention.ResultsThe magnesium sulphate group had higher treatment success (33/34, 97%) than the terbutaline and aminophylline groups (both 23/33, 70%)(p=0.006) and faster resolution of retractions, wheeze and dyspnoea (p<0.001). No adverse events occurred among patients receiving magnesium sulfate, but two patients receiving terbutaline had hypokalemia and nine patients receiving aminophylline had nausea and, or, vomiting.Conclusion Adding a single dose of Intravenous magnesium sulfate to inhaled beta2-agonists and corticosteroids was more effective, and safer, than using terbutaline or aminophylline when treating a child with acute severe asthma poorly responsive to initial treatment.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimViral respiratory infections and atopy have been implicated in the pathogenesis of adenotonsillar hypertrophy and obstructive sleep apnoea (OSA), but the role of atopy is controversial. We aimed to test our hypothesis that atopy, expressed as physician-diagnosed eczema, was associated with adenotonsillar hypertrophy and OSA among children who snored.Methods Data on children who snored and were referred for polysomnography were reviewed. The primary outcome measures were adenotonsillar hypertrophy and OSA.ResultsWe analysed data on 855 children with a mean age (± standard deviation) of 6.3 (± 2.5) years and median obstructive apnoea-hypopnea index of 2.1 episodes per hour. Of the 855 subjects, 133 (15.6%) had physician-diagnosed eczema, 591 (69.1%) had adenoidal hypertrophy, 605 (70.8%) had tonsillar hypertrophy, 219 (25.6%) were obese and 470 (55%) had OSA. Eczema was not related to adenoidal or tonsillar hypertrophy after adjustment for gender and age, with odds ratios (OR) of 1.00 (95% confidence interval 0.67-1.49; p=0.98) and 0.88 (0.59-1.32; p=0.54), respectively. Similarly, eczema did not affect OSA frequency after adjustment for adenoidal and tonsillar hypertrophy, obesity, gender and age, with an adjusted OR of 0.82 (0.56-1.21; p=0.32).Conclusions Atopy was not related to adenotonsillar hypertrophy or OSA in children who snore.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThis study assessed the mental health of parents of children with inflammatory bowel disease (IBD), compared their mental health with age-matched and gender-matched references and examined parental and child predictors for mental health problems.MethodsA total of 125 mothers and 106 fathers of 125 children with active and inactive IBD from the Swiss IBD multicentre cohort study were included. Parental mental health was assessed by the Symptom Checklist 27 and child behaviour problems by the Strengths and Difficulties Questionnaire. Child medical data were extracted from hospital records.ResultsWhile the mothers reported lower mental health, the fathers’ mental health was similar, or even better, than in age-matched and gender-matched community controls. In both parents, shorter time since the child's diagnosis was associated with poorer mental health. In addition, the presence of their own IBD diagnosis and child behaviour problems predicted maternal mental health problems.Conclusions Parents of children with IBD may need professional support when their child is diagnosed, in order to mitigate distress. This, in turn, may help the child to adjust better to IBD. Particular attention should be paid to mothers who have their own IBD diagnosis and whose children display behaviour problems.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: Behavioural sleep disorders are highly prevalent in children and associated with impaired daytime functioning and significant social and psychological consequences (1-3). Thus, a careful evaluation of sleep patterns is essential for the management of children's sleep disorders by healthcare professionals. Recently, we provided data about the interchangeable use of actigraphy, a sleep diary and sleep questionnaire for the assessment of sleep patterns in a sample of healthy kindergarten children (4).This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe most common manifestation of sickle cell disease (SCD) is painful vaso-occlusive episodes (PVOE) and inappropriate treatment leads to unnecessary suffering and potentially fatal complications. This study describes how French paediatric emergency departments (EDs) manage PVOE and their knowledge, and implementation, of the French National Authority for Health recommendations on the management of sickle cell patients.MethodsA questionnaire on managing PVOE was sent to all 111 French paediatric EDs.ResultsWe received responses from 81 (72.9%) of the EDs. Of those who responded to each individual question, 85% said that they had read the National recommendations, 71.6% said they used nalbuphine for moderate PVOE and 85% used intravenous morphine for severe PVOE. The majority (91.7%) of EDs thought that intravenous morphine provided relief for severe PVOE, but only 30.9% thought that intravenous nalbuphine did. A 50/50 nitrous oxide/oxygen mix was used by 71.3% of departments to relieve procedural pain and by 48% to enhance analgesia when morphine was insufficient for severe pain.Conclusions Most French EDs follow the National recommendations for PVOE. Nalbuphine was the most commonly used opioid for moderate PVOE and morphine for severe PVOE. A nitrous oxide/oxygen mixture was widely used for PVOE.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimsMost Italian children are cared for by a family paediatrician until they are 14-years-old and their duties include prescribing drugs recommended by specialists so that they are free. This study aimed to draw up a list of the drugs most commonly prescribed by family paediatricians.Methods We surveyed 64 experienced family paediatricians to find out what drugs they prescribed over an eight-week period, including those recommended by a specialist, using cartons of drugs as the unit of measurement. A list of commonly prescribed drugs was then drawn up.ResultsA total of 381 active substances were prescribed. The most commonly prescribed drugs were amoxicillin (25.8% of te cartons), amoxicillin clavulanate (9.2%), and cetirizine (9.0%). The most commonly prescribed drug classes were antibiotics (43.8%), anti-asthmatics (12.9%) and anti-histamines (11.8%). A list of 38 commonly prescribed drugs belonging to 16 therapeutic subgroups and covering 83.1% of cartons was identified. Of these, 33 were prescribed by 50% or more of the paediatricians and five were mainly prescribed following the recommendation of a specialist.Conclusions Our review of the prescribing habits of family paediatricians showed that 38 commonly prescribed drugs were sufficient to treat most common diseases in children under 15-years-of-age.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 08/2014;
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    ABSTRACT: AimThe aim was to evaluate and compare different bowel regimes with regard to satisfaction, faecal incontinence and independence, and the relationship to quality of life among children with myelomeningocele (MMC).MethodsA questionnaire, including the Health-Related Quality of Life instrument PedsQL 4.0®, was sent to all children aged seven to 16 years (n=172) with MMC, treated at two centres in Sweden and one in Norway. The three centres cover a third of the population in the two countries. The response rate was 61%.ResultsParents of children (30%) using antegrade colonic enemas (ACE) reported higher satisfaction (p=0.01) than the parents of those (47%) using transanal retrograde enemas (TRI). The children reported no significant difference. Children and parents in the ACE group reported more complete evacuation of the bowels than the TRI group. No significant difference was found in faecal incontinence or independent toileting. The children (40%) who emptied their bowels independently reported a higher quality of life. Children using TRI or ACE spent around one hour on the toilet at every bowel emptying.ConclusionTRI and ACE are effective treatments, but time-consuming and difficult to perform independently. Higher parental satisfaction is obtained with ACE, and children who can use the toilet independently report a higher quality of life, which makes efforts to support independence valuable.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 07/2014;
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    ABSTRACT: AimThere is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents.Methods The Spanish UP&DOWN study is a three-year longitudinal study designed to assess the impact, over time, of physical activity and sedentary behaviours on health indicators This present analysis was conducted with 1,778 children and adolescents aged six to18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades.ResultsPhysical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p<0.05). This association became non-significant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d< 0.20).Conclusion Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding.This article is protected by copyright. All rights reserved.
    Acta Paediatrica 07/2014;

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