Objective: The development and severity of attention deficit hyperactivity disorder (ADHD) has been linked to a number of psychosocial risk factors. Research has shown that the amount of social capital in a community influences the physical and mental health of community members. We assessed the independent role of perceived neighborhood context, including physical and socioeconomic characteristics, and collective efficacy, a form of social capital, on ADHD prevalence. Methods: Cross-sectional study utilizing the 2007 National Survey of Children's Health, a nationally representative dataset. The population of interest was children between the ages of four and seventeen living in randomly selected households. Multiple logistic regression models were used to assess the association between indices of perceived neighborhood socioeconomic conditions, built environment, and collective efficacy (study exposures) on risk of ADHD (outcome), controlling for pertinent individual and family risk factors. Results: Nine percent of children in the US (ages 4-17 ) had ADHD as reported by their caregiver. Univariately, all 3 neighborhood characteristics were associated with risk of ADHD (p-value =.01, .04, and .0002 for socioeconomic conditions, built environment, and collective efficacy, respectively). After accounting for well-established risk factors for ADHD, perceived neighborhood socioeconomic conditions and built environment were no longer associated with ADHD, while collective efficacy remained significant (p=.0002). Lower level of perceived neighborhood collective efficacy was associated with increased risk of ADHD (OR: 1.7; 95% CI: 1.3-2.2, comparing the lowest with the highest level). Conclusions: Our study suggests that perceived neighborhood collective efficacy may buffer the impact of individual-and family-level risk factors for ADHD in children.
Background: Children with disabilities are at a higher risk of visual impairment as compared to normal population. The present study was conducted to find out the prevalence of various ocular manifestations and to assess the possible aetiological factors including psycho-social and hereditary factors. Subjects and Methods: The present study was undertaken in the department of ophthalomology and paediatrics, S.N. Medical College, Agra. Two hundred and forty mentally retarded children between the ages of 3 months to 15 years of either sex were scrutinized to find out the prevalence of ocular manifestations in cases of mental retardation. A complete case history was taken. Results: In the present study, in 50% cases, the cause of mental retardation could not be identified clinically. Causes of mental retardation which could be identified in our study were developmental cranial anomalies -12.5%, down's syndrome (7.5%), post inflectional (6.7%), congenital cerebral palsy (5.8%) , epilepsy (3.3%), endocrine disorders, others 11.6%. Out of these 66.7% were males and 33.3% cases were females. Ocular examination of the mentally retarded children revealed that 60% cases were having one or other form of ocular abnormalities. Strabismus (30.5%) was the commonest ocular anomaly followed by refractive errors (27.8%). Other ocular manifestations in order of frequency were congenital cataract (12.5%), optic nerve disorders (7.5%), lid and orbital abnormalities (5.5%), nystagmus (2.7%) and retinal disorders (1.4%). Colour vision defects were found to be present in 13.2% mentally retarded children. Conclusion: The children with disabilities should undergo annual ophthalmic evaluation. We concluded from our study that visual function of the children should be assessed as soon as the child is admitted to the school. Earlier assessment and correction of the visual problems will have greater chance of achieving potential and will prevent unnecessary visual impairment.
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