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Indian Journal of Pediatrics Dec 2021Pediatric overweight/obesity has assumed epidemic proportions in India. It is associated with several significant complications and tracks into adulthood. The mainstay... (Review)
Review
Pediatric overweight/obesity has assumed epidemic proportions in India. It is associated with several significant complications and tracks into adulthood. The mainstay of management is a holistic lifestyle modification that must be adopted by the family as a whole. It involves dietary changes, regular physical activity, and behavioral changes that favor a healthy way of life. Regular follow-up, and attention to keeping up the motivation of the child and family achieves good results. In the present paper, a stepwise approach to prevention and management of childhood obesity is presented along with the recommendations for screening and management of associated complications and the role of pharmacotherapy and bariatric surgery.
Topics: Adolescent; Adult; Child; Exercise; Humans; India; Life Style; Overweight; Pediatric Obesity
PubMed: 34609654
DOI: 10.1007/s12098-021-03913-3 -
Current Opinion in Psychology Feb 2021The diagnostic concept of Personality Disorder (PD) is changing. A dimensional PD concept that focuses on severity of impairment of personality functioning was... (Review)
Review
The diagnostic concept of Personality Disorder (PD) is changing. A dimensional PD concept that focuses on severity of impairment of personality functioning was introduced in the DSM 5 Section III in 2013 and is adopted by the upcoming ICD-11 in a similar manner. Several reliable, valid and useful instruments to assess personality functioning (Criterion A) either as self-report, expert rating or clinical interview were developed in the past years. This article gives a latest state-of-the-art overview of these measures. It underlines the importance of multi-informant multi-method assessment of, and a longitudinal perspective on PD pathology and the importance of standardized inclusion of PD individuals in studies to increase the significance of research findings.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Personality; Personality Assessment; Personality Disorders; Personality Inventory
PubMed: 33099168
DOI: 10.1016/j.copsyc.2020.09.009 -
World Journal of Psychiatry Sep 2018It was once impossible anywhere in the world for single adults to adopt children, and this is still the case in many jurisdictions. Elsewhere, however, single adults are... (Review)
Review
It was once impossible anywhere in the world for single adults to adopt children, and this is still the case in many jurisdictions. Elsewhere, however, single adults are now being actively recruited primarily because they are more willing than are married couples to adopt older or disabled children or to adopt across racial or other barriers. This is true for single men as well as for single women, but single men seeking to adopt continue to be widely viewed with skepticism and are reportedly often judged to be inappropriate parents. This paper reviews the sparse fostering and adoption literature on single heterosexual males and addresses the evident ambivalence with which parenting by single men is held among both child and adult mental health professionals. The paper also discusses the parenting styles of mothers and fathers, the ways that the central nervous system in both sexes has been found to respond to parenthood, the similarity of outcomes between single male and single female parenting, and the availability in North America of support and training for foster and adoptive single parents. The paper concludes that, in general, single men have as much to offer an adopted child as do single women and that seeming discrimination against them by childcare agencies requires investigation.
PubMed: 30254978
DOI: 10.5498/wjp.v8.i3.83 -
Italian Journal of Pediatrics Jan 2022In the last year, many countries adopted a plan to contain hospital infections by Sars-Cov-2 also limiting pulmonary function tests (PFTs), exclusively to indispensable... (Review)
Review
In the last year, many countries adopted a plan to contain hospital infections by Sars-Cov-2 also limiting pulmonary function tests (PFTs), exclusively to indispensable cases. All the recommendations of the major scientific societies regarding the use of PFTs, in particular spirometry, in the Covid era were formulated in the initial period of the pandemic. Currently, the new scientific knowledge about Sars-Cov-2 and the vaccination among healthcare workers, shown new insight to start doing PFTs again to help the investigation and monitoring of patients with respiratory pathology. In this article, we sum up the recommendations of major International Respiratory Societies, and we shared our experience about PFTs in a Pediatric Respiratory Disease Unit during the pandemic.
Topics: Adult; Appointments and Schedules; COVID-19; Child; Communicable Disease Control; Humans; Respiratory Aerosols and Droplets; Respiratory Function Tests; Risk Assessment; SARS-CoV-2; Societies, Scientific; Spirometry; Triage
PubMed: 35042531
DOI: 10.1186/s13052-022-01199-5 -
International Journal of Environmental... Feb 2021The aim of this study was to examine the relationship among aggressiveness, parenting practices, and attachment security in adolescents, assessing maternal and paternal...
The aim of this study was to examine the relationship among aggressiveness, parenting practices, and attachment security in adolescents, assessing maternal and paternal effects separately. Two different subsamples of adolescents between 12 and 16 years old participated in the study ( = 157): 67 adopted adolescents (61.2% girls) and 90 non-adopted adolescents (56.7% girls). Partial and full mediation models were analyzed in multi-group structural equation models (using maximum likelihood estimates), allocating non-adoptive and adoptive adolescents into two different groups. Results showed that whereas acceptance/involvement of each parent predicted attachment security towards the corresponding parental figure, only the father's coercion/imposition predicted aggressiveness, and only attachment security to the mother was a (negative) predictor of adolescent's aggressiveness. The partial mediation model provided the most parsimonious explanation for the data, showing no differences between adopted and non-adopted subsamples and supporting a good model fit for both boys and girls in a multi-group invariance analysis. The implications of these results are discussed in light of the protective effects of care relationships in early adolescence (vs. late adolescence) as well as the differential role of parent figures.
Topics: Adolescent; Adoption; Aggression; Child; Female; Humans; Male; Mothers; Object Attachment; Parent-Child Relations; Parenting
PubMed: 33669739
DOI: 10.3390/ijerph18042034 -
Clinical Endoscopy Mar 2018Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies... (Review)
Review
Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.
PubMed: 29618173
DOI: 10.5946/ce.2018.028 -
European Journal of Psychotraumatology May 2018An earlier meta-analysis and review indicated that trauma exposure may be related to lower levels of executive functioning in youth. Since different developmental... (Review)
Review
An earlier meta-analysis and review indicated that trauma exposure may be related to lower levels of executive functioning in youth. Since different developmental trajectories were found for three core executive functions, the present study focused on working memory, inhibition, and cognitive flexibility specifically. We conducted a multi-level meta-analysis on 55 studies and 322 effect sizes published between 2001 and 2017 that were retrieved from MEDLINE, Embase, and PsycINFO. The 8070 participants in selected studies were aged 2-25 years. We investigated whether the association between constructs would be moderated by trauma-specific moderators (onset, duration, and type), and study (age, gender, ethnicity, and socio-economic status) and measurement (quality) characteristics. We found small to medium effect sizes for working memory (= -0.49), inhibition (= -0.46), and cognitive flexibility (= -0.44). Moderator analyses showed that, for working memory, when studies used low-quality measurements the effect size was significantly stronger than when studies used high-quality measurements.Compared to single trauma-exposed youth, violence-exposed/abused and foster care/adopted youth showed more problems in inhibition, and foster care/adopted youth showed more problems in cognitive flexibility. Our findings imply that trauma-exposed youth have lower levels of executive functions. Clinical practice should incorporate problems in executive functioning, especially working memory, inhibition, and cognitive flexibility, in assessment and treatment guidelines.
PubMed: 33488998
DOI: 10.1080/20008198.2018.1450595 -
Neurology India 2021To analyze the common problems in shunt surgery and measures to avoid them. Management of hydrocephalus takes up as much as 50% of a pediatric ' 'neurosurgeon's time,... (Review)
Review
BACKGROUND AND OBJECTIVE
To analyze the common problems in shunt surgery and measures to avoid them. Management of hydrocephalus takes up as much as 50% of a pediatric ' 'neurosurgeon's time, and these are notoriously prone to complications. In this article, the author analysis his series of ventriculoperitoneal shunts and discusses his technique, nuances and avoidance of shunt complications.
METHODS AND MATERIALS
The author will review common issues related to hydrocephalus shunt management with a review of 549 procedures and associated complications.
RESULTS
Key features and basic principles of complication avoidance in shunt surgery is provided. The analysis looks into the complications and ways to avoid them based on the author's experience.
CONCLUSIONS
Specific measures may be adopted to minimize or avoid these complications. These will be discussed based on the author's series and experiences.
Topics: Child; Humans; Hydrocephalus; Prostheses and Implants; Ventriculoperitoneal Shunt
PubMed: 35103008
DOI: 10.4103/0028-3886.332256 -
Pharmacology, Biochemistry, and Behavior Nov 2021The effect of experiences in infancy on human development is a central question in developmental science. Children raised in orphanage-like institutions for their first... (Review)
Review
The effect of experiences in infancy on human development is a central question in developmental science. Children raised in orphanage-like institutions for their first year or so of life and then adopted into well-resourced and supportive families provide a lens on the long-term effects of early deprivation and the capacity of children to recover from this type of early adversity. While it is challenging to identify cause-and-effect relations in the study of previously institutionalized individuals, finding results that are consistent with animal experimental studies and the one randomized study of removal from institutional care support the conclusion that many of the outcomes for these children were induced by early institutional deprivation. This review examines the behavioral and neural evidence for altered executive function, declarative memory, affective disorders, reward processing, reactivity to threat, risk-taking and sensation-seeking. We then provide a brief overview of the neurobiological mechanisms that may transduce early institutional experiences into effects on brain and behavior. In addition, we discuss implications for policy and practice.
Topics: Animals; Brain; Child; Child Behavior; Child Development; Child, Preschool; Executive Function; Female; Humans; Infant; Learning; Male; Memory; Mood Disorders; Neurobiology; Orphanages; Reward; Risk-Taking; Time Factors
PubMed: 34509501
DOI: 10.1016/j.pbb.2021.173272 -
Pediatric Research May 2022After adoption, children exposed to institutionalized care show significant improvement, but incomplete recovery of growth and developmental milestones. There is a...
BACKGROUND
After adoption, children exposed to institutionalized care show significant improvement, but incomplete recovery of growth and developmental milestones. There is a paucity of data regarding risk and protective factors in children adopted from institutionalized care. This prospective study followed children recently adopted from institutionalized care to investigate the relationship between family environment, executive function, and behavioral outcomes.
METHODS
Anthropometric measurements, physical examination, endocrine and bone age evaluations, neurocognitive testing, and behavioral questionnaires were evaluated over a 2-year period with children adopted from institutionalized care and non-adopted controls.
RESULTS
Adopted children had significant deficits in growth, cognitive, and developmental measurements compared to controls that improved; however, residual deficits remained. Family cohesiveness and expressiveness were protective influences, associated with less behavioral problems, while family conflict and greater emphasis on rules were associated with greater risk for executive dysfunction.
CONCLUSIONS
Our data suggest that a cohesive and expressive family environment moderated the effect of pre-adoption adversity on cognitive and behavioral development in toddlers, while family conflict and greater emphasis on rules were associated with greater risk for executive dysfunction. Early assessment of child temperament and parenting context may serve to optimize the fit between parenting style, family environment, and the child's development.
IMPACT
Children who experience institutionalized care are at increased risk for significant deficits in developmental, cognitive, and social functioning associated with a disruption in the development of the prefrontal cortex. Aspects of the family caregiving environment moderate the effect of early life social deprivation in children. Family cohesiveness and expressiveness were protective influences, while family conflict and greater emphasis on rules were associated with a greater risk for executive dysfunction problems. This study should be viewed as preliminary data to be referenced by larger studies investigating developmental and behavioral outcomes of children adopted from institutional care.
Topics: Child, Adopted; Cognitive Dysfunction; Executive Function; Humans; Parenting; Prospective Studies
PubMed: 34040161
DOI: 10.1038/s41390-020-01325-1