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Children (Basel, Switzerland) Sep 2023Pediatric chronic pain is an important public health issue given its notable impact on numerous domains of living. Pediatric chronic pain is also often comorbid with...
Pediatric chronic pain is an important public health issue given its notable impact on numerous domains of living. Pediatric chronic pain is also often comorbid with emotional, developmental, or behavioral conditions, which can lead to more severe negative outcomes and an even greater reduction in positive outcomes compared to those without comorbidities. Flourishing is a positive outcome that chronic pain status has been shown to impact. Flourishing in children aged 6-17 years living with chronic pain, as well as those with chronic pain and comorbidities, was explored using data from the 2018/2019 National Survey of Child Health. Chronic pain occurred in 4.0% of our sample, and the prevalence of chronic pain plus comorbidities was 3.9%. There were significant associations between the chronic pain condition status and all demographic variables (sex, age, race/ethnicity, poverty level, parental education, and health insurance status). The results of the hierarchical logistic regression found that the chronic pain condition status significantly predicted flourishing. Children with chronic pain were 2.33 times less likely to flourish, and children with chronic pain plus an emotional, developmental, or behavioral comorbidity were 13 times less likely to flourish than their typical peers. Given their significantly lower likelihood of flourishing, there is an urgent need for interventions targeted at children experiencing chronic pain and mental health comorbidities.
PubMed: 37761492
DOI: 10.3390/children10091531 -
Journal of Perinatology : Official... Nov 2023We investigated the relationship between respiratory events experienced before and after hospital discharge and developmental outcomes at 6 months corrected age (CA).
OBJECTIVE
We investigated the relationship between respiratory events experienced before and after hospital discharge and developmental outcomes at 6 months corrected age (CA).
STUDY DESIGN
Preterm infants born between 28-32 weeks gestational age (GA) were studied at 32-36 weeks postmenstrual age (PMA), 36-40 weeks PMA, 3- and 6-months CA. Percentage total sleep time (%TST) with respiratory events (isolated apneas, sequential apneas and periodic breathing (PB)) at each study was calculated. Stepwise multiple linear regressions determined significant predictors of developmental outcomes at 6 months.
RESULT
%TST with respiratory events at term were significant predictors of language (R = 0.165, β = -0.416) and motor (R = 0.180, β = -0.485) composite scores of the Bayley Scales of Infant Development at 6 months, independent of GA, birth weight and sex.
CONCLUSIONS
In clinically stable very preterm infants at term equivalent age, time spent having respiratory events, was related to a reduction in language and motor outcomes at 6 months.
Topics: Infant; Child; Infant, Newborn; Humans; Infant, Premature; Apnea; Gestational Age; Birth Weight; Infant, Very Low Birth Weight
PubMed: 37558750
DOI: 10.1038/s41372-023-01748-8 -
American Journal of Obstetrics and... May 2024Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how...
BACKGROUND
Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive healthcare.
OBJECTIVE
We aimed to characterize the use of reproductive healthcare services among adolescents with autism and those with other developmental disabilities in comparison with adolescents with typical development.
STUDY DESIGN
We conducted a cohort study of a sample of adolescents who were continuously enrolled members of Kaiser Permanente Northern California, an integrated healthcare system, from ages 14 to 18 years. The final analytical sample included 700 adolescents with autism, 836 adolescents with other developmental disabilities, and 2187 typically developing adolescents who sought care between 2000 and 2017. Using the electronic health record, we obtained information on menstrual conditions, the use of obstetrical-gynecologic care, and prescriptions of hormonal contraception. We compared healthcare use between the groups using chi-square tests and covariate-adjusted risk ratios estimated using modified Poisson regression.
RESULTS
Adolescents with autism and those with other developmental disabilities were significantly more likely to have diagnoses of menstrual disorders, polycystic ovary syndrome, and premenstrual syndrome than typically developing adolescents. These 2 groups also were less likely than typically developing peers to visit the obstetrician-gynecologist or to use any form of hormonal contraception, including oral contraception, hormonal implants, and intrauterine devices. Adolescents in all 3 groups accessed hormonal contraception most frequently through their primary care provider, followed by an obstetrician-gynecologist.
CONCLUSION
Adolescents with autism and those with other developmental disabilities are less likely than their typically developing peers to visit the obstetrician-gynecologist and to use hormonal contraception, suggesting possible care disparities that may persist into adulthood. Efforts to improve access to reproductive healthcare in these populations should target care delivered in both the pediatric and obstetrics-gynecology settings.
Topics: Humans; Adolescent; Female; Developmental Disabilities; Autistic Disorder; Cohort Studies; Reproductive Health Services; California; Menstruation Disturbances; Polycystic Ovary Syndrome; Health Services Accessibility; Case-Control Studies; Contraception
PubMed: 38218512
DOI: 10.1016/j.ajog.2024.01.005 -
European Psychiatry : the Journal of... Aug 2023It is not clear if there is an interaction between psychotherapy and pharmacotherapy. First, there may be no interaction at all, meaning that the effects of both are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is not clear if there is an interaction between psychotherapy and pharmacotherapy. First, there may be no interaction at all, meaning that the effects of both are independent of each other. Second, antidepressants may reduce the effects of psychotherapy, and third, antidepressants may increase the effects of psychotherapy. We examined which of the three is correct.
METHODS
We conducted random effects meta-analyses of randomized trials comparing psychotherapies for adult depression with control conditions. The proportion of users of antidepressants was used as a predictor of the effect size in a series of meta-regression analyses, while adjusting for relevant moderators, such as type of control group and baseline severity.
RESULTS
We included 300 randomized controlled trials (353 comparisons between treatment and control; 32,852 participants). The main effect size of psychotherapy was = 0.71 (95% CI: 0.64; 0.79) with high heterogeneity ( = 82; 95% CI: 80; 84). We found no significant association between the proportion of antidepressants users and effect size ( = .07). We did find a significant association with some other predictors, including the type of control group and risk of bias. The use of antidepressants was associated with higher response rates within the control conditions, but not with the relative effects of the treatments compared to the control groups.
DISCUSSION
We found support for the independent effects of psychotherapy and pharmacotherapy, which is good news from a clinical perspective. Apparently, patients can start with psychotherapy and do not have to be afraid that this will reduce the effects of the therapy.
Topics: Adult; Humans; Antidepressive Agents; Psychotherapy; Combined Modality Therapy
PubMed: 37534407
DOI: 10.1192/j.eurpsy.2023.2437 -
Biomolecules Feb 2024Developmental and epileptic encephalopathies (DEE) encompass a group of rare diseases with hereditary and genetic causes as well as acquired causes such as brain... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Developmental and epileptic encephalopathies (DEE) encompass a group of rare diseases with hereditary and genetic causes as well as acquired causes such as brain injuries or metabolic abnormalities. The phosphofurin acidic cluster sorting protein 2 (PACS2) is a multifunctional protein with nuclear gene expression. The first cases of the recurrent c.625G>A pathogenic variant of gene were reported in 2018 by Olson et al. Since then, several case reports and case series have been published.
METHODS
We performed a systematic review of the PUBMED and SCOPUS databases using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Our search parameters included DEE66 with a pathogenic gene p.Glu209Lys mutation published cases to which we added our own clinical experience regarding this pathology.
RESULTS
A total of 11 articles and 29 patients were included in this review, to which we added our own experience for a total of 30 patients. There was not a significant difference between sexes regarding the incidence of this pathology (M/F: 16/14). The most common neurological and psychiatric symptoms presented by the patients were: early onset epileptic seizures, delayed global development (including motor and speech delays), behavioral disturbances, limited intellectual capacity, nystagmus, hypotonia, and a wide-based gait. Facial dysmorphism and other organs' involvement were also frequently reported. Brain MRIs evidenced anomalies of the posterior cerebellar fossa, foliar distortion of the cerebellum, vermis hypoplasia, white matter reduction, and lateral ventricles enlargement. Genetic testing is more frequent in children. Only 4 cases have been reported in adults to date.
CONCLUSIONS
It is important to maintain a high suspicion of new pathogenic gene variants in adult patients presenting with a characteristic clinical picture correlated with radiologic changes. The neurologist must gradually recognize the distinct evolving phenotype of DEE66 in adult patients, and genetic testing must become a scenario with which the neurologist attending adult patients should be familiar. Accurate diagnosis is required for adequate treatment, genetic counseling, and an improved long-term prognosis.
Topics: Child; Adult; Humans; Epilepsy; Mutation; Cerebellum; Phenotype; Brain Injuries; Vesicular Transport Proteins
PubMed: 38540691
DOI: 10.3390/biom14030270 -
Nutrition Journal Dec 2023Although an association between maternal nutritional intake and developmental delays in children has been demonstrated, the association of the timing of meal intake and...
Association between frequency of breakfast intake before and during pregnancy and developmental delays in children: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.
BACKGROUND
Although an association between maternal nutritional intake and developmental delays in children has been demonstrated, the association of the timing of meal intake and development delays remains unclear. We examined the association between breakfast intake frequency before and during pregnancy and developmental delay in children.
METHODS
Of the pregnant women who participated in the Tohoku Medical Megabank Project Three-Generation Cohort Study, 7491 answered the required questions and were analyzed. The frequency of breakfast intake from pre- to early pregnancy and from early to mid-pregnancy was classified into four groups: daily, and 5-6, 3-4, and 0-2 times/week. Child developmental delays at age 2 and 3.5 years were assessed using the Ages & Stages Questionnaire, Third Edition. Logistic regression models were constructed to examine the association between breakfast intake frequency in pregnant women and developmental delays in children aged 2 and 3.5 years.
RESULTS
The proportion of pregnant women who had breakfast daily was 78.1% in pre- to early pregnancy, and 82.2% in early to mid-pregnancy. The proportion of children with developmental delays was 14.7% and 13.4% at age 2 and 3.5 years, respectively. Compared with the risk in children of women who had breakfast daily from pre- to early pregnancy, children of women who had breakfast 0-2 times/week had a higher risk of developmental delays at 2 years of age: odds ratio (OR) 1.30, (95% confidence interval [CI], 1.02-1.66). The risk of developmental delays at age 2 years increased in the children of women who had breakfast 0-2 times/week in early to mid- pregnancy: OR 1.75 (95% CI, 1.32-2.32). The risk of developmental delays at age 3.5 years did not increase in the children of women who had breakfast 0-2 times/week from pre- to early and early to mid-pregnancy: OR 1.06 (95% CI, 0.81-1.39 and OR 1.15 (95% CI 0.84-1.57), respectively.
CONCLUSION
For women with a low frequency of breakfast intake from pre- to mid-pregnancy there was an association with developmental delays in their children at age 2, but not at 3.5 years.
Topics: Child; Female; Humans; Pregnancy; Child, Preschool; Cohort Studies; Breakfast; Pregnant Women; Eating; Surveys and Questionnaires
PubMed: 38053088
DOI: 10.1186/s12937-023-00901-5 -
BioRxiv : the Preprint Server For... Dec 2023We present an empirically benchmarked framework for sex-specific normative modeling of brain morphometry that can inform about the biological and behavioral significance...
We present an empirically benchmarked framework for sex-specific normative modeling of brain morphometry that can inform about the biological and behavioral significance of deviations from typical age-related neuroanatomical changes and support future study designs. This framework was developed using regional morphometric data from 37,407 healthy individuals (53% female; aged 3-90 years) following a comparative evaluation of eight algorithms and multiple covariate combinations pertaining to image acquisition and quality, parcellation software versions, global neuroimaging measures, and longitudinal stability. The Multivariate Factorial Polynomial Regression (MFPR) emerged as the preferred algorithm optimized using nonlinear polynomials for age and linear effects of global measures as covariates. The MFPR models showed excellent accuracy across the lifespan and within distinct age-bins, and longitudinal stability over a 2-year period. The performance of all MFPR models plateaued at sample sizes exceeding 3,000 study participants. The model and scripts described here are freely available through CentileBrain (https://centilebrain.org/).
PubMed: 38076938
DOI: 10.1101/2023.01.30.523509 -
Psychology Research and Behavior... 2023To explore the impact of the match between academic pressure and peer support on adolescents' sense of loneliness and examine whether social connectedness played a...
PURPOSE
To explore the impact of the match between academic pressure and peer support on adolescents' sense of loneliness and examine whether social connectedness played a mediating role, using a polynomial regression and response surface analysis.
METHODS
A questionnaire survey was conducted with 1277 adolescents from two cities in Sichuan Province, China, to investigate their academic pressure, peer support, social connectedness, and sense of loneliness.
RESULTS
(1) Adolescents' sense of loneliness positively correlated with their level of academic pressure and negatively correlated with their degree of peer support. (2) Social connectedness played a mediating role in the relationship between academic pressure, peer support, and sense of loneliness. (3) Adolescents with high academic pressure and low peer support had weaker social connectedness than those with low academic pressure and high peer support. (4) Adolescents with high academic pressure and high peer support had stronger social connectedness than those with low academic pressure and low peer support.
DISCUSSION
The study revealed the mechanism through which a match (or mismatch) between academic pressure and peer support influenced adolescents' sense of loneliness and validated the mediating role of social connectedness. The study enriches the developmental theory of adolescent loneliness and provides research experience for future interventions targeting adolescent loneliness.
PubMed: 37954932
DOI: 10.2147/PRBM.S435977 -
PloS One 2023Children in foster care are classified as a highly vulnerable population and struggle with both physical and mental health problems. Medical conditions, like poor...
BACKGROUND
Children in foster care are classified as a highly vulnerable population and struggle with both physical and mental health problems. Medical conditions, like poor nutritional status, remain understudied in children in foster care. To our knowledge, few studies in children in U.S. foster care have quantified the prevalence of anemia, and no studies have examined the association between anemia status and relevant developmental and behavioral outcomes.
OBJECTIVE/AIMS
(1) To determine the prevalence of anemia among children in or adopted from Pennsylvania foster care, between the ages of six months to ten years and (2) To examine if a child's anemia status is associated with greater odds of relevant developmental and behavioral diagnoses.
METHODS
We conducted a secondary data analysis utilizing the Medicaid Analytic eXtract database between 2010-2015. Children six months-ten years were included in the analysis if they were in or had been adopted from Pennsylvania foster care. Logistic regression was used to calculate adjusted odds ratios (AOR) with 95% confidence intervals for the association between iron status and health outcomes.
RESULTS
A total of 50,311 children were included in our sample, of which 1,365 children (2.7%) were diagnosed with anemia. Children diagnosed with anemia had greater odds of delayed milestones (AOR: 2.38 [1.64-3.45]), specific delays in development (AOR: 1.59 [1.23-2.07]), adjustment disorder (AOR: 1.59 [1.06-2.39]), and irritability (AOR: 10.57 [3.36-33.25]), than children not diagnosed with anemia.
CONCLUSION
The prevalence of anemia among children between six months-ten years in or adopted from the Pennsylvania foster care system is within the national rate of U.S. childhood anemia. Odds of several relevant developmental and behavioral diagnoses were greater among children diagnosed with anemia than children who were not.
Topics: United States; Humans; Child; Child, Preschool; Infant; Iron; Pennsylvania; Adjustment Disorders; Databases, Factual; Irritable Mood
PubMed: 37590213
DOI: 10.1371/journal.pone.0289951 -
Children (Basel, Switzerland) Dec 2023Previous research has highlighted an interplay between postural abilities and linguistic skills during infancy. However, this relationship could undergo further radical...
Previous research has highlighted an interplay between postural abilities and linguistic skills during infancy. However, this relationship could undergo further radical transformations in other periods of development. This current study explored a plausible network of relationships among postural abilities and vocabulary skills in a substantial cohort (N = 222) of preschoolers aged between 2 and 5 years-a developmental phase critical for refining both language and motor competencies. Here, postural stability was measured in terms of balance duration and accuracy, alongside an assessment of comprehension and expressive vocabulary skills. Employing a diverse set of techniques, i.e., data and missing data visualization and multilevel regression analysis, task complexity and age emerged as crucial factors explaining our data. In addition, network analysis indicates that language production plays a central role within postural and language interdomain networks. The resulting discussion focuses on the useful implications of this study for the assessment of typical preschool development, which would benefit from tailored methodological inspections guided by developmental theories that are framed in inter-domain approaches.
PubMed: 38136093
DOI: 10.3390/children10121891