Valproic acid therapy decreases serum 25-hydroxyvitamin D level in female infants and toddlers with epilepsy-a pilot longitudinal study

To evaluate if valproic acid(VPA)therapy is associated with vitamin D deficiency among infants and toddlers with epilepsy,a cross-sectional clinical study was conducted in 25 children with epilepsy taking VPA.Blood levels of calcium,phosphorus,alkaline phosphatase,and 25-hydroxy vitamin D[25(OH)D]and plasma VPA level were measured at 1-to 3-month intervals.At the initial and final measurements,vitamin D deficiency or insufficiency was recognized in 8(32%)and 12(42%),respectively.In girls,a decreasing trend in serum25(OH)D levels(P<0.05)was observed.Polytherapy had a significant negative effect on the longitudinal change of 25(OH)D(P<0.05)in girls.In conclusion,our study indicates that a high proportion of girls after VPA therapy had hypovitaminosis D.     

Mothers’ Intentions to Support Children’s Physical Activity Related to Attention and Implicit Agreement with Advertisements

Background

ParticipACTION’s Think Again campaign targeted mothers who think their children are sufficiently active, yet whose children do not achieve recommended amounts of physical activity.

Purpose

This research examined the relationship of mothers’ intentions to support children’s physical activity with explicit believability and implicit agreement with the Think Again campaign message, attention paid to the advertisement, involvement with the issue, concern regarding children’s inactivity, and attitudes.

Method

Participants were mothers from Edmonton, Canada (N?=?102) who viewed one Think Again advertisement then completed a measure of implicit agreement with the campaign message and questionnaires.

Results

The mothers who paid attention to the message and were concerned for their own children were more likely to intend to act on campaign messages. The majority of participants implicitly agreed that children’s physical inactivity was a problem, but there was less agreement that physical inactivity was a problem for their own children.

Conclusion

Participants automatically tended to agree with campaign messages when the focus was on children in general, but there was greater disagreement when asked about participant’s own children. Why most mothers were not in agreement with the reality of how much physical activity their children needs remains to be determined.     

The relationship between parents’ cognitions,bedtime behaviours and sleep-related practices with their child's sleep

Certain parental cognitions about child sleep and bedtime behaviours used with their child have been linked to poorer child sleep. However, previous research has focused on mothers and explored only a limited range of sleep-related cognitions and practices. The present study investigated whether parental cognitions and sleep-related practices (both in connection with their own sleep and their child's sleep), alongside the bedtime behaviours used with their child were associated with and/or were predictive of their child's sleep. Mothers and fathers from 44 families (with a child aged 12–24 months) separately completed questionnaires reporting (i) their cognitions (about their own sleep and their child's sleep), (ii) sleep-related practices (used in connection with their own and their child's sleep) and (iii) bedtime behaviours used with their child. Child sleep was assessed through parental report and actigraphy. Both parents’ cognitions about their own sleep predicted cognitions about their child's sleep. Mothers’ own sleep-related practices predicted the types of practices they used with their child. Different patterns of maternal and paternal variables influenced parental perceptions of their child having a sleep problem. The present findings highlight the importance of including mothers and fathers in child sleep research. Parents’ dysfunctional cognitions (their own sleep) and broader sleep-related practices (their own and child sleep) should be considered when exploring influences on child sleep. Results have possible implications for targets of interventions for child sleep problems and also potential implications for theoretical models of child sleep.     

Parental bonding: can obsessive symptoms and general distress be predicted by perceived rearing practices?

We investigated the relationship between obsessivity and reported parental rearing style (care and protection) in non‐ clinical subjects, controlling for anxiety and depression. One hundred and seventy subjects filled in four inventories: the Parental Bonding Instrument (PBI), the Padua Inventory Revised (PI‐R), the State‐Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Results showed a relationship between the STAI and the PBI, with high anxiety scores corresponding to low care and high protection. The same pattern was found for the BDI, with high depression scores corresponding to low care and overprotection. Concerning the PI‐R, we observed the absence of a significant relationship between parental care and protection and total obsessivity scores. A significant correlation was found for the ‘rumination’ subscale of the PI‐R, with high rumination scores corresponding to maternal overprotection and low parental care. Multiple regression analyses showed that there was no significant portion of variance unique to obsessive symptoms explained by parental rearing style. These results suggest that obsessivity is not linked to a specific parental rearing style, and that a poor parental bonding, especially regarding care, could constitute a general factor for emotional distress in adulthood, rather than acting as a precursor to a specific disorder. Copyright © 2000 John Wiley & Sons, Ltd.     

Mothers’ insightfulness regarding their children’s inner world: associations with mothers’ history of sexual abuse and lack of resolution of the trauma

ABSTRACT

The study examined the insightfulness of mothers who experienced Childhood Sexual Abuse (CSA). Based on attachment theory, we hypothesized that mothers who experienced CSA will be less insightful than those who did not experience CSA, and that state of mind with no marked signs of lack of resolution of the trauma can buffer against its negative effects. The insightfulness of 30 mothers who experienced CSA and 30 demographically matched mothers but with no CSA was assessed using the Insightfulness Assessment. Mothers’ lack of resolution of the trauma was assessed using the Adult Attachment Interview. In addition, maternal psychopathology was assessed using the Brief Symptom Inventory. As hypothesized, mothers who experienced CSA were less insightful than mothers who did not experience CSA. In addition, mothers who experienced CSA but who were not unresolved were more insightful than those who were unresolved, and no different than mothers who did not experience CSA. These results expand our understanding regarding the risk embedded in parenting in light of unresolved traumatic past and the importance of resolution as a buffer.     

Let’s stay together: relationship dissolution and sexually transmitted diseases among parenting and non-parenting adolescents

Relationships influence sexual risk and maternal-child health. Few studies have assessed relationship dissolution and its association with sexually transmitted diseases (STD) among adolescent parents. Our study aimed to describe relationship dissolution among 295 parenting and non-parenting adolescents over an 18-month period and how it related to STD incidence. Results showed that nonparenting adolescents in a relationship with someone other than their baby’s father were more likely to have a relationship dissolution over an 18-month period compared to those in a relationship with the baby’s father (OR = 1.69, P < .05). Parenting adolescents who ended their relationship with their baby’s father were 3 times more likely to get an STD over the course of the study compared to parenting adolescents who remained with their baby’s father (39% vs. 13%). Comparatively, nonparenting adolescents who ended their relationship were only 1.4 times more likely to get an STD compared to non-parenting adolescents who remained with their partner (44% vs. 32%). Our results suggest that prevention programs that incorporate male partners and components that strengthen relationship skills may reduce HIV/STD risk and help adolescents adapt during times of transition such as parenthood.     

Coping with pain and surgery: Children’s and parents’ perspectives

This article examines relations between coping with general and postoperative pain. Children's and parent's coping ratings, and the contribution of temperament and coping to postoperative adjustment. Before and after day surgery, 7-to 12-year-olds (n = 124) rated their coping with pain. Parents rated their child's coping and temperament pain and distress were rated on the day of and 2 days following surgery. Coping with general and postoperative pain were moderately correlated (median r = .48). Except for distraction, all types of coping strategies were used more frequently for general than postoperative pain. Correlations between child and parent coping ratings were moderate (median r = .36). After controlling for emotionality and medications, lower levels of emotion-focused avoidance and higher levels of distraction were related to lower pain and distress. After controlling for a priori surgical group (no-low pain; moderate-high pain), emotionality, and medications, lower levels of emotion-focused avoidance were related to lower pain and distress but distraction was no longer significant in a number of the regressions. Coping with pain has trait-like qualities but differences in the nature and context of pain create differences in strategy use. Level of pain appears to influence the type of coping strategies used. Interventions should target children's use of distraction and minimize us of emotion-focused avoidance.     

Clinical communication and the ‘triangle of care’ in mental health and deafness: Sign language interpreters’ perspectives

Objective To explore the processes by which therapeutic alliance develops in mental health consultations with Sign Language interpreters.Method Semi-structured interviews with 7 qualified interpreters were transcribed and analysed with interpretative phenomenological analysis.Results Two key themes were generated: (1) Nurturing the triangle of care, where the therapeutic process relied on collaboration, continuity, and trust; and (2) Shared vision and knowledge, in which participants felt misunderstood and unsupported; there was a lack of deaf awareness and clinicians appeared to feel deskilled.Conclusions Interpreters should be viewed as valued members of clinical teams and have access to clinical supervision so that they can be supported in interpreting emotional distressing content. Clinicians can aim to be collaborative with interpreters and improve their knowledge of mental health issues that are relevant to deaf people.Practice Implications An aide-memoire of the role and practicalities of working with SL interpreters should be developed and disseminated to relevant services to support collaborative working with clinicians. A core competence in SL interpreter training is reflexivity. This should be embedded in educational curricula and facilitated through clinical supervision. Funding by commissioning services should be subject to services being deaf aware and interpreters being mental health aware.     

Autonomy-restrictive socialization of anger: Associations with school-aged children’s physiology,trait anxiety,state distress,and relationship closeness

Parental socialization that infringes on children's autonomy may have consequences for physiological regulation, trait anxiety, and state distress. One such practice is the use of positive conditional regard (CR)—the provision of extra attention/affection when children meet parents’ expectations. Self-determination theory proposes that CR thwarts satisfaction of children's basic needs for relatedness and autonomy by placing these needs in conflict. We evaluate associations among children's (N = 106, 51% male, M_age = 10.27 years, SD = 1.09) reports of their mothers’ use of positive CR to suppress anger expression (PCR-anger), their physiological regulation (resting respiratory sinus arrhythmia, RSA), and their trait anxiety and state distress, in light of perceived relationship closeness. After controlling demographics, mothers’ reports of positive and negative CR-anger, children's reports of mothers’ negative CR-anger and depressive symptoms, greater child-reported positive CR-anger was significantly associated with greater child anxiety and with lower resting RSA. Resting RSA mediated associations of child-reported positive CR-anger with greater child anxiety and post-failure distress. These indirect effects were significant for children low or moderate in closeness to mother. We conclude that autonomy-restrictive socialization is a concurrent correlate of children's physiological regulation, anxiety, and state distress, with these associations dependent on relational distance.     

Parent–child attachment: meta-analysis of associations with parenting behaviors in middle childhood and adolescence

Maternal sensitivity predicts mother–child attachment in young children, but no meta-analysis has investigated the link between parenting and parent–child attachment in older children. This study examined the relationship between parent–child attachment and multiple components of parenting in children 5–18 years of age. A series of meta-analyses showed that parents of children with more secure attachment are more responsive, more supportive of the child’s autonomy, use more behavioral control strategies, and use less harsh control strategies. Parents of children with more avoidant attachment were less responsive and used less behavioral control strategies. Ambivalent attachment was not significantly related to any of the parenting behaviors, and there were not enough studies to reliably test the relationship between disorganized attachment and parenting. There were few significant moderators. The findings inform new areas for future research, as well as family interventions for at-risk youth.     

Contingencies Between Infants’ Gaze,Vocal, and Manual Actions and Mothers’ Object-Naming: Longitudinal Changes From 4 to 9 Months

ABSTRACT

Infants’ early motor actions help organize social interactions, forming the context of caregiver speech. We investigated changes across the first year in social contingencies between infant gaze and object exploration, and mothers’ speech. We recorded mother–infant object play at 4, 6, and 9 months, identifying infants’ and mothers’ gaze and hand actions, and mothers’ object naming and general utterances. Mothers named objects more when infants vocalized, looked at objects or the mother’s face, or handled multiple objects. As infants aged, their increasing object exploration created opportunities for caregiver contingencies and changed how gaze and hands accompany object naming over time.     

Juvenile polyposis with macrocephaly and mental retardation (? Ruvalcava-Myhre-Smith syndrome)--a case report

A male child aged one and a half years with a history of rectal bleeding, on examination was found to have severe degree of anaemia with grade -III protein-energy-malnutrition and pneumonia. Colonoscopy revealed features of colonic polyposis. An upper gastro-intestinal endoscopy showed a duodenal polyp while barium meal follow-through did not reveal any polyps in the small intestine. Total colectomy and ileo-rectal anastomosis was done. Following histopathological study, the diagnosis of Juvenile polyposis syndrome was made, a very rare entity and is known to lead to adenocarcinoma of the gastrointestinal tract. In addition the child was found to have macrocephaly and mental retardation. The rarity and importance of the diagnosis of juvenile polyposis syndrome associated with macrocephaly and mental retardation (?Ruvalcava-Myhre-Smith syndrome) prompted the documentation of this case.     

Mothers with intellectual disability,their experiences of maltreatment,and their children’s attachment representations: a small-group matched comparison study

Maternal intellectual disability (ID) is regarded a risk factor in child development, but there is no scientific evidence on maternal ID in relation to children’s attachment. Using a matched comparison design, a small group (n = 23) of mothers diagnosed with ID was studied to help fill this gap. Besides maternal ID, we examined the role of abuse/trauma/maltreatment (ATM) in the mothers’ biographies, along with potential confounds. Comparison group mothers (n = 25) had normal variations in intelligence and matched mothers with ID on residential area, income, child age, and sex. History of maternal ATM was assessed using a semi-structured interview and was found to be significantly more likely in the ID group mothers’ experience than the comparison group mothers. Children’s (M age = 77 months) attachment representations were assessed with the Separation Anxiety Test. Among children of mothers with ID, a substantial minority (35%) had a secure and the vast majority (>80%) an organized attachment representation. Mothers with ID who had suffered elevated ATM were significantly more likely to have children who were scored high on disorganization and insecurity. We discuss possible implications of our findings for societal considerations regarding parenting and child attachment in the context of parental ID status.     

Β-Adrenoceptor density on mononuclear leukocytes and right atrial myocardium in infants and children with congenital heart disease

Summary Sympathetic regulation of myocardial performance has been shown to be altered in congestive heart failure. Right atrial tissue of children with severe acyanotic and cyanotic congenital heart disease (CHD) showed a significantly lower-receptor density than that of children with less severe defects. Since mononuclear leukocytes (MNL) contain a homogeneous population of ₂-adrenoceptors which have similar properties to those of cardiac ₂-adrenoceptors, they are frequently used for studying the-adrenergic system. In a group of 37 children with CHD of different types and severity who underwent cardiac surgery, we compared the MNL-adrenoceptor density to the type and severity of CHD and looked for a possible relationship to plasma catecholamine levels and to the right atrial-adrenoceptor density. Membranes of MNL and myocardial cells were radiolabeled with (–)3-[¹²⁵I]Iodocyanopindolol ([¹²⁵I]ICYP). A significantly higher-adrenoceptor density on MNL was found in patients with moderate acyanotic CHD (group I) than in those with severe acyanotic (group II) and cyanotic CHD (group III). Patients of group I showed approximatively 50% higher myocardial-receptor density than those of groups II and III. ICI 118.551-[¹²⁵I]ICYP competition studies revealed that in groups II and III significantly lower proportions and densities of ₁-receptors were found compared to group I. Noradrenaline (NA) plasma levels in group II and group III were significantly higher than those in group I. The adrenaline plasma levels were found to be very high in all children with CHD. A significant negative correlation between NA levels and myocardial total and ₁-adrenoceptor density, but no correlation between plasma catecholamines and MNL-adrenoceptor density, was calculated. We conclude that modulation of MNL-adrenoceptors is not simply controlled by circulating catecholamine levels. Cardiac ₂-adrenoceptor density remained unaltered, but the ₁-density was significantly lowered. ₂-adrenoceptors on MNL showed a slight but significant decrease. However, cardiac ₂-adrenoceptor density cannot be predicted by measuring the-adrenoceptor density on MNL.Abbreviations CHD Congenital heart disease - MNL mononuclear leukocytes - NA noradrenaline - P_PA/P_AO Ratio between pulmonary and aortic pressure - Qp/Qs Ratio between pulmonary and systemic blood flow - HPLC-ED High performance liquid chromatography with electrochemical detector     

Who’s distressed? A comparison of diabetes-related distress by type of diabetes and medication

Objective

We hypothesized that diabetes-related distress would vary by type of diabetes and medication regimen [Type 1 diabetes (T1DM), Type 2 diabetes with insulin use (T2DM-i), Type 2 diabetes without insulin use (T2DM)]. Thus, the aim of this study was to identify groups with elevated diabetes-related distress.

SNP array and cytogenetic analysis of a patient with unexplained mental retardation北大核心CSCD

Objective: To analyze a patient with unexplained mental retardation by using three primer PCR(TP-PCR) and single nucleotide polymorphisms array(SNP-array), and to correlate the genotype with phenotype. Methods: Peripheral blood sample was taken from the patient for the extraction of DNA. TP-PCR was used to determine the copy number of CGG repeats in the 5′-UTR of the FMR1 gene. SNP array was used for high resolution analysis of the patient's genome. Results: TP-PCR has shown no abnormal amplification of CGG in the 5′-UTR of FMR1 gene. Hence, Fragile X syndrome was excluded as the cause for mental retardation. SNP array analysis has identified a 0.93 Mb duplication at 7q36.1-q36.2 and a 2.2 Mb deletion at 12p13.1-p13.2 in the patient. Conclusion: The microduplication and microdeletion discovered in the patient probably underlies the intelligence disability. The high-resolution SNP array can provide accurate information for the identification of pathogenesis, and is the preferred method for the diagnosis of unexplained mental retardation. © 2016, West China University of Medical Sciences. All rights reserved.