Random dominance and childhood migraine: a new marker? A controlled study of laterality in children with migraine

We assessed various aspects of laterality by direct observation in children with migraine and peer controls, with special reference to the frequency of random dominance. This frequency varied with the test battery used, being lower on the Edinburgh and Oldfield inventories which measure hand-use preference, and higher on the Handedness index and Spontaneous gestural index, which explore "genetic laterality". Random dominance would seem to be a new marker of migraine in childhood, for use alongside the hyperreactivity marker found in a previous study.     

Psychosocial problems and adjustment of children with β-thalassemia and their families

This study explores the psychosocial problems experienced by families with children aged 6 to 14 years suffering from -thalassemia major (N=188). The psychosocial problems and the family's adjustment to the effects of the illness were compared across a number of cultures where the disease is prevalent, namely Cyprus, Greece, and Italy. A small number of migrant children.in the United Kingdom was also included in the study. Semi-structured interviews were conducted with parents who also completed the Rutter Parental Questionnaire and the Goldberg General Health Questionnaire. Teachers were asked to complete a Children's Behaviour Questionnaire designed by Rutter. In all countries the disease seemed to have a binding effect on the family, thus mobilizing adaptive mechanisms. Father's low education level and the presence of major medical complications were predictors of poor family adjustment. Differences between and within countries may well reflect differences in health policies, existing level of socio-economic development, and in the cultural patterns in coping with a chronic illness.     

Where do families of children with epilepsy obtain their information?

A structured interview of 84 families of children with epilepsy followed through the neurology clinic of a tertiary care children's hospital was conducted to assess the epilepsy-specific information sources accessed and the perceived accuracy of these sources. Families accessed a mean of 3.5 sources from or specifically recommended by the clinic or family doctor and 4.1 sources outside these areas. Families of children with intractable epilepsy and higher-educated parents, but not those of higher socioeconomic status, consulted more extensively. The perceived accuracy of information rated highest for clinic-recommended Internet sites (100%), the clinic nurse (97%), and the neurologist (93%). Sources external to the clinic had variable ratings; those with the greatest perceived accuracy included other Internet sites or family members within the medical profession (85% for both) and lay organizations (84%). Friends within the medical profession, other families, and complementary health care providers also ranked highly. Recommendation of sites and books by epilepsy clinics is more helpful than general handouts.     

The effect of maternal migraine headache on their children’s quality of life

Migraine is an episodic disease characterized by a throbbing and generally unilateral headache, often accompanied by nausea, vomiting and light and sound sensitivity. Migraine is known to affect one’s quality of life; not only the person with migraine but also his/her family and social environment are affected by this condition. Our study aimed to evaluate the effects of maternal migraine on children’s quality of life. The patient group comprised 70 mothers with migraine diagnoses and their 111 healthy children, while 50 healthy mothers and their 86 children were included in this study as the control group. The Visual Analog Scale (VAS), Migraine Disability Assessment Scale, Beck Depression Index (BDI) and Beck Anxiety Index (BAI) were used for evaluation of mothers; 3 to 7-year old KINDL and 7- to 17-year-old KINDL-R Quality of Life Scales were used to evaluate the quality of life of children. The SPSS 21.0 program was used for statistical analysis and p < 0.05 was assumed to be statistically significant. The mean age of the migraine group was 37.09 ± 6.94 years, and the mean age of the control group was 38.2 ± 4.5. Symptoms of depression and anxiety were more frequently found in subjects with migraine (p < 0.05). In comparison with the control group: 3 to 7-year old KINDL total scores, self-esteem and school subscales, 7- to 17-year-old KINDL total scores, self-esteem and the social relationships subscale scores were lower in migraine group. It was found to be significant that VAS, BDI and BAI scores of the mothers were negatively correlated with the children’s quality of life. Our study concluded that the presence of migraine-type headache in mothers worsen the relations in school, self-esteem and quality of life in younger children and social relations, relations in school and quality of life in older children. The maternal age, disease severity, and anxiety and depression symptoms were shown to predict the quality of life in children. Performing preventive interventions by individually assessing bio-psycho-social elements for the treatment of mothers with migraine will preserve other family member’s and especially children’s quality of life.     

Chronotypes in menstrual migraine: a case–control study

Migraine attacks have a seasonal, menstrual and circadian periodicity, suggesting a role of chronobiological mechanisms probably related to a hypothalamic involvement. The aim of the study was to evaluate the chronotypes in patients with menstrual migraine, a migraine sub-type with a cyclical recurrence compared to normal female. Ninety-three patients with ICHD-II diagnosis of pure menstrual migraine and menstrually-related migraine were recruited and compared to 85 age-matched healthy women. The Italian version of Morningness–Eveningness Questionnaire was administered to identify circadian preference of our participants. No differences were found regarding the distribution of chronotypes in patients with menstrual migraine and healthy controls. The study did not confirm the presence of a morning and evening preference among migraineurs as previously reported.

     

Dizziness and migraine: a causal relationship?

Both migraine and dizziness are very frequent complaints, but the comorbidity of the two disorders is higher than it might be expected to be on the basis of chance alone. This implies a possible causal relationship, but definite diagnostic criteria for migraine-related vertigo are still lacking. Very recent attempts in this direction have shown that migraine may be the third leading cause of vertigo and that migraine-related vertigo may be effectively treated. A review of the literature on this topic, which includes some preliminary data of our own, demonstrates the difficulty in pinpointing migraine-associated vertigo as a clearly-defined entity. However, there is a measure of agreement on a few points: the spells of vertigo occur in patients who habitually suffer from motion sickness, and who have a history of migraine, either without or with aura; the delay between migraine and vertigo onset may be several years; migraine-related vertigo may be described as rotatory and/or as a feeling of unsteadiness, and single spells can occur without any other accompanying symptoms, however, when spells do occur in association with headache, they usually precede it. The vertigo duration may be shorter or longer than that of the migraine aura since it ranges from a few seconds to a continuous condition of unsteadiness.     

Low fetuin-A level in migraine: a case–control study

Migraine is a type of primary headache which is caused by the alterations in trigeminovascular system. Migraine attacks are associated with neurovascular inflammation of the cerebral and extracerebral vessels, but its pathophysiological mechanisms have not still been fully delineated. Also, migraine has been found to be associated with higher risks for various metabolic disorders. Thus, we aimed to investigate the matrix metalloproteinases (MMP), fetuin-A, ghrelin, and omentin levels which have important roles in metabolic disorders and inflammation, and to examine their relationship with migraine subtypes and attack frequency. Forty-nine migraine patients and 30 age- and sex-matched healthy control subjects were enrolled. Migraine diagnosis was confirmed according to the International Classification of Headache Disorders-II diagnostic criteria. Analyses of MMP9,MMP3, ghrelin, omentin, and fetuin-A were performed by the ELISA method. Fetuin-A, MMP-9, and MMP-3 levels were significantly lower in migraine than controls (p < 0.05). There were no significant differences between groups with respect to omentin and ghrelin (p > 0.05). In migraine patients, serum fetuin-A levels were positively correlated with MMP-9 and negatively correlated with MMP-3. MMP-3, MMP-9, fetuin-A, omentin and ghrelin levels did not correlate with age, disease duration, or frequency of migraine headache (p > 0.05). Migraine patients have lower fetuin-A, MMP-3 and MMP-9 levels than healthy individuals. Migraine patients have low fetuin-A levels, which may be related to the pathogenesis of migraine. The importance and impact of our findings on the pathogenesis, characteristics, and treatment of migraine needs to be investigated in further detailed studies.     

Phonological development: a normative study of British English‐speaking children

This paper reports a normative study on the phonological development of British English‐speaking children. Speech samples of 684 children, aged between 3;0 and 6;11 years, randomly selected from nurseries and schools in eight different areas throughout the UK, were collected and analysed to obtain normative data. This paper reports on two aspects of speech development: the age of acquisition of sounds (phonetic acquisition) and the age that error patterns were suppressed (phonemic acquisition). It discusses the effects of age, gender and socio‐economic status on speech sound development. The study found that older children had more accurate production and fewer error patterns in their speech. It found no gender differences in the younger age groups. However, in the oldest age group, it found the phonological accuracy measures of girls' better than boys. It found no significant effects of socio‐economic status on any of the phonological accuracy measures.     

What are patients and their families told about the diagnosis of dementia? Results of a family survey

BACKGROUND: Controversy exists as to whether dementia patients should be told their diagnosis and prognosis. OBJECTIVE: This study examined the experience of patients and families when a diagnosis of dementia is given. METHOD: Fifty-seven family members from community dementia support groups answered a questionnaire regarding the diagnosis of dementia in a family member. RESULTS: Family members were significantly more likely to have been told the diagnosis and symptoms to expect in dementia than patients themselves. Half of the families felt they were not given enough information regarding dementia. Interestingly, the majority of family members believed patients should be told their diagnosis and prognosis yet about half had reported that informed patients had reacted poorly to being told their diagnosis and only about a third felt it was helpful to the patient. CONCLUSION: The results suggest physicians should better involve patients and their families in disclosing diagnoses and information regarding dementia. The results also suggest the current AMA guidelines to inform patients their diagnosis of dementia are inadequate to address the clinical complexities of this issue.     

Prevalence of cardiac right left shunts in migraine: a population-based case–control study

We aimed to investigate the prevalence of cardiac right left shunts (RLS) in population-based samples of subjects with migraine with aura (n = 42), migraine without aura (n = 44) and controls without headache (n = 41). Cardiac RLS was assessed with transcranial Doppler sonography with intravenous injection of saline. Prevalence of RLS was highest in migraineurs with aura (45.2%) compared to migraineurs without aura (34.1%) and controls (41.5%). Permanent as opposed to latent RLS was more common among patients with migraine with aura (40.5%) than in patients with migraine without aura (23.3%) or controls (24.4%). Differences did not reach statistical significance between the three groups (p = 0.564 for RLS prevalence, p = 0.349 for prevalence of permanent shunts). Our data implicate a trend towards higher prevalence of RLS with larger shunts in subjects with migraine with aura.     

Mothers’ perceptions of their relationships with their children and their responses to joint drawings

Although the association between parental relationships with their children and creative output is one of the basic tenets of therapeutic work in dyadic art therapy, this assumption has rarely been examined experimentally. This study was designed to explore associations between mothers’ perceptions of their relationships with their children and their responses to a joint drawing task. Seventy-four dyads composed of mothers and their 6–9-year-olds created joint drawings. The mothers then filled out the Art-Based Intervention Questionnaire (ABI) and the Relations with Father/Mother Questionnaire (RFMQ) to assess responses to their drawing experience and perceptions of their relationship with their child. The findings showed that mothers who had a more positive perception of their relationship with their daughter also had a more positive experience in the joint drawing activity, whereas no such correlations were found for mother–son relationships.     

The value of the CoughAssist® in the daily lives of children with neuromuscular disorders: Experiences of families,children and physiotherapists

Objectives: We explored parents’, children’s and physiotherapists’ experiences of regular CoughAssist® use, along with their perceptions of its value as an adjunct to in their daily, home respiratory management. Methods: All children in the care of a specialist neuromuscular service who regularly used a CoughAssist® device at home participated. Qualitative case study methods involved semi-structured interviews with three children with neuromuscular disorders (NMD), their parents and physiotherapist. Data were analysed using thematic content analysis. Results: Participants (n?=?9) perceived the CoughAssist® held benefits for physical, social and emotional aspects of living with NMD. Poor adherence was identified as the major barrier to effective use, governed by factors including child’s resistance, time constraints, treatment preference, practitioner support and fear of pressure trauma. Conclusions: Barriers to regular CoughAssist® use must be identified and individually addressed to enable uptake into respiratory care, accurately measure its effectiveness and realise its perceived benefits to children with NMD.     

Bouffée délirante and ICD-10 acute and transient psychoses: a comparative study

OBJECTIVE: ICD-10 acute and transient psychotic disorder (ATPD; F23) has one of its historical roots in the French concept of bouffée délirante. This study explores the empirical relationship of the two concepts. METHOD: During a 5-year period, all inpatients with ATPD were identified; the diagnosis of bouffée délirante was also determined. We systematically evaluated demographic and clinical features and carried out follow-up investigations at an average of 2.2 years after the index episode using standardized instruments. RESULTS: Forty-two (4.1%) of 1036 patients treated for psychotic disorders or major affective episode fulfilled the ICD-10 criteria of ATPD. Of these, only 28.6% also fulfilled the criteria of bouffée délirante. Patients with bouffée délirante were significantly younger than the remaining ATPD patients. Outcome parameters were generally more favourable for patients diagnosed with bouffée délirante than for ATPD patients without a concurrent diagnosis of bouffée délirante, but the difference was statistically significant only for occupational status. CONCLUSIONS: There are indications that a diagnosis of bouffée délirante carries a somewhat better prognosis than ATPD in general. However, the low frequency of operationally diagnosed bouffée délirante suggests that the criteria might be too narrow.     

Trauma exposure in children with and without ADHD: prevalence and functional impairment in a community-based study of 6–8-year-old Australian children

Both ADHD and trauma exposure are common childhood problems, but there are few empirical data regarding the association between the two conditions. The aims of this study were to compare lifetime prevalence of trauma exposure in children with and without ADHD, and to explore the association between trauma exposure and outcomes in children with ADHD. Children aged 6–8 years with ADHD (n = 179) and controls (n = 212) recruited from 43 schools were assessed for ADHD, trauma exposure and comorbid mental health disorders using the Diagnostic Interview Schedule for Children IV. Outcome data were collected by direct child assessment, parent report and teacher-report, and included ADHD symptom severity, internalizing and externalizing problems, quality of life, and academic functioning. Logistic and linear regression models were used to examine differences adjusted for child and family socio-demographics. Children with ADHD were more likely than controls to have ever experienced a traumatic event (27 vs 16%; OR: 1.99; 95% CI 1.21, 3.27). This difference remained significant in the adjusted model (OR: 1.76, 95% CI 1.03, 3.01) accounting for child factors (age and gender) and family socio-demographic factors (parent age, parent high school completion and single parent status). Among those with ADHD, trauma-exposed children had higher parent-reported ADHD severity and more externalizing problems than non-exposed children, however, this effect attenuated in adjusted model. Children with ADHD were more likely to have experienced a traumatic event than controls. The high prevalence of trauma exposure in our sample suggests that clinicians should evaluate for trauma histories in children presenting with ADHD.     

Preparation of students to work with children and families: Is it meeting the need?

This paper reviews changes in approaches to serving children with emotional disorders and their families over the last decade. The implications of these changes for the professional mental health disciplines in general, and for academic training programs in particular, are then examined. Proposals are made for changes in curricula and increased faculty development; policy issues concerning academic training programs are re-examined.This paper is based on a presentation made at the conference Meeting the Challenge: New Directions in Education and Training Services to Children and Youth October 26, 1990, sponsored by the School of Social Work, Univ. of Maryland, Baltimore, and the Mental Hygiene Administration of the Maryland Dept. of Health and Mental Hygiene.     

Pictures and their colors: what do children remember?

Theories regarding children's reliability as witnesses suggest that children are more likely to confuse memories from different sources especially when the sources are highly similar. To investigate the developmental aspects of source retrieval, we measured brain electrical activity from children and adults while they retrieved content and source information. Similar brain responses among the age groups were found when participants were asked to retrieve content information. However, retrieval of source information improved with age and was accompanied by different patterns of brain potentials. The results implicate immaturity of frontal lobe structures in children's difficulty in retrieving source information.     

Holger Hydén's technique of preparation of single Deiters' neurons and study of permeability characteristics of their plasma membranes

The protocols described here refer to Hydén's technique of isolation and microdissection of vestibular Deiters' neurons from adult mammals. The isolation of Deiters' cells from bovine is described and an example is given of the immunocytochemical visualization of their GABA(A) receptors by monoclonal antibodies against the beta(2/3) subunit. In addition, the protocol of the method for isolation of Deiters' cells from adult rabbit brain stem, the preparation of their plasma membranes and the study of their permeability characteristics is presented. Also in this case, examples of its application to the determination of chloride permeability and its modulation by GABA are given.     

Maternal common mental disorders and malnutrition in children: a case�Ccontrol study

Background

Despite improvements in the nutritional status of Brazilian children, child malnutrition remains a public health issue. The objective of the present study was to analyse the effect of maternal common mental disorders (MCMD) on child malnutrition in a large Brazilian urban centre with low rates of child malnutrition. Furthermore, we explored the hypothesis that a reduction in the quality of maternal caregiving mediates the relationship between maternal mental health problems and child nutrition.

Methods

A case?Ccontrol study including 294 children aged between 0 and 5?years, with 147 cases and 147 age- and sex-matched controls, was conducted in the city of Salvador, northeastern Brazil. Mothers completed the Self-Report Questionnaire (SRQ-20), the family??s socio-economic status was evaluated and the Home Observation for Measurement of the Environment (HOME) Inventory was applied. Children were diagnosed as moderately or severely malnourished when the weight-for-height z-score was below ?C2?SD. Conditional logistic regression was used in the analysis, and the final model was created using the backward technique.

Results

MCMD doubled the risk of moderate or severe malnutrition in children (OR?=?2.04; 95% CI: 1.10?C3.78). Maternal caregiving can be an important factor mediating the relationship between maternal mental health and child malnutrition.

Conclusion

MCMD must be taken into account in programmes for the treatment and prevention of malnutrition, especially in areas of low malnutrition prevalence.