微型腹腔镜下微创治疗小儿鞘膜积液与隐睾症

目的：探讨微型腹腔镜下内环口关闭术与睾丸下降固定术治疗小儿鞘膜积液与隐睾症的方法及疗效。方法：设治疗组微型腹腔镜下内环口关闭术与睾丸下降固定术治疗小儿鞘膜积液与隐睾症和对照组开放手术治疗小儿鞘膜积液与隐睾症,比较两组的平均手术时间、术后平均住院时间、术后并发症发生率的差异。结果：治疗组与对照组的术后平均住院时间、术后并发症发生率差异有统计学意义（P〈0.05）,平均手术时间差异无统计学意义（P〉0.05）。结论：微型腹腔镜下内环口关闭术与睾丸下降固定术治疗小儿鞘膜积液与隐睾症的方法创伤小,恢复快,并发症少,较开放手术更具优势,值得临床推广应用。     

Furthering the Understanding of Parent–Child Relationships: A Nursing Scholarship Review Series. Part 1: Introduction

PURPOSE.  Understanding the parent–child relationship is fundamental to nursing of children and families. The purpose of this integrative review is to explore nursing scholarship published from 1980–2008 concerning parent–child relationships. Study approaches are examined, critiqued, and future directions for research identified.
CONCLUSIONS.  A historical review of nursing research is presented and methods described as an introduction to a review series of the parent–child relationship.
IMPLICATIONS.  Definition and explication of the parent–child relationship is a first-step in understanding factors amenable to nursing intervention. A clear definition of the concept of parent–child relationship will support further study using appropriate theoretical frameworks, and enable development and testing of supportive nursing interventions.     

Do no more harm: The psychological stress of the medical examination for alleged child sexual abuse

Aim:   Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination.
Methods:   We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables.
Results:   Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports.
Conclusion:   Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.     

Glomus tumours in the long finger and in the thumb of a young patient with neurofibromatosis-1 (Nf-1)

Abstract

Glomus tumours are rare in adults, and such tumours may be associated with neurofibromatosis-1 (Nf-1). Here we describe successful treatment of two glomus tumours initially in the long finger and, one year later, in the thumb in a 17-year young girl with Nf-1.     

Behavior and psychological functioning of young children of HIV-positive mothers in South Africa

Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6–10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children.     

Der neonatale Lupus erythematosus und seine klinische Variabilität

Neonatal lupus erythematosus (NLE) is a rare disease affecting newborns that is caused by maternal autoantibodies transmitted across the placenta. The disease may affect the skin, the heart, and rarely the hepatobiliary or hematological systems. A serious complication affecting some patients with NLE is atri‐oventricular heart block (AV block). The clinical picture of cutaneous NLE varies considerably. NLE presents with confluent, scaly, periorbital erythema, or erythematous infiltrated plaques with central vesicles and lesions resembling seborrheic eczema or fungal infection. In any newborn with such skin lesions, NLE should be included in the differential diagnosis. Dermatologists play an important role in the diagnosis. We review different skin lesions occurring in neonatal lupus erythematosus based on five patients from our own clinic.     

Effects of Welfare Reform on Children of Adolescent Mothers: Moderation by Maternal Depression,Father Involvement,and Grandmother Involvement

SUMMARY

There are few data available on how effects of welfare reform on children may differ for different kinds of families. This study examined the constructs of maternal depression, father involvement, and grandmother involvement as moderators of the effects of a welfare reform program on children. The sample included 1,602 children between the ages of 3 and 6 ½ whose mothers had participated in New Chance, a multi-site welfare-to-work program with an emphasis on human capital development (i.e., education, job training). Father and grandmother co-residence were investigated, in addition to perceived support from these family members, in predicting cognitive and behavioral child outcomes. The mediating roles of parenting stress and emotional support in parenting were also explored. Although main effects were found for the intervention and for maternal depression, no main effects were found for the family ecology variables. However, interactions suggested complex relationships among New Chance and the family characteristics for both the full sample and for Latina families. Results are discussed in terms of policy implications and possible future research.     

Tracking speech sound acquisition

This article describes a procedure to aid in the clinical appraisal of child speech. The approach, based on the work by Dinnsen, Chin, Elbert, and Powell (1990; Some constraints on functionally disordered phonologies: Phonetic inventories and phonotactics. Journal of Speech and Hearing Research, 33, 28–37), uses a railway idiom to track gains in the complexity of speech sound production. A clinical case study is reviewed to illustrate application of the procedure. The procedure is intended to facilitate application of an evidence-based procedure to the clinical management of developmental speech sound disorders.     

听障儿童会话流畅度研究

目的：探讨提高听障儿童会话流畅度的有效方法。方法采用调查研究法对20名听障儿童会话表现进行分析。结果会话流畅度与流畅度问卷得分存在显著相关。听障儿童平均说话次数、平均会话轮替长度（Mean length of turn,MLT）及MLT比率分别为7.8、8.3、.42。会话流畅度与年龄、年级、性别、裸耳听阈及助听听阈没有显著相关。结论预测分析显示，会话流畅度问卷能够预测MLT及MLT比率，因此在听障儿童康复训练中应强调会话策略的教学，以期提升会话流畅度。