Oesophageal dysfunction in male patients with angina-like pain

The value of betamethasone valerate by inhalation in the prophylactic therapy of severe childhood asthma has been established. To determine whether the efficacy of this drug is due to a local or a systemic action a double-blind crossover study of 28 days' treatment with oral betamethasone valerate and 28 days' treatment with inhaled steroid was carried out in 10 asthmatic children. Daily doses used were 1 mg orally and 800 mug by inhalation. Nine patients had fewer symptoms, higher peak expiratory flow rates, and a lower bronchodilator requirement on inhaled than on oral therapy. Exercise-induced bronchoconstriction was diminished on inhaled therapy. Five children requested early termination of the oral therapy period because of unacceptable symptoms. Nine parents stated a preference for the period of inhaled therapy. It is concluded that betamethasone valerate is highly effective by inhalation but that a comparable oral dose has no appreciable clinical effect.     

Behavioral, situational, and temporal effects of treatment of ADHD with methylphenidate

OBJECTIVE: To determine the behavioral, situational, and temporal effects of 4 months of methylphenidate (MPH) treatment for attention-deficit hyperactivity disorder (ADHD). METHOD: Ninety-one children with ADHD were randomly assigned to receive either MPH (titrated to a target dose of 0.7 mg/kg twice a day) or a placebo. Treatment effects were investigated with measures sensitive to various behaviors (core and associated symptoms), situations (home and school), time periods (morning and afternoon, after reaching the target dose, and after 4 months of treatment), and side effects. RESULTS: MPH treatment improved symptoms of ADHD and oppositional behavior at school, both in the morning and afternoon, but not at home. Side effects (increase in physiological and effective symptoms, lack of weight gain) were significantly more frequent with MPH than with placebo treatment. Benefit was evident after titration, but the onset of some side effects was delayed. Side effects were reported by parents but not by teachers. CONCLUSIONS: Positive effects of MPH on behavior are evident in the classroom, but with MPH given twice daily, parents do not report that MPH improves behavior at home. Greater impact on home behavior may require three times daily MPH and combined treatments.     

Implementing Play Therapy in the Schools: Lessons Learned.

This article presents a rationale and understanding of the function of play therapy in the school environment. Although there are many benefits to providing play therapy in the school, there are also many challenges. The authors offer details of a yearlong pilot play therapy program in an elementary school. The advantages of delivering play therapy directly to students, filial therapy to parents and teachers, and education to teachers are discussed. In addition, the challenges of such a program are enumerated along with suggestions for avoiding possible pitfalls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multitrait-multisource confirmatory factor analytic approach to the construct validity of ADHD rating scales.

Confirmatory factor analysis was used to model a multitrait-multisource design to evaluate the construct validity of attention-deficit/hyperactivity disorder (ADHD) rating scales. The 2 trait factors were the ADHD inattention and hyperactivity/impulsivity dimensions. The 2 source factors were parents and teachers. In Study 1, parents and teachers rated 1,475 Australian elementary school children on the ADHD symptoms. In Study 2, parents and teachers rated 285 Brazilian elementary school children on the ADHD symptoms. Similar results occurred in both studies with most of the ADHD symptoms containing more source than trait variance, thus providing weak evidence for the convergent and discriminant validity of the symptoms as measured by rating scales. The study outlines the implications of such strong source effects for understanding ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a daylight cycle reversal on locomotor activity in several inbred strains of mice

In order to find out whether parents and teachers report depressive symptoms in children with self-reported depression and which features are connected with sought psychiatric care, a sample of 5682 prepubertal children was assessed with the Children's Depression Inventory (CDI), the Rutter A2 scale (RA) and Rutter B2 scale (RB). In stepwise regression analysis of parent report, depressed mood, unpopularity, social withdrawal, disobedience, inattentiveness, and stealing were associated with high CDI scores. The items of the teacher report associated with high CDI scores included poor school performance, restlessness, somatic complaints, unresponsiveness, being bullied, and absenteeism from school. Although the parents and teachers readily saw and reported depressive symptoms in children, only for a small minority of children with multiple depressive symptoms had psychiatric care been sought or even considered. The symptoms associated with sought psychiatric care for depressed children were somatic (soiling, asthma) and behavioural (disobedient, restless). The results indicate that a large number of children with multiple depressive symptoms are left without necessary psychiatric assessment and help.     

School-based prevention of depression and anxiety symptoms in early adolescence: A pilot of a parent intervention component.

Previous studies suggest that school-based cognitive-behavioral interventions can reduce and prevent depressive symptoms in youth. This pilot study investigated the effectiveness of a cognitive-behavioral depression prevention program, the Penn Resiliency Program for Children and Adolescents (the PRP-CA), when combined with a parent intervention component. Forty-four middle school students and their parents were randomly assigned to the enhanced PRP (the PRP-CA plus parent program) or control conditions. Students completed measures of depression and anxiety symptoms at baseline and 2 weeks, 6 months, and 1 year after the intervention ended. The combined version of the PRP significantly reduced symptoms of depression and anxiety during the follow-up period. Children assigned to the intervention condition were less likely than controls to report clinical levels of anxiety symptoms. Findings suggest that school-based cognitive-behavioral interventions that include parents may prevent depression and anxiety symptoms in early adolescence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Managed care--an example for future structural developments in health care. Reflections on a informational visit on direction and administration of medical centers in east USA

OBJECTIVE: To conduct a controlled group outcome investigation of the efficacy of cognitive-behavioral treatment for school phobia. METHOD: Fifty-six children with school phobia were randomly assigned to 12 weeks of cognitive-behavioral therapy or an attention-placebo control condition. Pre- and posttreatment school attendance, self-reported anxiety and depression, and diagnostic status were compared. RESULTS: Both the experimental and control treatments were equally effective at returning children to school. Both treatments also were effective in reducing children's anxiety and depressive symptoms. Follow-up revealed no differences between groups when the children reentered school the next school year. CONCLUSIONS: Overall, results suggest that psychosocial treatments are effective at returning school-phobic children to school and that the highly structured cognitive-behavioral approach may not be superior to more traditional educational and supportive treatment methods.     

Children of substance abusers: the life experiences of children of opiate addicts in methadone maintenance

We interviewed 70 substance abusers in methadone maintenance treatment regarding the life experiences of their 188 children. Sixty-four percent of the mothers reported using psychoactive drugs during their pregnancies. Eighty percent of parents reported an arrest during the time the child was growing up, 34% reported receiving treatment for an emotional disorder, and 14% were hospitalized. Four percent of the parents reported that their children had been placed in adoptive care, 9% in foster care, and 1% had a child in a group home. Forty-one percent of the parents reported that at least one of their children repeated a grade in school, 19% were involved in truancy, and 30% had been suspended from school. Twenty percent of parents reported their children's involvement with the law, and 17% reported drug or alcohol use. Problems with the law correlated highly with 1) being held back a grade, 2) truancy, 3) suspension from school, 4) expulsion from school, and 5) treatment for alcohol or drug abuse.     

Families and schools: What is the role of the school psychologist?

Described 5 lessons learned and 1 lesson yet to be learned by researchers examining home–school collaboration policies and practices. These lessons are (1) parent involvement is associated with student success; (2) home–school partnerships are not the norms; (3) schools need to reach out to parents; (4) measuring the effects of home and school on student performance is complex; and (5) parents and schools must have positive communication. The role of the school psychologist vis-a-vis families and schools includes providing information on how parents can facilitate their children's school performance and development, attending to differential resources available to parents for influencing their children's school performance, and providing support and consultation to parents as they become involved in their children's educational lives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wegener's granulomatosis

Diagnostic difficulties have been described together with the course of hospital treatment of a 48-year old female patient who suffered from Wegener's granulomatosis. A first, the patient was treated by various specialists because of otolaryngological, ophthalmic, rheumatic and respiratory symptoms. Despite numerous symptoms suggesting Wegener's granulomatosis, ineffective treatment had been instituted for two months. Appropriate diagnosis was made on the basis of clinical symptoms and histological examination od lung biopsy. In the course of hospital diagnostic procedures, symptoms of kidney failure occurred. Treatment with cyclophosphamide and prednisone was instituted which resulted in remission of both radiological and clinical symptoms, however, the prognosis is still poor. The patient will requires long-term therapy with cyclophosphamide and a number of complications related to the therapy can be expected.     

A comparison of three family therapy programs for treating family conflicts in adolescents with attention-deficit hyperactivity disorder.

61 12- to 18-yr-olds were randomized to 8–20 sessions of behavior management training (n?=?20), problem-solving and communication training (n?=?21), or structural family therapy (n?=?20). Families were assessed at pre- and posttreatment and 3-mo follow-up. All treatments resulted in significant reductions in negative communication, conflicts, and anger during conflicts and improved ratings of school adjustment, reduced internalizing and externalizing symptoms, and decreased maternal depressive symptoms. Most outcomes remained stable between posttreatment and follow-up, and some continued to improve over this time. Despite group improvements, analyses of clinically significant change and clinical recovery within Ss showed that only 5–30% reliably improved from treatment and only 5–20% recovered following treatment. The 3 treatments did not differ in these rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High school students as therapeutic agents with young children experiencing school adjustment difficulties: The effectiveness of a filial therapy training model.

Filial therapy has been used since the early 1960s to train parents as therapeutic agents for children experiencing a broad range of social, emotional and behavioral difficulties. Using a pretest-posttest control group design, this study examined the efficacy of a filial therapy model in training high school students to be effective helpers with young children experiencing school adjustment difficulties. 32 high school students enrolled in a Peer Assistance and Leadership course titled PALs were trained to become therapeutic change agents for identified prekindergarten and kindergarten students. The PALs students received training and supervision in child-centered play therapy skills that they practiced in weekly play sessions with their assigned child. Results from the statistical analyses reveal that the experimental group of high school students receiving filial therapy training demonstrated a significant increase in their empathic interactions with children and that the experimental group of children receiving the play therapy intervention experienced a significant reduction in problem behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hereditary spastic paraplegia with dementia

OBJECTIVE: Hereditary spastic paraplegia (HSP) with dementia is a very rare condition. The aim of the paper is to present the first report of HSP in a Fijian Indian family. METHOD: A psychiatrist and a general physician examined the affected members of the family on five occasions over three years. RESULTS: There are three affected individuals in a sibship of seven. The parents are without symptoms and the marriage is non-consanguineous. The course of the disease has been remarkably similar. All subjects were healthy and performing well in the early years of school. In two, symptoms of cognitive loss preceded difficulty with ambulation and in the third, these symptoms appeared concurrently. All subjects had both symptoms by 13 years of age; they were unable to ambulate independently by the mid to late teens, at which time there was dysarthria spastic paraplegia and dementia. One subject suffered a three month episode of hypomanic behaviour. Over the three-year study period deterioration was slight but noticeable. CONCLUSIONS: It is possible that HSP is more commonly associated with pre-senile dementia than is currently recognised. HSP with dementia is a very rare cause of failing school performance. Physical examination of the patient and other family members is indicated if this diagnosis is being considered.     

Course of psychological symptoms in sexually abused young children.

Assessed 8 sexually abused (SA) children (aged 3–7 yrs) repeatedly with the Child Behavior Checklist during a 10–18 mo period to explore the course of psychological symptoms that emerged in response to the abuse. Their individual courses were linked to whether treatment was provided and pathology in the parents. In some Ss, symptoms reflected a similar pattern of resolution. Symptomatology included depression and somatic complaints, aggressiveness, and the emergence of sexualized behavior. Parent–child interactions and the impact of therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AV nodal re-entry tachycardia in elderly patients: clinical presentation and results of radiofrequency catheter ablation therapy

STUDY OBJECTIVE: To assess the prevalence of respiratory problems, and the relation of these problems with school attendance, medicine use, and medical treatment. DESIGN: The Child Health Monitoring System. SETTING: Nineteen public health services across the Netherlands. PARTICIPANTS: 5186 school children aged 4-15 years, who were eligible for a routine health assessment in the 1991/1992 school year. MAIN RESULTS: Respiratory symptoms were present in 12% of the children. Recent symptoms suggestive of asthma (wheezing or episodes of shortness of breath with wheezing in the past 12 months, or chronic cough, or a combination of these) were reported for 8%. These symptoms were most frequent in the younger children, and in children at school in towns with less than 20,000 inhabitants. Of the children with recent symptoms suggestive of asthma, 37% reported school absence for at least one week during the past 12 months, compared with 16% in children without respiratory symptoms. School absence because of respiratory illness was reported for 22%, and medicine use for respiratory problems for 38% of the children with recent symptoms suggestive of asthma. Of these children, 21% were receiving medical treatment, compared with 15% of the asymptomatic children. CONCLUSIONS: Respiratory symptoms are a common health problem in children, and they are an important cause of school absence and medicine use. However, the percentage of children receiving medical treatment seemed quite low, indicating that proper diagnosis and treatment are probably still a problem.     

Play performance scale as an index of quality of life of children with cancer.

This study explores the reliability and validity of the Play Performance Scale for Children (PPSC; a parental rating scale of child play behavior) as a measure of quality of life among 120 children with cancer who were either hospitalized patients receiving treatment, outpatients receiving treatment, or patients who had completed their treatment. Interrater reliability between parents and physicians was significant in each patient group and overall. Parent ratings on the PPSC were highly correlated with ratings on visual analog scales of quality of life, mood, and physical comfort and the Vineland Adaptive Behavior Scales. Multiple regression analyses revealed that the PPSC ratings of parents and physicians were most influenced by the child's physical symptoms. Neither the PPSC nor the other measures were able to discriminate outpatients receiving therapy from patients who had completed therapy, despite significant differences between inpatients and outpatients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Actinomyces naeslundii genospecies 1 and 2 express different binding specificities to N-acetyl-beta-D-galactosamine, whereas Actinomyces odontolyticus expresses a different binding specificity in colonizing the human mouth

Postoperative thromboembolism is a potentially lethal complication. Its diagnosis may be difficult, as the classic clinical signs and symptoms are often absent, making a high index of suspicion imperative for diagnosis. Anticoagulant therapy is effective in reducing morbidity and mortality due to thromboembolism, but is associated with a substantial rate of bleeding complications in the immediate postoperative period. Inferior vena cava filters constitute an alternative to anticoagulant therapy, but are also associated with a substantial complication rate. The appropriate use of diagnostic tests combined with clinical suspicion can guide the orthopaedic surgeon in deciding which patients require treatment for thromboembolism.     

Accent, perpetual foreigner stereotype, and perceived discrimination as indirect links between English proficiency and depressive symptoms in Chinese American adolescents.

The current study uses García Coll et al.'s (1996) developmental competence model of ethnic minority children and Kim's (1999) racial triangulation theory as frameworks for investigating the mechanisms whereby early adolescent English proficiency relates to perceived discriminatory experiences and adolescent depressive symptoms. Data from 444 adolescents (239 girls and 205 boys, with a mean age of 13.0 years for Wave 1 and 17.0 years for Wave 2) and their parents living in major metropolitan areas of Northern California were collected. The structural equation modeling analyses indicate that self-reported low levels of English proficiency among Chinese American adolescents in middle school are related to these same students later reporting that they speak English with an accent in high school, which in turn relates significantly to their perceiving that they have been stereotyped as perpetual foreigners. For girls, a perpetual foreigner stereotype relates to perceptions of chronic daily discrimination, increasing the risk of depressive symptoms. For boys, the path is different: A perpetual foreigner stereotype is apparently related to discriminatory victimization experiences, which increase the risk of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lumbar intervertebral disc herniation in children less than 16 years of age. Long-term follow-up study of surgically managed cases

STUDY DESIGN: In this retrospective study, the long-term clinical results of lumbar intervertebral disc herniation in children less than 16 years of age were reviewed. OBJECTIVES: To evaluate the effectiveness of surgical treatment including posterior discectomy, extraperitoneal anterolateral discectomy, and anterior interbody fusion for lumbar intervertebral disc herniation in children less than 16 years of age. SUMMARY OF BACKGROUND DATA: Although previous follow-up studies on surgically managed lumbar intervertebral disc herniation in children and adolescents generally reveal good outcomes, few reports have focused on the time course of clinical findings and the long-term results. METHODS: The outcome of subjective symptoms, clinical signs, and time-related change of the intervertebral disc space in 11 patients were evaluated with an average follow-up period of 9 years (range, 5-12 years). RESULTS: The posterior discectomy procedure relieved clinical symptoms quickly. In the case of central herniation with or without intervertebral instability, extraperitoneal anterolateral discectomy or anterior interbody fusion led to favorable long-term results. Clinical symptoms (lower back pain, leg pain) and neurologic disturbance disappeared within 3 months after surgery. Recovery of normal straight leg raising test results (tight hamstrings), however, required much more time than recovery of other symptoms. Narrowing of the intervertebral disc space progressed up to 3-6 months after discectomy, but then disc space widening occurred. CONCLUSIONS: Satisfactory long-term clinical results and early return to school life were obtained with each surgical procedure. It is important to aim toward an early return to school via surgical treatment.     

A longitudinal look at the relation between depression and anxiety in children and adolescents.

Elementary school students (n?=?330) and their parents (n?=?228) participated in a 3-year longitudinal study of the temporal relation between anxiety and depressive symptoms in children. Every 6 months, children and parents completed depression and anxiety questionnaires for a total of 6 waves. Structural equation modeling revealed that individual differences on all measures were remarkably stable over time. Nevertheless, high levels of anxiety symptoms at 1 point in time predicted high levels of depressive symptoms at subsequent points in time even after controlling for prior levels of depression symptoms. These findings were consistent across self- and parent reports. Results support the temporal hypothesis that anxiety leads to depression in children and adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)