Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

Parental Knowledge of Pre-Hospital Management of Avulsed Permanent Tooth in Children at Kath

BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.

Impact of increasing one-carbon metabolites on traumatic brain injury outcome using pre-clinical models

Traumatic brain injury is a major cause of death and disability worldwide,affecting over 69 million individuals yearly.One-carbon metabolism has been shown to have beneficial effects after brain damage,such as ischemic stroke.However,whether increasing one-carbon metabolite vitamins impacts traumatic brain injury outcomes in patients requires more investigation.The aim of this review is to evaluate how one-carbon metabolites impact outcomes after the onset of traumatic brain injury.PubMed,Web of Science,and Google Scholar databases were searched for studies that examined the impact of B-vitamin supplementation on traumatic brain injury outcomes.The search terms included combinations of the following words:traumatic brain injury,dietary supplementation,one-carbon metabolism,and B-vitamins.The focus of each literature search was basic science data.The year of publication in the literature searches was not limited.Our analysis of the literature has shown that dietary supplementation of B-vitamins has significantly improved the functional and behavioral recove ry of animals with traumatic brain injury compared to controls.Howeve r,this improvement is dosage-dependent and is contingent upon the onset of supplementation and whether there is a sustained or continuous delive ry of vitamin supplementation post-traumatic brain injury.The details of supplementation post-traumatic brain injury need to be further investigated.Overall,we conclude that B-vitamin supplementation improves behavioral outcomes and reduces cognitive impairment post-traumatic brain injury in animal model systems.Further investigation in a clinical setting should be stro ngly considered in co njunction with current medical treatments for traumatic brain injury-affected individuals.

Event segmentation in ADHD:neglect of social information and deviant theta activity point to a mechanism underlying ADHD

Background Attention-deficit/hyperactivity disorder(ADHD)is one of the most frequently diagnosed psychiatric conditions in children and adolescents.Although the symptoms appear to be well described,no coherent conceptual mechanistic framework integrates their occurrence and variance and the associated problems that people with ADHD face.Aims The current study proposes that altered event segmentation processes provide a novel mechanistic framework for understanding deficits in ADHD.Methods Adolescents with ADHD and neurotypically developing(NT)peers watched a short movie and were then asked to indicate the boundaries between meaningful segments of the movie.Concomitantly recorded electroencephalography(EEG)data were analysed for differences in frequency band activity and effective connectivity between brain areas.Results Compared with their NT peers,the ADHD group showed less dependence of their segmentation behaviour on social information,indicating that they did not consider social information to the same extent as their unaffected peers.This divergence was accompanied by differences in EEG theta band activity and a different effective connectivity network architecture at the source level.Specifically,NT adolescents primarily showed error signalling in and between the left and right fusiform gyri related to social information processing,which was not the case in the ADHD group.For the ADHD group,the inferior frontal cortex associated with attentional sampling served as a hub instead,indicating problems in the deployment of attentional control.Conclusions This study shows that adolescents with ADHD perceive events differently from their NT peers,in association with a different brain network architecture that reflects less adaptation to the situation and problems in attentional sampling of environmental information.The results call for a novel conceptual view of ADHD,based on event segmentation theory.

Psychiatric outcomes in outpatients affected by long COVID:A link between mental health and persistence of olfactory complaint

BACKGROUND Anosmia was one of the main symptoms of coronavirus disease 2019(COVID-19).A psychiatric history(i.e.,depression)may be an independent contributor to the risk of COVID-19 diagnosis,and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae(bidirectional association).AIM To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.METHODS We conducted a prospective case control study from March 2020 to May 2021.Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint(visual analogue scale)for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology.Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department.Psychiatric medical histories were collected by a psychiatrist during the assessments.RESULTS Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study.Fifty percent of the patients were female(n=17).The group’s mean age was 40.5±12.9 years.The control group included 32 participants,of which 34.4%were female(n=11),and had a mean age of 61.2±12.2 years.The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher(41.7%)than among patients without(18.8%)(χ2=5.9,P=0.015).CONCLUSION The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia.It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients.Further prospective,translational,and collaborative studies are needed to extrapolate these results to the general population.

Cognitive dysfunction in schizophrenia patients caused by downregulation of γ-aminobutyric acid receptor subunits

BACKGROUND The expression pattern of gamma aminobutyric acid(GABA)receptor subunits are commonly altered in patients with schizophrenia,which may lead to nerve excitation/inhibition problems,affecting cognition,emotion,and behavior.AIM To explore GABA receptor expression and its relationship with schizophrenia and to provide insights into more effective treatments.METHODS This case-control study enrolled 126 patients with schizophrenia treated at our hospital and 126 healthy volunteers who underwent physical examinations at our hospital during the same period.The expression levels of the GABA receptor subunits were detected using 1H-magnetic resonance spectroscopy.The recognized cognitive battery tool,the MATRICS Consensus Cognitive Battery,was used to evaluate the scores for various dimensions of cognitive function.The correlation between GABA receptor subunit downregulation and schizophrenia was also analyzed.RESULTS Significant differences in GABA receptor subunit levels were found between the case and control groups(P<0.05).A significant difference was also found between the case and control groups in terms of cognitive function measures,including attention/alertness and learning ability(P<0.05).Specifically,as the expression levels of GABRA1(α1 subunit gene),GABRB2(β2 subunit gene),GABRD(δsubunit),and GABRE(εsubunit)decreased,the severity of the patients’condition increased gradually,indicating a positive correlation between the downregulation of these 4 receptor subunits and schizophrenia(P<0.05).However,the expression levels of GABRA5(α5 subunit gene)and GABRA6(α6 subunit gene)showed no significant correlation with schizophrenia(P>0.05).CONCLUSION Downregulation of the GABA receptor subunits is positively correlated with schizophrenia.In other words,when GABA receptor subunits are downregulated in patients,cognitive impairment becomes more severe.

Knowledge and Attitudes of Knust Pre-Clinical Dental Students towards Orthodontic Treatment

Background: Orthodontics is a dental specialty focusing on correcting dental irregularities and malocclusion. Knowledge and attitudes towards orthodontic treatment are crucial for promoting oral health and overall well-being. Education and awareness play a vital role in ensuring optimal treatment outcomes and improving quality of life. Aim: This study aims to determine the knowledge and attitudes of Kwame Nkrumah University of Science and Technology (KNUST) pre-clinical dentistry students concerning orthodontic therapy. Methodology: This research is a quantitative descriptive cross-sectional study. The research used a non-random convenience sampling method to form the desired sample. For data collection, an interview-administered questionnaire was used over one month. The study set its sights on pre-clinical dental students in KNUST. A total of 150 questionnaires were printed to meet the sample size. Results: The results of the research showed that the knowledge level of KNUST pre-clinical students on orthodontic treatment and its nuances is quite limited. They however had a fair level of knowledge on the disease or ailment that orthodontic treatments solved (especially malocclusion). Their interest in orthodontic treatments on the other hand was quite significant, with a large number having interest in it. Conclusion: To conclude, KNUST pre-clinical students in Ghana although having a limited level of knowledge on orthodontic treatments have a keen interest in undergoing them regardless of the discomforts or the length of time.

Challenges and Motivating Factors of Orthodontic Treatment among Patients Attending Komfo Anokye Teaching Hospital

Background: Orthodontic treatment poses challenges such as discomfort, aesthetic concerns, dietary restrictions, time commitment, and financial considerations for patients. These challenges can deter individuals from pursuing treatment or cause anxiety during the process. However, patients are motivated by the desire to improve their appearance, boost self-confidence, and enhance oral health. They also value the long-term benefits of treatment, including improved dental function and overall well-being. Professional recommendations from dentists and orthodontists, along with social support from family and friends, further encourage patients to undergo treatment. Understanding these challenges and motivating factors is crucial for orthodontic professionals to tailor treatment plans and ensure positive experiences and successful outcomes for their patients. Objective: To determine the challenges and motivating factors of orthodontic treatment among patients attending Komfo Anokye Teaching Hospital. Method: The study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, with a sample size of 60 orthodontic patients. Data was collected using self-administered questionnaires and analyzed using SPSS software. Ethical approval was obtained, and the findings were shared with stakeholders. Results: Findings showed a higher representation of females (63.3%) seeking orthodontic treatment. Common motivations for seeking orthodontic treatment included aesthetic Concerns (38.2%), misaligned teeth (28.1%) and recommendation from dentist (19.2%). Challenges reported included pain and discomfort (36.7%), difficulty chewing (15%), expensive treatment (14.4%) and missed appointments (11.7%). Factors motivating treatment continuation were visible improvements (30%), achieving optimal results (23%), reducing pain and discomfort (17%). External influences, such as family pressure, also played a role. Patients appreciated the support of healthcare providers during treatment but suggested better pain management and education. Conclusion: The study provided valuable insights into patient motivations, challenges and factors influencing satisfaction and adherence to orthodontic treatment at KATH.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

Advances in the treatment of autism spectrum disorder:Wharton jelly mesenchymal stem cell transplantation

BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental disorder with multifaceted origins.In recent studies,neuroinflammation and immune dysregulation have come to the forefront in its pathogenesis.There are studies suggesting that stem cell therapy may be effective in the treatment of ASD.AIM To evolve the landscape of ASD treatment,focusing on the potential benefits and safety of stem cell transplantation.METHODS A detailed case report is presented,displaying the positive outcomes observed in a child who underwent intrathecal and intravenous Wharton’s jelly-derived mesenchymal stem cells(WJ-MSCs)transplantation combined with neurorehabilitation.RESULTS The study demonstrates a significant improvement in the child’s functional outcomes(Childhood Autism Rating Scale,Denver 2 Developmental Screening Test),especially in language and gross motor skills.No serious side effects were encountered during the 2-year follow-up.CONCLUSION The findings support the safety and effectiveness of WJ-MSC transplantation in managing ASD.

Study on the Effect of Behavioral Interventions Based on the Theory of“Knowledge,Attitude,Practice”on Tuberculosis Cognitive Level of Close Contacts

Objective:Based on the theory of“Knowledge,Attitude,Practice,”health education was carried out for close contact with tuberculosis(TB)at a university in Beijing,and its impact on the students’awareness of TB was studied.This study could provide a reference for effective health education interventions among close contacts of TB in undergraduates.Methods:102 undergraduates who had close contact with one confirmed case of pulmonary TB in April 2021 at a university were randomly divided into a control group and an intervention group.The intervention group was given the“Knowledge,Attitude,Practice”health education intervention by professionally trained doctors,and were asked to complete a self-designed TB-related questionnaire before and after the intervention.Both groups performed the Tuberculin Skin Test(TST)and chest X-ray(CR)examination.Results:The rate of the TST test was 18.6%,and CR examination showed 0 cases of pulmonary TB.The survey results showed that the TB awareness rate(96.1%,49/51)in the intervention group was significantly higher than that of the control group(51.0%,26/51),and the differences in awareness rate between the two groups were statistically significant(P<0.05).Regarding the attitude/skills toward TB,the prevalence rate of tuberculosis-related attitude/behavior in the intervention group(94.1%,47/51)was significantly higher than that of the control group(60.8%,31/51),and the differences between the two groups were statistically significant(P<0.05).Conclusion:Both self-controlled and parallel-controlled studies showed that the health education intervention of“Knowledge,Attitude,Practice”improved the awareness of TB among close contacts of TB in undergraduates.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions

BACKGROUND On January 22,2020,Macao reported its first case of coronavirus disease 2019(COVID-19)infection.By August 2021,the situation had escalated into a crisis of community transmission.In response,the government launched a recruitment campaign seeking assistance and services of healthcare workers(HCWs)from the private sector throughout Macao.These participants faced concerns about their own health and that of their families,as well as the responsibility of maintaining public health and wellness.This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress.AIM To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic.METHODS Data were collected from December 2020 to January 2022.Two consecutive surveys were conducted.The Pittsburgh Sleep Quality Index(PSQI)scale,Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were employed as investigation tools.RESULTS In the first-stage survey,32%of HCWs experienced a sleep disorder,compared to 28.45%in the second-stage survey.A total of 31.25%of HCWs in the first-stage survey and 28.03%in the second had varying degrees of anxiety.A total of 50.00%of HCWs in the first-stage survey and 50.63%in the second experienced varying degrees of depression.No difference in PSQI scores,SAS scores,or SDS scores were observed between the two surveys,indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs.The negative influence persisted over both periods but did not increase remarkably for more than a year.However,a positive correlation was observed between the PSQI,SAS,and SDS scores(r=0.428-0.775,P<0.01),indicating that when one of these states deteriorated,the other two tended to deteriorate as well.CONCLUSION The sleep quality,anxiety,and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic.While these factors did not deteriorate significantly,the negative effects persisted for a year and remained noteworthy.

Diagnosis,treatment and prevention of type 2 diabetes mellitus in children and adolescents

During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This trend,which parallels the increases in prevalence and degree of pediatric obesity,has caused great concern,even though T2 DM remains a relatively rare disease in children.Youth T2 DM differs not only from type 1 diabetes in children,from which it is sometimes difficult to differentiate,but also from T2 DM in adults,since it appears to be an aggressive disease with rapidly progressive β-cell decline,high treatment failure rate,and accelerated development of complications.Despite the recent research,many aspects of youth T2 DM still remain unknown,regarding both its pathophysiology and risk factor contribution,and its optimal management and prevention.Current management approaches include lifestyle changes,such as improved diet and increased physical activity,together with pharmacological interventions,including metformin,insulin,and the recently approved glucagonlike peptide-1 analog liraglutide.What is more important for everyone to realize though,from patients,families and physicians to schools,health services and policy-makers alike,is that T2 DM is a largely preventable disease that will be addressed effectively only if its major contributor(i.e.,pediatric obesity) is confronted and prevented at every possible stage of life,from conception until adulthood.Therefore,relevant comprehensive,coordinated,and innovative strategies are urgently needed.

Autism and Mental Retardation of Young Children in China

To understand the prevalence and rehabilitation status of autism and mental retardation in China. Methods Screening test and clinical assessment were conducted for the diagnosis of autism and mental retardation. The assessment included investigation of the histories of medical conditions and development of these two disorders, utilization and needs for the rehabilitation service, and related intellectual and behavioral appraisal. Results Among the 7345 children investigated, the prevalence of autism disorder was 1.10 cases per 1000 children aged 2-6 years （95% CI=0.34 to 2.54）, and the prevalence of mental retardation was 10.76 cases per 1000 children （95% CI=8.40 to 13.12）. All the children suffering from autistic disorder were intellectually disabled, whereas 31.0% of the non-autism mental retardates had other disabilities. The medical conditions prior to birth and perinatal period were important potential factors for autism. Half of the autistic children and 84% of the children with non-autism mental retardation had never received any rehabilitative service. Conclusions The prevalence of autistic disorder in children aged 2-6 years in Tianjin is rather high. It is urgent to improve the status of the autistic and intelligently disabled young children in China. In order to upgrade the level of early diagnostic and improve the intervention to autism and mental retardation, public awareness and training courses should be heightened.

Pediatricians lack knowledge for the diagnosis and management of functional constipation in children over 6 mo of age

AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia.RESULTS Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements(according to 87% of participants) with a mean of one bowel movement per 3.59 ± 1.0 d, hard stools(83%), blood in the stools(36%), fecal incontinence(33%), and/or difficulty in defecating(47%). Only 26 pediatricians prescribe pharmacologic treatment as first therapeutic approach, while the vast majority prefers nonpharmacologic treatment, mostly(according to 68%) The preferred nonpharmacologic treatment are high-fiber diet(96%), increased fluid intake(90%), toilet training(74%), and abdominal massage(49%). Duration of non-pharmacological treatment was limited to 1 to 2 wk. Seventy percent of the pediatricians recommending toilet training could only mention some elements of the technique, and only 15% was able to explain it fully and correctly. Lactulose is the most frequent pharmacologic intervention used(87% of the participants), and rectal treatment with sodium citrate, sodium lauryl sulfo acetate, and sorbitol is the most frequent rectal treatment(85%). Only 51% will prescribe rectal treatment for fecal impaction. The majority of the pediatricians(69%) expect a positive response during the first week with a mean(± SD) of 4.1(± 2.56) d. Most participants(86%) treat during one month or even less. And the majority(67%) stops treatment when the frequency and/or consistency of the stools have become normal, or if the patient had no longer complaints.CONCLUSION These data provide an insight on the diagnosis and management of constipation in childhood in Indonesia. Although general pediatricians are aware of some important aspects of the diagnosis and mangement of constipation, overall knowledge is limited. Efforts should be made to improve the distribution of existing guidelines. These findings highlight and confirm the difficulties in spreading existing information from guidelines to general pediatricians.

The Mediating Effect of Body Dissatisfaction in Association between Obesity and Dietary Behavior Changes for Weight Loss in Chinese Children

Objective The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss(DBCWL).Methods A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.Results The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females(P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL(OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction(OR = 6.00 and 4.70,respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL(OR = 2.20 and 1.92,respectively;P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.Conclusion Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.

Family empowerment and quality of life of parents raising children with Developmental Disabilities in 78 Japanese families

Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (QoL) and to effectively support these families in Japan.The objective of this study was to assess the actual conditions of families living with children having DDs and to explore the factors associated with family empowerment and parents' QoL.Methods: We surveyed ninety-three parents (78 mothers,15 fathers) from 78 families which lived with children with DDs in the capital region of Japan.We assessed two main outcomes using the Japanese versions of the following instruments: Family Empowerment Scale (FES),World Health Organization Quality of Life 26 (WHOQOL26),and other six outcomes.Correlation and multiple regression analyses were conducted.Results: No medication,cooperation with child rearing,assistance from a developmental support center,solved problems related to child rearing,and higher scores in Problem Solving contributed to higher FES scores.Higher WHOQOL26 scores were related to being a full-time housewife,higher self-esteem,no developmental support,a broad emotional support network,higher scores in Problem Solving and Role Function,and lower scores in Affective Reaction and General Function.Conclusions: We revealed that family empowerment and QoL of parents rearing children with DDs in Japan were affected by various subscales of family function and other family attributes.Effective interventions for improving family empowerment and QoL should be researched in the future.

Clinical profile of diabetes at diagnosis among children and adolescents at an endocrine clinic in Ghana

AIM To determine the clinical features of diabetes in children and adolescents in Ghana.METHODS Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auguest 2016. RESULTS One hundred and six subjects presented with diabetes. Ninety(84.9%) were diagnosed by clinical features and family history as type 1, and 16(15.1%) type 2. For type 1 subjects, age range at diagnosis was 0.9-19.9 year(y), peak age of onset 12-13 year, and 3.3% were < 5 year, 21.1% 5-< 10 year, 45.6% 10-< 15 year and 30.0% 15-< 20 year. Seventy-one point one percent were female. Common clinical features were polyuria(100%), polydipsia(98.9%), and weight loss(82.2%). Mean BMI SD was -0.54, range -3.84 to 2.47. 60.0% presented in diabetic ketoacidosis(DKA). Nine had infections at onset(skin, abscess, leg ulcer). Mean± SD HbA 1c at diagnosis was 12.7% ± 1.9%(115±21 mmol/mol). Four have since died: Hypoglycaemia(2), recurrent DKA(1), osteosarcoma(1). Two other type 1 cases died of DKA at presentation in emergency before being seen by the paediatric endocrinologist. Crude mortality rate including these 2 cases was 32.2/1000 patient years. Type 2 cases were 81% female, age of onset 9-19 year. Mean BMI SD was 1.49, range -0.87 to 2.61. Forty-three point eight percent presented in DKA. All type 2 cases had acanthosis nigricans. Overall, 9.8% did not have home refrigeration, most using clay pot evaporative cooling for insulin storage. CONCLUSION Type 1 occurs with a female preponderance and high DKA rates. Type 2 also occurs. Typology based on clinical features is difficult. Community and professional awareness is warranted.

A Controlled Study of the Effectiveness of EEG Biofeedback Training on Children with Attention Deficit Hyperactivity Disorder

In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.

Validity and reliability of Turkish version of the scales of perceived stigma for children with epilepsy and their parents

Purpose:This study aims to establish a Turkish version of the scales of perceived stigma amongst children with epilepsy and their parents by adopting the scales developed by Austin et al.This study also aims to analyse the scales'validity and reliability in evaluating stigma perceptions amongst the aforementioned population.Methods:The population of this methodological study consisted of parents and 85 epileptic children between 9 and 16 years old.This population visited the paediatric neurology clinic of a hospital in Erzurum Province,Turkey,between April 2015 and January 2016.The scales of perceived stigma amongst children with epilepsy and their parents,as well as its Turkish version,were used as measuring tools.Experts were also consulted for their opinions.Meanwhile,Bartlett's test,Kaiser-Meyer-Olkin(KMO)index,exploratory factor analysis,principal component analysis,varimax rotation and scree plot test were used to determine the validity of the study,Moreover,the coefficients of Cronbach'sαand Pearson's product-moment correlation were used to identify internal consistency,homogeneity and thus reliability.Results:Evaluations and analyses indicated that the Turkish version of the child and parent scales can be used with a single dimension.The mean scores of such scales were 24.02±8.47 and 15.68±4.04,respectively.All item-total score correlations of the child and parent scales were found to be significant(P<0.05).The KMO coefficient of the child scale was 0.94,whereas the chi-square value of Bartlett's test of sphericity was significant at 209.311(P<0.05).Moreover,the KMO coefficient of the parent scale was found to be 0.80,whereas the chi-square value of Bartlett's test of sphericity was found to be significant at 209.311(P<0.05).The Cronbach'sαcoefficients were 0.95 and 0.87 for the child and parent scales,respectively.Conclusion:The Turkish version of the child and parent scales of perceived stigma is valid and reliable in measuring the perception of stigma amongst children with epilepsy and their parents.