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We report a patient with long QT syndrome who received an inappropriate implantable cardioverter-defibrillator shock due to electrical interference from a refrigerator. This electrical interference was mistakenly detected as an episode of ventricular fibrillation and ended with an inappropriate delivery of shock without any warning symptoms before.
The long-term prospective multi-centre nationwide (French) observational study FRANCISCO will provide new information on perimembranous ventricular septal defect with left ventricular overload but no pulmonary hypertension in children older than 1 year. Outcomes will be compared according to treatment strategy (watchful waiting, surgical closure, or percutaneous closure) and anatomic features of the defect. The results are expected to provide additional guidance about the optimal treatment of this specific population, which is unclear at present.
The notion that a child has rights is longstanding: the 1924 Declaration of the Rights of the Child, adopted by the League of Nations, was the first international instrument explicitly acknowledging the existence of children’s rights. The formulation of the right to life under the Convention on the Rights of the Child—the most widely ratified human rights treaty in history – is distinct, referring to the duty to ensure to the maximum extent possible the survival and development of the child. Accordingly, the chapter considers infanticide and violence against children, including in domestic settings as well as against children in the streets. Also addressed are infant mortality, disease, illness, and substance abuse, and recruitment into armed forces, armed groups, and gangs.
The international community is moving towards the abolition of the death penalty but executions continue to lawful in a number of countries under certain circumstances where a crime of murder has been perpetrated at the issue of a fair trial. The mandatory death sentence is, however, always arbitrary. Those under 18 years of age at the time of the commission of the crime may not be lawfully sentenced to death and pregnant women may not be executed. The legality of executing persons with disabilities or older persons is also assessed. Finally, the death penalty in connection with an armed conflict is considered.
Though months have passed since the Trump administration ruthlessly enacted a “zero tolerance” family separation policy at the US–Mexico border, punitive deterrence policies remain the dominant governmental response to humanitarian emergencies. These policies violate longstanding constitutional values and institutional norms as well as national and international legal obligations to non-citizens. This chapter outlines these obligations; details the inhumane, futile, and violative policies deployed by the Trump administration to block or otherwise deter the entry of humanitarian migrant children and families; and proposes several alternatives to achieve a more equitable, effective, efficient, and law-abiding immigration policy. Key recommendations include increasing regional economic and civic collaboration; reinstituting supervised family release and legal representation to families and unaccompanied children; establishing special immigration policies that prioritize credible and well-regulated refugee status reviews particularly for children and families fleeing violence and persecution; expanding refugee resettlement programs at the federal, state, and local level; and subsidizing scholarship programs for at-risk children and adolescents. Reforms that protect the health and human rights of non-citizens not only advance equity, but also benefit the economic, social, and political interests of United States.
This chapter completes the account begun in Chapter 4 of why psychopaths are unable to see other people as sources of value. I argue that as well as, and partly because of, their emotional deficiencies, psychopaths suffer a severe deficit of empathy, either from birth or brought on by abuse or neglect in childhood. Based on evidence from developmental psychology, I argue that empathy plays a central role in the way we come to ascribe value to entities other than ourselves. Lacking this crucial developmental stage, psychopaths reach adulthood without the capacity to see others as valuable. Because they lack this capacity due to factors which they cannot be expected to change, they are not morally responsible for lacking it. They are therefore not morally responsible for the failure to respond to certain reasons which stems from this lack. Finally, I consider other disorders of low empathy, specifically autism spectrum disorder and borderline personality disorder, and give an account of why these conditions do not apparently lead to the same outcomes in respect of the ability to value others.
Subvalvular aortic stenosis is a progressive left-sided obstructive lesion, usually consisting of a discrete membrane, fibromuscular ridge, or tunnel. Surgical intervention is preferred over catheter intervention when the gradient across the lesion is greater than 40 mm Hg or aortic insufficiency has developed across the aortic valve. Perioperative anesthetic goals include maintaining adequate preload, afterload, and a low to normal heart rate.
Plant-based, i.e., vegetarian (without meat and fish) or vegan (exclusively plant-based foods) diets are in trend also among children and adolescents, but data on food intake in this group are lacking. Here, we compare the consumption of food groups of vegetarian (n 145), vegan (n 110), and omnivore (n 135) children and adolescents (6-18 years) in Germany using data of the VeChi Youth Study. Each food item reported in 3day weighed dietary records was assigned to one of 18 food groups and individual mean intake per day (g/MJ) was calculated. Group differences were assessed using covariance analyses adjusted for age, sex and other covariates. For food groups with a high number of non-consumers, non-parametric Kruskal-Wallis-Tests were run. Pairwise comparison of vegetarian and vegan groups indicated significantly higher intakes of legumes, nuts, milk alternatives (all P = 0.0003), and meat alternatives (P = 0.0065) among vegan subjects. Intake of these food groups of omnivore participants was low (Q3: 0.0 g/MJ for legumes, milk alternatives, and meat alternatives, 0.5 g/MJ for nuts). Dairy intake of vegetarians (11.6 g/MJ) was significantly lower than of omnivore subjects (24.7 g/MJ) (P = 0.0003). Intake of fats/oils and sweet foods was lowest in vegan compared to vegetarian and omnivore participants (p <0.05). Whole grain intake was higher in vegan participants (14.5 g/MJ) than of vegetarian (9.1 g/MJ) and omnivore (6.5 g/MJ) participants (P = 0.0003). Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan, and omnivore food patterns, especially in childhood and adolescence.
To translate and validate the Child Three-Factor Eating Questionnaire (CTFEQr17), assessing cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE), among French-speaking Canadian young individuals.
Phase 1 comprised a translation and the evaluation of the comprehension of the questionnaire. Phase 2 comprised a confirmatory factor analysis (CFA), the evaluation of internal consistency (Cronbach’s ⍺), test-retest reliability [Intraclass correlation coefficients (ICC)] and construct validity, including correlations among the CTFEQr17 and EAT-26, anthropometrics, dietary intake and diet quality.
Primary and secondary schools, Québec City, Canada.
Phases 1 and 2 included 20 [40% boys, mean age 11.5 (SD 2.4) years] and 145 [48% boys, mean age 11.0 (SD 1.9) years] participants, respectively.
Phase 1 resulted in the questionnaire to be used in Phase 2. In Phase 2, the CFA revealed that the 17-item, three-factor model (CTFEQr17) provided an excellent fit. Internal consistency was good (Cronbach’s ⍺: 0.81-0.90). Test-retest reliability was moderate to good [ICC = 0.59, 95% CI (0.48-0.70), ICC = 0.78, 95% CI (0.70-0.84), ICC = 0.50, 95% CI (0.38-0.62) for CR, UE and EE respectively]. CR correlated with EAT-26 score (r = 0.43, P < 0.0001). UE and EE correlated negatively with BMI z-scores (r = −0.26, P = 0.003; r = −0.19, P = 0.03, respectively). CR correlated with the proportion of energy intake from protein and diet quality (r = 0.18, P = 0.04; r = 0.20, P = 0.02, respectively).
The CTFEQr17 is suitable to use among French-speaking Canadian young individuals.
School food intake of Australian children is not comprehensively described in literature, with limited temporal, nationally representative data. Greater understanding of intake at school can inform school-based nutrition promotion. This study aimed to describe the dietary intake of primary-aged children during school hours and its contribution to daily intake.
This secondary analysis used nationally representative, cross-sectional data from the 2011-12 National Nutrition and Physical Activity Survey. Dietary intake was assessed using validated 24-hour dietary recalls on school days. Descriptive statistics were undertaken to determine energy, nutrients, food groups, and food products consumed during school hours, as well as their contributions to total daily intake. Associations between school food intake and socio-demographic characteristics were explored.
Seven hundred and ninety-five children aged 5-12 years.
Children consumed 37% of their daily energy and 31-43% of select nutrient intake during school hours, with discretionary choices contributing 44% of school energy intake. Most children consumed less than one serve of vegetables, meat and alternatives or milk and alternatives during school hours. Commonly consumed products were discretionary choices (34%, including biscuits, processed meat), bread (17%) and fruit (12%). There were limited associations with SES variables, apart from child age.
Children’s diets were not aligned with national recommendations, with school food characterised by high intake of discretionary choices. These findings are consistent with previous Australian evidence and support transformation of the Australian school food system to better align school food consumption with recommendations.
Accurate assessments of potassium intake in children are important for the early prevention of cardiovascular disease. Currently, there is no simple approach for accurate estimation of potassium intake in children. We aim to evaluate the accuracy of 24-hour urinary potassium excretion (24UKV) estimation in children using three common equations: the Kawasaki, Tanaka, and Mage formulas, in a hospital-based setting. A total of 151 participants aged 5˜18 years were initially enrolled, and spot urine samples were collected in the whole 24-hour duration to measure the concentrations of potassium and creatinine. We calculated the mean difference, absolute and relative difference, and misclassification rate between measured 24UKV and the predicted ones using Kawasaki, Tanaka, and Mage formulas in 129 participants. The mean measured 24UKV was 1193.3 mg/d in our study. Mean differences between estimated and measured 24UKV were 1215.6, −14.9, and 230.3 mg/d by the Kawasaki, Tanaka, and Mage formulas, respectively. All estimated 24UKV were significantly different from the measured values in all the timepoint (all P<0.05), except for the predicted values from Tanaka formula using morning, afternoon, and evening spot urine. The proportions with relative differences over 40% were 87.2%, 32.5%, and 47.3% for Kawasaki, Tanaka, and Mage formulas, respectively. Misclassification rates were 91.5% for Kawasaki, 44.4% for Tanaka, and 58.9% for Mage formula at the individual level.
Our findings showed that misclassification could occur on the individual level when using Kawasaki, Tanaka, and Mage formulas to estimate 24UKV from spot urine in the child population.
Despite the rapidly emerging reports of olfactory dysfunction amongst adult patients with coronavirus disease 2019, cases involving children and adolescents are scarcely reported. The literature was reviewed to elucidate olfactory dysfunction amongst children and adolescents with coronavirus disease 2019.
A search of the literature published from 1 December 2019 to 30 April 2021 was conducted using four databases, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The search was performed over one month (May 2021).
Only 9 articles were identified, with a total of 316 laboratory confirmed coronavirus disease 2019 positive children and adolescents, of whom 156 reported olfactory dysfunction. Four studies reported olfactory dysfunction based on subjective tests; four studies carried out objective assessment. Most studies reported on olfaction recovery.
The literature review revealed an olfactory dysfunction rate of 49 per cent amongst children and adolescents with coronavirus disease 2019. Persistence of olfactory dysfunction was reported in 7.1 per cent of the patients. Further studies involving objective measures need to be carried out in children and adolescents with coronavirus disease 2019.
Chapter Five, ‘Behind the Lines’, explores the men’s encounters with civilians. Focusing on spaces, like cafes, estaminets and domestic homes, in both Britain and France, the chapter begins with some of the youngest participants in colonial encounters - children. The chapter then explores how these more domestic contact zones were accessed, through entitlement or earning the right to connection with civilian women and the maternal, emotional, sexual and romantic support they might offer. In these spaces, we can see the beginnings of wartime encounter seeping beyond the boundaries of the conflict, especially through marriage. While camp and leave created memories of encounters that shaped veteran culture, civilian contact zones fostered in these liminal, overlapping spaces of living alongside the war had an impact on post-war life.
The incidence of traumatic brain injury (TBI) in children is estimated to be high, being an important cause of mortality and morbidity. Post traumatic seizures (PTS), post-traumatic epilepsy (PTE), and neuropsychiatric sequelae after TBI contribute to the medical health burden in children. PTE has been recognized as one of the most common forms of acquired epilepsies in young people, and it is associated with poor functional and psychosocial outcome. In this chapter, clinical presentation, diagnosis and management of PTE, and the role of antiepileptic drugs in children are discussed. In addition, the poorly understood pathophysiology of PTE is discussed with reference to genetic and neurophysiologic biomarkers and potential risk factors that increase the risk of developing PTE.
Language mixing is common in bilingual children's learning environments. Here, we investigated effects of language mixing on children's learning of new words. We tested two groups of 3-year-old bilinguals: French–English (Experiment 1) and Spanish–English (Experiment 2). Children were taught two novel words, one in single-language sentences (“Look! Do you see the dog on the teelo?”) and one in mixed-language sentences with a mid-sentence language switch (“Look! Do you see the chien/perro on the walem?”). During the learning phase, children correctly identified novel targets when hearing both single-language and mixed-language sentences. However, at test, French–English bilinguals did not successfully recognize the word encountered in mixed-language sentences. Spanish–English bilinguals failed to recognize either word, which underscores the importance of examining multiple bilingual populations. This research suggests that language mixing may sometimes hinder children's encoding of novel words that occur downstream, but leaves open several possible underlying mechanisms.
This chapter focuses on the different health needs and outcomes of Indigenous children and their families. It begins by discussing the national policies aimed at improving Indigenous child health, including the National Framework for Health Services for Aboriginal and Torres Strait Islander Children and Families, and by considering the cultural and social considerations when providing healthcare to Indigenous children. The gap between mortality and morbidity rates of Aboriginal and Torres Strait Islander children and non-Indigenous children is established as the authors call for nurses and midwives to understand the stories behind these statistics, before considering the programs and initiatives aimed at improving health outcomes of Indigenous children. The chapter discusses ways to promote health, and considers common health issues experienced by Indigenous children, including poor nutrition, oral and ear health, and infections. The chapter provides concrete ways in which nurses and midwives can care for Indigenous children and also discusses examples of community programs working to reduce the rate of accidents and self-harm in Indigenous children.
Parent training is an evidence based and highly effective intervention for conduct disorders in children. Traditionally, only the parents participate in behavioral trainings, implementing the new skills in their homes on their own between the appointments. In some cases, this turns out as not intense enough.
Therefore, we recently implemented the German version of the PCIT Parent Child Interaction Training in our clinic in Zurich, Switzerland.
PCIT is an evidence-based and highly effective intervention for children aged 2-7 years with conduct disorders (Zisser & Eyberg, 2010; Briegel, 2016). Parents visit the clinic weekly with their child and are directly supported in their interaction by the therapists. A special treatment room was set up for this intervention.
We will present our first experiences with this approach in the highly international and urban population of Zurich.
Parents appreciate to work with their child while being directly coached by the therapists. Almost all parents achieved considerable progress in their skills and the conduct problems reduced over time.
The prevalence of mental disorders (MD) is greater in children; however, they are the population with less help-seeking and access to mental health-care services (MHS).
To explore the characteristics of help-seeking and access to specialized MHS in children with MD.
A cross-sectional study was carried out from 2018 to 2019, in the Children’s Psychiatric Hospital and National Institute of Psychiatry in Mexico City. Sample 397 children and 397 caregivers. The project was approved by the Ethics Committee of both institutions. The patient’s family member was questioned on sociodemographic data and help-seeking to MHS. Sample’s descriptive statistics applying measures of central tendency, Inferential statistics with t-test for differences in means between groups (diagnosis), and one-way ANOVA to variables associated with the help-seeking to MHS.
Children´s sample: 37% female, average age 12 years (SD± 3.6), 51% had diagnosis of hyperkinetic disorder (HD), 34% depressive disorder (DD). The children´s age at the time of seeking healthcare was different according to the diagnosis: DD 10.1 (SD ± 4.5) and HD 6.95 (SD ± 3.4), (T = -3.18, p = 0.000); and by sex: girls 10.9 (SD ± 4.5), boys 7.85 (SD ± 4.0); (T = -3.07, p = 0.000). The mother was the first person to notice the symptoms.
The search for MHS differs by sex, diagnosis and family history; it is necessary to design mental health interventions considering gender-based differences, namely, to integrate a gender perspective.
When depression is comorbid with tuberculosis, it will lead to decreased quality of life, lack of adherence to anti-Tb drugs, progression to MDRTB and will end in death with mortality from the disease.
We aimed to study the association of Tuberculosis and depressive disorders in children aged 7-18 years compared to non-tuberculosis diseases and their correlation. We hypothesized that depression will be significantly more common in patients with tuberculosis than in non-TB patients, who served as a control.
A prospective observational case-type study for a period of 2 years, 2018-2020. The patients included in the study are patients diagnosed and treated in the Child Pneumology Department of the Pneumoftiziology Hospital “Sfantul Spiridon” Galati and in the TB Dispensaries in Galati County divided into the study group consisting of patients diagnosed with Tuberculosis and the control group of patients without a diagnosis of Tuberculosis or other previous chronic disease. For the diagnosis of depression in the case of the two groups, we used the CDI questionnaire (Depression Inventory for children).
Out of 100 children with TB, 68% had depression compared to the control group, which showed that only 9% had depression.
Depression can affect all parts of a child’s life, including behavior, appetite, energy levels, sleep patterns, relationships, and academic performance. We observe a wide range of symptoms in the group of children with tuberculosis compared to the control group.
The prevalence of ASD is 1 for every 59 children, an increase of 15%, referring to 2012. Studies supported the formulation of laws and guidance documents by the State in Brazil. Each location has found ways to meet their demands seeking to guarantee the needs of these users in public health services, whether through the Psychosocial Care Centers or the Rehabilitation Centers, healthcare clinics suggested by the Ministry of Health for the service to these users.
The general objective of this study is to characterize the psychosocial care network in Brazil, in order to verify whether these principles are considered in the line of care for ASD.
A public service evaluation questionnaire was applied to analyze the users’ perception on the care network effectiveness.
There is lack of communication, matrix support or articulation and highlight that the construction of physical spaces does not always translate into an integrated intersectoral treatment. The articulation between the services and referrals involved could contribute to greater treatment control of this demand.
Reflecting on the study, we consider that a network based on case severity care would be considerably more efficient, since the individual could use the services according to the demand present at the time. This proposal would create more humanized, personalized, assertive services, without financial waste, and would serve the system by guaranteeing the rights of integrality, universality and mainly of equity of these users within SUS.