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Howard CH Khoe, National Psychiatry Residency Programme, Singapore,Cheryl WL Chang, National University Hospital, Singapore,Cyrus SH Ho, National University Hospital, Singapore
Chapter 50 covers the topic of child and adolescent mental health services. Through a case vignette with topical MCQs for consolidation of learning, readers are brought through the management of young patients with psychiatric disorders from first presentation to subsequent complications of the conditions and its treatment. Things covered include the general principles of prescribing in children and adolescent patients with psychiatric disorders, the use of antidepressants, the use of mood stabilisers, the use of antipsychotics, treatment of anxiety disorders.
Patients diagnosed with hypertension (HT) are at high risk for end-organ damage. With changing living conditions and access to healthcare facilities worldwide, the rate of diagnosis in childhood is increasing. In this study, healthy children were compared with a group of pediatric patients diagnosed with hypertension. Cardiac findings in the hypertensive group were compared at presentation and at six months. We aimed to determine the discriminatory value of epicardial adipose tissue (EAT) measurements as an early imaging marker for cardiac involvement in children with HT compared to healthy children and to determine its prognostic feature for HT treatment response.
Methods:
Fifty-nine primary hypertension patients and 76 control patients aged 0-18 years were compared. EAT values measured between the healthy group and the patient group and at the beginning of treatment and subsequent follow-ups in the patient group were evaluated with M-mode measurements.
Results:
There was no difference between the groups in terms of sex, and age. EAT was found to be significantly higher in the patient group than in the healthy group. There was a statistically significant difference between the EAT measurements evaluated before and after treatment in the patient group.
Conclusions:
Hypertension is an important cause of morbidity and mortality. Using EAT measurements as a noninvasive parameter may provide information about early cardiac involvement due to HT. EAT is promising as an imaging marker that can be used in diagnosis and follow-up.
The study of infant, child, and adolescent remains (non-adult remains) is a topic of growing interest within the fields of archaeology and bioarchaeology. Many published volumes and articles delve into the experiences of childhood and what these small remains may tell us about life, more broadly, in the past. For those interested in exploring infant and child remains, it is an exciting period as more methods and approaches are constantly being incorporated into the archaeological toolkit. This Element introduces the reader to the topic and to common methodological approaches used to consider non-adult remains from archaeological contexts. With this toolkit in hand, readers will be able to begin their own explorations and analyses of non-adult human remains within archaeological contexts.
Epilepsy syndromes (electroclinical syndromes) are well-recognized groupings of clinical (seizure types) and EEG features that occur together. Each syndrome typically shares a common age of onset, deficits (intellectual dysfunction), treatment and prognosis. Syndromes are classified based on their onset, epilepsy type (focal, generalized, or mixed) and development of epileptic encephalopathy (disorder in which epileptic activity contributes to severe impairments in cognition and behavior). Relatively benign syndromes are typically associated with focal, generalized tonic-clonic (GTC), typical absences and myoclonic seizures. Epileptic encephalopathies are typically associated with atonic, tonic, atypical absences, and epileptic spasms in addition to the other seizure types. [106 words/729 characters]
This chapter describes the spectrum of age-related maturation of electrographic patterns through preterm, neonatal, infantile, childhood, and adolescence periods. Neonatal EEGs must be interpreted in the context of corrected age and physiological state. Sustained continuity is the hallmark of maturation. Preterm records are discontinuous irrespective of state while term records are continuous in all states. Between 30 and 37 weeks, the background becomes more continuous during wakefulness and active sleep compared to quiet sleep. At term, activité moyenne is present during wakefulness and active sleep and trace alternans occurs during quiet sleep. Anterior dysrhythmia and graphoelements occur between 32 and 44 weeks corrected age. Sharp transients may be normal in neonates. A reactive posterior dominant rhythm emerges at three months of age and attains alpha range at around 2 to 3 years of age. Asynchronous sleep spindles emerge before 3 months and synchronize at 6 months of age. [144 words/855 characters]
This chapter provides a preliminary Latinx literary history of both the representation of Latinxs in video games and how games shape narratives of Latinidad in the twenty-first century. The chapter first examines how non-Latinxs have dominated Latinx narratives and representation, shaping a narrow concept of who is Latinx and what it means to live as a Latinx person. While AAA games continue to circulate stereotyped images of Latinxs, more recent game narratives authored by Latin American and Latinx creators and distributed through independent publishers challenge these representations. The chapter provides close readings of Guacamelee! and Guacamelee! 2 from Drinkbox Studies and Minority Media’s Papo & Yo, both created by Latin American immigrants to North America. These games subvert gaming tropes and use characterization and worldbuilding to showcase the diversity of Latinidades. Finally, the chapter assesses video games that expand representation (including AfroLatinidades and trans Latinidades) as well as narratives that use ludic structures, such as Carmen Maria Machado’s In the Dream House: A Memoir and Nona Fernández’s Space Invaders.
Across Australia and beyond, early childhood education (ECE) services play a significant role in the everyday lives of infants, toddlers and their families. For some decades, the enrolment of infants and toddlers has increased to the extent that, in today’s Australian society, around 40% of birth to 24-month-olds and nearly 60% of two-year-olds spend at least part of their week in an early childhood service. More still balance ECE service attendance with informal care arrangements with family members and friends. With these figures echoed across many countries worldwide, the widespread uptake of infant and toddler early childhood programs has meant that this generation of infants and toddlers and their families are experiencing a markedly different start to life than previous generations. It is now the norm for infant–toddler care to be spread across multiple contexts both within and outside of the walls of the family home, and for the responsibility for early learning to be shared between family and non-familial adults.
Examines some philosophical issues raised by the problem of dressing children. These include Enlightenment discussions of childhood, education, and clothing, which arguably had a large impact on the development of children’s fashion. Discusses the extent to which parents and caretakers shape children’s identity through their choice of clothing.
Clothes are much more than just what we put on in the morning. They express our identity; they can be an independent statement or the result of coercion; and they have deeply entrenched historical, political, and social aspects. Kate Moran explores the connections between clothes and philosophy, showing how clothes can illustrate and pose philosophical problems, and how philosophical ideas influence clothing. She discusses what it might mean for an article of clothing to be beautiful; how we communicate with clothes; how we use clothes to navigate our social existence; and how our social existence leaves its mark on our clothes. She also considers the curious relationship between philosophers and children's clothes, legal restrictions on clothing, textile waste, and labor conditions of textile workers. Her absorbing and engaging portrait of our clothes helps us to understand an important and underexplored aspect of our lives.
There are 117.3 million people forcibly displaced because of war, conflict and natural disasters: 40% are children. With growing numbers, many high-income countries have adopted or are considering increasingly restrictive policies of immigration detention. Research on the impact of detention on mental health has focused on adults, although recent studies report on children.
Aims
To synthesise data on the impact of immigration detention on children’s mental health.
Method
Systematic searches were conducted in PsycINFO, MEDLINE and Embase databases and grey literature and studies assessed using PRISMA guidelines (PROSPERO registration CRD42023369680). Included studies were quantitative, assessed children younger than 18 years who had been in immigration detention and reported mental health symptoms or diagnoses. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses estimated prevalence for major depression and post-traumatic stress disorder (PTSD).
Results
Twenty-one studies reported data on 9620 children. Most studies were cross-sectional, had small sample sizes and used convenience sampling. A profoundly detrimental impact on children’s mental health across a variety of countries and detention settings was demonstrated. Meta-analysis found pooled prevalence of 42.2% for depression [95% CI 22.9, 64.3] and 32.0% for PTSD [95% CI 19.4, 48.0]. Severity of mental health impact increased with exposure to indefinite or protracted held detention.
Conclusions
Immigration detention harms children. No period of detention can be deemed safe, as all immigration detention is associated with adverse impacts on mental health. Our review highlights the urgency of alternative immigration policies that end the practice of detaining children and families.
The health and well-being of families is an important consideration for federal, state, and/or local levels of government. Family health policies based on recent knowledge of early childhood development have evolved to emphasise the importance of providing every child with the best possible start to life. Childhood sets the foundation for future health and well-being and is recognised by the 1979 United Nations Convention on the Rights of the Child. To impact health inequalities, government policies and services must address the social determinants of early child health, development and well-being.
Desminopathy is a rare heritable cardiac and skeletal muscle disease caused by variants in the DES gene, which encodes the primary muscle-specific intermediate filament protein, known as desmin. Childhood-onset is commonly associated with severe early-onset myopathy and early death. Here, we reported an 11-year-old Chinese girl presenting with complete atrioventricular block and cardiomyopathy, without skeletal muscle involvement. Genetic analysis identified a de novo variant (c.152C > T/p.Ser51Phe) in the DES gene.
This study aimed to investigate the association between family characteristics and adherence to the EAT-Lancet dietary recommendations in 7-year-old children. This is a prospective birth cohort study with 2125 children from Generation XXI (Porto, Portugal), who provided 3-day food diaries at age 7, used to assess habitual food consumption. At the age of 4, maternal diet was assessed using a Food Frequency Questionnaire, and a diet quality score was calculated (higher scores indicating a better maternal diet), and parental–child feeding practices were assessed with the Child Feeding Questionnaire. Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH) at the age of 7 years, previously adapted to paediatric age. Hierarchical linear regression models (consecutive addition of blocks of variables based on a theoretical framework) were employed to evaluate the associations between family characteristics and adherence to the WISH at age 7 (β regression coefficients and the respective 95 % confidence intervals (95 % CI)). Higher maternal age and education at child’s birth were associated with increased adherence to the WISH at age 7 (β = 0·018, 95 % CI 0·005, 0·031; β = 0·038, 95 % CI 0·024, 0·053, respectively). A better maternal diet quality and using more restrictive practices on child’s diet, at 4 years old, were both associated with higher scoring in the WISH at 7 years old (β = 0·033, 95 % CI 0·018, 0·049; β = 0·067, 95 % CI 0·009, 0·125, respectively). Early maternal sociodemographic and diet quality play a significant role in influencing the adherence to a healthy and environmentally sustainable dietary pattern at school-age.
A 7-year-old girl visited the outpatient clinic because of difficulty walking. She had never managed to run properly, and experienced frequent falls ever since she began walking independently at the age of 18 months. Jumping was not possible, and when stepping up or down, she needed support below her arms. There was no fluctuation of symptoms during the day, but she had suffered from periods that could last several weeks in which using the stairs was completely impossible. She was unable to blow up a balloon and her speech was slow and poorly articulated. There were no complaints about chewing or swallowing. She had a healthy non-identical twin sister and the family history was unremarkable.
Private speech is a tool through which children self-regulate. The regulatory content of children’s overt private speech is associated with response to task difficulty and task performance. Parenting is proposed to play a role in the development of private speech as co-regulatory interactions become represented by the child as private speech to regulate thinking and behaviour. This study investigated the relationship between maternal parenting style and the spontaneous regulatory content of private speech in 3- to 5-year-old children (N = 70) during a problem-solving Duplo construction task. Sixty-six children used intelligible private speech which was coded according to its functional self-regulatory content (i.e., forethought, performance, and self-reflective). Mothers completed the Australian version of the Parenting Styles and Dimensions Questionnaire. Results revealed a significant positive association between maternal authoritative parenting and the frequency and proportion of children’s forethought type (i.e., planning and self-motivational) utterances during the construction task. There were no significant associations between maternal parenting style and other private speech content subtypes.
New Religious Movements have arisen not only in the present but have also developed in the past. While they differ in ideology and practice, they generally seem to live in high tension with mainstream society, especially when it comes to child-rearing. This Element examines several aspects of children growing up in new religions. It relies upon literature from different groups concerning child upbringing, the function of children in the groups considering the religious ideologies, and parental perspectives and parental styles. It also utilizes accounts from young adults growing up in these groups, both those who chose to stay and who chose to leave their groups as adults. A range of topics, such as socialization, education, health care, and relations to surrounding society are explored. In addition, this Element considers issues of physical and emotional abuse, state interventions, and the impact of second- and third generations of children in new religions.
This chapter discusses Clare’s nature poetry, in the contexts of the politics of land use, then and now. It reads the verse against issues including the introduction of capitalist forms of agriculture and their effects, including the dispossession and pauperization of agricultural labourers and the degradation of ecosystems. It also considers the politics of language and memory in Clare’s poetry, in relation to changes in the agricultural economy.
Violence and time are elements shaping the lives of children. For children, time is something that to a large part is placed in the future, while to adults, it is placed in the past; still, it is within this time that violence directed toward children occurs because they are children, often with the purpose of shaping their personhood and controlling them. To be able to speak freely about how time and violence socially construct the self-identity as a child is an important act of resistance against the use of violence constructing childhood but also an important form of protection. To fight violence, the child rights discourse must move beyond the child’s rights to be heard to also take seriously the right to freedom of speech.
A large increase in the rate of hospitalizations for adolescents and children with anorexia nervosa (AN) was observed during the coronavirus disease (COVID-19) pandemic. It is still not clear whether this was a temporary effect or whether the increased admission rates persist.
Methods
Data were retrieved from the largest health insurance in Germany comprising 2.5 million children between 9 and 19 y. All patients of this age group with a discharge diagnosis of typical (AN) and atypical AN (AAN) according to the International Classification of Diseases, Tenth Revision (ICD-10), were included. Admission rates per 10,000 person-years were computed separately by sex, age and type of AN for entire years from 2019 to 2022 and the first half of 2023 in relation to the entire number of insured persons of the same sex and age per year.
Results
Two years after the final lockdown admission rates were still significantly higher in adolescent and childhood AN than in the pre-COVID-19 time. While admission rates declined for adolescents in 2023, those for children remained high, with an increase for girls of more than 40% compared with the rate before the pandemic (1.42 (CI 1.26, 1.60); p < 0.0001). The highest admission risk for AAN relative to the pre-COVID-19 period was observed in adolescents in the first half of 2023 (1.6; CI 1.34; 1.90; p < 0.0001).
Conclusions
Children appear to be especially vulnerable to the pandemic-associated disruptions. Clinicians should try to determine the ongoing effects of the pandemic and support early detection and treatment of AN to prevent its often lifelong consequences.
Far from being cut-down versions of the adult form, children’s dictionaries constitute a distinct genre with their own history and methodology. The chapter charts the development of children’s dictionaries, from Renaissance bilingual dictionaries to the present day, showing how they have evolved to reflect changing perceptions of childhood. It discusses the bewildering range of dictionaries now available for children as they progress from ABCs and picture dictionaries to those for school use and creative writing, including innovative subgenres based on fictional worlds and dictionaries supporting language revitalisation. Drawing on historical and contemporary examples, the chapter explores content and page design adapted to engage young readers. It considers how lexicographers aim to reflect the world as experienced by children, from the selection of headwords to the framing of definitions, using dedicated corpora and reading programmes. The tension between descriptive and prescriptive approaches is often acute in children’s dictionaries, for example over the inclusion of slang and taboo words, and lexicographers aim to balance young dictionary users’ needs against adult perceptions of what a children’s dictionary is for.