PARENT-CHILD RELATIONSHIPS

Parents and doctors have an obligation to supply children with an emotional diet leading to their eventual maturity. This is as important to the child as is his physical guidance. The proteins, carbohydrates, fats, minerals and vitamins of a child''s emotional diet are: (1) the need for security; (2) the need to achieve social adaptability; (3) the need for success; and (4) the need for independence. In helping parents provide their children with these major guideposts along the road of character development toward maturity, physicians have a challenge and opportunity for real service to the humanities—a field of endeavor far behind science in human progress.     

Feeding habits of the cuttlefish <Emphasis Type="Italic">Sepia</Emphasis> <Emphasis Type="Italic">officinalis</Emphasis> during its life cycle in the Sado estuary (Portugal)

The importance of cephalopods in marine ecosystems is well recognized as they serve as important predators and prey in many food chains. During a 1-year period, cuttlefish were monthly sampled in five areas throughout the Sado estuary, and the stomachs of 445 individuals were examined. Significant changes in the diet according to their life stage were revealed, but similar food habits were presented by males and females. Juvenile individuals (the smaller ones with no visible distinct gonads) preyed mainly upon small crustaceans, while the immature ones (maturity stages I and II) had the most diverse diet with brachyurans as the major prey group. The mature individuals (maturity stages III and IV) showed a clear preference for larger crabs and fishes. Although the cuttlefish are known for their opportunistic feeding behaviour, a preference for some prey according to length and behaviour could be perceived during this study. Seasonal differences in the diet were mostly due to the variation of individuals according to their maturity stage during the year.     

The Relationship of Rapid Weight Gain in Infancy to Obesity and Skeletal Maturity in Childhood

Objective: Children with birth weight appropriate for gestational age (AGA) who also demonstrate rapid weight gain in infancy have a greater risk of being overweight or obese during childhood. A concurrent advancement in skeletal maturity would account for their greater size and would, therefore, not necessarily pose a threat of greater risk during adolescence and early adulthood. This study aims to determine whether children with rapid weight gain during infancy have advanced skeletal maturity during childhood. Research Methods and Procedures: One hundred and ninety‐three African children (boys = 108; girls = 85) of normal birth weight and gestational age were assessed from birth to 9 years. Body composition was assessed at 9 years of age by whole‐body DXA, and skeletal maturity was assessed using the Tanner‐Whitehouse II technique. Rapid weight gain in infancy was defined as a +0.67 change in weight‐for‐age Z‐score between birth and 2 years. Results: Rapid weight gain was experienced by over 20% of the sample. Children with rapid weight gain were significantly lighter at birth and significantly taller, heavier, and fatter throughout childhood. Chronological age and Tanner‐Whitehouse II technique skeletal ages at 9 years were not significantly different between groups or between sexes within groups. Discussion: Because AGA children with rapid weight gain have a greater risk of overweight and obesity but are not advanced in skeletal maturity, later adolescent adjustments toward average weight and fatness values are unlikely. The identification and monitoring of such children is of importance in reducing their risk of morbidity.     

Parents for children.

Parents for Children is a specialist adoption agency set up to find homes for children with special needs--that is, those with physical, mental, and emotional handicaps; older children; and sibling groups. Of the first 38 children placed, one child died and six placements broke down, although four children were later re-placed. Almost all the children referred to the agency had been in care for most of their lives. A full assessment of each child is necessary before placement, but in several cases the medical assessment in care had been inadequate. Many of the prospective parents themselves had serious medical conditions. The agency has proved that homes can be found for children in need, but there have been problems and parents require advice and support in the management of the children after placement.     

Counselling the parents of handicapped children.

The parents of handicapped children have to adjust to a wide variety of emotional and psychological problems when first confronted with the failure of their reproductive expectations. Counselling is a formal procedure or transaction in which both counsellor and parents aim to find a mutually acceptable plan of adjustment. Parents may need support to cope with their own personal inadequacies as well as with their own personal inadequacies as well as with the needs of the child. Counselling should be a continuous process, in which the parents can learn to accept the child as a different rather than a lesser person.     

Research into the (Cost-) effectiveness of the ketogenic diet among children and adolescents with intractable epilepsy: design of a randomized controlled trial

Background  

Epilepsy is a neurological disorder, characterized by recurrent unprovoked seizures which have a high impact on the individual as well as on society as a whole. In addition to the economic burden, epilepsy imposes a substantial burden on the patients and their surroundings. Patients with uncontrolled epilepsy depend heavily on informal care and on health care professionals. About 30% of patients suffer from drug-resistant epilepsy. The ketogenic diet can be a treatment of last resort, especially for children. The beneficial effect of the ketogenic diet has been proven, but information is lacking about its cost-effectiveness. In the current study we will evaluate the (cost-) effectiveness of the ketogenic diet in children and adolescents with intractable epilepsy.     

Physiological Investigation of Emotional Responses In Animals And Man

This survey is not intended as an exhaustive review of investigations of Soviet authors on emotional responses in animals and man. This is not only due to the voluminousness of the factual material. We have tried to concentrate on the physiology of emotions in the strict and proper sense of the term. Such an approach immediately obviates the necessity of treating studies devoted to complex nonconditioned responses (instincts) as integral acts of adaptative behavior. It is quite clear that the involvement of the nervous mechanisms of emotions in the formation of a nonconditioned response is only one of many links in a chain of events. Moreover, the emotional component is not identical with the nonconditioned response as a whole. On the other hand, we are justified in considering the problem of needs and motivations as individually distinct components of adaptative behavior to be beyond the range of this survey. Although need [potrebnosf] is the basis of any emotional response, the mechanism of its occurrence and its transformation into goal-directed drive (motivation) have their own unique functional characteristics and their own morphological substrate.     

Emotional dysregulation in children with attention-deficit/hyperactivity disorder

Emotional dysregulation is increasingly recognized as a core feature of attention-deficit/hyperactivity disorder (ADHD). The purpose of the present systematic literature review was to identify published data related to the neuropsychology of emotional dysregulation in children with ADHD. The literature obtained is discussed in the contexts of deficits in emotional control, impairments in executive function, the emotional components of comorbidities, neurophysiological and autonomic correlates of emotional dysregulation, and the significance of multiple neuropsychological pathways of ADHD on emotional dysregulation. These various lines of evidence are used to create a patient-oriented conceptual model framework of the pathway from stimulus to inappropriate internalized (sadness, moodiness) or externalized (anger, aggressiveness) emotional responses. The article concludes by calling for continued research into the development of reliable and universally accepted measures of emotional dysregulation in order to provide children affected with ADHD, and their caregivers, some explanation for their emotional lability and, ultimately, to be used as tools to evaluate potential treatments.     

Are parents’ working patterns associated with their child’s sleep? An analysis of dualparent families in Australia

Insufficient sleep in children predicts emotional and behavioral problems, poorer school performance, and health problems. Child sleep durations have declined in recent decades, suggesting a need to identify and understand predictors of short sleep. The present study investigated whether aspects of parental employment (i.e. parental work hours, and non-standard work hours) were associated with sleep in children. Data collected from 2477 children aged 6-7 years as part of the Longitudinal Study of Australian Children were used in this paper. Child sleep duration, bedtimes, and wake times were determined from parent self-report using time-use diaries. Parents completed a survey assessing their work patterns as well as a range of other demographic and social factors. The results indicated that long mother work hours were associated with later bedtimes and increased odds of <9.5 h sleep in children. Long father work hours were associated with earlier waketimes, earlier bedtimes, and reduced odds of long sleep. Non-standard work hours were associated with longer sleep and earlier bedtimes. The present results indicate the need to develop strategies to limit any adverse effects of parental work on child sleep, perhaps by promoting earlier and regular bedtimes. These findings warrant further investigation given the importance of sleep in healthy child development.

     

A Bayesian Model of the Uncanny Valley Effect for Explaining the Effects of Therapeutic Robots in Autism Spectrum Disorder

One of the core features of autism spectrum disorder (ASD) is impaired reciprocal social interaction, especially in processing emotional information. Social robots are used to encourage children with ASD to take the initiative and to interact with the robotic tools to stimulate emotional responses. However, the existing evidence is limited by poor trial designs. The purpose of this study was to provide computational evidence in support of robot-assisted therapy for children with ASD. We thus propose an emotional model of ASD that adapts a Bayesian model of the uncanny valley effect, which holds that a human-looking robot can provoke repulsion and sensations of eeriness. Based on the unique emotional responses of children with ASD to the robots, we postulate that ASD induces a unique emotional response curve, more like a cliff than a valley. Thus, we performed numerical simulations of robot-assisted therapy to evaluate its effects. The results showed that, although a stimulus fell into the uncanny valley in the typical condition, it was effective at avoiding the uncanny cliff in the ASD condition. Consequently, individuals with ASD may find it more comfortable, and may modify their emotional response, if the robots look like deformed humans, even if they appear “creepy” to typical individuals. Therefore, we suggest that our model explains the effects of robot-assisted therapy in children with ASD and that human-looking robots may have potential advantages for improving social interactions in ASD.     

The value of a dog in a classroom of children with severe emotional disorders

Abstract

The purpose of the present study was to determine how a dog's presence in a self-contained classroom of six children diagnosed with severe emotional disorders affected students' emotional stability and their learning. Across an eight-week period of time, the children were observed, the children and their parents were interviewed, and behavioral data were recorded when students went into emotional crisis. Qualitative analysis of all coded data indicated that the dog's placement in this self-contained classroom: a) contributed to students' overall emotional stability evidenced by prevention and de-escalation of episodes of emotional crisis; b) improved students' attitudes toward school; and c) facilitated students' learning lessons in responsibility, respect and empathy.     

"My parents decide if I can. I decide if I want to." Children's views on participation in medical research

The participation of children in medical research raises many ethical issues, in particular regarding assent. However, little is known about children's own views on participation. This study presents results from interviews with children 10-12 years old with and without experience in a large-scale longitudinal screening study. We identified five themes: (1) knowledge about research, (2) a sense of altruism, (3) shared decision-making and right to dissent, (4) notions of integrity, privacy, and access, and (5) understanding of disease risk and personal responsibilities. We conclude that the children feel positive towards medical research, and want to take an active part in decisions and have their integrity respected. However, the study also indicates that children who had participated in longitudinal screening had a limited understanding, suggesting the vital importance of providing information appropriate to their age and maturity. This information should be provided out of respect for the children as persons, but also to promote their willingness to continue participating in longitudinal studies.     

Dietary n-3 polyunsaturated fatty acid deprivation together with early maternal separation increases anxiety and vulnerability to stress in adult rats

Low concentrations of n-3 polyunsaturated fatty acid (PUFA) and chronic stress are implicated in susceptibility to mood disorders. We have investigated the combined effects of chronic n-3 PUFA dietary deficiency and early maternal separation (MS) stress on the reactivity to stressful situations of rats as adults. Pups fed a control or an n-3 PUFA deficient diet were daily separated for two weeks before weaning They were all tested at 3 month-old to determine their anxiety, and their ability to learn two aversive tasks differing in the control they could exert on the situation: auditory fear conditioning and brightness avoidance discrimination. Neither the n-3 PUFA-deficient diet nor MS alone significantly affected behavior. But n-3 PUFA-deficient rats that had been separated were more anxious and fearful in inescapable situations, while their ability to cope with an aversive avoidance task remained unaffected. These results support the notion that PUFA-unbalanced diet, together with stress, may be a determinant risk factor in emotional disorders.     

The role of emotional labour in oncology

Oncologists and related health care professionals (HCPs) do not only have to follow professional protocols in their everyday work, but also have to communicate proper attitudes towards patients suffering from malignant diseases. This task is often a heavier load than the implementation of professional activities themselves. The present article is based on a survey on HCP work motivation, employment parameters and correlations with emotional labour. Fifty oncology HCPs at Debrecen University Medical Health Sciences Centre volunteered to participate in this survey containing 20 simple-choice questions. More than 90 percent of HCPs make an effort to hide their emotional state, giving way to possible negative side effects. The survey showed significant differences between the level of emotional labour of those working in the field of oncology longer or shorter than ten years. Surface and deep emotional labour is more frequent among professionals already working in oncology for a longer period of time. This can serve us with explanation to the burn-out syndrome so frequent in this profession. To diminish the load of emotional labour, healthcare institutes have to aim at hiring employees that spontaneously fit the emotional and behavioural norms facing them, and do not need officially prescribed behavioural norms for everyday work. Their constant need for respect and appreciation of their values must be kept in mind, because the capability of genuine emotional labour diminishes parallel to the number of years spent in work.     

RCT of a High‐protein Diet on Hunger Motivation and Weight‐loss in Obese Children: An Extension and Replication

This study aimed to evaluate the weight loss and hunger motivation effects of an energy‐restricted high‐protein (HP) diet in overweight and obese children. In total, 95 overweight and obese children attended an 8‐week (maximum) program of physical activity, reduced‐energy intake, and behavior change education. Children were randomly assigned to one of two isoenergetic diets (standard (SP): 15% protein; HP: 25% protein), based on individually estimated energy requirements. Anthropometry and body composition were assessed at the start and end of the program and appetite and mood ratings completed on the first 3 consecutive weekdays of each week children attended camp. The HP diet had no greater effect on weight loss, body composition, or changes in appetite or mood when compared to the SP diet. Overall, campers lost 5.2 ± 3.0 kg in body weight and reduced their BMI standard deviation score (sds) by 0.25. Ratings of desire to eat increased significantly over the duration of the intervention, irrespective of diet. This is the third time we have reported an increase in hunger motivation in weight‐loss campers and replicates our previous failure to block this with a higher protein diet. Further work is warranted into the management of hunger motivation as a result of negative energy balance.     

REFLECTIONS ON CONTEMPORARY PSYCHIATRY

Valid data on the effectiveness of preventive programs in psychiatry are badly needed but cannot be obtained until reliable statistics on incidence and frequency of emotional disorders are available.There is a suggestion that clear cut neuroses are less frequent but an equally strong suggestion that psychosomatic disorders are increasing in frequency. There is a tendency to look upon the increasing freedom of some aspects of our culture as a great advance over Victorian rigidity and restraint—but to what extent is this related to seeming increases in delinquency?Parents seem to have become increasingly fearful of disciplining, training or frustrating children as a result of what is considered psychiatric teaching. Psychiatry has the responsibility for correcting such a misunderstanding. Psychotherapists who have not resolved their own dependency needs are in no position to help others with the dependency problems which underlie their neurotic difficulties. Psychotherapy involves more than just arranging the world to accommodate itself to the patient (which occasionally needs to be done). The patient too, has a responsibility for his illness and its treatment and must learn that life is characterized by the need to take some chances, by dangers, difficulties, frustrations and unknowns, as well as pleasures, safety, comfort and the familiar. The responsibility for meeting the need for psychiatric services belongs to all of medicine and not just to psychiatry.     

The Role of Cognitive and Emotional Perspective Taking in Economic Decision Making in the Ultimatum Game

We conducted a simple resource allocation game known as the ultimatum game (UG) with preschoolers to examine the role of cognitive and emotional perspective-taking ability on allocation and rejection behavior. A total of 146 preschoolers played the UG and completed a false belief task and an emotional perspective-taking test. Results showed that cognitive perspective taking ability had a significant positive effect on the proposer’s offer and a negative effect on the responder’s rejection behavior, whereas emotional perspective taking ability did not impact either the proposer’s or responder’s behavior. These results imply that the ability to anticipate the responder’s beliefs, but not their emotional state, plays an important role in the proposer’s choice of a fair allocation in an UG, and that children who have not acquired theory of mind still reject unfair offers.     

Effects of an insect‐mediated mental healthcare program for mentally disordered children

Insects are the most diverse groups of animals on the planet, representing more than one‐half of all known living organisms, and are found in nearly every environment. Recently, the importance of insects as food sources or as pets has increased in many countries, including Korea. In addition, several insects have been shown to exert a strong influence on people's emotions. Our insect‐mediated mental healthcare program is designed to help meet the physical, behavioral and developmental needs of people with mental disorders. Children with mental disorders, the experimental group, were provided with an insect‐mediated mental healthcare program for a total of eight sessions, one session per week, at 1–2 h per session, accompanied by a pre‐test and post‐test. The overall, gender, education level, and mental disease profiles of the participants in this study were balanced. Our results indicated that children who participated in the insect‐mediated healthcare program group once showed significant improvement in their emotional health and insect awareness. Additionally, paired education level's t‐tests showed that the outcomes of the participants in treatment group were significantly improved (α < 0.05). However, participants' satisfaction with their school life (middle school) was not influenced. These results suggest that insects positively influence children's emotional health through an insect‐mediated healthcare program. Further research on the basis of this study is expected to help children with emotional therapy in other areas.     

Exploring Children’s Perspectives on the Welfare Needs of Pet Animals

Children are increasingly viewed as important recipients of educational interventions to improve animal welfare, yet research examining their perspectives is lacking, particularly within the UK. Helping children to care appropriately for animals depends, not least, on an ability to understand the needs of different species and correctly identify cues given by the animal that indicate its welfare state. This study began to explore: (a) children’s perceptions of welfare needs, focusing on four common pet animals; (b) influences on the development of knowledge; (c) beliefs about whether or not (all) animals are sentient, and (d) their confidence in identifying when their own pets are in need. Fourteen focus groups were carried out with 53 children aged 7 to 13 years. Findings highlighted an affirmative response that animals have feelings (dogs especially), albeit with doubts about this applying universally. There was wide variation in children’s knowledge of welfare needs, even among owners of the animal in question. Conversely, some children lacked confidence in spite of the extensive knowledge they had developed through direct experience. An important finding was a perceived difficulty in identifying the needs of particular species or specific types of need in their own pets. Fitting well with a recent emphasis on “positive welfare,” children felt that many animals need demonstrative love and attention, especially cats and dogs. While there is clearly scope for educating children about common needs and cues that indicate animals’ welfare state, other areas pose a greater challenge. Emotional connection seems important in the development of extensive knowledge and concern for welfare. Accordingly, animals that do not possess the kind of behavioral repertoire that is easy to interpret or allows for a perceived sense of reciprocity are possibly at risk of negative welfare experiences.