The effectiveness of cognitive-behavioural play therapy on the symptoms of attention-deficit/hyperactivity disorder in children aged 7–9 years

Attention-deficit/hyperactivity disorder (ADHD) is considered to be the most prevalent disorder of childhood and adolescence, and a variety of methods have been used in its diagnosis and treatment. This study was conducted to study the efficacy of play therapy on the symptoms of ADHD in children aged 7–9 years. Using a clinical trial design, we selected 30 study participants among individuals who had been referred to the Ebne-sina hospital, child and adolescent outpatient clinic, Mashhad, Iran, and who had been diagnosed with ADHD by psychiatrists. The 30 study participants were then divided into two groups, experimental and control, based on similar characteristics (Birth order, parents’ educational level, parents’ occupation and average of last year school marks). Pre-tests (the Rutter Parental Questionnaire and the Rutter Children Behaviour Questionnaire for teachers) were performed prior to play therapy, and all patients in both groups had been receiving medication. Following play therapy, post-tests were also conducted for both groups. Eight sessions of sham play therapy has been performed for case group. (Cognitive-behavioural play therapy has not been performed basically.) All results were evaluated using an independent t test and a comparative test. Play therapy appeared to significantly reduce the symptoms of ADHD. The significant differences found between the experimental and control groups indicate that play therapy could be used as an effective treatment method for children with ADHD.     

Methodological issues in studying the anxiety-reducing effects of animals: Reflections from a pediatric dental study

Abstract

This article reports observations made during a study investigating the role of a therapy dog in reducing anxiety in urban children visiting the dentist. The design and execution of the study were affected by methodological issues such as the reaction of urban children to the dog in the clinic, the tools used to measure anxiety in the children, the age and pet-ownership status of the children, and the personality of the therapy dog. Suggestions made for researchers designing similar studies include allowing children to become comfortable with the therapy dog before beginning formal data collection, working with younger children who have made fewer visits to the dentist, and using or developing more accurate tools for measuring behavioral and physiological anxiety.     

Dual vs. triple therapy for childhood Helicobacter pylori gastritis: a double-blind randomized multicentre trial

BACKGROUND: Data on the efficacy of eradication treatment for Helicobacter pylori gastritis in children are scarce. AIM: To evaluate the efficacy of triple therapy with lansoprazole plus amoxicillin and tinidazole vs. dual therapy with amoxicillin and tinidazole in a double-blind randomized multicentre trial, and the usefulness of eradication in terms of long-term symptom resolution. SUBJECTS: We enrolled 43 consecutive children undergoing endoscopy for upper gastrointestinal dyspepsia with H. pylori gastritis. They underwent a 13C-urea breath test, completed a 2-week symptom diary card, and were randomized. Treatment was given in a Redidose box (Redidose Company Ltd., Brighton, UK) containing either lansoprazole-amoxicillin-tinidazole (triple therapy) or placebo plus amoxicillin-tinidazole (dual therapy) for 1 week. The completion of a 2-week symptom diary card and the performance of a breath test were repeated 6 weeks and 6 months after the end of therapy. One to two years later, a structured telephone interview was conducted with 36 of the children. RESULTS: According to the breath test, 6 weeks after the end of therapy H. pylori was eradicated in 15 of 22 children on triple therapy [68.2%; 95% confidence interval (CI) = 45-88] and in 15 of 21 children on dual therapy (71%; 95% CI = 48-89; not significant), and 6 months after the end of therapy it was eradicated in 16 of 22 children on triple therapy (72.7%) and in 15 of 21 children on dual therapy. Six months after therapy, symptoms were analysed in 11 H. pylori-positive and 31 H. pylori-negative children, and it was found that dyspeptic symptoms had disappeared or improved in both groups, with no difference between them. One to two years later, 36 children were interviewed. Epigastric pain had recurred in three of 26 H. pylori-negative and in seven of 10 H. pylori-positive children (p = .001); in three of the latter, pain was severe and required additional treatment. CONCLUSION: One-week triple or dual therapy with two antibiotics achieved similar eradication rates. Soon after treatment, symptoms disappeared or improved in most children irrespective of eradication, but epigastric pain recurred in the majority of the still-infected children within 2 years.     

Twice-daily antibiotics in the treatment of acute otitis media: trimethoprim-sulfamethoxazole versus amoxicillin-clavulanate.

Twice-daily trimethoprim-sulfamethoxazole has been shown to be effective in the treatment of acute otitis media except that caused by group A beta-streptococci. Amoxicillin-clavulanate potassium is effective in vitro against all bacterial pathogens causing acute otitis media and has been reported to be effective when given twice daily for urinary tract infections, acute otitis media and respiratory tract infections. To determine whether the in-vitro efficacy of amoxicillin-clavulanate carries over clinically, we conducted a prospective randomized double-blind trial in 219 children presenting at a pediatric walk-in clinic. Diagnosis and follow-up assessments were made by means of examination of the tympanic membrane and acoustic otoscopy. Of the 219 children 202 (101 in either group) were assessed by a specially trained nurse at a follow-up visit 12 to 16 (mean 14) days after treatment was begun. Cure was defined as absence of symptoms and normal results of both visual inspection of the tympanic membrane and acoustic reflectometry; improvement was defined as absence of symptoms and either normal appearance of the tympanic membrane or normal results of acoustic reflectometry; treatment failure was defined as abnormal appearance of the tympanic membrane along with an acoustic reflectometry reading of 5 units or more. There were no differences in age (mean 60 months), sex or proportion of subjects with unilateral versus bilateral disease between the two groups. The combined rate of cure an improvement was significantly higher with trimethoprim-sulfamethoxazole (93%) than with amoxicillin-clavulanate (82%) (p = 0.03). The rate of compliance (more than 80% of the drug taken) did not differ significantly between the two groups. Gastrointestinal side effects were more common with amoxicillin-clavulanate (p less than 0.0001). Our results suggest that for acute otitis media twice-daily trimethoprim-sulfamethoxazole is more effective clinically and produces fewer side effects than twice-daily amoxicillin-clavulanate.     

左旋多巴联合综合疗法治疗屈光不正性弱视患儿的临床效果

目的:探究左旋多巴联合综合疗法治疗屈光不正性弱视患儿的临床效果。方法:选取2013年4月至2016年3月在我院接受治疗的屈光不正性弱视青少年103例(180眼),随机分为对照组52例(90眼)和观察组51例(90眼)。对照组患儿给予常规的综合治疗,观察组在对照组之上给予左旋多巴治疗。治疗6个月后,观察比较两组患儿的治疗有效率、图形视觉诱发电位(P-VEP)、视觉对比敏感度和视功能等以及不良反应的发生情况。结果:观察组的视力治疗有效率为90.00%,显著高于对照组(68.89%),差异具有统计学意义(P0.05)。治疗6个月后,两组的振幅出现明显的升高,且观察组显著高于对照组(P0.05);两组的潜伏期发生明显降低,且观察组的显著低于对照组(P0.05)。观察组患儿的100%、25%、10%及5%空间频率视觉对比敏感度均显著低于对照组(P0.05)。观察组患儿的矫正辐辏范围、矫正分开范围显著高于对照组,矫正近立体锐度显著低于对照组(P0.05)。治疗期间,两组不良反应发生情况比较差异无统计学意义(P0.05)。结论:左旋多巴联合综合疗法可有效改善屈光不正患儿的视觉中枢神经元功能,明显提高视力水平及视觉敏感度。     

音乐治疗效应的动物实验研究

近年来国内外关于音乐治疗效应的动物实验研究认为：音乐能影响动物的情绪;音乐还对动物的免疫功能、学习及记忆能力、以及动物的神经系统结构和功能等均有一定影响。该领域的研究有利于深入探索音乐疗法的作用机理。     

音乐疗法在眶壁骨折围手术期护理中的应用研究

目的:观察音乐疗法在眶壁骨折围手术期对患者焦虑情绪和术后疼痛程度的影响.方法:自2010年3月至2011年12月哈尔滨医科大学附属第一临床医院眼科医院共收治眶壁骨折患者40例,随机将40例患者分为观察组和对照组,两组均采用常规术前健康护理和心理指导,观察组给予音乐疗法,比较两组患者围手术期的焦虑程度和术后疼痛的程度;运用SPSS11.5进行统计学处理.结果:观察组采用音乐疗法后,观察组在围手术期的焦虑自评量表评分及疼痛程度均比对照组低,差异有统计学意义(P＜0.01).结论:音乐疗法能改善眶壁骨折患者围手术期的焦虑状态和减轻术后的疼痛程度,使手术病人顺利渡过围手术期,促进术后恢复,是一种受患者欢迎的辅助治疗方法.     

CHRONOTHERAPY WITH VALSARTAN/AMLODIPINE FIXED COMBINATION: IMPROVED BLOOD PRESSURE CONTROL OF ESSENTIAL HYPERTENSION WITH BEDTIME DOSING

Administration of valsartan at bedtime as opposed to upon wakening improves the sleep-time relative blood pressure (BP) decline towards a more normal dipper pattern without loss of 24-h efficacy. Amlodipine, however, has been shown to be effective in reducing BP throughout the day and night, independent of dosing time. A large proportion of hypertensive subjects cannot be properly controlled with a single medication. However, no study has yet investigated the potential differing effects of combination therapy depending of the time-of-day of administration. Accordingly, the authors investigated the administration-time-dependent BP-lowering efficacy of valsartan/amlodipine combination. The authors studied 203 hypertensive subjects (92 men/111 women), 56.7?±?12.5 yrs of age, randomized to receive valsartan (160?mg/day) and amlodipine (5?mg/day) in one of the following four therapeutic schemes: both medications on awakening, both at bedtime, either one administered on awakening and the other at bedtime. BP was measured by ambulatory monitoring for 48 consecutive hours before and after 12 wks of treatment. Physical activity was simultaneously monitored every min by wrist actigraphy to accurately determine the beginning and end of daytime activity and nocturnal sleep. BP-lowering efficacy (quantified in terms of reduction of the 48-h mean of systolic/diastolic BP) was highest when both hypertension medications were ingested at bedtime, as compared to any one of the three other tested therapeutic schemes (17.4/13.4?mm Hg reduction with both medications on awakening; 15.1/9.6?mm Hg with valsartan on awakening and amlodipine at bedtime; 18.2/12.3?mm Hg with valsartan at bedtime and amlodipine on awakening; 24.7/13.5?mm Hg with both medications at bedtime; p?<?.018 between groups). The sleep-time relative BP decline was significantly increased towards a more normal dipper pattern only when both medications were jointly ingested at bedtime (p?<?.001). Bedtime dosing of the combination of the two medications also resulted in the largest percentage of controlled subjects among all the assessed therapeutic schemes (p?=?.003 between groups). In subjects requiring combination therapy to achieve proper BP control, the association of amlodipine and valsartan efficiently reduces BP for the entire 24?h independent of dosing time. However, the greater proportion of controlled patients, improved efficacy on lowering asleep BP mean, and increased sleep-time relative BP decline suggest valsartan/amlodipine combination therapy should be preferably administered at bedtime. (Author correspondence: rhermida@uvigo.es).     

Clinical efficacy of cycloferon in complex therapy of infectious mononucleosis in pediatrics

The results of the cycloferon use in therapy of 80 children at the age of 1 to 15 years with infectious mononucleosis are presented. The children were divided by chance sampling into two comparable groups of 40 subjects each. In the first group the children in addition to the standard therapy were treated with cycloferon for 10 days, intramuscularly or orally depending on the age. The reference group included the patients under the standard therapy alone. The efficacy of the drug was evaluated by reduction and more rapid disappearance of the main clinical symptoms of the disease. The improvement of certain laboratory indices, including those of the liver protein synthesis function were recorded, that allowed to reduce the hospitalization term. No side effects of the cycloferon use were observed.     

Experiencing of Music as the Basis of the Effectiveness of Music Therapy

In transposing the discussion of L.S. Vygotsky’s ideas to the cross-cultural area of science, the authors summarize the contexts and positions regarding the contribution of the Russian psychological school to the substantiation of musical therapeutic theory and practice. The analysis by Dr. Mastnak of European and American academic periodicals in psychology and music therapy showed that Western science does not have access to all of the content and achievements of Russian and Russian-language psychology. Reading Vygotsky’s works from a musical therapeutic perspective and, in addition, in a cross-cultural interpretation, the authors discuss the abundance of the psychological scientist’s methodological ideas that could provide a theoretical substantiation of effective music therapy.     

Gene therapy: progress and predictions

The first clinical gene delivery, which involved insertion of a marker gene into lymphocytes from cancer patients, was published 25 years ago. In this review, we describe progress since then in gene therapy. Patients with some inherited single-gene defects can now be treated with their own bone marrow stem cells that have been engineered with a viral vector carrying the missing gene. Patients with inherited retinopathies and haemophilia B can also be treated by local or systemic injection of viral vectors. There are also a number of promising gene therapy approaches for cancer and infectious disease. We predict that the next 25 years will see improvements in safety, efficacy and manufacture of gene delivery vectors and introduction of gene-editing technologies to the clinic. Gene delivery may also prove a cost-effective method for the delivery of biological medicines.     

Group Music Training and Children's Prosocial Skills

We investigated if group music training in childhood is associated with prosocial skills. Children in 3^rd or 4^th grade who attended 10 months of music lessons taught in groups were compared to a control group of children matched for socio-economic status. All children were administered tests of prosocial skills near the beginning and end of the 10-month period. Compared to the control group, children in the music group had larger increases in sympathy and prosocial behavior, but this effect was limited to children who had poor prosocial skills before the lessons began. The effect was evident even when the lessons were compulsory, which minimized the role of self-selection. The results suggest that group music training facilitates the development of prosocial skills.     

Music therapy in supportive cancer care

The purpose of this paper is to show some aspects of music therapy application in cancer care and to present the integration of music therapy program into a continuous supportive cancer care for inpatients. A cancer diagnosis is one of the most feared and serious life events that causes stress in individuals and families. Cancer disrupts social, physical and emotional well-being and results in a range of emotions, including anger, fear, sadness, guilt, embarrassment and shame. Music therapy is a part of a complementary medicine program in supportive cancer care which accompanies medical treatment. There are many benefits of music therapy for cancer patients—interactive music therapy techniques (instrumental improvisation, singing) as well as receptive music therapy techniques (listening to recorded or live music, music and imaginary) can be used to improve mood, decrease stress, pain, anxiety level and enhance relaxation. Music therapy is an effective form of supporting cancer care for patients during the treatment process. It may be also basic for planning effective programs of rehabilitation to promote wellness, improve physical and emotional well-being and the quality of life.     

Intersections between music education and music therapy: Education reform,arts education,exceptionality, and policy at the local level

In this article, a music teacher educator and a music therapy clinician and educator discuss special education policy and arts instruction at the district level. To illustrate the gulf between federal and local policies with regard to exceptional learners and arts instruction, we examine the intersections of music therapy and music education with regard to self-contained classes of students with moderate to severe disabilities. Our discussion focuses on provision of services and opportunity to learn, and results in specific policy suggestions, including: (a) increasing administrators' understanding of music therapy, adaptive music education, and music education, so that decisions regarding arts instruction can be better-informed and more child-centered, (b) treating music therapists as allied health professionals who do not need to be certified teachers to practice in schools, and (c) improving initial music teacher preparation and providing opportunities for professional development to increase awareness of necessary information and effective strategies to improve music teaching and learning for students with special needs.     

Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – A randomized double blind placebo controlled trial

Osteoarthritis is a common, chronic, progressive, skeletal, degenerative disorder, which commonly affects the knee joint. Boswellia serrata tree is commonly found in India. The therapeutic value of its gum (guggulu) has been known. It posses good anti-inflammatory, anti-arthritic and analgesic activity. A randomized double blind placebo controlled crossover study was conducted to assess the efficacy, safety and tolerability of Boswellia serrata Extract (BSE) in 30 patients of osteoarthritis of knee, 15 each receiving active drug or placebo for eight weeks. After the first intervention, washout was given and then the groups were crossed over to receive the opposite intervention for eight weeks. All patients receiving drug treatment reported decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling in the knee joint was decreased. Radiologically there was no change. The observed differences between drug treated and placebo being statistically significant, are clinically relevant. BSE was well tolerated by the subjects except for minor gastrointestinal ADRs. BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis.     

The Presence of a Therapy Dog Results in Improved Object Recognition Performance in Preschool Children

ABSTRACT

The purpose of this study was to determine whether the presence of a dog would have an impact on object recognition memory performance of preschool children. This work represents an extension of previous research which found that preschoolers require fewer instructional prompts to complete this type of memory task when in the presence of a dog. If children require fewer instructional prompts it is possible that they are better able to focus on the task itself and as a result, improved memory performance is likely. Because the earlier experiment utilized a very simple version of the task that was readily completed by the preschool children, the overall performance data were at ceiling. The current study, involving 20 preschool children, included a manipulation of task difficulty through varying the number of distracters (one versus four) present at test. Increasing the number of distractors in a simple recognition task is known to make that task more challenging, and thus performance was expected to be slower and less accurate in the four distracter conditions relative to the one-distracter conditions. The collaborators in the study were either a therapy dog or a human. A two-way repeated measures design was used such that each child served as his/her own control and was tested in each of four separate conditions: dog present (one and four distracters) and human present (one and four distracters). The results showed that the preschool children performed the object recognition task faster and more accurately in the presence of the therapy dog relative to a human and also in the one-distracter versus four-distracter condition. The authors conclude that these effects result from increased focus and/or motivation resulting from the presence of the dog.     

Evaluation of tolerance and efficacy of pefloxacin in the treatment and prevention of severe infections in children with mucoviscidosis and aplastic anemia]

Pefloxacin (Abaktal) efficacy and safety were investigated at 21 children (7-16 years old) randomized in 2 groups: children with mucoviscidosis and children with aplastic anemia. The drug was used at the dose 15-20 mg/kg per day bid for 14-28 days. Pefloxacin was used in combination with ceftazidime and amikacin. Combined therapy demonstrated good clinical efficacy. Bacteriological efficacy was not uniform: staphylococci were not isolated from sputum since the 7th day of treatment, but pseudomonads were cultured even on the 14th day of the treatment (the sensitivity to pefloxacin remained). The only but frequent side-effect was arthropathy. The background and some peculiarities of arthropathy development were analyzed. This phenomenon is called quinolone-induced synovitis. The risk group for quinolone-induced synovitis was estimated--children elder than 10 years with allergic anamnesis. Good clinical efficacy and tolerability of pefloxacin at the children with mucoviscidosis or aplastic anemia is a reason and base to cancel the limits to its use in pediatrics.     

阿托品压抑疗法和遮盖疗法治疗学龄儿童单眼弱视的临床效果

目的:探讨阿托品不同治疗方法对于学龄儿童单眼弱势的治疗效果。方法:回顾抽取我院眼科住院治疗的90例单眼弱视学龄儿童患者,根据疗法分成压抑组(压抑疗法)和遮盖组(短时遮盖疗法)各45例,对比分析两组患儿在视力、依从性、临床疗效和不良反应方面的差异性。结果:治疗后,压抑组患儿的视力、依从率(93.33%)、总有效率(91.11%)均显著高于遮盖组,且不良反应总发生率(15.00%)显著低于遮盖组(26.67%),差异具有统计学意义(P0.05)。结论:阿托品压抑疗法治疗学龄儿童单眼弱视具有疗效显著、依从性好、视力矫正效果明显、安全性好等优点,值得临床推荐。     

Is group progressive relaxation training as effective with hyperactive children as individual EMG biofeedback treatment?

This study examined whether group progressive relaxation training was as effective as individual EMG biofeedback training in facilitating the academic achievement and self-control of 45 hyperactive elementary school children. Academic achievement was assessed with the Gates-MacGinities Reading Tests, and self-control was measured with the Nowicki-Strickland and the Teacher Rating scales. Eight sessions were scheduled at weekly intervals. Progressive relaxation was conducted in groups of seven or eight and was induced with a commercial audiocassette program. EMG training augmented frontalis biofeedback with those taped exercises. A placebo group listened to taped children's stories. Multivariate analysis of variance indicated no significant differences among the three contrast groups when all dependent variables were considered together. However, univariate F values and discriminant analysis disclosed locus of control to be significantly more internal for the progressive relaxation condition. Also, differences between the two relaxation and the placebo groups, though not statistically significant, were all in the expected direction. While the relative efficacy of group progressive relaxation could not be established conclusively, the data appeared sufficiently positive to warrant further investigation of this cost-effective prospective intervention.The opinions expressed by the authors are not necessarily those of their respective institutions.     

Two Randomized Trials Provide No Consistent Evidence for Nonmusical Cognitive Benefits of Brief Preschool Music Enrichment

Young children regularly engage in musical activities, but the effects of early music education on children''s cognitive development are unknown. While some studies have found associations between musical training in childhood and later nonmusical cognitive outcomes, few randomized controlled trials (RCTs) have been employed to assess causal effects of music lessons on child cognition and no clear pattern of results has emerged. We conducted two RCTs with preschool children investigating the cognitive effects of a brief series of music classes, as compared to a similar but non-musical form of arts instruction (visual arts classes, Experiment 1) or to a no-treatment control (Experiment 2). Consistent with typical preschool arts enrichment programs, parents attended classes with their children, participating in a variety of developmentally appropriate arts activities. After six weeks of class, we assessed children''s skills in four distinct cognitive areas in which older arts-trained students have been reported to excel: spatial-navigational reasoning, visual form analysis, numerical discrimination, and receptive vocabulary. We initially found that children from the music class showed greater spatial-navigational ability than did children from the visual arts class, while children from the visual arts class showed greater visual form analysis ability than children from the music class (Experiment 1). However, a partial replication attempt comparing music training to a no-treatment control failed to confirm these findings (Experiment 2), and the combined results of the two experiments were negative: overall, children provided with music classes performed no better than those with visual arts or no classes on any assessment. Our findings underscore the need for replication in RCTs, and suggest caution in interpreting the positive findings from past studies of cognitive effects of music instruction.