Believers and Beaters: A Case Study of Supernatural Beliefs and Child Rearing in the Bahama Islands

The research described in this article tests the hypothesis that caretakers who fear the supernatural will inflict more pain on the children in their charge than will those caretakers who do not fear the supernatural. The hypothesis is drawn from a larger body of theory which states that child training practices influence adult personality, including beliefs in the supernatural—these beliefs in turn influence the training of children. In order to test the hypothesis it was necessary to find a group of people whose adults differ from each other in theirbeliefs in the supernatural and whose children receive differential training. The village of Congo Town, located on Andros Island in the Bahamas, provides such a group of people. In the course of ethnographic fieldwork carried out in 1968 in this village, twenty caretakers were interviewed about the training given to their forty-eight children and grandchildren, as well as about their beliefs in the supernatural. Differences both in beliefs in the supernatural and in child training practices exist. Three specific hypotheses are derived from the major hypothesis described above. Each of these hypotheses is found to be supported by data gathered in Congo Town. Since each of the derived hypotheses receives support, it is concluded that the major hypothesis is confirmed.     

Fetal infection after maternal reinfection with rubella: criteria for defining reinfection.

Five cases of asymptomatic maternal reinfection with rubella are described that occurred in England and Wales during 1985-8 and resulted in intrauterine infection. The criteria for diagnosing reinfection are described. In four cases the rubella contact was with the woman''s own children. Two women had therapeutic abortions, rubella virus being recovered from the products of conception, and three were delivered of infants with congenitally acquired disease. Though the risks associated with maternal reinfection with rubella are very small and being measured in a prospective study, it is hoped that the recently introduced augmented programme of rubella vaccination will reduce rubella in the community and therefore this small risk still further.     

Isolation of Campylobacter jejuni and Campylobacter coli from children with acute intestinal diseases

In this work the data obtained in the examination of 338 children with diarrhea, aged 5 days to 14 years, are presented. The methods used for the collection of samples and their storage till the moment of inoculation are described. The possibility of using the microscopic examination of Campylobacter-containing native feces is shown. The work resulted in the isolation of 85 C. jejuni and C. coli strains. As shown in this work, the isolation of Campylobacter depended on the age of children and the season. The etiological importance of Campylobacter for the development of acute enterocolitis and gastroenteritis in 10% of the children under examination is suggested.     

Global and regional differences in brain anatomy of young children born small for gestational age

In children who are born small for gestational age (SGA), an adverse intrauterine environment has led to underdevelopment of both the body and the brain. The delay in body growth is (partially) restored during the first two years in a majority of these children. In addition to a negative influence on these physical parameters, decreased levels of intelligence and cognitive impairments have been described in children born SGA. In this study, we used magnetic resonance imaging to examine brain anatomy in 4- to 7-year-old SGA children with and without complete bodily catch-up growth and compared them to healthy children born appropriate for gestational age. Our findings demonstrate that these children strongly differ on brain organisation when compared with healthy controls relating to both global and regional anatomical differences. Children born SGA displayed reduced cerebral and cerebellar grey and white matter volumes, smaller volumes of subcortical structures and reduced cortical surface area. Regional differences in prefrontal cortical thickness suggest a different development of the cerebral cortex. SGA children with bodily catch-up growth constitute an intermediate between those children without catch-up growth and healthy controls. Therefore, bodily catch-up growth in children born SGA does not implicate full catch-up growth of the brain.     

EEG in Children: Periodometric Analysis,Typology, and Age Peculiarities

We carried out a computer analysis of the EEG of 169 healthy schoolchildren (6 to 17 years old) with the use of a periodometric approach allowing us to obtain a number of quantitative indices that characterize the temporal structure of the analyzed EEG segment (histogram of distribution of the frequencies of EEG oscillations within the analyzed time period, indices of the different rhythms, and matrix of the probabilities of conversion from waves of one frequency range to waves of other ranges). We demonstrated that data of the periodometric analysis can be used for objective classification of EEG patterns. In children of different age groups, five types of background EEG activity were classified and described; we also demonstrated that the intragroup frequencies of these EEG types vary in healthy children with age. We discuss the advantages and disadvantages of the periodometric analysis of EEG, as well as the prospects and expediency of use of this analysis in physiological studies and in clinics.     

Leydig-cell tumour in children: variable clinical presentation, diagnostic features, follow-up and genetic analysis of four cases

BACKGROUND: Testicular tumours are relatively uncommon in infants and children, accounting for only 1-2% of all paediatric solid tumours. Of these approximately 1.5% are Leydig-cell tumours. Further, activating mutations of the luteinizing hormone receptor gene (LHR), as well as of the G protein genes, such as Gsalpha (gsp) and Gialpha (gip2) subunits, and cyclin-dependent kinase gene 4(CDK4) have been associated with the development of several endocrine neoplasms. AIMS/METHODS: In this report, the clinical variability of Leydig-cell tumours in four children is described. The LHR-, gsp-, gip2- and CDK4 genes were investigated to establish the possible molecular pathogenesis of the variable phenotype of the Leydig-cell tumours. RESULTS: No activating mutations in these genes were found in the four Leydig-cell tumours studied. Therefore, the absence of activating mutations in LHR, as well as in both the 'hot spot' regions for activating mutations within the G-alpha subunits and in the regulatory 'hot spot' on the CDK4 genes in these tumours indicates molecular heterogeneity among Leydig-cell tumours. CONCLUSION: Four children with a variable phenotype caused by Leydig-cell tumours are described. A molecular analysis of all the 'activating' genes and mutational regions known so far was performed, but no abnormalities were found. The lessons learnt from these clinically variable cases are: perform ultrasound early and most importantly, consider discrepancies between testicular swelling, tumour size and androgen production.     

Wolf-Hirschhorn (4p-)syndrome in a near adult with major depression; successful treatment with citalopram

The Wolf-Hirschhorn Syndrome (WHS) or 4p-deletion syndrome is characterized by mental retardation, growth retardation, microcephaly and typical facial features. In addition, a wide spectrum of somatic abnormalities can be associated that may cause comorbidity. The syndrome has been extensively described in children, but less information is available about adult patienis. In this case report a near adult female WHS patient is described who developed a major depression with atypical symptoms that was successfully treated with citalopram. Treatment for one year in the effective dose prevented recurrence of depressive symptomatology.     

Fetal alcohol spectrum disorders: an overview with emphasis on changes in brain and behavior

Fetal alcohol spectrum disorders constitute a major public health problem. This article presents an overview of important issues that surround these disorders and emphasizes the structural and neurobehavioral consequences associated with prenatal exposure to alcohol. Diagnostic criteria are discussed, and possible moderating factors for the range of outcomes are mentioned. In addition, the prevalence of fetal alcohol spectrum disorders is described, and estimates of the financial impact of these disorders are given. Heavy prenatal alcohol exposure can severely affect the physical and neurobehavioral development of a child. Autopsy and brain imaging studies indicate reductions and abnormalities in overall brain size and shape, specifically in structures such as the cerebellum, basal ganglia, and corpus callosum. A wide range of neuropsychological deficits have been found in children prenatally exposed to alcohol, including deficits in visuospatial functioning, verbal and nonverbal learning, attention, and executive functioning. These children also exhibit a variety of behavioral problems that can further affect their daily functioning. Children exposed to alcohol prenatally, with and without the physical features of fetal alcohol syndrome, display qualitatively similar deficits. Determining the behavioral phenotypes that result from heavy prenatal alcohol exposure is critical, because the identification of these children is crucial for early interventions. In addition, knowing which brain areas are involved might enable the development of better intervention strategies. However, intervention needs to go beyond the affected individual to prevent future cases. As evidenced by the staggering financial impact these disorders have on society, prevention efforts need to be aimed at high-risk groups, and this issue needs to be made a high priority in terms of public health.     

Growth during early childhood in asthmatic children: relation to inhalation steroid dose and clinical severity score

BACKGROUND/AIM: While short-term studies reported a growth retardation in children with asthma treated with inhaled steroids, long-term studies described attainment of adult heights within the target height range. In the present work, we describe the growth pattern of children with asthma. METHODS: In 58 children with asthma, we compared the height at age 3 years with the height at a mean age of 7.5 years during a 12-month study period. RESULTS: No differences in growth could be detected within the study year. Children in the lowest tertile but not in other tertiles for asthma severity score and inhaled steroid dose showed a significant decrease in height standard deviation scores from age 3 to age 7.5 years. CONCLUSION: The decrease in height standard deviation scores might be explained by undertreatment or an individual sensitivity to inhaled steroids.     

Early puberty in adopted children

Early puberty is frequently observed in adopted children. In various studies, early puberty has been associated with decreased final height. In Europe, studies were undertaken to treat early puberty in adopted children with GnRH agonist. This article reviews the current understanding of early puberty in adopted children, including prevalence, background and treatment options. Data from the European studies are briefly described. Besides auxological aspects, psychological items are addressed as well. Studies on the psychological effect of early puberty in adopted children are reported. Future issues include further study in the mechanism of early puberty in adopted children, evaluation of final height results of the growth studies and quality of life assessments in this specific group of children.     

Identification of overweight in children in the United States: a simplified approach

The objective of this study was to develop a screening instrument for easy identification of overweight in children and adolescents in the United States. Data derived from the 2000 Growth Charts published by the Centers for Disease Control and Prevention (CDC) were utilized to compute gender-specific screening values for identification of overweight in children and adolescents. Computations were based on age- and gender-specific 85th percentile BMI calculated for the various height percentiles at 6-month age intervals. The simplified approach for identification of overweight in children and adolescents consisted of two tables, one each for males and females. Each table described the screening values for overweight at 6-month age intervals for all the nine height percentiles described in the CDC Stature for Age Tables. Two screening tables for identification of obesity were also developed in a similar manner using age- and gender-specific 95th percentile BMI. The simplified approach described for identification of overweight uses only the child's height and weight measurements and obviates the need to compute BMI or assess BMI percentile scores.     

Congenital Anomalies of the Limbs: Part I. Medical Aspects

As a preparatory step towards the development of a complete habilitation program for children with congenital limb anomalies associated with maternal ingestion of thalidomide, the medical records of all patients with congenital limb anomalies referred to the Rehabilitation Institute of Montreal in the past decade were studied, and an examination and a thorough reassessment were made of 41 patients (21 males and 20 females).In this paper, Part I, the medical and prosthetic aspects are dealt with and a form of management is described for each type of anomaly. The conclusions are reached that prosthetic fitting and training should be initiated very early in life and that co-operation of the parent is essential to successful habilitation of a child with congenital limb anomalies.     

HIV prevalence and impact on renutrition in children hospitalised for severe malnutrition in Niger: an argument for more systematic screening

Background

In developing countries, malnutrition is a contributing factor in over 50% of child deaths. Mortality rates are higher in underweight children, and HIV-infection is known to increase underweight. Our goals were to evaluate the prevalence of HIV among children hospitalised for severe malnutrition (SM) at the Niamey national hospital (Niger), and to compare renutrition and mortality by HIV-status.

Methods

Retrospective study based on all children <5 years hospitalised for SM between January 1^st 2008 and July 1^st 2009. HIV-prevalence was the ratio of HIV+ children on the number of children tested. Duration of renutrition and mortality were described using survival curves.

Results

During the study period, 477 children were hospitalised for SM. HIV testing was accepted in 470 (98.5%), of which 40 were HIV+ (HIV prevalence (95% confidence interval) of 8.6% (6.2–11.5)). Duration of renutrition was longer in HIV+ than HIV− children (mean: 22 vs. 15 days; p = 0.003). During renutrition, 8 (20%) and 61 (14%) HIV+ and HIV− children died, respectively (p = 0.81).

Conclusion

Around 9% of children hospitalised for severe malnutrition were HIV infected, while in Niger HIV prevalence in adults is estimated at 0.8%. This pleads for wider access to HIV testing in this population.     

Using a mock trial to make a difficult clinical decision.

Many clinical decisions have to be taken with inadequate scientific information. Reaching a consensus among experts has been tried as one response to this problem. Another, described here, is to use legal process to dissect a difficult question. In this case a mock trial--using barristers, expert witnesses, and a jury--was conducted on whether bone marrow transplantation should be offered to all children with symptomatic sickle cell disease. Transplantation seems to offer about a 90% cure rate for a condition that may kill 15% of children before they reach 20. But transplantation carries a 10% risk of death or severe disability, and doctors cannot predict which children will suffer severely from their sickle cell disease and which will suffer little or nothing. The jury eventually reached a majority decision that transplantation should not be offered now to all symptomatic children.     

A migraine variant with abdominal colic and Alice in wonderland syndrome: a case report and review

Background  

Abdominal migraine is a commonly described migraine variant in children and young adults, but associations with Alice in Wonderland syndrome and lilliputian hallucinations are exceptional.     

Maternal and infant MTHFR gene polymorphisms and non-syndromic oral cleft susceptibility: An updated meta-analysis

Non-syndromic cleft lip with or without cleft palate (NSCLP) is a common craniofacial malformation. Irregular folate metabolism plays a significant role in the etiopathology of NSCLP. In this study, we aim to examine the association of the maternal and cleft child methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms (C677 T and A1298C) with nonsyndromic cleft lip with or without cleft palate (NSCLP) by carefully evaluating established studies. The meta-analysis includes 39 studies that focused on MTHFR C677T and A1298C polymorphisms in cleft children or cleft children’s mothers. All statistical data underwent random or fixed effects model with an odds ratio and 95% confidence intervals as effect measures and was preformed using a web tool MetaGenyo. Statistical analyses showed that the MTHFR C677T is significantly associated with the increased risk of NSCLP in children but not in the mothers. In contrast to this, there is no evidence for association between MTHFR A1298C and NSCLP risk in both children and the mothers. Furthermore, there is no evidence for publication bias for both MTHFR C677T and A1298C polymorphisms in cleft children as well as the mothers of cleft children. In conclusion, we determined that there is a strong association between the MTHFR C677 T polymorphism and NSCLP.     

Language Lateralization in Children Aged 10 to 11 Years: A Combined fMRI and Dichotic Listening Study

Objective

The aims of this study were to develop and assess a method to map language networks in children with two auditory fMRI protocols in combination with a dichotic listening task (DL). The method is intended for pediatric patients prior to epilepsy surgery. To evaluate the potential clinical usefulness of the method we first wanted to assess data from a group of healthy children.

Methods

In a first step language test materials were developed, intended for subsequent implementation in fMRI protocols. An evaluation of this material was done in 30 children with typical development, 10 from the 1^st, 4^th and the 7^th grade, respectively. The language test material was then adapted and implemented in two fMRI protocols intended to target frontal and posterior language networks. In a second step language lateralization was assessed in 17 typical 10–11 year olds with fMRI and DL. To reach a conclusion about language lateralization, firstly, quantitative analyses of the index data from the two fMRI tasks and the index data from the DL task were done separately. In a second step a set of criteria were applied to these results to reach a conclusion about language lateralization. The steps of these analyses are described in detail.

Results

The behavioral assessment of the language test material showed that it was well suited for typical children. The results of the language lateralization assessments, based on fMRI data and DL data, showed that for 15 of the 17 subjects (88%) a conclusion could be reached about hemispheric language dominance. In 2 cases (12%) DL provided critical data.

Conclusions

The employment of DL combined with language mapping using fMRI for assessing hemispheric language dominance is novel and it was deemed valuable since it provided additional information compared to the results gained from each method individually.     

Preschoolers and the Endowment Effect

We show that preschoolers exhibit the endowment effect as evidenced by experiments where children generally chose to keep their own toys rather than trading them for similar ones. Furthermore, we relate the emergence of this effect to children''s innate psychobiological traits—emotional state, gender, handedness, and digit ratio. The trials were conducted with 141 children across 6 kindergartens. We also found support that children, like adults, exhibit a preference for physical possession as opposed to ownership. As with adults, emotions also seem to matter, as children who were described as quiet and calm were more likely to present the endowment effect. Also of note, right-handed children described as quiet were more likely to exhibit the phenomenon. Furthermore, female children were generally found to be calmer than males, while males tended to be more fearful than females. This result was also previously found in teenagers.     

Maturation of gait dynamics: stride-to-stride variability and its temporal organization in children.

In very young children, immature control of posture and gait results in unsteady locomotion. In children of approximately 3 yr of age, gait appears relatively mature; however, it is unknown whether the dynamics of walking change beyond this age. Because stride dynamics depend on neural control, we hypothesized that motor control would continue to develop beyond age 3. To test this hypothesis, we measured the gait cycle duration on a stride-by-stride basis in 50 healthy 3- to 14-yr-old children (25 girls). Measurements of stride-to-stride variability were significantly larger both in the 3- and 4-yr-old children, compared with the 6- and 7-yr-old children, and in the 6- and 7-yr-old children, compared with the 11- to 14-yr-old children. Measurements of the temporal organization of gait also revealed significant age-dependent changes. The effects of age persisted even after adjusting for height. These findings indicate that mature stride dynamics may not be completely developed even in healthy 7-yr-old children and that different aspects of stride dynamics mature at different ages.     

Language development: breaking the code

This paper reviews the major achievements of the preschool years regarding language acquisition. Although most children appear to master their native language with little apparent effort, learning a language is a complex task. It requires the ability to extract clues from environmental stimuli and to discover how those stimuli convey meanings and are modified according to the meaning conveyed. In general, language learning follows a similar sequence regardless of the language being learned. The major accomplishments in the areas of speech perception, early sound production, phonology, lexicon, syntax, and morphology are described, with specific examples from recent studies of acquisition of French in young children from Québec. These examples confirm major milestones observed in other languages, but also illustrate how comparisons across languages and across children learning the same language can be challenging. For each area, current issues are identified regarding the bases (neurological, genetic) of language development, as well as the processes (social, cognitive, linguistic) involved. Current hypotheses regarding language acquisition and language disorders are briefly discussed.