Addressing children’s mental health issues in the 21st century

Posljednjih dvadeset godina svjedočimo kontinuiranom porastu psihičkih problema među djecom i mladima, što je pobudilo rastući interes stručnjaka za njihovo zdravlje. Istraživanja jasno pokazuju da čak 20% djece pati od psihičkih teškoća, uključujući anksioznost, depresiju, poremećaje ponašanja, smetnje učenja, te sve češće probleme poput samoozljeđivanja, poteškoća s raznolikim identitetima i ovisnosti o digitalnim tehnologijama. Negativna iskustva iz djetinjstva, promjene u obiteljskoj strukturi, prezaštićujući odgojni stil, nedostatak slobodnog vremena za igru i druženje s vršnjacima, društveni pritisci i sveprisutni utjecaj tehnologije – samo su neki od izazova koji su povezani s rastućim stopama problema s mentalnim zdravljem u djece. Dodatno, nedavni događaji, poput pandemije COVID-19, rata u Ukrajini, globalne recesije i klimatskih promjena, značajno su povećali stopu anksioznosti i depresije u djece i mladih. Nužno je osigurati podršku za djecu koja se suočavaju s ovim problemima na svim razinama, uključujući obitelj, školu i zdravstveni sustav. Zajednica ima odgovornost osigurati resurse putem zdravstvenih, obrazovnih i socijalnih politika kako bi svako dijete koje se bori s mentalnim problemima dobilo pomoć. Napori usmjereni na smanjenje prevalencije negativnih iskustava iz djetinjstva, pružanje sveobuhvatne podrške obiteljima i djeci od najranije dobi te promicanje zdravih ponašanja i strategija za uspješno suočavanje s teškoćama mogu značajno ublažiti negativne posljedice ovih stresora na mentalno zdravlje djece. Posebno važnu ulogu imaju pedijatri, koji su prvi u kontaktu s djecom i obiteljima, te imaju mogućnost prepoznavanja, prevencije i smanjenja simptoma, kao i pravodobnog upućivanja stručnjacima za mentalno zdravlje.Over the last two decades, there has been a continuous increase in psychological problems among children and young people, which has increased the interest of experts who take care of their health. Research indicates that 20% of children commonly experience psychological problems such as anxiety, depression, behavioral disorders, and learning disabilities. Furthermore, emerging issues like self-injury, problems with gender identity, and addiction to digital technology have gained prominence. Moreover, adverse childhood experiences, shifts in family structures, overprotective parenting styles, reduced time allocated for free play, and socializing with peers, societal pressures, and the influence of technology on children’s lives are among the challenges closely linked to the rising rates of mental health problems. Recent events like the COVID-19 pandemic, the war in Ukraine, the global recession, and climate change have significantly heightened the prevalence of anxiety and depression among children and young people. It is crucial to provide comprehensive support to children facing these challenges across various domains, including families, schools, and the healthcare system. It is the community’s responsibility to provide resources through health, education, and social policy to ensure that every child struggling with mental health issues can access help. Efforts aimed at reducing the prevalence of adverse childhood experiences, providing support for families and children from early childhood, and promoting healthy behaviors and coping strategies may help mitigate the negative effects of these stressors on children’s mental health. In this context, the role of pediatricians is vital as they serve as the primary point of contact

CORRELATES OF QUALITY OF LIFE IN PEDIATRIC CANCER SURVIVORS

Background: Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. Aim of the research was to examine the possible predictors of quality of life, that is, to examine the impact and relative contribution of post-traumatic stress symptoms, post-traumatic growth, the effects of treatment and social functioning on quality of life. Subjects and methods: Participants were 83 pediatric cancer survivors at age 16 to 29 who were off-therapy for more than one year. They filled out the Impact of Event Scale-Revised Questionnaire (IES-R), Quality of life scale (QOLS) and Social Adjustment Scale (SAS-SR). Demographic data including child health status information were also collected. Results: Findings indicate a significant association between quality of life and social adjustment, posttraumatic growth, health consequences and posttraumatic stress disorder. Regression analysis showed that posttraumatic growth, social functioning and treatment consequences are significant predictors of quality of life in pediatric cancer survivors. Conclusion: The findings highlight the importance of key factors associated with quality of life in pediatric cancer survivors. Interventions aimed at strengthening social support and highlighting positive changes following trauma of cancer treatment could improve quality of life of pediatric cancer survivors

Educiranost primalja o cijepljenju protiv gripe tijekom trudnoće

Gripa je potencijalno ozbiljna zarazna bolest, posebno za određene skupine kao što su trudnice, koje imaju povećani rizik od obolijevanja i smrtnosti. Osjetljivost trudnica na infekciju virusom gripe objašnjava se fiziološkim promjenama koje nastaju u trudnoći. Prevencija gripe cijepljenjem ključna je strategija za sprječavanje nastanka bolesti i razvoj mogućih komplikacija u trudnica i novorođenčadi. Primalje trebaju biti pouzdan i pravovremen izvor informacija o cijepljenju s obzirom na to da rade u izravnom doticaju s trudnicama. Cilj ovog istraživanja je ispitati znanje i stavove primalja u Hrvatskoj o cijepljenju trudnica protiv gripe. Rezultati anketnog istraživanja kojim su obuhvaćene 82 primalje iz cijele države pokazali su ograničena znanja ispitanika o cijepljenju protiv gripe tijekom trudnoće. Manje od polovine ispitanika smatra da je cijepljenje protiv gripe u trudnoći učinkovito, a samo četvrtina ispitanika smatra da je cjepivo sigurno. Trećina ispitanih primalja zna da se trudnicama u Hrvatskoj preporučuje inaktivirano cjepivo protiv gripe, a manje od četvrtine zna da se cjepivo može primijeniti u bilo kojem tromjesečju. Velika većina primalja uključenih u istraživanje (93%) navela je da ne pružaju trudnicama informacije o cijepljenju protiv gripe, a kao vodeći razlog navode manjak educiranosti. Nije utvrđena statistički značajna razlika u znanju i stavovima ovisno o stupnju obrazovanja i duljini radnog staža. Poboljšanje procijepljenosti trudnica protiv gripe uvelike ovisi o preporukama zdravstvenih djelatnika. Ova studija pruža vrijedan uvid u znanja, stavove i praksu hrvatskih primalja ukazujući na potrebu dodatne edukacije primalja o sigurnosti cjepiva protiv gripe i potencijalnoj koristi za majku i dijete

Coping strategies and health-related quality of life in children and adolescents with type 1 diabetes

The aim of this study was to identify relationships between coping strategies and different aspects of health-related quality of life in children with type 1 diabetes measured with the Croatian translation of the PedsQL 4.0 Generic Core Scales and PedsQL Diabetes Module. The sample consisted of 199 schoolchildren: 47 patients with type 1 diabetes and 152 healthy children. Children health problems were rated with PedsQL 4.0 Generic Core Scale and with PedsQL Diabetes Module. Coping strategies were measured with The Coping Strategies Inventory for Children and Adolescents. The results showed that all subscales of the PedsQL 4.0 Generic Core Scales and the PedsQL Diabetes Module have satisfactory reliability with the majority of scales exceeding a Cronbach α of 0,70. Significant correlations were found between coping strategies and different aspects of health-related quality of life and those correlations were higher in girls than in boys. The findings of the present study suggest that child psychologists and clinicians treating children and adolescents suffering diabetes should address coping strategies related to specific health-related problems and assist them in developing more effective ways of coping

Anxiety in Children with Headaches

The aim of this study was to examine the different aspects of anxiety symptoms: separation anxiety, social anxiety, test anxiety, obsessive-compulsive symptoms, worry, anxiety sensitivity, somatic symptoms in four groups of subjects: 1) children with headaches in pediatric care, 2) nonclinical headachers, 3) subjects with anxiety disorders, and 4) healthy controls. The sample consisted of 187 schoolchildren: 43 patients with headaches as a primary complaint, 59 headachers recruited from the general population, 43 patients with a diagnosis of anxiety disorders and 42 healthy children in control group. Two questionnaires for children and adolescents were used: The Fear and Anxiety Scale and The Psychosomatic Symptoms Questionnaire. Headache problems were rated by experienced pediatric specialists. There were no age and gender differences in anxiety symptoms in the two headache groups and control group. No significant differences were found on any of the anxiety subscales between headachers in pediatric care and headachers who did not ask for medical help. Significant differences in anxiety scales were found between headachers, anxious children and healthy controls. Headachers suffer from more anxiety problems than healthy controls. In the clinical sample of children suffering headaches anxiety problems of clinical relevance were found in range from 7% on the measures of excessive worry and anxiety sensitivity to 32% on the separation anxiety. In the community sample anxiety problems of clinical relevance were found in range from 5% on the measure of obsessive compulsive symptoms to 17% on the test anxiety. The majority of children with headaches complaints do not have a clinically significant anxiety symptomathology, but the incidence of anxiety symptoms is higher than in a population of non-headachers

BENTONITE IN NUTRITION OF DAIRY CATTLE

There are numerous methods for decontamination of animal feed, and a relatively inexpensive method is the application of inorganic adsorbents. Adsorbents from the group of alumosilicates are particularly important, especially bentonite. Inorganic adsorbents are able to detoxify foods contaminated with mycotoxins by their adsorption power, while minimizing the negative effects on the organism. The aim of this study was to examine and determine whether the use of natural bentonite has an effect on adsorption of aflatoxins from food. The influence of daily intake of bentonite at different doses (30 and 50 g / head) on the content of aflatoxin M1 (AFM1) in milk of examined cows was examined. By mycotoxicological analysis of the feed it was determined that maize grains were infested with aflatoxin B1 (1.24 μg/kg) and that this was the cause of the AFM1 metabolite in raw milk of cows. Based on the results obtained, it was concluded that the content of AFM1 in milk of cows consuming food with a daily intake of 30 and 50 g bentonite was significantly reduced

Platypnea-orthodeoxia syndrome related to the patent foramen ovale and atrial septal aneurysm

The platypnea-orthodeoxia syndrome is a rare condition characterized by postural dyspnea and hypoxemia that disappear or diminish in lying position, so it can be difficult to recognize without close assessment of the patient\u27s pattern of dyspnea. The syndrome is commonly associated to an intra-cardiac right-to-left shunt through a patent foramen ovale as the most frequently reported site of the shunt. Platypnea-orthodeoxia syndrome can be the cause of refractory hypoxemia leading to pulmonary hypertension, whereby, if suspected, contrast echocardiography in supine as well as in upright position should be performed. We are presenting a case of an unrecognized platypnea-orthodeoxia syndrome because of a patent foramen ovale and atrial septal aneurysm, with developed chronic complications due to long-standing hypoxemia. This case highlights the need of a high index of suspicion to diagnose the syndrome on time and the necessity of careful echocardiographic evaluation