Adoption in Romania: Historical Perspectives and Recent Statistics

In this article we present a brief history and recent statistics of child abandonment and adoption in Romania. After a rise in international adoptions in the 90s, a moratorium on adoption was established and in 2004 international adoptions became virtually impossible. Based on statistics of the Romanian National Authority for the Protection of Children's Rights and Adoption, we noted that since 2004 international adoptions were rare, whereas domestic adoptions remained relatively stable with about 1,000 adoptions each year. To date, not all potential adoption placements are realized. We conclude with reflecting on possible changes to improve child welfare in Romania.Education and Child Studie

A previously unobserved conformation for the human Pex5p receptor suggests roles for intrinsic flexibility and rigid domain motions in ligand binding

BACKGROUND: The C-terminal tetratricopeptide (TPR) repeat domain of Pex5p recognises proteins carrying a peroxisomal targeting signal type 1 (PTS1) tripeptide in their C-terminus. Previously, structural data have been obtained from the TPR domain of Pex5p in both the liganded and unliganded states, indicating a conformational change taking place upon cargo protein binding. Such a conformational change would be expected to play a major role both during PTS1 protein recognition as well as in cargo release into the peroxisomal lumen. However, little information is available on the factors that may regulate such structural changes. RESULTS: We have used a range of biophysical and computational methods to further analyse the conformational flexibility and ligand binding of Pex5p. A new crystal form for the human Pex5p C-terminal domain (Pex5p(C)) was obtained in the presence of Sr(2+ )ions, and the structure presents a novel conformation, distinct from all previous liganded and apo crystal structures for Pex5p(C). The difference relates to a near-rigid body movement of two halves of the molecule, and this movement is different from that required to reach a ring-like conformation upon PTS1 ligand binding. The bound Sr(2+ )ion changes the dynamic properties of Pex5p(C) affecting its conformation, possibly by making the Sr(2+)-binding loop – located near the hinge region for the observed domain motions – more rigid. CONCLUSION: The current data indicate that Pex5p(C) is able to sample a range of conformational states in the absence of bound PTS1 ligand. The domain movements between various apo conformations are distinct from those involved in ligand binding, although the differences between all observed conformations so far can be characterised by the movement of the two halves of Pex5p(C) as near-rigid bodies with respect to each other

The effectiveness of Video-feedback Intervention to promote Positive Parenting for Foster Care (VIPP-FC)

Background: Foster children are at higher risk of the development of behavior and emotional problems, which can contribute to the development of insecure attachment bonds with their foster parents and (subsequently) to placement breakdown. Sensitive parenting might minimize the adverse effects of the behavior and emotional problems. Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care (VIPP-FC) is an adaptation of the evidence-based Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and aims at increasing sensitive parenting and the use of sensitive discipline strategies of foster parents. The current study is the first to examine the effectiveness of VIPP-FC. Methods: A randomized controlled trial is used with 60 foster parent-child dyads (intervention group n=30, control group n=30). The primary outcomes are parental sensitivity, parental disciplining, and parental attitudes towards parenting. Data about attachment (in)security, behavioral and emotional problems, neurobiological parameters, and possible confounders is additionally collected. Discussion: Examining the effectiveness of VIPP-FC contributes to the knowledge of evidence-based prevention and intervention programs needed in foster care practice

Positive parenting in foster care: Testing the effectiveness of a video-feedback intervention program on foster parents’ behavior and attitudes

The current randomized controlled trial examined the effectiveness of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline in Foster Care (VIPP-FC) on parenting behavior and attitudes in foster parents (N = 60, 31–61 years, 83% female). The intervention group (n = 30) received VIPP-FC, consisting of six sessions. During the first four sessions, a specific theme from Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; e.g., attachment vs. exploration behavior), and an additional foster care theme (e.g., subtle or missing attachment signals) are discussed. Each theme is discussed during the consecutive sessions and the last two sessions are booster sessions during which all themes are discussed. The control group (n = 30) received a dummy intervention consisting of six telephone calls about general child developmental topics. The Ainsworth Scales for sensitivity and non-interference, the Erickson scale for supportive presence, and the Questionnaire Attitudes towards Parenting were used to measure parental sensitivity, sensitive discipline, and attitudes towards parenting, respectively. The intervention and control group did not differ on demographic characteristics or outcome variables at pretest. Multilevel analyses based on the intent-to-treat principle yielded no evidence that VIPP-FC was more effective in improving foster parents’ sensitive parenting behavior or eliciting more positive attitudes compared to the control condition. We suggest that the outcomes in this study may be explained by a possible selection bias, which may have resulted in a ceiling effect. Future research might include foster families that experience more severe challenges (i.e., elevated levels of child behavior problems) or indicate a need for help and support

Metropolis simulations of Met-Enkephalin with solvent-accessible area parameterizations

We investigate the solvent-accessible area method by means of Metropolis simulations of the brain peptide Met-Enkephalin at 300$K$. For the energy function ECEPP/2 nine atomic solvation parameter (ASP) sets are studied. The simulations are compared with one another, with simulations with a distance dependent electrostatic permittivity $\epsilon (r)$, and with vacuum simulations ($\epsilon =2$). Parallel tempering and the biased Metropolis techniques RM$_1$ are employed and their performance is evaluated. The measured observables include energy and dihedral probability densities (pds), integrated autocorrelation times, and acceptance rates. Two of the ASP sets turn out to be unsuitable for these simulations. For all other systems selected configurations are minimized in search of the global energy minima, which are found for the vacuum and the $\epsilon(r)$ system, but for none of the ASP models. Other observables show a remarkable dependence on the ASPs. In particular, we find three ASP sets for which the autocorrelations at 300$$K are considerably smaller than for vacuum simulations.Comment: 10 pages and 8 figure

Five-year safety and efficacy of leadless pacemakers in a Dutch cohort

BACKGROUND: Adequate real-world safety and efficacy of leadless pacemakers (LPs) have been demonstrated up to 3 years after implantation. Longer-term data are warranted to assess the net clinical benefit of leadless pacing.OBJECTIVE: The purpose of this study was to evaluate the long-term safety and efficacy of LP therapy in a real-world cohort.METHODS: In this retrospective cohort study, all consecutive patients with a first LP implantation from December 21, 2012, to December 13, 2016, in 6 Dutch high-volume centers were included. The primary safety endpoint was the rate of major procedure- or device-related complications (ie, requiring surgery) at 5-year follow-up. Analyses were performed with and without Nanostim battery advisory-related complications. The primary efficacy endpoint was the percentage of patients with a pacing capture threshold ≤2.0 V at implantation and without ≥1.5-V increase at the last follow-up visit.RESULTS: A total of 179 patients were included (mean age 79 ± 9 years), 93 (52%) with a Nanostim and 86 (48%) with a Micra VR LP. Mean follow-up duration was 44 ± 26 months. Forty-one major complications occurred, of which 7 were not advisory related. The 5-year major complication rate was 4% without advisory-related complications and 27% including advisory-related complications. No advisory-related major complications occurred a median 10 days (range 0-88 days) postimplantation. The pacing capture threshold was low in 163 of 167 patients (98%) and stable in 157 of 160 (98%).CONCLUSION: The long-term major complication rate without advisory-related complications was low with LPs. No complications occurred after the acute phase and no infections occurred, which may be a specific benefit of LPs. The performance was adequate with a stable pacing capture threshold.</p

Excess Mortality Rate During Adulthood Among Danish Adoptees

BACKGROUND AND OBJECTIVE: Adoption studies have been used to disentangle the influence of genes from shared familial environment on various traits and disease risks. However, both the factors leading to adoption and living as an adoptee may bias the studies with regard to the relative influence of genes and environment compared to the general population. The aim was to investigate whether the cohort of domestic adoptees used for these studies in Denmark is similar to the general population with respect to all-cause mortality and cause-specific mortality rates. METHODS: 13,111 adoptees born in Denmark in 1917, or later, and adopted in 1924 to 1947 were compared to all Danes from the same birth cohorts using standardized mortality ratios (SMR). The 12,729 adoptees alive in 1970 were similarly compared to all Danes using SMR as well as cause-specific SMR. RESULTS: The excess in all-cause mortality before age 65 years in adoptees was estimated to be 1.30 (95% CI 1.26-1.35). Significant excess mortality before age 65 years was also observed for infections, vascular deaths, cancer, alcohol-related deaths and suicide. Analyses including deaths after age 65 generally showed slightly less excess in mortality, but the excess was significant for all-cause mortality, cancer, alcohol-related deaths and suicides. CONCLUSION: Adoptees have an increased all-cause mortality compared to the general population. All major specific causes of death contributed, and the highest excess is seen for alcohol-related deaths

School performance of international adoptees better than expected from cognitive test results

Objective: To investigate school performance of international adoptees in relation to their cognitive competence. Method: From the population of all male Swedish residents born 1973–1976, registered in the census 1985 and with complete test scores from military conscription, the following study groups were identified: Korean adoptees (n = 320), non-Korean adoptees (n = 1,125), siblings (children born by adoptive parents, n = 190) and Swedish majority comparisons (n = 142,024). Global scores from intelligence tests at conscription were compared with grade points from the last compulsory school year (year 9). Linear and logistic regression was applied in statistical analyses. Results: The mean grade points in theoretical subjects were lower in non-Korean adoptees than in the majority population, but when global test scores from military conscription were adjusted for, outcomes were significantly better, equal for physics, than in the majority population. The grade points of Korean adoptees were higher than in the majority population and the same held true after adjusting for global test scores. When SES was taken into account, the risk of poor school performance (only completed lower subject levels) increased in non-Korean adoptees compared to models only adjusted for age and sex. Conclusion: Male international adoptees generally perform better in school than expected by their cognitive competence. A cognitive evaluation is important in the assessment of adoptees with learning difficulties