Kei Apple Plant Thorn Synovitis

Plant thorn synovitis is well described but may be overlooked in the differential diagnosis of monoarticular inflammatory disease. It can present as a diagnostic difficulty because of its insidious onset after an apparently trivial injury, which may not be reported. Historically, thorn synovitis has been considered aseptic and treated with removal of the intra-articular foreign body and the affected synovial ring. We present a child with Kei apple thorn that had penetrated into the right knee joint and lodged in the medial compartment.Keywords: Kei Apple, Plant Thorn, Foreign Body Synovitis

Relearning the lesson – amelanotic malignant melanoma: a case report

Although not as common as the other melanomas, amelanotic melanoma often evades diagnosis by masquerading as other pathology. A high index of suspicion is therefore required for early and appropriate intervention. We present a patient who was diagnosed and managed as having paronychia of the middle finger while in actual fact he had a subungual amelanotic melanoma. By the time of his referral to the orthopaedic team it had progressed to an advanced stage. Our case underlies the importance of early recognition and referral of this rare but malignant lesion by primary care physicians

Causes and consequences of psychological distress among orphans in eastern Zimbabwe.

Substantial resources are invested in psychological support for children orphaned or otherwise made vulnerable in the context of HIV/AIDS (OVC). However, there is still only limited scientific evidence for greater psychological distress amongst orphans and even less evidence for the effectiveness of current support strategies. Furthermore, programmes that address established mechanisms through which orphanhood can lead to greater psychological distress should be more effective. We use quantitative and qualitative data from Eastern Zimbabwe to measure the effects of orphanhood on psychological distress and to test mechanisms for greater distress amongst orphans suggested in a recently published theoretical framework

Puberty Predicts Approach But Not Avoidance on the Iowa Gambling Task in a Multinational Sample

According to the dual systems model of adolescent risk taking, sensation seeking and impulse control follow different developmental trajectories across adolescence and are governed by two different brain systems. The authors tested whether different underlying processes also drive age differences in reward approach and cost avoidance. Using a modified Iowa Gambling Task in a multinational, cross‐sectional sample of 3,234 adolescents (ages 9–17; M = 12.87, SD = 2.36), pubertal maturation, but not age, predicted reward approach, mediated through higher sensation seeking. In contrast, age, but not pubertal maturation, predicted increased cost avoidance, mediated through greater impulse control. These findings add to evidence that adolescent behavior is best understood as the product of two interacting, but independently developing, brain systems

Severity and justness do not moderate the relation between corporal punishment and negative child outcomes: A multicultural and longitudinal study

There is strong evidence of a positive association between corporal punishment and negative child outcomes, but previous studies have suggested that the manner in which parents implement corporal punishment moderates the effects of its use. This study investigated whether severity and justness in the use of corporal punishment moderate the associations between frequency of corporal punishment and child externalizing and internalizing behaviors. This question was examined using a multicultural sample from eight countries and two waves of data collected one year apart. Interviews were conducted with 998 children aged 7–10 years, and their mothers and fathers, from China, Colombia, Italy, Jordan, Kenya, Philippines, Thailand, and the United States. Mothers and fathers responded to questions on the frequency, severity, and justness of their use of corporal punishment; they also reported on the externalizing and internalizing behavior of their child. Children reported on their aggression. Multigroup path models revealed that across cultural groups, and as reported by mothers and fathers, there is a positive relation between the frequency of corporal punishment and externalizing child behaviors. Mother-reported severity and father-reported justness were associated with child-reported aggression. Neither severity nor justness moderated the relation between frequency of corporal punishment and child problem behavior. The null result suggests that more use of corporal punishment is harmful to children regardless of how it is implemented, but requires further substantiation as the study is unable to definitively conclude that there is no true interaction effect

Safety and immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in children in Sierra Leone: a randomised, double-blind, controlled trial

Background—Children account for a substantial proportion of cases and deaths from Ebola virus disease. We aimed to assess the safety and immunogenicity of a two-dose heterologous vaccine regimen, comprising the adenovirus type 26 vector-based vaccine encoding the Ebola virus glycoprotein (Ad26.ZEBOV) and the modified vaccinia Ankara vectorbased vaccine, encoding glycoproteins from the Ebola virus, Sudan virus, and Marburg virus, and the nucleoprotein from the Tai Forest virus (MVA-BN-Filo), in a paediatric population in Sierra Leone. Methods—This randomised, double-blind, controlled trial was done at three clinics in Kambia district, Sierra Leone. Healthy children and adolescents aged 1–17 years were enrolled in three age cohorts (12–17 years, 4–11 years, and 1–3 years) and randomly assigned (3:1), via computer-generated block randomisation (block size of eight), to receive an intramuscular injection of either Ad26.ZEBOV (5 × 1010 viral particles; first dose) followed by MVA-BN-Filo (1 × 108 infectious units; second dose) on day 57 (Ebola vaccine group), or a single dose of meningococcal quadrivalent (serogroups A, C, W135, and Y) conjugate vaccine (MenACWY; first dose) followed by placebo (second dose) on day 57 (control group). Study team personnel (except for those with primary responsibility for study vaccine preparation), participants, and their parents or guardians were masked to study vaccine allocation. The primary outcome was safety, measured as the occurrence of solicited local and systemic adverse symptoms during 7 days after each vaccination, unsolicited systemic adverse events during 28 days after each vaccination, abnormal laboratory results during the study period, and serious adverse events or immediate reportable events throughout the study period. The secondary outcome was immunogenicity (humoral immune response), measured as the concentration of Ebola virus glycoprotein-specific binding antibodies at 21 days after the second dose. The primary outcome was assessed in all participants who had received at least one dose of study vaccine and had available reactogenicity data, and immunogenicity was assessed in all participants who had received both vaccinations within the protocol-defined time window, had at least one evaluable post-vaccination sample, and had no major protocol deviations that could have influenced the immune response. This study is registered at ClinicalTrials.gov, NCT02509494. Findings—From April 4, 2017, to July 5, 2018, 576 eligible children or adolescents (192 in each of the three age cohorts) were enrolled and randomly assigned. The most common solicited local adverse event during the 7 days after the first and second dose was injection-site pain in all age groups, with frequencies ranging from 0% (none of 48) of children aged 1–3 years after placebo injection to 21% (30 of 144) of children aged 4–11 years after Ad26.ZEBOV vaccination. The most frequently observed solicited systemic adverse event during the 7 days was headache in the 12–17 years and 4–11 years age cohorts after the first and second dose, and pyrexia in the 1–3 years age cohort after the first and second dose. The most frequent unsolicited adverse event after the first and second dose vaccinations was malaria in all age cohorts, irrespective of the vaccine types. Following vaccination with MenACWY, severe thrombocytopaenia was observed in one participant aged 3 years. No other clinically significant laboratory abnormalities were observed in other study participants, and no serious adverse events related to the Ebola vaccine regimen were reported. There were no treatment-related deaths. Ebola virus glycoprotein-specific binding antibody responses at 21 days after the second dose of the Ebola virus vaccine regimen were observed in 131 (98%) of 134 children aged 12–17 years (9929 ELISA units [EU]/mL [95% CI 8172–12 064]), in 119 (99%) of 120 aged 4–11 years (10 212 EU/mL [8419–12 388]), and in 118 (98%) of 121 aged 1–3 years (22 568 EU/mL [18 426–27 642]). Interpretation—The Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen was well tolerated with no safety concerns in children aged 1–17 years, and induced robust humoral immune responses, suggesting suitability of this regimen for Ebola virus disease prophylaxis in children

Childrearing Violence and Child Adjustment After Exposure to Kenyan Post-election Violence

Objective: This study examines parents’ and children’s exposure to short-term political violence and the relation between childrearing violence and child adjustment after widespread violence that erupted in Kisumu, Kenya after the disputed presidential election in December 2007. Method: Mothers of 100 Luo children (mean age 8.46 years, 61% female) reported on their own use of childrearing violence at Time 1, approximately 4 months after the disputed election, and again at Times 2 (n 95) and 3 (n 95), approximately 12 and 24 months later, respectively. At Time 2, mothers reported about post-election violence directed at them and about their children’s exposure to post-election violence. Children reported about their own externalizing behaviors at Times 1, 2, and 3. Results: Children’s exposure to post-election violence was related to Time 2 externalizing behavior, and childrearing violence at Time 1 predicted child externalizing behavior at Time 2. Exposure to post-election violence was not directly related to either childrearing violence or children’s externalizing behavior by Time 3, although children’s externalizing at Time 2 predicted more childrearing violence at Time 3. Conclusion: These results support earlier work that links childrearing violence and children’s exposure to political violence with increases in child externalizing behavior, but examined these links in the understudied area of short-term political violence. Even though sudden and severe political violence may subside significantly in weeks or months, increased attention to long-term effects on parenting and child adjustment is warranted

Physical Discipline and Children’s Adjustment: Cultural Normativeness as a Moderator

Interviews were conducted with 336 mother – child dyads (children’s ages ranged from 6 to 17 years; mothers’ ages ranged from 20 to 59 years) in China, India, Italy, Kenya, the Philippines, and Thailand to examine whether normativeness of physical discipline moderates the link between mothers’ use of physical discipline and children’s adjustment. Multilevel regression analyses revealed that physical discipline was less strongly associated with adverse child outcomes in conditions of greater perceived normativeness, but physical discipline was also associated with more adverse outcomes regardless of its perceived normativeness. Countries with the lowest use of physical discipline showed the strongest association between mothers’ use and children’s behavior problems, but in all countries higher use of physical discipline was associated with more aggression and anxiety