Offspring of parents with recurrent depression: which features of parent depression index risk for offspring psychopathology?

Background: Parental depression is associated with an increased risk of psychiatric disorder in offspring, although outcomes vary. At present relatively little is known about how differences in episode timing, severity, and course of recurrentdepression relate to risk in children. The aim of this study was to consider the offspring of parents with recurrentdepression and examine whether a recent episode of parental depressionindexesrisk for offspringpsychopathology over and above these other parental depressionfeatures. <p/>Methods: Three hundred and thirty seven recurrently depressed parents and their offspring (aged 9–17) were interviewed as part of an ongoing study, the ‘Early Prediction of Adolescent Depression Study’. The Child and Adolescent Psychiatric Assessment was used to assess two child outcomes; presence of a DSM-IV psychiatric disorder and number of DSM-IV child-rated depression symptoms. <p/>Results: Children whose parents had experienced a recent episode of depression reported significantly more depression symptoms, and odds of child psychiatric disorder were doubled relative to children whose parents had not experienced a recent episode of depression. Past severity of parental depression was also significantly associated with child depression symptoms. <p/>Limitations: Statistical analyses preclude causal conclusions pertaining to parental depression influences on offspringpsychopathology; several features of parental depression were recalled retrospectively. <p/>Conclusions: This study suggests that particular features of parental depression, specifically past depression severity and presence of a recent episode, may be important indicators of risk for child psychiatric disorder and depressive symptoms

Anorectal Manometry for the Diagnosis of Hirschsprung Disease: New Heights for the Balloon or Just Hot Air?

In this issue of the Journal of Pediatric Gastroenterology and Nutrition, Meinds et al (1) report on the performance of a modified anorectal manometry (ARM) protocol for the diagnosis of Hirschsprung Disease (HSCR). In a prospective study of 105 patients suspected of having HSCR they showed that both the sensitivity and specificity of their modified ARM protocol were equivalent to rectal suction biopsy (RSB) with a 100% negative predictive value. They conclude that ARM is a viable screening tool for HSCR and could be used as a first diagnostic step to exclude HSCR across all age groups and ultimately reduce the need for rectal biopsies

The evaluation and management of recurrent abdominal pain in childhood

Recurrent abdominal pain (RAP) is a common complaint in children. Previously considered a single entity, RAP is now used as a descriptive term and sub-classified in the recently published Rome IV criteria, into four functional abdominal pain disorders (FAPD), including functional dyspepsia and irritable bowel syndrome. All share common pathogenic mechanisms of visceral hypersensitivity and central hypervigilance, resulting from disruption of the microbiota–gut–brain axis and abnormal enteric neuro–immune interactions. Although FAPDs are benign in nature, the persistence of symptoms and effects on everyday life can have significant secondary effects including psychosocial morbidity. The diagnosis of FAPDs is based on careful history and examination looking for ‘alarm signs’, although a limited battery of laboratory investigations to screen for organic disease may be of value. The management of FAPDs should be multidisciplinary and based on the bio-psychosocial model of care with careful education and engagement of patients/parents. There is currently little evidence to support the routine use of pharmacotherapy, probiotics or diet and a significant placebo effect should be considered when assessing treatment effect. Hypnotherapy has been shown to be an effective therapy. Approximately 50% of FAPDs cases will achieve resolution, especially those that have engaged with the appropriate model of management

Gastro-Esophageal Reflux in Children

Gastro-esophageal reflux (GER) is common in infants and children and has a varied clinical presentation: from infants with innocent regurgitation to infants and children with severe esophageal and extra-esophageal complications that define pathological gastro-esophageal reflux disease (GERD). Although the pathophysiology is similar to that of adults, symptoms of GERD in infants and children are often distinct from classic ones such as heartburn. The passage of gastric contents into the esophagus is a normal phenomenon occurring many times a day both in adults and children, but, in infants, several factors contribute to exacerbate this phenomenon, including a liquid milk-based diet, recumbent position and both structural and functional immaturity of the gastro-esophageal junction. This article focuses on the presentation, diagnosis and treatment of GERD that occurs in infants and children, based on available and current guidelines

Five years on: public sector service use related to mental health in young people with ADHD or hyperkinetic disorder five years after diagnosis

This is the peer reviewed version of the article, which has been published in final form at DOI: 10.1111/j.1475-3588.2007.00466.x. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Background: Little is known about ongoing service use among young people with ADHD, but this informationis important to the development of services to support these young people. Methods: A cohort of young people with ADHD or hyperkinetic disorder (n ¼ 115) was followed up five to seven years after diagnosis.Details are presented of their use of public sector services over the 12 months preceding reassessment, compared to young people with ADHD from a large epidemiological study. Results: Most children remained in contact with CAMHS, with high rates of contact with schools, educational professionals and the criminal justice system. Nearly all had taken medication at some point, while many still were using it. There were low reported rates of psychological and group interventions within the last twelve months, but this does not rule out earlier access to such treatments. Conclusions: Children with ADHD utilise long-term support from public sector services, and cross agency strategies or clinics may help to optimise functioning.Wellcome Trus

Synchronous imaging of coherent plasma fluctuations

A new method for imaging high frequency plasma fluctuations is described. A phase locked loop and field programmable gate array are used to generate gating triggers for an intensified CCD camera. A reference signal from another diagnostic such as a magnetic probe ensures that the triggers are synchronous with the fluctuation being imaged. The synchronous imaging technique allows effective frame rates exceeding millions per second, good signal to noise through the accumulation of multiple exposures per frame, and produces high resolution images without generating excessive quantities of data. The technique can be used to image modes in the MHz range opening up the possibility of spectrally filtered high resolution imaging of MHD instabilities that produce sufficient light fluctuations. Some examples of projection images of plasma fluctuations on the H-1NF heliac obtained using this approach are presented here.This work was supported by the Education Investment Fund under the Super Science Initiative of the Australian Government. S.R.H. wishes to thank AINSE Ltd. for providing financial assistance to enable this work on H-1NF to be conducted. J.H. and B.B. acknowledge support from the Australian Research Council Discovery, Grant Nos. DP110104833 and DP0666440, respectively

Self care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India

Background: Increasing prevalence of diabetes in India is resulting in an epidemiological transition. The care of the people with diabetes is traditionally seen as doctor centered, but the concept of self‑care of people with diabetes is a new domain and is proven beneficial. Aim: The aim was to determine the practice of self‑care activities among people with diabetes attending a tertiary care hospital in Mangalore. Subjects and Methods: A facility‑based cross‑sectional study was conducted in Government Wenlock Hospital, Mangalore during September–October 2012. A total of 290 patients with >1‑year duration of diabetes mellitus (DM) were asked to respond to summary diabetes self‑care activities questionnaire after obtaining the consent from them. The statistical analysis was performed in terms of descriptive statistics and association between the variables was tested using Mann–Whitney U‑test. Results: A healthy eating plan on a daily basis was followed by 45.9% (133/290) of the participants, daily exercises for 30 min were followed by 43.4% (126/290), and regular blood sugar monitoring was done by 76.6% (222/290). Regarding the adherence to oral hypoglycemic agents and insulin, daily adherence to medication was seen among 60.5% (155/256) and 66.9% (138/206) were found to be adherent to insulin injections on a daily basis. Conclusions: Self‑care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of complications and better quality‑of ‑life, more efforts should be put to educate the people with diabetes.Keywords: Cross‑sectional studies, Diabetes mellitus, India, Self‑car

Liquid-liquid dispersions from in-line rotor-stator mixers

Experiments were performed on an industrial scale Silverson in-line rotor-stator mixer to investigate its liquid-liquid dispersion capabilities. A non-coalescing kerosene-water system was used in the tests and the effect of stator geometry, rotor-speeds, flowrates and dispersed phase concentrations on the droplet size distribution was investigated. The rotor-speed and the dispersed phase concentration were found to have the most influence on droplet size. Drop sizes were also seen to increase with an increase in open area. No differences were observed in the droplet sizes or power draw of the stators with the smallest and similar open areas (Emulsor Screens and Square Hole High Shear screen). The power supplied to the fluid was proportional to N3 indicating the mixer was operating under turbulent conditions. d32 was correlated against the rotor speed and dispersed phase and the relationship was found to be close to that described by Chen and Middleman (1967). This analysis suggested that inertial stresses in the viscous sub-range were mainly responsible for drop break-up. d32 = 2x109 (1 + 20(D)(We Re4)-'" An estimation of the average energy dissipation rate was made in order to determine the Kolomogov length scale. The droplet sizes ranged from below the Kolmogorov length scale to significantly higher, suggesting that droplet break-up is due to inertial and viscous sub-range eddies. The Re could be defined in different regions within the mixer these values were used along with the nominal residence times in each region to determine where in the mixer the main drop break-up was occurring. The residence times for each region were in the following order: Shear Gap < Stator < Inlet < Rotor < Volute. The relatively long residence times and the magnitude of the stresses indicated that droplet break-up in a single pass through the in-line rotor-stator mixer is predominately determined by the viscous and inertial stresses in the rotor region.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Dual labeling of neural crest cells and blood vessels within chicken embryos using chickGFP neural tube grafting and carbocyanine dye DiI injection

All developing organs need to be connected to both the nervous system (for sensory and motor control) as well as the vascular system (for gas exchange, fluid and nutrient supply). Consequently both the nervous and vascular systems develop alongside each other and share striking similarities in their branching architecture. Here we report embryonic manipulations that allow us to study the simultaneous development of neural crest-derived nervous tissue (in this case the enteric nervous system), and the vascular system. This is achieved by generating chicken chimeras via transplantation of discrete segments of the neural tube, and associated neural crest, combined with vascular DiI injection in the same embryo. Our method uses transgenic chickGFP embryos for intraspecies grafting, making the transplant technique more powerful than the classical quail-chick interspecies grafting protocol used with great effect since the 1970s. ChickGFP-chick intraspecies grafting facilitates imaging of transplanted cells and their projections in intact tissues, and eliminates any potential bias in cell development linked to species differences. This method takes full advantage of the ease of access of the avian embryo (compared with other vertebrate embryos) to study the co-development of the enteric nervous system and the vascular system

Anorectal manometry in children with defecation disorders BSPGHAN Motility Working Group consensus statement

Defecatory disorders in children, including chronic constipation (CC) and fecal incontinence (FI), are common conditions worldwide and have a significant impact on children, their families, and the healthcare system. Anorectal manometry (ARM) and high‐resolution anorectal manometry (HRAM) are relatively novel tools for the assessment of anal sphincter function and rectal sensation and have contributed significantly to improving the understanding of the anorectum as a functional unit. ARM has been recognized as the investigation of choice for adults with symptoms of defecation disorders, including fecal incontinence (FI), evacuation difficulties, and constipation. Although it is the gold standard tool in adults, it has yet to be formally accepted as a standardized diagnostic tool in the pediatric age, with limited knowledge regarding indications, protocol, and normal values. ARM/HRAM is slowly becoming recognized among pediatricians, but given that there are currently no agreed guidelines there is a risk that will lead to diversity in practice. The British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN)—Motility Working Group (MWG) therefore has taken the opportunity to provide guidance on the use of ARM/HRAM in children with CC and/or FI