Avoidant/Restrictive Food Intake Disorder. A longitudinal study of malnutrition and psychopathological risk factors from 2 to 11 years of age

Aim: To evaluate different types and degrees of malnutrition over time in a sample of children diagnosed with Infantile Anorexia (IA), based on the DC:0-3R criteria, and recently defined by DSM-5 as the first subtype of Avoidant/Restrictive Food Intake Disorder (ARFID), and to investigate the relationship between children’s severity of malnutrition and emotional/behavioral development, and mothers’ long-term psychopathological symptoms. Methods: A total of 113 children (58 boys, 55 girls), originally diagnosed with IA, and their mothers, were evaluated at four assessment points at the children’s mean age of 2, 5, 7, and 11 years. Several measures were used to assess the children’s growth and level of malnutrition, mothers’ psychopathological symptoms and eating attitudes, as well as their children’s emotional/behavioral functioning. Results: A steady improvement in the severity of malnutrition over time emerged, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. Moreover, the children showed increasing internalizing and externalizing emotional/behavioral problems, and their mothers’ psychopathological symptoms and eating problems worsened as well over time. At 11 years of age, the girls’ emotional/behavioral problems and their mothers’ psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. Finally, during the last assessment, significant associations between the mothers’ psychopathology and disturbed eating attitudes, the severity of the children’s malnutrition, and their emotional/behavioral problems emerged. Discussion: Our longitudinal study points out that the developmental course of children, originally diagnosed with IA and who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological symptoms in both, the children and their mothers, up to the sensitive period of pre-pubert

Creating Political Leaders: Lawyer Stories About Transitioning into Political Office in Canada

Problem. Sustaining healthy democracies requires citizens to successfully transition from civilian life into political leadership positions. Despite the need for this transition to take place, little is known about the transition. Globally, lawyers are the most represented professional group inpolitics, therefore, a study of their transition acts as a good starting point in understanding the process. This study used the Nicholson Transition Cycle (NTC) to explore the transition of 65 lawyers into Canadian politics. Method. An exploratory multiple case study approach was used to gather data from face-to-face interviews, phone interviews, public archives, email, and websites. Interviews were transcribed, coded, and categorized to fit under the NTC\u27s four phases of transition: preparation, encounter, adjustment, and stabilization. Qualitative Data Analysis software assisted with the organization of the data. Confidentiality and anonymity were maintained by concealing the identity of participants by changing some geographic locations, omitting obvious identifiers, and occasionally changing gender. Results. Statements about motivation, early exposure or experience with politics, as well as early steps into political activity were classified under the preparation phase. Many participants reported having family members who worked in politics, and that experience prepared them for politics. Reported motivations for entering politics included career advancement, using politics as a stepping stone, and fulfilling a childhood dream. Participants who were unhappy with the status quo regarded politics as an ideal forum for creating change and improving social conditions. Participants reported that the knowledge and skills obtained in law helped them transition intopolitics. Early exposure to politics and politicians provided advanced insight about the work of politicians. Many participants were encouraged by others to run for political office because of their legal skills and social networking. Statements about getting through the initial days, weeks, and months of political office were grouped under the encounter phase. Stories about how participants coped with new and unfamiliar experiences in politics were included here. Some participants reported they coped with the transitory nature of employment in politics by maintaining a part-time law practice they could go back to if they lost an election. Developing mentors and relying on peers was regarded as crucial in understanding their new environment, processes, and procedures; in handling the media, and in communicating with the public. Participants provided numerous examples of how their litigation skills became useful such as when they engaged in heated debate and inwithstanding personal attacks during a Question Period. Female politicians indicated that they experienced special challenges due to gender discrimination. The experience of helping constituents, meeting fascinating people, and enjoying the privileges of public office were cited by participants as joyful new experiences during the encounter phase. Personal changes, role development, and relationship building were major areas participants reported working through and were labeled under the adjustment phase. Adjusting to the loss of income and personal privacy, and having to maintain a hectic schedule were part of this transition. Some reported a disruption of the family unit related to prolonged absence from the home. Divorces were reported and some noted that children experienced difficulties in home and school. Participants found that consensus, collaboration, and building bridges were vital in getting things done. Due to the volume of issues requiring attention, delegating to competent staff was imperative for survival. For Anglophone participants, learning French was regarded as a valuable skill in running an efficient constituency office, if they were not already bilingual. When respondents reported aspects of settling into political life, these were classified under the stabilization phase. Central in this process were reports of beginning to see social problems from broader societal perspectives and not just from legal or policy views. They reported learning how to work with others to identify the core cause of social problems. Some reported harnessing their knowledge of the political process and combining it with the law to advance democratic principles of freedom, equality, justice, and diversity. Some communicated with constituents by using social media and the internet as well as traditional forms of communication. Being re-elected on multiple occasions was seen by some as an indication that their work was being helpful to others. Others viewed being given a government portfolio as a sign of political competence. Conclusions and Recommendations. Overall, participants reported that the promise to make a positive change in society was a strong motivation to prepare for and transition into politics. Psychological preparation contained elements of political socialization, previous career skills, prior learning, and consistent exposure to politics and politicians. Participants reported confronting the newness of the job by developing coping mechanisms, learning the new rules of the game, and experiencing the joy of political life. Adjusting to the new requirements of the job meant changing personal habits, reaching out to build bridges, broadening their thinking, and leveraging administrative skills. Learning French presented distinct advantages. As participants matured into their political leadership roles, they transitioned from highly specialized knowledge in the law to civic leaders with social insights. This study shows the challenges of transitioning from civilian to political office in the lives of 65 lawyers. While these findings can\u27t be generalized to all professions, they raise conclusions that call for more research and for action to create resources that help individuals willing to make the sacrifices to become political leaders. Concern to understand more about the transition process and develop ways of evaluating and mentoring civilians in this transition promises to make a major contribution to the long-term viability of democratic states

Webinar: Exploring a (new) Praxis for Internationalization: Equity, Diversity, Inclusion and Decolonization (EDID)

This webinar aims to shed light on the role international education has (and could) play in driving local and global action to address injustices through developing citizens with a critical ‘global’ perspective, intercultural competencies, and a strong sense of social ‘global’ responsibility. Speakers: Merli Tamtik, Associate Professor, Faculty of Education – University of Manitoba Kumari Beck, Associate Professor, Faculty of Education – Simon Fraser University Ken Chatoor, Senior Researcher - Higher Education Quality Council of Ontario (HEQCO) Thevi Pather, Associate Vice President International - Saskatchewan Polytechnic Moderated by: Jane Ngobia, Vice President of Inclusive Communities - Sheridanhttps://source.sheridancollege.ca/cgei_events/1002/thumbnail.jp

Failure to thrive in toddlers with lack of interest in eating and food and their cognitive development during later childhood

Background: Experiencing Failure to Thrive or malnutrition in early years has been associated with children later displaying low Intelligence Quotient (IQ). The current study's aim was to examine whether Failure to Thrive in Toddlers with Lack of Interest in Eating and Food, a subtype of Avoidant/Restrictive Food Intake Disorder as defined by DSM-5, which has also previously been identified as Infantile Anorexia (IA), was associated with poor cognitive development outcomes during later childhood. Methods: The IQs and growth parameter of 30 children (53% female) previously diagnosed and treated for IA at 12 to 42 months of age, were reevaluated at a mean age of 10.0 years (SD = 2.1 years) and compared to 30 matched control children. Children's growth was assessed using Z-scores and their cognitive development was measured using the Wechsler Intelligence Scale for Children-4th Edition. Results: None of the growth parameters were significantly related to IQ. Further, IQ scores of children previously diagnosed with IA and control children were not significantly different. However, the education level of children's fathers had a significantly positive effect on IQ. Conclusions: Our study highlights the disjunction between growth parameters and IQ within our sample. Overall, our findings suggest that the primary target of intervention for these children should be the parent-child conflict around the feeding relationship, rather than a focus on the child's weight itself. Finally, our results confirm the relevance to include fathers in the intervention of these children

Magnetic resonance imaging assessed enteric motility and luminal content analysis in patients with severe bloating and visible distension

Background: Gastrointestinal symptoms in functional gut disorders occur without any discernible structural gut abnormality. Preliminary observations on enteric MRI suggest possible abnormal content and motility of the terminal ileum (TI) in constipation-predominant IBS (IBS-C) with severe bloating, and in functional bloating and distension (FABD) patients. We investigated whether MRI can quantify differences in small bowel (SB) content and motility between patients and healthy controls (HCs). Methods: 11 IBS-C (mean age 40 [21–52] years; 10 women) and 7 FABD (36 [21–56]; all women) patients with bloating and 20 HCs (28 [22–48]; 6 women) underwent enteric MRI, including dynamic motility and anatomical sequences. Three texture analysis (TA) parameters assessed the homogeneity of the luminal content, with ratios calculated between the TI and (1) the SB and (2) the ascending colon. Four TI motility metrics were derived. Ascending colon diameter (ACD) was measured. A comparison between HCs and patients was performed independently for: (1) three TA parameters, (2) four TI motility metrics, and (3) ACD. Key Results: Compared with HCs, patients had TI:colon ratios higher for TA contrast (p < 0.001), decreased TI motility (lower mean motility [p = 0.04], spatial motility variation [p = 0.03], and area of motile TI [p = 0.03]), and increased ACD (p = 0.001). Conclusions and Inferences: IBS-C and FABD patients show reduced TI motility and differences in luminal content compared with HCs. This potentially indicates reflux of colonic contents or delayed clearance of the TI, which alongside increased ACD may contribute to symptoms of constipation and bloating

Relationships between temperament and eating behaviours in young children

This study examined the associations between eating behaviours and temperament in a sample of young children. Mothers (N=241) of children aged 3-8 years completed measures of their children's eating behaviours and temperament and reported their child's height and weight. Children with more emotional temperaments were reported to display more food avoidant eating behaviours. Shyness, sociability and activity were not related to children's eating behaviours. Higher child BMI was related to more food approach eating behaviours but BMI was unrelated to child temperament. Future research should explore more specifically how emotional temperaments might influence child eating behaviour

Development and Evaluation of SENSE-ational Mealtimes: a Book for Families with Mealtime Difficulties

Many families with young children experience mealtime difficulties whereby the child eats a limited range of foods and/or refuses new food. Clinical interventions typically include behaviour training, enhancement of parenting skills and nutrition education. Clinical experience and a review of the literature across several domains suggested that interventions that optimise reflective functioning and understandings about sensory preferences at mealtimes are needed for both mild and complex mealtime difficulties. This study describes the development of the SENSE-ational Mealtimes book for families with mealtime difficulties and reports the findings of the initial evaluation. A questionnaire was used to assess the change in the frequency of difficult mealtimes, level of concern, understandings, feelings and goals of mothers 2 months after the book was distributed in a community setting. Mothers also provided feedback regarding helpfulness of the book, needs of families and recommendations. There was a statistically significant improvement in all aspects, namely frequency of mealtime difficulties, level of concern, understandings, feelings and goals. The subjective data indicated that the concepts instrumental in enhancing most mothers' understandings were how sensory preferences and past experiences of all members of the family had an impact on mealtime interactions. Initial evaluation suggests that wide-spread access to the SENSE-ational Mealtimes book could be an inexpensive approach to reduce the costs of adverse effects of mealtime difficulties on the emotional well-being of families and dietary intake of children. Mothers unanimously recommended the SENSE-ational Mealtimes book for both targeted prevention of and early intervention with mealtime difficulties in families

Crying and feeding problems in infancy and cognitive outcome in preschool children born at risk : a prospective population study

Objective: To investigate whether regulatory problems, i.e., crying and feeding problems in infants > 3 months of age, predict cognitive outcome in preschool children born at risk even when controlled for confounding factors. Methods: A prospective longitudinal study of children born in a geographically defined area in Germany. N = 4427 children of 6705 eligible survivors (66%) participated at all four assessment points (neonatal, 5, 20, and 56 months of age). Excessive crying and feeding problems were measured at 5 months. Mental development was assessed with the Griffiths Scale at 20 months, and cognitive assessments were conducted at 56 months. Neonatal complications, neurological, and psychosocial factors were controlled as confounders in structural equation modeling and analyses of variance. Results: One in five infants suffered from single crying or feeding problems, and 2% had multiple regulatory problems, i.e., combined crying and feeding problems at 5 months. In girls, regulatory problems were directly predictive of lower cognition at 56 months, even when controlled for confounders, whereas in boys, the influence on cognition at 56 months was mediated by low mental development at 20 months. Both in boys and girls, shortened gestational age, neonatal neurological complications, and poor parent-infant relationship were predictive of regulatory problems at 5 months and lower cognition at 56 months. Conclusion: Regulatory problems in infancy have a small but significant adverse effect on cognitive development

Prostate cancer, treatment modalities and complications: an evaluation of the scientific literature

Prostate (PR) cancer (CA) is one of the most common malignant neoplasms in men all over the world. In general, if prostate cancer (PC) is detected early, treatment usually involves either surgical removal of the prostate or radiotherapy (RT). Hormone Therapy (HT) or chemotherapy (CH) is the preferred treatment for more advanced cases of PC or if CA spreads beyond the PT. A number of complications, such as urinary incontinence (IU) or erectile dysfunction (ED), can be associated with some modalities of treatment of the PC. The aim of this work is to evaluate, in PubMed, the number of publications related with prostate cancer and the main modalities of treatment, as well as some clinical complications. The searches were performed in PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) in the period 1950 to 2008 using the words: (i) CA, (ii) CA and PR or penis or testis, (iii) CA and PR and RT, CA and PR and surgery (SU), CA and PR and CH and, CA and PR and HT and (iv) CA and PR and RT and IU or ED, CA and PR and SU and IU or ED, CA and PR and CH and IU or ED and, CA and PR and HT and CH and IU or ED, and (V) PC and the same modalities of treatment. The data was obtained on July 20th, 2008. PC, as expected has been cited extensively and surgery has been identified as the most widely referenced modality of treatment. Furthermore, urinary incontinence and erectile dysfunction are important complications that have attracted significant scientific interest. In conclusion, these findings have shown the relevance of the PubMed to analyze quantitatively the publications in cancer and this information could be worthwhile in aiding the comprehension of some clinical aspects related with PC, as well as the development of preventative actions. The analysis of the scientific interest, considering the number of publications in the PubMed, reveals research trends in the field and demonstrates the importance of the surgical procedures in the treatment of the prostate cancer. Moreover, this finding is relevant due to the fact that surgery is the treatment of choice when early detection of PC is achieved. However, it is important to consider clinical complications related to such procedures, such as urinary incontinence and erectile dysfunctions that can reduce the quality of life of the patient