Serotonin and emotion regulation: the impact of tryptophan depletion on emotional experience, neural and autonomic activity.

The involvement of serotonin in emotion and psychopathology has been extensively examined. Studies using acute tryptophan depletion (ATD) have found limited effects on mood and aggression, and one of the explanations suggests that serotonin may be involved in higher-order functions, such as emotion regulation. However, there is very limited evidence for this hypothesis. The present study investigated the impact of ATD on emotion regulation in a double-blind, placebo-controlled, crossover design. A sample of psychiatrically healthy men (N = 28) completed a cognitive task assessing reappraisal ability (i.e., the success of using reappraisal, an emotion regulation strategy, to modulate emotional responses), following ATD and placebo. EEG frontal activity and asymmetry, as well as heart-rate variability (HRV), also were assessed in the reappraisal task. Both frequentist and Bayesian methods were employed for statistical analysis. Results indicated that ATD reduced plasma tryptophan, and reappraisal was effective in modulating emotional experience in the emotion regulation task. However, ATD had no significant effect on reappraisal ability, frontal activity, and HRV. These results offer direct and compelling evidence that decreasing serotonin synthesis through ATD does not alter an emotion regulation ability that is considered crucial in mood and aggression and has been linked with transdiagnostic risk of psychopathology.

Childhood maltreatment and emotion regulation in everyday life: an experience sampling study.

Childhood maltreatment is a major risk factor for psychopathology, and increasing evidence suggests that emotion regulation is one of the underlying mechanisms. However, most of this evidence comes from single assessments of habitual emotion regulation, which may not overlap with spontaneous emotion regulation in daily life and which fail to account for within-individual variability in emotion regulation across multiple contexts. In the present study, we investigated the relation between history of childhood maltreatment, positive and negative affect, and multiple dimensions of spontaneous emotion regulation (strategy use, emotion regulation goals, emotion regulation success and effort) in everyday life, using experience sampling method (3 assessments/day, for 10 consecutive days), in a sample of healthy volunteers (N = 118). Multilevel modeling results indicated that childhood maltreatment was associated with lower positive affect and higher negative affect. Childhood maltreatment was also related to lower use of reappraisal and savoring (but not suppression, rumination and distraction), reduced emotion regulation success (but not effort), as well as lower levels of and higher within-individual variability of hedonic (but not instrumental) emotion regulation goals. These results provide ecological evidence for multiple differences in emotion regulation in individuals with a history of childhood maltreatment.

Safety of Vaccination within First Year of Life-The Experience of One General Medicine Center.

Vaccines represent an important preventive strategy in paediatric populations, but the rate of vaccination has been constantly declining in the last decade. Concerns about vaccines' safety represent one of the main causes of vaccine hesitancy among parents. The aim of this study was the analysis of the immediate adverse reactions induced by vaccines included in the national program of immunization for the first year of life. Method: Eighty-one children born between 1st of January 2018 and 31st of March 2019 were included. The vaccination refusal rate, and incidence and severity of adverse effects induced by three mandatory vaccines (Hexavalent, Prevenar 13 and MMR) were analyzed. The level of parents' education and the sources of information that were consulted in order to understand the adverse effects were also analyzed. Results and conclusions: The rate of adverse events was lower than 30% of the total number of doses, and most of them were mild. The incidence and severity of vaccine-induced adverse effects were correlated with prematurity. The vaccine hesitancy rate was lower than the national one, possibly due to a high level of education and good information provided by doctors that might have led to parents' concerns regarding vaccination being answered.

Overview of the pediatric healthcare system in Romania.

Until 1989, Romania was one of the countries of the communist bloc in Europe and its healthcare system was characterized by centralized planning and severe underfunding, with low performance and low quality healthcare. Since 1998, Romania replaced the Semashko model with a social health insurance system, highly centralized under the management of the Ministry of Health as the central administrative authority. After joining the European Union, quality of life increased in our country and there were efforts to improve the quality of healthcare, including pediatric and neonatal care. Still, Romania has the lowest share of health expenditure of gross domestic product among the European Union Member States and the lowest level of expenditure per inhabitant. The Romanian health system is organized on three levels of assistance: primary, secondary and tertiary assistance. This overview presents the organization and the characteristics of pediatric and neonatal healthcare in Romania at all levels, the infrastructure and the human resources, the educational system from medical school to pediatric residency, professional organizations, national health programs, and the child health status in Romania. Infant mortality, the most descriptive single indicator of the quality of a health system, decreased constantly for the last 30 years in Romania, but is still the highest in the European Union. Even though there were great improvements in the healthcare for children, more efforts should be made to assure a better quality of care for the future of our nation, both on the human resources (in great danger due to the brain-drain of medical professionals during the last 12 years), and on the infrastructure plan.

[Quality of life in children with bronchial asthma and allergic rhinitis]. / Calitatea vietii la copilul cu astm bronsic si rinita alergica.

The quality of life is a subjective parameter that evaluates the impact of asthma on daily life of the child. The authors evaluated the evolution of the quality of life score in children with persistent asthma and analyzed the impact of association of allergic rhinitis on this parameter. The evaluation of the quality of life was based on a questionnaire with 23 items (PAQLQ), which was applied on 54 children with asthma (35 of them having rhinitis allergic associated to asthma). The quality of life score was evaluated initial and every 3 months, during one year. At the end of the study the authors revealed the improvement of the quality of life score in 87% of children, with significant improvement of the scores for symptoms, activities and emotions (p=0.002). There were no significant differences between the 19 patients with only asthma as compared with the 35 patients that had both asthma and allergic rhinitis either at the beginning of the study (p = 0,19) or after 12 months of follow-up (p = 0,34). In conclusion, allergic rhinitis is frequently associated with asthma in children, but its impact on the quality of life is not significant.

[Evaluation of quality of life in children with bronchial asthma]. / Evaluarea calitatii vietii la copilul cu astm bronsic.

Asthma affects children physically, psychologically and socially. The quality of life is a subjective parameter that evaluates the impact of asthma on daily life of the child. The authors evaluated the evolution of the quality of life score in children with persistent asthma treated with controllers, during one year, and the correlation between the quality of life score and pulmonary function parameters. The evaluation of the quality of life was based on a questionnaire with 23 items (PA QLQ), which was applied on 64 children with asthma. The quality of life score was evaluated initially and every 3 months. Pulmonary function tests were measured by spirometry every 3 months and children recorded PEF twice daily At the end of the study the authors revealed the improvement of the quality of life score in 87% of children. Initially the value of the general score of quality of life was of 4.78 +/- 1.09 and it increased up to 6.53 +/- 0.56 (p = 0.0001) after 12 months. We noticed significant improvement of the scores for symptoms, activities and emotions, and also of circadian variation of PEF (p = 0.002). We revealed a relatively poor reverse correlation between general score of the quality of life and circadian variation of PEF (r = - 0.330). In conclusion, the evaluation of quality of life might appreciate the clinical course of asthma patients. Based on this results the authors suggest the use of the evaluation of the quality of life as a complementary method to the classical methods used for asthma monitoring in children.