Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders.

Affective dysregulation (AD) is characterized by irritability, severe temper outbursts, anger, and unpredictable mood swings, and is typically classified as a transdiagnostic entity. A reliable and valid measure is needed to adequately identify children at risk of AD. This study sought to validate a parent-rated screening questionnaire, which is part of the comprehensive Diagnostic Tool for Affective Dysregulation in Children (DADYS-Screen), by analyzing relationships with comprehensive measures of AD and related mental disorders in a community sample of children with and without AD. The sample comprised 1114 children aged 8-12 years and their parents. We used clinical, parent, and child ratings for our analyses. Across all raters, the DADYS-Screen showed large correlations with comprehensive measures of AD. As expected, correlations were stronger for measures of externalizing symptoms than for measures of internalizing symptoms. Moreover, we found negative associations with emotion regulation strategies and health-related quality of life. In receiver operating characteristic (ROC) analyses, the DADYS-Screen adequately identified children with AD and provided an optimal cut-off. We conclude that the DADYS-Screen appears to be a reliable and valid measure to identify school-aged children at risk of AD.

German translation of the PROMIS® pediatric anxiety, anger, depressive symptoms, fatigue, pain interference and peer relationships item banks.

BACKGROUND: The present study aimed at the translation and cross-cultural adaptation of six PROMIS® pediatric self- and proxy- item banks and short forms to universal German: anxiety (ANX), anger (ANG), depressive symptoms (DEP), Fatigue (FAT), pain interference (P) and peer relationships (PR). METHODS: Using standardized methodology approved by the PROMIS Statistical Center and in line with recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force, two translators for each German-speaking country (Germany, Austria, and Switzerland) commented on and rated the translation difficulty and provided forward translations, followed by a review and reconciliation phase. An independent translator performed back translations, which were reviewed and harmonized. The items were tested in cognitive interviews with 58 children and adolescents from Germany (16), Austria (22), and Switzerland (20) for the self-report and 42 parents and other caregivers (Germany (12), Austria (17), and Switzerland (13)) for the proxy-report. RESULTS: Translators rated the translation difficulty of most items (95%) as easy or feasible. Pretesting showed that items of the universal German version were understood as they were intended, as only 14 out of 82 items of the self-report and 15 out of 82 items of the proxy-report versions required minor rewording. However, on average German translators rated the items more difficult to translate (M = 1.5, SD = 0.20) than the Austrian (M = 1.3, SD = 0.16) and the Swiss translators (M = 1.2, SD = 0.14) on a three-point Likert scale. CONCLUSIONS: The translated German short forms are ready for use by researchers and clinicians ( https://www.healthmeasures.net/search-view-measures ).

A multitude of questionnaires exist, which are not comparable due to different questions or no available translations. PROMIS is an initiative, which was funded by the National Institute of Health in the US, to build better, i.e., more precise and efficient questionnaires, which can be used and compared worldwide. The PROMIS questionnaires include paper-and-pencil short forms and computerized adaptive tests. So far numerous PROMIS surveys have been created using advanced methodologies. They can be used by health care professionals to assess different aspects of health and compare the results internationally. To allow for international comparability of studies using those questionnaires, they need to be translated. This study reports the thorough translation process of the US-American PROMIS^® questionnaires measuring anxiety, anger, depressive symptoms, fatigue, pain interference, and peer relationships in children and adolescents into German. The translation included researchers, children, and parents from Germany, Austria, and Switzerland to ensure that the final German version is fully and equally well understood in all of those German-speaking countries. The article describes the translation process, so that the user can understand the translations and use them in an informed way. The translated German questionnaires are ready for use by researchers and clinicians. ( https://www.healthmeasures.net/search-view-measures ).

Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families.

Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-19 has led to interruptions in psychotherapy for children with mental health problems and to potentially reduced resources to implement treatment strategies in daily life in families or in out-of-home care, these children might show a particularly strong increase in stress levels. In this study, 512 families of children without AD and 269 families of children with AD reported on COVID-19-related stress. The sample comprised screened community, clinical, and out-of-home care samples. Sociodemographic factors, characteristics of child and caregiver before the pandemic, and perceived change in external conditions due to the pandemic were examined as potential risk or protective factors. Interestingly, only small differences emerged between families of children with and without AD or between subsamples: families of children with AD and families in out-of-home care were affected slightly more, but in few domains. Improvements and deteriorations in treatment-related effects balanced each other out. Overall, the most stable and strongest risk factor for COVID-19-related stress was perceived negative change in external conditions-particularly family conditions and leisure options. Additionally, caregiver characteristics emerged as risk factors across most models. Actions to support families during the pandemic should, therefore, facilitate external conditions and focus on caregiver characteristic to reduce familial COVID-19-related stress. Trial registration: German Clinical Trials Register (DRKS), ADOPT Online: DRKS00014963 registered 27 June 2018, ADOPT Treatment: DRKS00013317 registered 27 September 2018, ADOPT Institution: DRKS00014581 registered 04 July 2018.

Turkish pediatric residents' knowledge, perceptions, and practices of blood culture sampling.

INTRODUCTION: Pediatrics is one of the medical specialties in which blood cultures for bloodstream infections are performed very frequently. This study aimed to evaluate pediatric residents' knowledge and perceptions of blood culture sampling. MATERIAL AND METHODS: Between June 2019 and September 2019, a questionnaire comprising 20 questions about blood culture sampling was sent via email to participants who were pediatric residents at five different hospitals in Turkey. There were 11 true/false and nine multiple-choice questions that assessed three aspects of culture sampling: indications, sampling practice and knowledge, and contamination. The percentage of correct answers was used to calculate an overall score and subsection scores. RESULTS: A total of 132 pediatric residents [102 (77%) female] with a mean age of 28.3±2.8 years completed the questionnaire. Forty-five (35%) were in their 1st year of residency. Sixty (46%) participants reported that they had not performed blood culture sampling in the last week. There was a negative relationship between years in training and the number of cultures performed (Kendal's tau-b=-0.297, p<0.001). The overall median score was 65 (range, 35-90) and it seemed to increase with years of training. The lowest median score was in the contamination subscale and only one (0.76%) participant correctly answered all questions concerning contamination. CONCLUSION: Residents who obtained the majority of blood cultures had the lowest knowledge levels. Therefore, it is evident that the knowledge levels of pediatric residents must be increased in order to improve blood culture sampling practices in centers where they perform blood culture sampling.

[Heterogeneity of Schistosoma haematobium transmission in irrigated fields]. / Hétérogénéité de la transmission de Schistosoma haematobium dans les périmètres irrigués du Niger.

Heterogeneity of Schistosoma haematobium transmission in irrigated fields. Although irrigated areas exist since a long time in the Niger Valley the distribution of the urinary schistosomiasis does not appear homogeneous, testifying to the existence of limiting or favourable factors. The identification of these factors could lead to a better definition of the distribution of the schistosomiasis risks and to optimise control programmes. The population of five villages about 1,900 inhabitants living in the same irrigated area (Sébéri) was examined at the end of 1999 before treatment and surveyed two and ten months after treatment by praziquantel in order to investigate re-infections. In parallel, the transmission sites were subject to a semi-monthly malacological follow-up from 1998 to 2001 and the water contacts were quantified in the sites of the main village during 2000. Before treatment, schistosomiasis risks appeared related to the proximity between habitat and lateral canals: the infections concerning youngers were all the more intense that the dwellings were close to the canal. The parasitological indices were the highest in the village lacking of other water sources. The morbidity indices followed a similar distribution with maximum values in the children of the 3 villages located to less than 1 km from the canal; however, morbidity was mainly observed in the adult population, in particular male, of the 2 villages which were the most distant from the canal. After treatment, the incidence of the re-infection between 2 and 10 months was comparable in the 3 villages close to the canal (28%) but was significantly weaker in the 2 villages far from the transmission sites (5%). In the villages bordering the canal, the incidence in the children was all the more high since the habitat was close to the canal. Between 1999 and 2000, the collected number of Bulinus truncatus decreased from 1.4 to 0.6 individuals per survey; moreover, no mollusc harbouring parasites was found, representing the decrease of the parasite burden. The abnormal weakness of re-infection, regarding this type of focus, could be explained by the repeated stop of water supply inducing a complete drying out of the canal for 2 months during the year preceding the study. These repeated drying out also resulted in a reduction of the exposure. Whereas the average frequentation of the sites of the canal remained rather comparable between January (cold dry season) and May (dry hot season), it decreased dramatically in September (rainy season but canals were not irrigated this year) from 99 to 11 daily contacts. The use of the lateral canal when filled represented 80% of the contacts. In the event of drying out, 80% of the contacts were transferred in the ponds but not in the river (5% of the contacts whatever the season). These results confirmed (1) that the presence of canals reduced the use of natural sites and (2) that the drying out of the canals induced a total reduction of the contacts.

Lincoff temporary balloon buckle in retinal detachment surgery.

PURPOSE: To assess the long-term anatomical and functional results of balloon buckle surgery for rhegmatogenous retinal detachment. PATIENTS AND METHODS: Twenty-five selected detachments with a single break or a group of breaks close together were treated with a temporary parabulbar balloon. Adhesion was obtained with transconjunctival cryopexy and argon laser photocoagulation. Retinal detachment was associated with the following risk factors: myopia (15 eyes), aphakia (2 eyes), blunt trauma (1 eye). Twenty-three eyes had a detached macula. The balloon was withdrawn after one week. The patients were kept under observation for at least six months (mean 44.7 months). RESULTS: Initial retinal attachment was achieved in 29 eyes. After the balloon was removed redetachment occurred in two eyes; thus, complete attachment was attained in 27 eyes. Causes of failure were: undetected break (2 eyes), inadequate buckle (4 eyes), proliferative vitreoretinopathy (2 eyes). Conventional scleral buckling and subretinal fluid drainage was done in all failed cases. Vitrectomy and silicone oil were employed in one patient, and finally retinal attachment was achieved in all patients. CONCLUSIONS: Temporary balloon buckling is a simple and curative technique for a selected group of patients with retinal detachments.

Recent urban growth and urinary schistosomiasis in Niamey, Niger.

A cluster sample survey was conducted in 1998 in 30 schools to assess the effect of the growth of Niamey during the last decade on a urinary schistosomiasis urban focus described in 1989. Two thousand and forty-two children (11.0 + 0.1 years old) had a urine filtration test and answered a behavioural questionnaire. Snail populations of the sites used by schoolchildren were followed up in 1999. The global prevalence was 15.7% in 1998, as opposed to 23.7% in 1989. The prevalence was very low in schools far from the river and higher in those along the Niger banks, particularly in villages on the periphery of the urban area. Geographical factors were more important than socio-economic ones in explaining the distribution of the disease. Only 46% of the children in Niamey reported water contact; mainly in the river, rarely in pools and the canal. The infection risk was low in pools (RR = 1.6), high in the river (RR = 3.5) and very high in the canal (RR = 12.5). Malacological studies confirmed the location of transmission sites obtained through parasitological studies and the questionnaire. Sixty-one per cent of the children travelled outside Niamey to the hyperendemic surrounding areas. However, these movements did not increase their infection level. The results are discussed in relation to water contact behaviour and Schistosoma haematobium transmission features.

[A computerized follow up system of obstetric and genetic care]. / A szülészeti és genetikai ellátás nyomon követése számítógépes rendszer segítségével.

The authors have implemented and introduced a new filing system representing the complexity of obstetric, genetic and neonatal care for the three counties of the Eastern part of Hungary. Data about the pre-, peri- and postnatal management are supplied by the genetic/teratologic, obstetric, neonatal and pathological units and processed at the Department of Obstetrics and Gynaecology, University Medical School of Debrecen with an IBM compatible AT computer. This computerised registry is based on the personal identification number, so it is easy to handle for storing data about the course and outcome of a large number of pregnancies as well as the detection and follow-up of fetal malformations and genetic diseases. The computer register is suitable for easy and systematic storage of the more than 20 thousand pregnancies screened by both maternal serum AFP and ultrasound including nearly 500 prenatal diagnosis cases per year. When devising the system, the classic parameters of the "revised Tauffer statistics" have been taken into consideration, but the emphasis has been put mostly on the assessment of fetal/infantile health status and the prevention of malformations and genetic diseases. This computerised system greatly facilitates the correct assessment of statistical parameters in related medical fields and provides better possibilities for studying the cause and effect relationship between the efficacy of medical care and perinatal events.(ABSTRACT TRUNCATED AT 250 WORDS)