Journal of developmental and behavioral pediatrics : JDBP
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The primary aim of this systematic review was to examine the evidence for a pain-sleep relationship in children with persistent pain by reviewing studies using single and mixed pediatric persistent pain samples. ⋯ Findings from this review highlight the need to assess and treat sleep problems in children presenting with persistent pain. Health care providers should consider conducting routine sleep screenings, including a comprehensive description of sleep patterns and behaviors obtained through clinical interview, sleep diaries, and/or the use of standardized measures of sleep. Future research focusing on investigating the mechanisms associating sleep and pediatric persistent pain and on functional outcomes of poor sleep in pediatric pain populations is needed.
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J Dev Behav Pediatr · Jun 2009
ReviewPhysician behavior in the care of pediatric chronic illness: association with health outcomes and treatment adherence.
Physician behavior is an important but understudied influence on child and parental adherence to medical treatment. ⋯ Future research should be guided by a comprehensive model of physician behavior in chronic illness management that considers contextual determinants (e.g., culture and socioeconomic status), identifies clinically relevant targets for intervention, and documents the impact on health outcomes. Approaches to chronic illness management that involve physicians in active communication, support, and decision making with children with chronic illness and their parents should be developed and evaluated.
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J Dev Behav Pediatr · Feb 2008
ReviewPhysical punishment, culture, and rights: current issues for professionals.
Once considered a legitimate parenting tool, physical punishment is increasingly being redefined as a developmental risk factor by health professionals. Three forces that have contributed to this significant social change are the evolution of pediatric psychology, increasing understanding of the dynamics of parental violence, and growing recognition of children as rights bearers. However, despite the consistency of research findings demonstrating the risks of physical punishment, some practitioners still struggle with the question of whether physical punishment is an appropriate practice among some cultural or ethnic groups. ⋯ Despite practitioners' awareness of the prevalence and impact of parental violence, some still struggle with deciding where to "draw the line" in advising parents about spanking. This issue is addressed through an examination of the role that physical punishment plays in child maltreatment. Finally, the human rights perspective on physical punishment is offered as a new lens through which practitioners may view physical punishment to clarify the fuzzy issues of cultural relativity and the punishment-abuse dichotomy.
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J Dev Behav Pediatr · Feb 2006
ReviewLessons from fragile X regarding neurobiology, autism, and neurodegeneration.
The fragile X mental retardation 1 gene (FMR1) mutation causes two disorders: fragile X syndrome (FXS) in those with the full mutation and the fragile X-associated tremor/ataxia syndrome (FXTAS) in some older individuals with the premutation. FXS is caused by a deficiency of the FMR1 protein (FMRP) leading to dysregulation of many genes that create a phenotype with ADHD, anxiety, and autism. ⋯ This causes an RNA gain of function toxicity leading to brain atrophy, white matter disease, neuronal and astrocytic inclusion formation, and subsequent ataxia, intention tremor, peripheral neuropathy, and cognitive decline. The neurobiology and pathophysiology of FXS and FXTAS are described in detail.