Child and adolescent psychiatric clinics of North America
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Child Adolesc Psychiatr Clin N Am · Oct 2009
ReviewEmerging medicolegal issues in the practice of pediatric sleep medicine.
With the rapid growth in the field of pediatric sleep medicine, health care providers need to be aware of several emerging legal issues that have the potential of impacting their clinical practice. This article provides an overview of emerging legal areas that might impact the practice of pediatric sleep medicine, and discusses civil liability emerging from medical malpractice, issues that health care providers must be aware of including issues related to providing care for minors, and newer areas that relate to legal prosecution for health care fraud as it may relate to violations of quality of care.
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Childhood and adolescent obesity has been increasing in most middle- and high-income countries, and, as with adult obesity, this has been driven by increasingly obesogenic environments, especially the food environment. This constitutes a "market failure," signaling the need for government interventions with policies, programs, and social marketing. Population prevention strategies are critical, and children and adolescents should be the priority populations. ⋯ Community-based intervention programs show some real promise in reducing childhood obesity, but the 2 big challenges ahead are to ensure that there is substantial ongoing funding so that the community capacity to promote healthy weights can be scaled up to a national level and to ensure that policies are in place to support these efforts. The social and cultural shifts that support healthy eating and physical activity occur differentially, and special efforts are needed to reduce the socioeconomic gradients associated with childhood obesity. A positive public health approach encompassing environmental, regulatory, sociocultural, and educational strategies offer the best chance of reducing obesity without increasing disordered eating patterns.
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Child Adolesc Psychiatr Clin N Am · Jan 2009
ReviewEnvironmental and genetic risk factors in obesity.
Because of its high prevalence and the associated medical and psychosocial risks, research into the causes of childhood obesity has experienced a tremendous upswing. Formal genetic data based on twin, adoption, and family studies lead to the conclusion that at least 50% of the interindividual variance of the body mass index (BMI; defined as weight in kilograms divided by height in meters squared) is due to genetic factors. As a result of the recent advent of genome-wide association studies, the first polygenes involved in body weight regulation have been detected. ⋯ In addition, the validation of the true causality of such factors is not a straightforward task. Important factors are socioeconomic status and television consumption. The authors conclude by briefly assessing implications for treatment and prevention of childhood obesity.
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Child Adolesc Psychiatr Clin N Am · Apr 2008
ReviewIs there a need to reformulate attention deficit hyperactivity disorder criteria in future nosologic classifications?
The development of classification systems in psychiatry has been a complex task. In clinical settings, these classification systems help communication about disorders among professionals and between them and their patients. ⋯ There is a recent interest in research opportunities for improving the nosology of attention deficit hyperactivity disorder (ADHD) in future classification systems like the DSM-V and the ICD-11. This article addresses the potential need to reformulate ADHD criteria in future nosologic classifications.