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Although several studies have illustrated the effectiveness of cognitive behavior therapy (CBT) on adult pain patients, there are few randomized controlled trials on children and adolescents. There is particularly a need for studies on pediatric patients who are severely disabled by longstanding pain syndromes. Acceptance and Commitment Therapy, as an extension of traditional CBT, focuses on improving functioning and quality of life by increasing the patient's ability to act effectively in concordance with personal values also in the presence of pain and distress. Following a pilot study, we sought to evaluate the effectiveness of an ACT-oriented intervention based on exposure and acceptance strategies and to compare this with a multidisciplinary treatment approach including amitriptyline (n=32). The ACT condition underwent a relatively brief treatment protocol of approximately 10 weekly sessions. Assessments were made before and immediately after treatment, as well as at 3.5 and 6.5 months follow-up. Prolonged treatment in the MDT group complicated comparisons between groups at follow-up assessments. Results showed substantial and sustained improvements for the ACT group. When follow-up assessments were included, ACT performed significantly better than MDT on perceived functional ability in relation to pain, pain intensity and to pain-related discomfort (intent-to-treat analyses). At post-treatment, significant differences in favor of the ACT condition were also seen in fear of re/injury or kinesiophobia, pain interference and in quality of life. Thus, results from the present study support previous findings and suggest the effectiveness of this ACT-oriented intervention for pediatric longstanding pain syndromes. [ABSTRACT FROM AUTHOR]

Abstract: The modified Iosipescu test uses a variable notch opening angle θ, depending on the material anisotropy and orientation, to accomplish even stress- and strain-fields in the test region. Constitutive shear properties can thus be measured more accurately, more completely, and with fewer sources of error. Here more materials and properties were studied, and a 3D optical strain- and displacement-monitoring system was used to evaluate and improve both the modified test and the novel fixture used here. It performed substantially better than the commonly used Wyoming fixture in terms of producing constant through specimen thickness conditions and preventing undesired specimen twisting. Additionally, loading–unloading behavior of two high-performance, essentially unidirectional, fiber composites was investigated to assess stiffness reduction, damage, localization, and irreversible strains. In the present of such, well controlled testing conditions are even more important. [Copyright &y& Elsevier]

Aim: To evaluate cognitive and neuropsychological abilities of adopted delinquent adolescents in institutional care. Methods: Transnationally adopted adolescents admitted to institutional care ( n = 20) and non-delinquent controls who were also transnationally adopted ( n = 21) were compared concerning the Wechsler Intelligence Scale for Children and Adults (WISC and WAIS), the Wisconsin Card Sorting Test (WCST) and the Tower of London test (TOL). The adoptive parents answered questions about the adoption, early childhood and family circumstances by a questionnaire sent by mail. Results: The adopted delinquents had a significantly lower IQ and significantly lower results on several other measurements in the WISC/WAIS compared to the controls even after adjustment for age of arrival in the adoptive home. Both groups of adoptees scored low in the WISC/WAIS subscale of arithmetics when compared to the population mean. The TOL test showed that the delinquents were slower and made more errors than the controls. Conclusion: The delinquent adoptees scored significantly lower on many variables in the WISC/WAIS. Both delinquent and non-delinquent adoptees had some difficulties with arithmetic. The weak performances in arithmetics might point to some weaknesses in the neuropsychological domain. These results probably have complex explanatory causes and need to be further evaluated. [ABSTRACT FROM AUTHOR]

Weaning of piglets complicated with an exposure to pathogenic strains of Escherichia coli was scrutinized in two sets. The first set comprised 20 animals representing two litters and the second set included 30 animals from five litters. The piglets were either left as controls or exposed to one or three pathogenic strains of E. coli. Aiming to simulate a natural exposure the challenge strains were spread on the floor of the pens at weaning. In addition the pigs experienced several non-infectious stress factors commonly occurring at that occasion. Some groups were given adrenocorticotropic hormone (ACTH), aiming to simulate a stressful weaning. The balance and the composition of the faecal coliform populations, measured by a metabolic fingerprinting method, was disturbed among all animals following weaning. This disturbance was more pronounced and lasted longer among piglets exposed to pathogenic strains of E. coli. All piglets exposed to pathogenic E. coli shed these strains in faeces. Diarrhoea was induced in the groups exposed to E. coli, but not among the control animals. Pigs not treated with ACTH and subjected to a single pathogenic strain of E. coli became infected but did not develop diarrhoea unless if coinciding with shed of rotavirus. Control pigs excreting rotavirus had no diarrhoea. Diarrhoea was most frequent in the groups exposed to three pathogenic strains of E. coli, and in these groups diarrhoea was seen in the absence of rotavirus. ACTH administration amplified the clinical signs. The litter of origin influenced the development of post-weaning diarrhoea. [ABSTRACT FROM AUTHOR]

The factor structure of the Autism Behavior Checklist (ABC) (Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening instrument for autism, was examined on a sample of 383 individuals with autism spectrum disorders (i.e., autistic disorder, Asperger syndrome, and other autism-like conditions) aged 5-22 years. A five-factor model accounted for 80% of the total variance in the checklist. Thirty-nine of the 57 items had factor loadings of 0.4 or more, with 13 items loading on Factor 1, 11 items on Factor 2, 6 items on Factor 3, 5 items on Factor 4, and 4 items on Factor 5. No support was found for classifying the 57 items into the five subscales proposed by Krug et al. (1980a, 1980b) or for the three-factor solution suggested by Wadden, Bryson, and Rodger (1991). [ABSTRACT FROM AUTHOR]

The ability of feed related measures to prevent or reduce post weaning diarrhoea (PWD) was examined in a split litter study including 30 pigs from 6 litters allotted into 5 groups. Four groups were exposed to 3 pathogenic strains of E. coli via the environment at weaning. Three of them were given zinc oxide, lactose+fibres or non-pathogenic strains of E. coli as probiotics. The challenged and the unchallenged control groups were given a standard creep feed. Diarrhoea was observed in all challenged groups but not among uninfected animals, and the incidence of diarrhoea was lower in the group given nonpathogenic E. coli compared to all other challenged groups. The severity of PWD also differed between litters. When corrected for mortality due to PWD, a decreased incidence of diarrhoea was also seen in the groups given zinc oxide or lactose+fibres. The dominating serotype of E. coli within faecal samples varied from day to day, also among diarrhoeic pigs, indicating that diarrhoea was not induced by one single serotype alone. The diversity of the faecal coliform populations decreased in all piglets during the first week post weaning, coinciding with an increased similarity between these populations among pigs in the challenged groups. This indicated an influence of the challenge strains, which ceased during the second week. The group given lactose+fibres was least affected with respect to these parameters. In conclusion feed related measures may alleviate symptoms of PWD. [ABSTRACT FROM AUTHOR]

Summary The influence of weaning on day 32 and a simultaneous challenge with a pathogenic strain of Escherichia coli was studied in eight piglets. Another nine weaned but non-infected piglets were used as controls. The distribution of peripheral blood mononuclear cells (PBMC) into subpopulations, as well as their response when stimulated in vitro by pokeweed mitogen, changed in a similar manner during post-weaning in both groups. In contrast, superior responses were recorded for PBMC collected from the challenged pigs when stimulated in vitro with concanavalin A and with a heat-inactivated extract of the E. coli strain used for infection, respectively. Despite a successful colonization of the challenge strain, no clinical signs of disease were recorded. Nor did the daily weight gain or the number of E. coli, enterococci, or Clostridium perfringens excreted per gram of faeces differ between the groups. However, the weaning induced a marked decrease in the diversity of coliforms in individual piglets, which announced a reduced colonization resistance of that flora. Also, a decreased homogeneity between coliform floras of different piglets was observed following weaning. The decreased homogeneity indicated that different strains of E. coli were predominant in different animals, which may in turn facilitate the spread of pathogenic strains. The enteric changes were more pronounced and lasted longer in infected animals. Still, the influence of a sole pathogenic strain of E. coli was not enough to induce post-weaning diarrhoea. [ABSTRACT FROM AUTHOR]

The effect of a dietary supplementation of zinc oxide (ZnO) on the stability of the intestinal flora and on the composition of coliforms in weaned pigs was investigated. Faecal floras were characterized by their metabolic activities and fermentative capacity (FC) using the Phene Plate generalized microplate. Coliforms were characterized by conventional enumeration and by the Phene Plate-RS plates. The latter measured FC, phenotypic diversity, persistence of each coliform strain in piglets, and similarity among the coliform populations within groups. From weaning onwards, the control pigs (n = 5) were fed a basal diet ad libitum, while experimental pigs (n = 5) were given the same food supplemented with 2500 ppm ZnO. Metabolic fingerprinting of faecal floras indicated marked differences between the composition of floras of treated and control pigs during the first 2 weeks post-weaning. The FC of faecal flora in both groups decreased as pigs aged, but it was significantly (P ≤ 0·0001) lower in control pigs during the first 2 weeks post-weaning. Neither the number of coliforms, nor their FC-values, differed between the groups. However, during the first 2 weeks post-weaning, there was a significant increase in both variety (P = 0·019) and diversity (P ≤ 0·001) of coliforms in control pigs compared with the ZnO treated group. Homogeneity between coliform populations of piglets was high during the suckling period, indicating the presence of many identical strains among piglets. This, however, decreased in control pigs during the first 2 weeks post-weaning. Several coliform strains that colonized the gut at the early stage of the pigs’ life were found to be resident in animals of both groups. It is concluded that supplementation of ZnO to weaned pigs helped to maintain the stability of the intestinal microflora and the diversity of coliforms during the first 2 weeks post-weaning, but not later, and that ZnO supplementation to creep feed should be restricted to the first 2 weeks post-weaning in veterinary practice. [ABSTRACT FROM AUTHOR]

Meniere's disease, an inner ear disorder, is known to cause considerable distress. The aims of this study were to investigate whether coping strategies would predict the perceived handicap from dizziness, reported discomfort from Meniere's disease and anxiety sensitivity. The relations of anxiety sensitivity to the other above variables were also investigated. Fifty Meniere patients participated in the study, completing three standardized questionnaires: the Ways of Coping Questionnaire (WOCQ), the Anxiety Sensitivity Index (ASI) and the Dizziness Handicap Inventory (DHI). Results showed that three coping strategies correlated with perceived functional handicap from dizziness. Escape/Avoidance and Distancing were positively and Self-Controlling negatively related to perceived functional handicap. The coping strategies Accepting Responsibility and Escape/Avoidance were correlated with anxiety sensitivity. Moreover, anxiety sensitivity was correlated with perceived emotional handicap from dizziness and reported discomfort from Meniere's disease. It is suggested that cognitive and behavioural variables should be taken into account in medical management and counselling of Meniere's disease patients. [ABSTRACT FROM AUTHOR]

Meniere's disease, an inner ear disorder, is known to cause considerable distress. The aims of this study were to investigate whether coping strategies would predict the perceived handicap from dizziness, reported discomfort from Meniere's disease and anxiety sensitivity. The relations of anxiety sensitivity to the other above variables were also investigated. Fifty Meniere patients participated in the study, completing three standardized questionnaires: the Ways of Coping Questionnaire (WOCQ), the Anxiety Sensitivity Index (ASI) and the Dizziness Handicap Inventory (DHI). Results showed that three coping strategies correlated with perceived functional handicap from dizziness. Escape/Avoidance and Distancing were positively and Self-Controlling negatively related to perceived functional handicap. The coping strategies Accepting Responsibility and Escape/Avoidance were correlated with anxiety sensitivity. Moreover, anxiety sensitivity was correlated with perceived emotional handicap from dizziness and reported discomfort from Meniere's disease. It is suggested that cognitive and behavioural variables should be taken into account in medical management and counselling of Meniere's disease patients. [ABSTRACT FROM AUTHOR]

The item, total, and subscale scores on the Autism Behavior Checklist (ABC) were compared for 155 mute and 335 speaking individuals with autism spectrum disorders. Although no significant difference was observed between the groups on the ABC total score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores on expressive language items to speaking, rather than to mute, individuals is called into question. The authors speculate whether the expressive language items are weighted too heavily, in regard both to the Language subscale and to the ABC total score. If the expressive language items were removed, the mute group would have significantly higher ABC total scores and therefore a greater degree of autism severity. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study), a randomised, double-blind, placebo-controlled trial," in the December 21, 2013 issue, with reply from the report's authors D.L. Harris and colleagues.

Abstract: A novel technique to study secondary bending due to the eccentric load path in single shear, composite-to-aluminium lap joints has been developed and used in a parametric study. The method is based on the specimen curvature, which is derived from lateral displacements of the surface. The lateral displacements are measured with an optical measurement system or calculated with the finite element method. It was found that the specimen curvature is equivalent to the secondary bending which is usually measured with strain gauges in the vicinity of the bolt holes. The two most important parameters affecting specimen curvature is the overlap length and the thickness of the aluminium plate in the joints. [Copyright &y& Elsevier]

A neuropsychological assessment was conducted to study cognition, with emphasis on memory, information processing/learning ability, and executive functions in boys with Duchenne muscular dystrophy (DMD). A group of 20 boys with DMD, aged 7 to 14 years (mean age 9 years 5 months, SD 2 years 2 months), was contrasted with 17 normally developing age-matched comparison individuals, using specific neuropsychological tests (Block Span, Digit Span, Story Recall, Rey Auditory Verbal Learning Test, Rey Complex Figure Test, Spatial Learning Test, Verbal Fluency, Trail Making Test, Tower of London, Memory for Faces, and Raven's Coloured Progressive Matrices). The DMD group performed significantly worse on all aspects of memory, learning, and executive functions. There was no significant difference in general intellectual ability between the two groups. Analyses of group differences indicate that problems in short-term memory are the most apparent, suggesting specific cognitive deficits. The differences between the groups were similar for both verbal-auditory and visuospatial tests, thus contradicting the idea that cognitive deficits are related to type of stimulus presented. It is concluded from this study that short-term memory deficits might play a critical role in the cognitive impairment and intellectual development seen in those with DMD. [ABSTRACT FROM AUTHOR]

Quasi-isotropic carbon/epoxy laminates with holes, polymer plugs and cut fibres are studied experimentally and analytically. Strain fields are measured using digital speckle photography. The results are used to validate an inverse method, where elastic properties of inclusions are determined by matching computed and measured displacements. Tensile and compressive strength is measured and the applicability of notch failure criteria to soft inclusions is examined. Available closed form solutions agree well with measured strains. The elastic properties predicted by the inverse method are in fairly good agreement with data from coupon tests although predictions are sensitive to measuring errors. The laminate toughness in compression was higher than in tension, as expected from the different failure mechanisms (fibre kinking versus fibre tearing). Laminates with inclusions were tougher than laminates with holes, which may indicate that inclusions restrain in-plane fibre kinking. Higher toughness was reflected in larger characteristic lengths. [Copyright &y& Elsevier]

Unlabelled: In this investigation we present a recent survey of treatment effects among 8 to 19-y-old Swedish children and youths with phenylketonuria (PKU). The results from intelligence tests and a questionnaire comprising four scales, work capacity, social competence, and internalising and externalising problems, were used. Severity of disease, early treatment, and contemporary phenylalanine levels were assessed. The results showed that development of the patients' intelligence was normal. Adjustments were rated by the patients, their parents and their teachers, and the results were compared with those of a healthy reference group. The PKU patients did not differ from the reference group except for externalising problems judged by the children themselves. None of the patients with PKU showed signs of externalising problems in contrast to the reference group, where such behaviour was observed. Patients with severe PKU, however, showed less social competence compared with patients with a milder form of the disease, according to their own and their parents' ratings. Phenylalanine level in blood tests was in accordance with treatment norms, although the teenagers had higher levels of phenylalanine than the younger patients.Conclusion: Normal intelligence and adjustment is found among patients with PKU when plasma phenylalanine levels are within treatment norms. [ABSTRACT FROM AUTHOR]

Twenty-four patients with self-reported 'sensitivity to electricity' were divided into two groups and tested in a double-blind provocation study. These patients, who reported increased skin symptoms when exposed to electromagnetic fields, were compared with 12 age- and sex-matched controls. Both groups were exposed to 30-minute periods of high or low stress situations, with and without simultaneous exposure to electromagnetic fields from a visual display unit. The matched controls were tested twice and given the same exposure as the patients but had the fields turned on every time. Stress was induced by requiring the participants to act in accordance with a random sequence of flashing lights while simultaneously solving complicated mathematical problems. Blood samples were analyzed for levels of the stress-related hormones melatonin, prolactin, adrenocorticotrophic hormone, neuropeptide Y, and growth hormone, and the expression of different peptides, cellular markers, and cytokines (somatostatin, CD1, factor XIIIa, and tumor necrosis factor-alpha). Skin biopsies were also analyzed for the occurrence of mast cells. Stress provocation resulted in feelings of more intense mental stress and elevated heart rate. The patients reported increased skin symptoms when they knew or believed that the electromagnetic field was turned on. With the blind conditions there were no differences between 'on' or 'off.' Inflammatory mediators and mast cells in the skin were not affected by the stress exposure or by exposure to electromagnetic fields. The main conclusion was that the patients did not react to the fields. [ABSTRACT FROM AUTHOR]

Summary: Background: Scratching and itch are common clinical signs of atopic dermatitis (AD). Studies of adult patients have shown that a decrease in scratching behaviour results in regression of inflammation and improved healing of the skin. Objectives: To investigate whether a modified habit reversal (HR) treatment protocol could be used for the treatment of scratching in children to improve skin status. Methods: The study is a single‐blind, randomized controlled trial of 39 patients who started with registration a week before randomization into one of two groups (intervention or control). The participants in the intervention group received a habit‐breaking therapy of their scratching behaviour (i.e. HR) in addition to a potent steroid (mometasone furoate), whereas the patients in the control group received the steroid alone. The patients were assessed by an independent dermatologist after the first week of registration (baseline assessment) and then after 3 and 8 weeks of treatment. The primary efficacy variable was a change in objective Scoring Atopic Dermatitis (SCORAD). Results: At the end of the 3‐week treatment period, the change in mean objective SCORAD was significantly (P = 0·027) higher in the intervention group (−31·9 ± 9·5) than in the control group (−23·8 ± 10·1). After the 8‐week follow‐up, the change in mean objective SCORAD was significantly (P = 0·0038) higher in the intervention group (−31·7 ± 10·4) than in the control group (−19·7 ± 9·4). Conclusions: The treatment of scratching with the HR method in combination with a potent steroid was found to improve skin status significantly after 3 and 11 weeks. [ABSTRACT FROM AUTHOR]

Abstract: An experimental model using 3-day-old snatch-farrowed colostrum-deprived piglets co-infected with porcine circovirus type 2 (PCV2) and porcine parvovirus (PPV) is at present one of the best methods to study factors affecting development of postweaning multisystemic wasting syndrome (PMWS). A Swedish isolate of PCV2 (S-PCV2) retrieved in 1993 from a healthy pig has been used in this model to reproduce PMWS in pigs from Northern Ireland. This virus has been present in the Swedish pig population for at least a decade without causing any known PMWS disease problems, despite its potential pathogenicity. The reasons for this are unknown, but could be related to genetics, absence of triggers for PCV2 upregulation (infectious agent and/or management forms) within Swedish pig husbandry. In order to confirm the pathogenicity of S-PCV2, Swedish and Danish pigs were experimentally infected with this isolate according to the established model. Swedish pigs were also infected with a reference isolate of PCV2 (PCV2-1010) to compare the severity of disease caused by the two isolates in Swedish pigs. Both Danish and Swedish pigs developed PMWS after the experimental infection with S-PCV2. Antibodies to PCV2 developed later and reached lower levels in serum from pigs infected with S-PCV2 than in pigs inoculated with PCV2-1010. In general, pigs infected with S-PCV2 showed more severe clinical signs of disease than pigs infected with PCV2-1010, but pigs from all PCV2-inoculated groups displayed gross and histological lesions consistent with PMWS. All pigs inoculated with PPV, alone or in combination with PCV2, displayed interleukin-10 responses in serum while only pigs infected with PPV in combination with PCV2 showed interferon-α in serum on repeated occasions. Thus, the pathogenicity of S-PCV2 was confirmed and a role for cytokines in the etiology of PMWS was indicated. [Copyright &y& Elsevier]

Summary: 瘙痒是湿疹的主要症状,包括常见于儿童的异位性皮炎。人们在感到瘙痒时通常会抓挠皮肤,但这只能暂时缓解,而抓挠可能会导致皮肤损伤和感染。对成人患者的研究表明,减少抓挠可缓解炎症并改善皮肤的愈合,因此减少抓挠的方法对湿疹患者来说大有益处。科学家们发现,抓挠对瘙痒的早期缓解会加强这一行为,从而发展成习惯或强迫行为。不久之后,抓挠习惯就会变成无意识的自动行为了。这意味着,大量的抓挠行为已经变成习惯,而不是对瘙痒的直接反应。减少成人的习惯性抓挠行为的一种方法称为习惯消除治疗,而本项研究旨在调查适用于家长及其孩子的习惯消除治疗结合强力类固醇药膏(湿疹的常见疗法)是否能改善儿童的抓挠和湿疹治疗效果(与单用类固醇相比)。主要结果(表示如何衡量治疗的成功性)是一种称为SCORAD的打分体系,关注于湿疹的严重性;次要结果为CDLQI分数,是一种关注于生活质量的调查表(分数越低表示对生活质量的负面影响越少)。采用习惯消除(HR)方法治疗抓挠行为并结合强力类固醇药膏治疗3周和11周后,研究人员发现SCORAD和CDLQI分数都有显著提高。 [ABSTRACT FROM AUTHOR]

Summary: Itching is a main symptom signs of eczema, including the type called atopic dermatitis which is common in children. People often scratch their skin in response to the itching but this only gives temporary relief, and scratching may cause skin damage and infections. Studies of adult patients have shown that reducing scratching can lead to less inflammation and improved healing of the skin, so ways of reducing scratching can be of benefit to eczema patients. Scientists have discovered that the early relief of the itch by scratching serves to reinforce the behaviour, which becomes habitual or compulsive. After a while, scratching behaviour becomes involuntary and automatic. This means that a significant amount of scratching has become a habit, and not necessarily directly in response to itching. One way of reducing this type of habitual scratching in adults is called habit reversal treatment, and this study looked at whether habit reversal, adapted for parents and their children, in combination with a potent steroid cream (which is a normal treatment for eczema), would offer a better outcome in the treatment of scratching and eczema in children compared to the steroid alone. The primary outcome, meaning how they measured the treatment success, was a scoring system called SCORAD that looks at the eczema's severity, the secondary outcome was CDLQI score, which is a questionnaire looking at quality of life (with lower scores indicating less negative impact on quality of life). The treatment of scratching with the HR method in combination with a potent steroid was found to significantly improve both SCORAD and CDLQI after 3 and 11 weeks. [ABSTRACT FROM AUTHOR]