Consultation with the Specialist

1992 ◽  
Vol 13 (2) ◽  
pp. 72-73
Author(s):  
Lawrence C. Pakula

Among the most frequent questions pediatricians must address are those related to sibling rivalry, which is important regarding both behavior and development.1 The parents' concerns often begin before the next child is born and may be the result of their own personal experience or family situation. They need guidelines for managing this situation. Parents often find it difficult to understand the concept of innate competition between siblings and to accept some conflict as common in healthy families regardless of how loving, clever, persistent, and available adults may be. The pediatrician is in a unique position to intervene because of the frequent contacts with the family. Many potential situations should alert both parents and physicians to a potential problem, including: the sibling reaching significant milestones (eg, walking); change in status (eg, no longer being the oldest, only, or youngest child); change in health status of sibling (eg, injury, malignant illness, identification of disabilities); and change involving a significant adult (eg, illness, death, divorce, job loss, change in caregiver). History taking is essential and can be therapeutic as well as diagnostic. It should include inquiry about who is involved (both children and adults) and their perceived roles; the reporter and most frequent observer; time, situation, and place of occurrence; significance attached to the problem by each of the parents; other occurrences in the entire household regarding relationships; why this problem is receiving attention now and not earlier; and any long-term concerns.

2002 ◽  
Vol 34 (1) ◽  
pp. 162-165
Author(s):  
Judith E. Tucker

Breastfeeding, as Avner Giladi amply demonstrates, is far more than the simple matter of providing nutrition to an infant. Who breastfeeds, for how long, and with what kind of encouragement, respect, and reward can tell us much about social attitudes toward infancy and the mother–child bond, as well as the value placed on motherhood in general. The extent to which the father alternately provides general support for mother and child or controls and limits the breastfeeding relationship, for example, can shape the father–child and husband–wife relationship in the long term. And a breastfeeding mother, as the primary nurturer of a child, finds herself in a unique position in relation to her children, her husband, and society in general: it is a moment pregnant with possibilities for the enhancement of a woman's power. A close study of breastfeeding, then, draws our attention to a society's attitudes toward young children, the construction of the family in relation to the needs of these children, and the ways in which relations between a husband and wife are informed by the rights and responsibilities surrounding this act of pivotal importance to the survival of the species, particularly in the days before pasteurization and infant formula, when the absence of a mother or wet nurse spelled almost certain death for a baby.


Author(s):  
Ylva Almquist ◽  
Evelina Landstedt ◽  
Josephine Jackisch ◽  
Kristiina Rajaleid ◽  
Hugo Westerlund ◽  
...  

Disadvantaged circumstances in youth tend to translate into poor health development. However, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n = 908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.


Author(s):  
Ylva B Almquist ◽  
Evelina Landstedt ◽  
Josephine Jackisch ◽  
Kristiina Rajaleid ◽  
Hugo Westerlund ◽  
...  

Disadvantaged circumstances in youth tend to translate into poor health development. Yet, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time, were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n=908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.


2018 ◽  
Vol 3 (3) ◽  

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.


2020 ◽  
Vol 16 ◽  
Author(s):  
Lalitha Vivekanandan ◽  
Roxanne Gekonge Mandere ◽  
Sivakumar Thangavel

Background: Constipation is a common, predominant, chronic gastrointestinal functional disorder. The drugs available to treat constipation are limited because of their side effects in long term use. So we need of efficacious drug to treat constipation. Sapindus emarginatus Vahl belongs to the family Sapindaceae, commonly known as soapnut. Traditionally used for the antipruritic, antifertility, constipation, and anti-inflammatory agents. Objective: The present study was undertaken to evaluate the laxative activity of hydroethanolic pericarp extract of Sapindus emarginatus (HESE) in animal models. Methods: The saponin content in extract was measured by gravimetric analysis. The laxative activity of hydroethanolic pericarp extract of Sapindus emarginatus is evaluated by the weight of feces matter, charcoal meal hyperperistalsis test, and loperamide induced constipation model. Results: The saponin content of the soapnut pericarp was 13.48 % and the extract was found to be 11.92 %. The results obtained from these models showed a significant dose-dependent increase in fecal weight, peristalsis index, and moisture content compared to control animals. Conclusion: The present study concluded that the oral administration of HESE showed a significant laxative activity by using different animal models. The presence of triterpene saponins is responsible for this activity. Further studies are needed to confirm their mechanism behind the laxative effect. The administration of extract was found to be a valid candidate in constipation therapy.


Zootaxa ◽  
2011 ◽  
Vol 2794 (1) ◽  
pp. 57 ◽  
Author(s):  
ROBIN KUNDRATA ◽  
LADISLAV BOCAK

Pseudothilmanus Pic, 1918 is redescribed and two species, P. alatus Pic, 1918 and P. marginatus Pic, 1918, are placed in the genus. The subgenus Drilothilmanus Pic, 1918 is synonymized with the nominotypical genus on the basis of low morphological divergence and redundancy in classification. Pseudothilmanus is newly classified in the family Rhagophthalmidae, in contrast to the original placement in Drilidae. Diagnostic characters for Pseudothilmanus and both species placed within the genus are illustrated.


SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110223
Author(s):  
Jahanzaib Haider ◽  
Abdul Qayyum ◽  
Zalina Zainudin

This study analyzes the leverage policies of the family and non-family firms of eight East Asian Economies (Hong Kong, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, and Taiwan) by using combined data of 690 family and non-family firms with 3,224 firm–years over the period 2006–2010. This study has used an ordinary least squares (OLS) regression for analyzing the data for the first question, while for the second question, logit regression has been used as the dependent variable (a binary variable). Prior research on family and non-family firms has revealed that family firms issue less (high) debt than non-family firms. Our analysis on a sample of East Asian Economies discloses that family firms have significantly different leverage levels than non-family firms, but their signs are not consistent. On the contrary, when the owner works as CEO/Chairman or member of the Board of Directors, then the family firms issue less debt than the non-family firms. Besides that, this study adds a new question that has not been addressed in the prior studies. The new question has focused on the speed of leverage adjustment. It is found that family firms and non-family firms regarding their debt maturity structure (short-term debt and long-term debt), the speed of leverage adjustments, and their decision to issue securities (i.e., debt vs. equity) are not significantly different. This study concluded that though family firms have a strong influence on each economy, but in South-East Asian countries, leverage policies of the family firms are not much different than that of non-family firms.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Baysson ◽  
S Joost ◽  
H Attar Cohen ◽  
I Guessous ◽  
S Stringhini

Abstract Background In order to provide efficient public health decisions making, it is crucial to obtain reliable and recent data on the state of health of the population. For that purpose, a web-platform for the dynamic monitoring of the health status and well-being of the population is being developed in the Geneva canton. Methods Using a dedicated website, recruitment will be carried out over 5 years so as to enroll up to 20 000 volunteers, resident in Geneva and aged ≥ 18 years, followed-up for at least 10 years. Once connected to the website, participants will fill a general self-administered questionnaire on their socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Environmental, behavioral and occupational exposures will also be evaluated via more specific questionnaires. Current addresses of residence will be geocoded and linked to geographical databases to passively gather information on noise, air pollution, green areas, and other exposures. Surveillance of health events will be implemented via yearly self-administered on line questionnaires and potentially via passive linkage to medical databases (medical file) and health registries with the participants' consent. For a subsample of volunteers, biochemical samples and biomarkers will be collected. Results The pilot study shows that the project is feasible, potentially cost-effective but requires innovative methodologies for ensuring long term follow-up. Different communication strategies used for recruitment and long-term participation need to be implemented ensuring trust from participants, different levels of health literacy and the need of justice. Conclusions Specchio is a new project aimed at setting up a digital longitudinal health study in Geneva. Challenges concerns the determinants of participation, recruitment and attrition, quality of data and ethics. Long-term funding by the Directorate General of Health Geneva is currently under evaluation. Key messages This digital longitudinal health study will enable dynamic monitoring of the health status and well-being of Geneva residents and will enable efficient public health decision making. Specchio is a new project funded by the Directorate General of Health Geneva.


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