Manipulation In Children Research Articles

“I Was Told When I Could Hold, Talk With, or Kiss Our Daughter”: Exploring Fathers’ Experiences of Parental Alienation Within the Context of Intimate Partner Violence

Previous research has highlighted that when men describe their experiences of intimate partner violence (IPV), they frequently talk about the use of children by their abusive partners. The behaviors they describe align with descriptions of so-called parental alienation (PA) where children are coercively controlled to reject one (alienated) parent in favor of the other. The situation of alienating behaviors within intimate partner and family violence structures is one that has been proposed but rarely explicitly studied. This study analyzed qualitative responses to an online survey by 171 fathers who have experienced alienating behaviors within the context of IPV. Four themes were found: direct manipulation of contact (including relocation and control of contact), manipulation through systems (including false allegations, and court and school settings), manipulation of children (including lying directly to children about fathers and involving children in abuse), and the wider context of violence (including physical, psychological, and controlling behaviors). The experiences described by men are discussed in relation to the theoretical and practical relationship between IPV and PA and implications for the current debate around the use of PA within family court cases.

Description of recurrent headaches in 7–14-year-old children: Baseline data from a randomized clinical trial on effectiveness of chiropractic spinal manipulation in children with recurrent headaches

BackgroundHeadaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally.MethodsBaseline data for a clinical trial included a questionnaire and a physical screening. Children's characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a “non-classifiable” group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index.Results253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups.ConclusionsChildren with recurrent headaches are often severely affected. A questionnaire-based classification appeared feasible to distinguish between migraine and tension-type headaches in children but leaving many children unclassified. A migraine-tension-type-index can be generated allowing to regard the traditional distinction as a continuum (including mixed headache), and potentially serving as an instrument to improve headache management.Trial registration ClinicalTrials.gov, identifier NCT02684916.

Control effect of virtual reality technology on procedural pain in children's wound: A meta-analysis.

Background:Children who undergo wound manipulation usually experience pain. Virtual reality technology is a novel and effective non pharmaceutical therapy for reducing pain in children scheduled to undergo wound manipulation. However, the effectiveness of Virtual reality technology in controlling procedural pain in children’s wounds has not been evaluated in a systematic review.Methods:It employed a meta-analysis design. We included studies with randomized controlled trials, reporting children’s wound manipulation pain, and published them in English. Two reviewers independently evaluated the methodological quality of the included studies.Results:Of the 108 studies identified, 39 were eligible for the meta-analysis, with a total sample of 273 patients. The use of virtual reality technology has significantly reduced pain intensity during wound manipulation in children. There was a significant difference between the experimental group (virtual reality) and the control group (no virtual reality) in reducing the pain of the children’s wound manipulation (P < .05).Conclusion:As a distraction method of non drug assisted analgesia intervention, virtual reality technology can reduce children’s procedural pain and discomfort symptoms.

Therapeutic efficacy and safety rating of Tui-Pushing chest-back manipulation for children with cough variant asthma

Therapeutic efficacy and safety rating of Tui-Pushing chest-back manipulation for children with cough variant asthma

Sedation and analgesia during manipulation in children

The article provides an overview of modern methods of sedation and analgesia during therapeutic and diagnostic manipulations in children, indicates indications and contraindications. Special attention is paid to the assessment of sedation and anaesthesia effectiveness, scales used for this purpose in children of different ages are described, criteria of sedation depth are given, equipment and measures necessary to ensure patient safety during manipulation are described. It has been noted that BIS index values correlate with sedation scales in children and adults, but values that determine deep sedation in children are currently not clearly defined, which requires further research. Drugs for sedation, their main characteristics and limitations for use are presented. The differences between sedation and monitored anesthesiology care (MAC), which can be provided only by a qualified anesthesiologist, are described in detail. It has been demonstrated that monitored anesthesiologic care implies deep sedation with control of vital functions, control of breathing and hemodynamics during manipulation, and it is noted that capnography is a mandatory element of monitoring in this type of anesthesiologic care in order to detect apnea as early as possible. Criteria for recovery of consciousness after completion of sedation are specified, which include normal airway, adequate ventilation, stability of hemodynamic, restoration of initial level of consciousness, motor activity and possibility to receive liquids through mouth in absence of vomiting. It is noted that the average time from the end of procedural sedation to the restoration of the original state is about 2 hours.

Age-group differences in beginning-state comfort reveal an increase in motor planning capabilities

Objects can be grasped in different ways to ensure a movement plan is aligned with the intended action. The current study assessed grasp posture in joint action object manipulation in children (ages 6–11, n = 68), young adults (n = 21), and older adults (n = 23). Participants performed two actions (pickup and pass; pickup and pass for use) within two movement contexts (using a dowel as if it were the actual object; actual object use), using two objects (glass and hammer) that differed in use-dependent experience. Beginning-state comfort (prioritizing a comfortable initial hand posture for an object recipient) was assessed. Taken together, findings support the notion that the ability to anticipate the intended action, and thus consider an action partner in one’s action plan, increases with age. With age and use-dependent experience, it can be argued that there is a shift from stimulus-driven, familiar responses, to considering affordances and task demands. Together, findings add to our understanding of changes in motor planning capabilities across the life span.

Visceral and Neural Manipulation in Children with Cerebral Palsy and Chronic Constipation: Five Case Reports

The purpose of this case study series was to assess improvement in the quality of life, function, and colonic motility before and after visceral and neural manipulation in five children with cerebral palsy and chronic constipation who had Gross Motor Function Classification System (GMFCS) levels of IV and V. Quality of life and function were assessed using the CPCHILD and the WeeFIM respectively. The CPCHILD and WeeFIM were administered at baseline before the intervention, after the intervention, and again at least three months post intervention. Colonic motility was assessed radiographically at baseline and post-intervention utilizing ingested radiopaque markers (Sitz markers). Bowel movement number and quality were assessed through family diaries. All subjects showed some degree of improved quality of life and function on the CPCHILD and WeeFIM at the end of the intervention. Colonic motility assessed radiographically before and after treatment was not statistically significant due to the small number of participants; however, the number of bowel movements increased during the study for 100% of the participants. Visceral and neural manipulation modalities may provide clinicians and families with an alternative to medications and/or other more invasive interventions.

Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program.

Appetite manipulation can be effective in weaning children off gastrostomy tube feeding dependence but can cause dehydration, hypoglycaemia, and ketone body production, which is anorexigenic. As the safety of this approach has not been described, our aim was to describe adverse events observed when weaning children from G-tube dependence using our appetite manipulation protocol. This was a retrospective study of prospectively collected data of patients who completed our inpatient tube-weaning protocol. Daily safety parameters included twice-daily urine specific gravities and urine ketones and fasting capillary blood glucose. Graded clinical interventions to manage adverse events were collected. A total of 143 children with a mean age of 4.8 ± 2.4 years were seen in the inpatient feeding program of which 74 (51.7%) were male. The children were hospitalized 10.1 ± 2.5 days with the vast majority being discharged between days 11 and 14. Overall, 78.2% of patients experienced at least 1 adverse event: urine specific gravity >1.020 was seen in 60.5%, ketonuria in 48.9%, and hypoglycemia (≤60 mg/dL) in 13.4%. Only 2 children had blood glucose levels <40 mg/dL and these were corrected with oral supplementation. Graded clinical interventions to manage adverse events included oral rehydration in 89.9% of children and supplemental tube feeding in 25.2%. Adverse effects are common when appetite manipulation is used to wean children off G-tube dependence. Anticipating, monitoring, and having a clear intervention plan in a closely monitored setting are necessary to safely use this method.

X &amp; Y Chromosomal Variations: Hormones, Brain Development, and Neurodevelopmental Performance

Abstract This is the first book on X and Y chromosomal disorders to address these common but rarely diagnosed conditions. This book seeks to present the latest in research and clinical care addressing neuroimaging, the interaction between hormones, brain development, and neurodevelopmental progression. This book will primarily focus on 47, XXY (Klinefelter syndrome, or KS), 47, XYY (Jacobs' syndrome), and 47, XXX (Triple X). More variant disorders such as 48, XXXX, 48, XXXY and 49, XXXXY will be discussed. Topics of interest include neurological functioning, neuroimaging, social language, and the evolving perspectives of these XY chromosomal disorders. The effects of testosterone supplementation in males with 47, XXY will also be examined. Table of Contents: Dedication / Acknowledgments / Introduction / Meiosis and Mitosis / Testosterone and 47, XXY / Endocrinological Issues and Hormonal Manipulation in Children and Men With Klinefelter Syndrome / Neurological Functioning in 47, XXY / Neuroimaging in XY C...

The Manipulation of Children’s Preferences, Old-Age Support, and Investment in Children’s Human Capital

We consider the link between parents’ influence over the preferences of children, parental investments in children’s human capital, and children’s support of elderly parents. It may pay for parents to spend resources to “manipulate” children’s preferences in order to induce them to support their parents in old age. Since parents invest more in children when they expect greater support, manipulation of child preferences may end up helping children and parents. A new result, which we call the “Rotten Parent Theorem,” demonstrates that if children are altruistic, then even selfish parents will make the optimal investment in their children’s human capital.

The Manipulation of Children's Preferences, Old Age Support, and Investment in Children's Human Capital

We consider the link between parents' influence over the preferences of children, parental investments in children's human capital, and children's support of elderly parents. It may pay for parents to spend resources to manipulate children's preferences in order to induce them to support their parents in old age. Since parents invest more in children when they expect greater support, manipulation of child preferences may end up helping children and parents. A new result, that we call the Rotten Parent Theorem, demonstrates that if children are altruistic, then even selfish parents will make the optimal investment in kids' human capital.

Developmental improvements in dynamic control of fingertip forces last throughout childhood and into adolescence

While it is clear that the development of dexterous manipulation in children exhibits dramatic improvements over an extended period, it is difficult to separate musculoskeletal from neural contributors to these important functional gains. This is in part due to the inability of current methods to disambiguate improvements in hand strength from gains in finger dexterity (i.e., the dynamic control of fingertip force vectors at low magnitudes). We adapted our novel instrumentation to evaluate finger dexterity in 130 typically developing children between the ages of 4 and 16 yr. We find that finger dexterity continues to develop well into late adolescence and musculoskeletal growth and strength are poorly correlated with the improvements in dexterity. Importantly, because these behavioral results seem to mirror the known timelines of neuroanatomical development up to adolescence, we speculate that they reflect the functional benefits of such continual neural maturation. This novel perspective now enables the systematic study of the functional roles of specific neuroanatomical structures and their connectivity, maturity, and plasticity. Moreover, the temporal dynamics of the fingertip force vectors shows improvements in stability that provide a novel way to look at the maturation of finger control. From a clinical perspective, our results provide a practical means to chart functional development of dexterous manipulation in typically developing children and could be adapted for clinical use and for use in children with developmental disorders.

Endocrinological issues and hormonal manipulation in children and men with Klinefelter syndrome

47, XXY or Klinefelter syndrome (KS), the most common chromosomal aberration in males, is characterized by either absolute or relative hypogonadism with frequent decline in serum testosterone (T) following the onset of puberty. Decreased T levels are the result of testicular dysfunction with decrease in size of Leydig cells, and loss of germs and Sertoli cells leading to tubular hyalinization. Increase in estradiol results from over-expression of aromatase CYP19. Deficient androgen production and observed varied response of end-organs to T leads to delayed progression of puberty with decreased facial/body hair, poor muscle development, osteoporosis, and gynecomastia. It is possible that hypogonadism and excessive estradiol production contribute to emotional and social immaturity, and specific learning disabilities in KS. Based on the authors' experience and literature review, early fertility preservation and hormonal supplementation may normalize pubertal development, prevent metabolic sequelae of hypogonadism, and have a positive effect on academic and social development. No randomized clinical trials are available studying the effects of T supplementation on reproductive or cognitive issues in KS. Aggressive T supplementation (topical gel) and selective use of aromatase inhibitors may be considered at the onset of puberty with careful follow-up and titration to reach age-specific high-normal physiologic serum values. The decision to institute hormonal therapy should be part of a multidisciplinary approach including physical, speech, behavioral, and occupational therapy. © 2013 Wiley Periodicals, Inc.

Use of ultrasonography after ureteroscopic stone manipulation in children

Use of ultrasonography after ureteroscopic stone manipulation in children

Practice of nurses in the manipulation of children’s feeding under 1 year old

ABSTRACTObjective: to evaluate the practice of nurses in the manipulation of children’s feeding under one year old, exclusively breastfed up to six months of age, accompanied at the Family’s Health Units from the 4th Sanitary District of Recife City. Method: a descriptive and quantitative study. The data collection was carried out by interviews with 32 nurses between September to November 2010, and the individuals were informed about the objectives and content of the research, being invited to participate by signing the Clarified Free Consent Term (CFCT). Data were processed using EPI-INFO 6.04 Software. The research was approved by the Research Ethics Committee of UFPE under protocol No. 211/2010. Results: it was observed that 46.7% of the nurses interviewed conceptualized complementary feeding correctly. The difficulties on the implementation of appropriate complementary feeding for children under one year old were reported by 70.4% of nurses, highlighting the cultural beliefs as the main one. It was found that 75% and 77.8% of the respondents followed the guidelines of the Ministry of Health for infants between six and seven months old, respectively. For the eight-month infant, only 23.8% oriented the introduction of the family menu. Conclusion: the study revealed that nurses did not use fully the recommendations of the Ministry of Health for the feeding of children under two years old. Descriptors: childcare; breastfeeding; infant foods.RESUMOObjetivo: avaliar a prática dos enfermeiros no manejo da alimentação de crianças menores de um ano de idade, amamentadas exclusivamente até os seis meses de idade, acompanhadas nas Unidades De Saúde da Família do Distrito Sanitário IV da cidade do Recife-PE. Método: estudo descritivo, quantitativo, cujos dados foram coletados mediante a realização de entrevistas com 32 enfermeiras. A coleta de dados foi realizada de setembro a novembro de 2010, e os sujeitos foram informados quanto aos objetivos e ao conteúdo da pesquisa, sendo convidados a participar com a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE). Os dados foram processados pelo software EPI-INFO 6.04. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da UFPE, sob protocolo nº 211/2010. Resultados: foi observado que 46,7% das enfermeiras entrevistadas conceituaram alimentação complementar corretamente. As dificuldades na implementação da alimentação complementar adequada para as crianças menores de um ano foram informadas por 70,4% das Enfermeiras, destacando-se as crenças culturais como a principal. Constatou-se que 75% e 77,8% dos entrevistados seguia as orientações do Ministério da Saúde, para os lactentes de seis e sete meses de idade, respectivamente. Para o lactente de oito meses, apenas 23,8% orientava a introdução do cardápio familiar. Conclusão: o estudo revelou que as enfermeiras não utilizavam integralmente as recomendações do Ministério da Saúde (MS) para a alimentação das crianças menores de dois anos. Descritores: puericultura; aleitamento; alimentos infantis.RESUMENObjetivo: evaluar la práctica de los enfermeros en el manejo de alimentación de niños menores de un año de edad, amamantados exclusivamente hasta los seis meses de edad, seguidos en las Unidades de Salud de la Familia del Distrito Sanitario IV de la ciudad de Recife 0 PE. Método: estudio descriptivo, cuantitativo, cuyos datos se recogieron mediante la realización de entrevistas con 32 enfermeras. La recogida de datos se realizó entre setiembre y noviembre de 2010. Se informó a los entrevistados respecto a los objetivos y al contenido de la investigación, siendo invitados a participar mediante firma del Término de Libre y Espontánea Voluntad (TCLE). Los datos se procesaron por el software EPI-INFO 6.04. El Comité de Ética en Investigación de la UFPE aprobó el proyecto bajo protocolo nº 211/2010. Resultados: se observó que el 46,7% de las enfermeras entrevistadas concibieron la alimentación complementaria correctamente. Las dificultades en la implementación de la alimentación complementaria adecuada para los niños menores de un año se relataron por el 70,4% de las Enfermeras, destacándose las creencias culturales como la principal. Se constató que el 75% y 77,8% de los entrevistados seguían las orientaciones del Ministerio de Sanidad para los lactantes de entre seis y siete meses de edad, respectivamente. Para el lactante de ocho meses, apenas el 23,8% orientaban la introducción en el menú familiar. Conclusión: el estudio reveló que las enfermeras no utilizaban integralmente las recomendaciones del Ministerio de Sanidad (MS) para la alimentación de los niños menores de dos años. Descriptores: puericultura; amamantamiento; alimentos infantiles.

Pediatric fractures: temporal trends and cost implications of treatment under general anesthesia

Pediatric fractures are common and are often managed by manipulation under general anesthesia (MUA). This study's aim was to assess the changing pattern of pediatric fractures over 6 years and use this data to perform a workload forecast and estimate cost implications of treatment under general anesthesia. The Emergency Department (ED), operating theater and ward admissions data of children aged 1-11years presenting with fractures was analyzed. We calculated caseload trends, delay to operation, various parameters of service provision, and the current cost of treating each fracture. We then performed predictive cost analysis for the next 3 years to estimate potential savings by manipulating fractures in ED under ketamine sedation. The case load has increased>350% in 6 years (total fractures increasing at 23% and MUAs increasing at 17% per year, respectively). The summer months and evenings have been consistently busier. 72% of fractures were managed by pure reduction alone (MUA), 22% by reduction+K-wires, and various other procedures were performed in 1%. The median delays from ED presentation to admission, definitive procedure and discharge were 4, 21 and 33 h, respectively. Each MUA took 52 min and cost the hospital £723. Assuming that the current trends continue, the expenditures would be £101K, £114K, and £128K for 2010, 2011 and 2012, respectively. Fracture manipulation in children under general anesthesia often requires an overnight hospital stay, which is not only uncomfortable for the child and inconvenient for the parents but it also increases the burden on the limited National Health Service (NHS) resources. There is a 23% annual increase in fractures and children have to wait for 21 h before the definitive procedure. Using ketamine to manipulate children's fractures in the ED could offer potential service and cost improvements.

Effects of varied levels of treatment integrity on appropriate toy manipulation in children with autism

We assessed the effects of varying the treatment integrity of a prompting procedure on appropriate toy manipulation in two preschool-aged children with autism. Following an assessment to identify toys with high levels of inappropriate toy manipulation, each of three toys was associated with implementation of the prompting procedure at a different integrity level (10%, 50%, or 100%). For one participant, only the 100% integrity condition produced increases in appropriate toy manipulation. For the second participant, both the 50% and 100% integrity conditions produced increases in appropriate toy manipulation. These results suggest that integrity errors negatively impacted the acquisition of appropriate toy manipulation in children with autism, although the necessary level of treatment integrity varied across participants.

Possible adverse events in children treated by manual therapy: a review

BackgroundPediatric manual therapy is controversial within the medical community particularly with respect to adverse events. Pediatric manual therapy (Ped MT) is commonly used by a number of professions such as chiropractors, osteopaths and naturopaths for a variety of treatments in children. Ped MT interventions range from advice, light touch, massage, through to mobilisation and high velocity spinal manipulation. However, current evidence related to adverse events associated with Ped MT is not well understood.ObjectiveTo update the clinical research literature from the 2007 report by Vohra, Johnston, Cramer and Humphreys on possible adverse events in children treated by spinal manipulation.MethodsA review of the clinical research literature from June 2004 until January 2010 as reported in MEDLINE, PubMed and PubMed Central for adverse events specifically related to the treatment of pediatric cases by manual therapy.ResultsOnly three new clinical studies, one systematic review with meta-analysis and one evidence report were identified. Two clinical studies reported on chiropractic care and one on osteopathic spinal manipulation in children. The systematic review investigated all studies of adverse events and manual therapy and was not specific for pediatric patients. The evidence review focused on effectiveness of spinal manipulation in a variety of musculoskeletal conditions. No serious or catastrophic adverse events were reported in the clinical studies or systematic review. However for adults, it has been estimated that between 0.003% and 0.13% of manual therapy treatments may result in a serious adverse event. Although mild to moderate adverse events are common in adults, an accurate estimate from high quality pediatric studies is currently not available.ConclusionsThere is currently insufficient research evidence related to adverse events and manual therapy. However, clinical studies and systematic reviews from adult patients undergoing manual therapy, particularly spinal manipulation report that mild to moderate adverse events are common and self limiting. However serious adverse events are rare and much less than for medication commonly prescribed for these problems. More high quality research specifically addressing adverse events and pediatric manual therapy is needed.

Sensitivity of cognitive tests to a breakfast vs. no breakfast manipulation in children

Sensitivity of cognitive tests to a breakfast vs. no breakfast manipulation in children

Food allergy in children suffering from atopic eczema

Whilst the association between eczema and food allergy is well established, the role of dietary manipulation in children with eczema remains controversial. These case histories highlight the differing outcomes that dietary manipulation may have in an infant with early onset, severe eczema and an older child with milder eczema. Management strategies and the evidence to support them are presented, followed by a review of clinical recommendations.