Growth and development in a child with resistance to thyroid hormone and ectopic thyroid gland

Resistance to thyroid hormone is an uncommon problem, which has rarely been associated with thyroid dysgenesis. We report a case with both thyroid gland ectopy and resistance to thyroid hormone and, thus, a reduced capacity to produce and respond to thyroid hormone. The patient presented at 2 years of age with developmental delay, dysmorphic features, and elevation in both thyroxine and thyrotropin. We document her response to therapy with thyroxine, with particular regard to her growth and development. Persistent elevation of thyrotropin is commonly recognized during treatment of congenital hypothyroidism. Resistance to thyroid hormone may be an important additional diagnosis to consider in cases where thyrotropin remains persistently elevated.

Trace metal concentrations in Nile Tilapia (Oreochromis Niloticus) in three catchments, Sri Lanka

Samples of the muscle and liver of the Nile tilapia (Oreochromis niloticus) were obtained from a single reservoir in each of three Sri Lankan catchments (Kaudulla, Rajanganaya, and Udawalawe reservoirs in the Mahaweli, Kala Oya, and Walawe Ganga river basins, respectively) in 2002. The concentrations of 12 elements were consistently detected in the tilapia muscle and liver (Ca, Cd, Cu, Fe, Hg, K, Mg, Mn, Na, P, Sr and Zn). However, a three factorial principal components analysis suggested that there were no differences in the metal profiles (range of elements and concentration) of the fish obtained from any of the three reservoirs, although the chemistries of each tissue (muscle and liver) were different. Metal concentrations were below WHO and Food Standards Australia and New Zealand guideline values, and substantial quantities of tilapia would need to be consumed each week on a regular basis to exceed intake limits (e.g. more than 1.5 kg to exceed intake lits for Cu), suggesting consumption of tilapia from these reservoirs poses little risk to human health.

Utility-based quality of life of overweight and obese adolescents

Objective : To explore the relationship between overweight/obesity and utility in adolescents.

Methods : Data were collected from 2890 adolescents attending 13 secondary schools in the state of Victoria, Australia. The Assessment of Quality of Life 6-Dimension (AQoL-6D) questionnaire was used to measure individual utility. Adolescent's height and weight were measured and weight status categories assigned according to the World Health Organization adolescent growth standards. Multivariate linear regression analyses were undertaken for the whole population and subpopulations of boys and girls to estimate the mean differences in utility scores between 1) overweight and healthy weight and 2) obese and healthy weight adolescents, while controlling for demographic and socioeconomic status variables.

Results : The mean age of adolescents was 14.6 years, 56.2% were boys, 22.2% were overweight, and 9.4% were obese. The mean utility of healthy weight adolescents was 0.860. After adjustments, the overweight and obese groups reported significantly lower mean utility scores (differences: −0.018 and −0.059, respectively, relative to the healthy weight group). This can be interpreted as equivalent to a stated willingness to sacrifice 1.8% and 5.9% of a life in perfect health or 2.3% and 6.8% of a life at healthy weight. A significant utility difference associated with overweight was only experienced by girls (−0.039, P = 0.003). Both sexes experienced significant utility differences associated with obesity, but the magnitude was double for girls (−0.084, P < 0.001) relative to boys (−0.041, P = 0.022).

Conclusion : Utility is lower among overweight and more so among obese adolescents.

Systematic review of sedentary behavior and cognitive development in early childhood

OBJECTIVE: To comprehensively review observational and experimental studies examining the relationship between sedentary behavior and cognitive development during early childhood (birth to 5years). METHOD: Electronic databases were searched in July, 2014 and no limits were imposed on the search. Included studies had to be peer-reviewed, published, and meet the a priori determined population (apparently healthy children aged birth to 5years), intervention (duration, types, and patterns of sedentary behavior), comparator (various durations, types, or patterns of sedentary behavior), and outcome (cognitive development) study criteria. Data extraction occurred in October and November 2014 and study quality and risk of bias were assessed in December 2014. RESULTS: A total of 37 studies, representing 14,487 participants from nine different countries were included. Thirty-one studies used observational study designs and six studies used experimental study designs. Across study designs, increased or higher screen time (most commonly assessed as television viewing (TV)), reading, child-specific TV content, and adult-specific TV content had detrimental (negative) associations with cognitive development outcomes for 38%, 0%, 8%, and 25% of associations reported, respectively, and beneficial (positive) associations with cognitive development outcomes for 6%, 60%, 13%, and 3% of associations reported, respectively. Ten studies were moderate quality and 27 studies were weak quality. CONCLUSIONS: The type of sedentary behavior, such as TV versus reading, may have different impacts on cognitive development in early childhood. Future research with reliable and valid tools and adequate sample sizes that examine multiple cognitive domains (e.g., language, spatial cognition, executive function, memory) are needed. Registration no. CRD42014010004.

Preparing construction project managers to document professional growth

Deakin University’s School of Architecture and Building is renowned for producing graduates who possess relevant attributes that make them job ready for the building and construction industry. Graduate destination surveys indicate that in the last eight (8) years, 100% of all Infrastructure Logistics (Construction and Facility Management) course graduates found relevant employment. This success is a direct result of a curriculum that is responsive to industry needs alongside educational methodology that focuses on excellent teaching and research while seeking new ways of developing and delivering courses.

The Infrastructure Logistics course prepares graduates to successfully compete in today’s global job market, and allows them to showcase relevant knowledge and skills that are critical in seeking and sustaining employment. Traditionally, tailored resumes served this purpose; however, in many professional fields, professional portfolios are now becoming a more desirable way of providing a summary of relevant attributes alongside evidence of professional abilities.

Sustaining employment, appraisals, and applying for a promotion are often subject to adequate evidence of professional standards and growth. Professional bodies require records of contribution to Continuing Professional Development (CPD) schemes; and accrediting organisations require professionals applying for professional registration to provide documented evidence of their relevant experience and abilities. The Australian Institute of Project Management (AIPM 2007) requires candidates wanting to become Registered Project Managers (RegPM) to demonstrate their current work-based experience and competencies.

This paper reports on a teaching strategy adopted in the Project Management (PM) stream, offered as part of Infrastructure Logistic courses. The teaching strategy is based on a combination of constructivism theory of learning, problem and project based learning, and active learning. The strategy requires systematic reflection and conscious creation of documented evidence of PM attributes and competences in the form of a portfolio.

Preliminary results of action research monitoring the effectiveness of systematic reflection indicate that students respond very positively to the idea of professional journals and professional portfolios. Preliminary results also indicate that students accept reflection and conscious documentation of their achievements as an integral part of their study and future practice.

Therapeutic Jurisprudence, juvenile justice and the UN Convention on the Rights of the Child : do they coexist?

The UN Convention on the Rights of the Child provides children and young people with over 40 substantive rights, the five outcomes of which are living a healthy lifestyle, staying safe, enjoying and achieving, making a positive contribution, and economic wellbeing. Moreover, Article 3 dictates that all organizations concerned with children should work towards what is best of each child. It is not clear how these rights translate to the care of children and young people who come before the courts (particularly those who are subsequently incarcerated). A review of the literature suggests that while best practice guidelines for the treatment and rehabilitation of adult offenders has moved forward, there is little consensus about how this might be achieved for young people. Therapeutic Jurisprudence (TJ) needs to extend beyond its current considerations of the rights of children and young people, and to expand its focus to the extent to which international human rights standards are complied with in the cases of juveniles in the criminal justice system. This presentation will (a) explore the extent to which current practices in juvenile justice are consistent with the UN's Convention and (b) whether the adoption a rehabilitative and treatment approach based on a TJ framework might serve to improve outcomes for young people and ensure their rights are not being violated.

Dynamics of childhood growth and obesity: development and validation of a quantitative mathematical model

Background
Clinicians and policy makers need the ability to predict quantitatively how childhood bodyweight will respond to obesity interventions.

Methods
We developed and validated a mathematical model of childhood energy balance that accounts for healthy growth and development of obesity, and that makes quantitative predictions about weight-management interventions. The model was calibrated to reference body composition data in healthy children and validated by comparing model predictions with data other than those used to build the model.

Findings
The model accurately simulated the changes in body composition and energy expenditure reported in reference data during healthy growth, and predicted increases in energy intake from ages 5—18 years of roughly 1200 kcal per day in boys and 900 kcal per day in girls. Development of childhood obesity necessitated a substantially greater excess energy intake than for development of adult obesity. Furthermore, excess energy intake in overweight and obese children calculated by the model greatly exceeded the typical energy balance calculated on the basis of growth charts. At the population level, the excess weight of US children in 2003—06 was associated with a mean increase in energy intake of roughly 200 kcal per day per child compared with similar children in 1971—74. The model also suggests that therapeutic windows when children can outgrow obesity without losing weight might exist, especially during periods of high growth potential in boys who are not severely obese.

Interpretation
This model quantifies the energy excess underlying obesity and calculates the necessary intervention magnitude to achieve bodyweight change in children. Policy makers and clinicians now have a quantitative technique for understanding the childhood obesity epidemic and planning interventions to control it.

Funding
Intramural Research Program of the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

Estradiol for treatment-resistant schizophrenia: a large-scale randomized-controlled trial in women of child-bearing age

Many women with schizophrenia remain symptomatic despite optimal use of current therapies. While previous studies suggest that adjunctive oestrogen therapy might be effective, large-scale clinical trials are required before clinical applications are possible. This study is the first large-scale randomized-controlled trial in women with treatment-resistant schizophrenia. This Definitive Oestrogen Patch Trial was an 8-week, three-arm, double-blind, randomized-controlled trial conducted between 2006 and 2011. The 183 female participants were aged between 18 and 45 (mean=35 years), with schizophrenia or schizoaffective disorder and ongoing symptoms of psychosis (Positive and Negative Syndrome Scale, PANSS score>60) despite a stable dose of antipsychotic medication for at least 4 weeks. Mean duration of illness was more than 10 years. Participants received transdermal estradiol 200 μg, transdermal estradiol 100 μg or an identical placebo patch. For the 180 women who completed the study, the a priori outcome measure was the change in PANSS score measured at baseline and days 7, 14, 28 and 56. Cognition was assessed at baseline and day 56 using the Repeatable Battery of Neuropsychological Status. Data were analysed using latent growth curve modelling. Both estradiol groups had greater decreases in PANSS positive, general and total symptoms compared with the placebo group (P<0.01), with a greater effect seen for 200 μg than 100 μg estradiol. The largest effect size was for the positive subscale of PANSS in the estradiol 200 μg treatment group (effect size 0.44, P<0.01). This study shows estradiol is an effective and clinically significant adjunctive therapy for women with treatment-resistant schizophrenia, particularly for positive symptoms.Molecular Psychiatry advance online publication, 15 April 2014; doi:10.1038/mp.2014.33.

Estradiol for treatment-resistant schizophrenia: a large-scale randomized-controlled trial in women of child-bearing age

Many women with schizophrenia remain symptomatic despite optimal use of current therapies. While previous studies suggest that adjunctive oestrogen therapy might be effective, large-scale clinical trials are required before clinical applications are possible. This study is the first large-scale randomized-controlled trial in women with treatment-resistant schizophrenia. This Definitive Oestrogen Patch Trial was an 8-week, three-arm, double-blind, randomized-controlled trial conducted between 2006 and 2011. The 183 female participants were aged between 18 and 45 (mean=35 years), with schizophrenia or schizoaffective disorder and ongoing symptoms of psychosis (Positive and Negative Syndrome Scale, PANSS score>60) despite a stable dose of antipsychotic medication for at least 4 weeks. Mean duration of illness was more than 10 years. Participants received transdermal estradiol 200 μg, transdermal estradiol 100 μg or an identical placebo patch. For the 180 women who completed the study, the a priori outcome measure was the change in PANSS score measured at baseline and days 7, 14, 28 and 56. Cognition was assessed at baseline and day 56 using the Repeatable Battery of Neuropsychological Status. Data were analysed using latent growth curve modelling. Both estradiol groups had greater decreases in PANSS positive, general and total symptoms compared with the placebo group (P<0.01), with a greater effect seen for 200 μg than 100 μg estradiol. The largest effect size was for the positive subscale of PANSS in the estradiol 200 μg treatment group (effect size 0.44, P<0.01). This study shows estradiol is an effective and clinically significant adjunctive therapy for women with treatment-resistant schizophrenia, particularly for positive symptoms.

Does training affect growth? - answers to common questions

Adolescent athletes may be at risk of restricted growth and delayed maturation when intense training is combined with insufficient energy intake. Because catch-up growth commonly occurs when training is reduced or ceases, final adult stature is unlikely to be compromised. However, in athletes who have long-term, clinically delayed maturation, catch-up growth may be incomplete. By charting individual growth patterns, physicians, coaches, and athletic trainers can detect vulnerable periods when the training intensity should be reduced and energy intake may need to be increased.

Is domestic violence learned? The contribution of five forms of child maltreatment to men's violence and adjustment

On the basis of a learning-theory approach to the intergenerational transmission of violence, researchers have focused almost exclusively on violent men's childhood experiences of physical abuse and witnessing family violence. Little consideration has been given to the coexistence of other forms of child maltreatment or the role of family dysfunction in contributing to violence. This study shows the relationships between the level of child maltreatment (physical abuse, psychological maltreatment, sexual abuse, neglect, and witnessing family violence), childhood family characteristics, current alcohol abuse, trauma symptomatology, and the level of physical and psychological spouse abuse perpetrated by 36 men with a history of perpetrating domestic violence who had attended counseling. As hypothesized, a high degree of overlap between risk factors was found. Child maltreatment, low family cohesion and adaptability, and alcohol abuse was significantly associated with frequency of physical spouse abuse and trauma symptomatology scores, but not psychological spouse abuse. Rather than physical abuse or witnessing family violence, childhood neglect uniquely predicted the level of physical spouse abuse. Witnessing family violence (but not physical abuse) was found to have a unique association with psychological spouse abuse and trauma symptomatology. These results present a challenge to the understanding of domestic violence obtained from learning theory.

Globalization, international trade and welfare

The term globalization is generally used to describe an increase in international transactions in markets for goods and services and factors of production, plus the growth and expanded scope of mar.y institutions that straddle international borders. Globalization has also led to a more liberal economic environment where issues such as labour standards, human rights, the environment, intellectual property rights, investment codes and competition policy are now considered legitimate topics in the trade debate. Free global markets cannot guarantee that air, water or energy resources are accurately priced for sustainable development since there is no mechanism to internalize environmental costs. Economic growth, although a powerful tool for increasing a country's wealth, cannot guarantee that such wealth will be equally distributed. What is needed is environmental and social policy to redistribute the benefits.
Recent empirical studies show that there are clear signs of income convergence among countries that integrate more fully with the world economy but a divergence between these active participants and those who elect to remain insulated from global markets. The inequality within nations (distribution of income) has increased during the period of globalization over the last fifty years.