A combination of ascorbic acid and α-tocopherol to test the effectiveness and safety in the fragile X syndrome: study protocol for a phase II, randomized, placebo-controlled trial.

BACKGROUND Fragile X syndrome (FXS) is an inherited neurodevelopmental condition characterised by behavioural, learning disabilities, physical and neurological symptoms. In addition, an important degree of comorbidity with autism is also present. Considered a rare disorder affecting both genders, it first becomes apparent during childhood with displays of language delay and behavioural symptoms.Main aim: To show whether the combination of 10 mg/kg/day of ascorbic acid (vitamin C) and 10 mg/kg/day of α-tocopherol (vitamin E) reduces FXS symptoms among male patients ages 6 to 18 years compared to placebo treatment, as measured on the standardized rating scales at baseline, and after 12 and 24 weeks of treatment.Secondary aims: To assess the safety of the treatment. To describe behavioural and cognitive changes revealed by the Developmental Behaviour Checklist Short Form (DBC-P24) and the Wechsler Intelligence Scale for Children-Revised. To describe metabolic changes revealed by blood analysis. To measure treatment impact at home and in an academic environment. METHODS/DESIGN A phase II randomized, double-blind pilot clinical trial. SCOPE male children and adolescents diagnosed with FXS, in accordance with a standardized molecular biology test, who met all the inclusion criteria and none of the exclusion criteria. INSTRUMENTATION clinical data, blood analysis, Wechsler Intelligence Scale for Children-Revised, Conners parent and teacher rating scale scores and the DBC-P24 results will be obtained at the baseline (t0). Follow up examinations will take place at 12 weeks (t1) and 24 weeks (t2) of treatment. DISCUSSION A limited number of clinical trials have been carried out on children with FXS, but more are necessary as current treatment possibilities are insufficient and often provoke side effects. In the present study, we sought to overcome possible methodological problems by conducting a phase II pilot study in order to calculate the relevant statistical parameters and determine the safety of the proposed treatment. The results will provide evidence to improve hyperactivity control and reduce behavioural and learning problems using ascorbic acid (vitamin C) and α-tocopherol (vitamin E). The study protocol was approved by the Regional Government Committee for Clinical Trials in Andalusia and the Spanish agency for drugs and health products. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01329770 (29 March 2011).

Incremental processing in head-final child language: online comprehension of relative clauses in Turkish-speaking children and adults

The present study investigates the parsing of pre-nominal relative clauses (RCs) in children for the first time with a realtime methodology that reveals moment-to-moment processing patterns as the sentence unfolds. A self-paced listening experiment with Turkish-speaking children (aged 5–8) and adults showed that both groups display a sign of processing cost both in subject and object RCs at different points through the flow of the utterance when integrating the cues that are uninformative (i.e., ambiguous in function) and that are structurally and probabilistically unexpected. Both groups show a processing facilitation as soon as the morphosyntactic dependencies are completed and parse the unbounded dependencies rapidly using the morphosyntactic cues rather than waiting for the clause-final filler. These findings show that five-year-old children show similar patterns to adults in processing the morphosyntactic cues incrementally and in forming expectations about the rest of the utterance on the basis of the probabilistic model of their language.

Child safety from the perspective of essential needs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efficiency and safety of bosentan in child C cirrhosis with portopulmonary hypertension and renal insufficiency

Bosentan has lately been described as a successful therapeutic agent for portopulmonary hypertension consecutive to child A cirrhosis. This is the first report of the effect of this substance with advanced liver cirrhosis (child C) and renal insufficiency. Low doses of bosentan (initially twice 31.25 mg/day and then 62.5 mg/day) increased cardiac output and allowed correction of renal insufficiency; it allowed one to stop the requirement of oxygen and not only improved the 6-min walking test by more than 400 m, but also decreased the severity of the liver cirrhosis to child B stadium. This suggests that patients, who would be excluded from a liver transplantation program because of their portopulmonary hypertension, could profit from a careful therapy with bosentan.

National Child Safety Seat Distribution Program evaluation.

National Highway Traffic Safety Administration, Washington, D.C.

Strategies to increase the use of child safety seats among toddlers. Volume I. Final report.

National Highway Traffic Safety Administration, Office of Driver and Pedestrian Research, Washington, D.C.

Evaluation of the effectiveness of child safety restraints. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

I. Safety belt usage among drivers. II. Use of child restraint devices, passenger safety belts and position of passengers in cars. III. Motorcycle helmet usage. Final report.

National Highway Traffic Safety Administration, Office of Research and Development, Washington, D.C.

Strategies to increase the use of child safety seats: an assessment of current knowledge. Final report.

National Highway Traffic Safety Administration, Office of Driver and Pedestrian Research, Washington, D.C.

Guidelines for observing child safety seat use. Technical report.

Mode of access: Internet.

Local police enforcement, public information and education strategies to foster more and proper use of child safety seats by toddlers: evaluation of demonstration project. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Safety belt usage among drivers : use of child restraint devices, passenger safety belts and position of passengers in cars : motorcycle helmet usage /

Final report; May 1980.

Family violence: Walking the tight rope between maternal alienation and child safety

Mothers are often alienated from their children when child abuse is suspected or confirmed, whether she is the primary abuser of the child or not. An abusive or violent partner often initiates the process of maternal alienation from children as a control mechanism. When the co-occurrence of maternal and child abuse is not recognised, nurses and health professionals risk further alienating a mother from her children, which can have detrimental effects in both the short and long term. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children. The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family. This fragmented approach to caring for abused children can inadvertently undermine the mother-child relationship and further contribute to maternal alienation. This paper discusses the complexity of family violence for nurses negotiating the 'tight rope' between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother-child relationship is paramount for the long-term wellbeing of both the children and the mother provides the basis for discussing implications for nursing practice.

Use of child safety seats among Mexican parents in a small south Dade community

The purpose of this study was to determine the use and misuse of child safety seats among Mexican parents. Data were collected via personal interview and by use of the SAFE KIDS BUCKLE UP Child Safety Seat Checklist Form. This study used a descriptive comparative design. The convenience sample consisted of 63 Mexican mothers with at least one child under the age of four (index child). The findings showed that Mexican parents tend to misuse or not use child safety seats. Most parents were not aware of the misuse, and receiving prior information on the use of child safety seats had no bearing on its correct use. Factors influencing nonuse include lack of finances, driving short distances, leaving child safety seat at home, and being unaware of the Florida child restraint law. Findings of this study have implications for how nurses need to educate mothers on car safety and help reduce childhood injuries.

HomeBank: An Online Repository of Daylong Child-Centered Audio Recordings.

HomeBank is introduced here. It is a public, permanent, extensible, online database of daylong audio recorded in naturalistic environments. HomeBank serves two primary purposes. First, it is a repository for raw audio and associated files: one database requires special permissions, and another redacted database allows unrestricted public access. Associated files include metadata such as participant demographics and clinical diagnostics, automated annotations, and human-generated transcriptions and annotations. Many recordings use the child-perspective LENA recorders (LENA Research Foundation, Boulder, Colorado, United States), but various recordings and metadata can be accommodated. The HomeBank database can have both vetted and unvetted recordings, with different levels of accessibility. Additionally, HomeBank is an open repository for processing and analysis tools for HomeBank or similar data sets. HomeBank is flexible for users and contributors, making primary data available to researchers, especially those in child development, linguistics, and audio engineering. HomeBank facilitates researchers' access to large-scale data and tools, linking the acoustic, auditory, and linguistic characteristics of children's environments with a variety of variables including socioeconomic status, family characteristics, language trajectories, and disorders. Automated processing applied to daylong home audio recordings is now becoming widely used in early intervention initiatives, helping parents to provide richer speech input to at-risk children.