Treatment of Childhood Obesity: A Systematic Review

Childhood obesity trends have increased dramatically over the past three decade’s. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment effect size. Searches revealed 61 relevant articles published from January 2000 to 2009, including both randomized and non-randomized controlled trials of childhood and adolescent obesity treatment interventions. The review identified scant measurement and reporting of issues around treatment fidelity, an increase in the number of interventions outside of the US, (particularly across Europe) and an emergence of studies involving older children and adolescents in a range of settings. Interventions comprising a dietary, exercise, and behavioral component, supported by family involvement and delivered by trained interventionists in specialized or supervised settings, appeared to offer a potentially effective treatment for obesity. However, concern remains over study quality (particularly sample size), dropout rates and study design. Variations in outcome measures and intervention designs means generalizable conclusions cannot be easily be made. Of greater concern is the lack of consideration for treatment fidelity, which has implications for the transfer of knowledge and the reliability of interventions. Conclusions from the review include; the need for increased accuracy of reporting and objective measurement of treatment fidelity; the need for further investigation of potential cost-effective treatment options (including maintenance strategies to enhance sustainability of current interventions); and an increase in the number of longitudinal trials beyond 1?year in duration.     

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges’ g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.     

儿童白血病治疗的几点思考

儿童白血病是小儿发病率最高的恶性肿瘤。随着分子生物学、遗传学、免疫学的发展,抗白血病的新药物不断被发现,新的治疗方法不断被采用。在选择治疗方法时,应用哲学思想进行指导,显得尤为重要。     

Executive Functions in Children and Adolescents with Turner Syndrome: A Systematic Review and Meta-Analysis

Turner syndrome (TS) is a genetic disorder, affecting 1/2500 to 1/3000 live female births, induced by partial or total deletion of one X chromosome. The neurocognitive profile of girls with TS is characterized by a normal Verbal IQ and weaknesses in visual-spatial, mathematics, and social cognitive domains. Executive functions (EFs) impairments have also been reported in these young patients. However, methodological differences across studies do not allow determination of which EFs are impaired and what is the magnitude of these impairments. The aim of this review was to clarify the EF profile of children and adolescents with TS. Sixteen samples, from thirteen studies, were included in the current meta-analysis. EFs measures used in these studies were classified into working memory, inhibitory control, cognitive flexibility, or higher-order EFs tasks in accordance with Diamond’s model, Annual Review of Psychology, 64, 135–168 (2013). Results confirmed that girls with TS had significant executive impairments with effect sizes varying from small (inhibitory control) to medium (cognitive flexibility) and large (working memory, higher-order EFs). Analyses by task revealed that cognitive inhibition may be more impaired than the other inhibitory control abilities. Heterogeneity across cognitive flexibility measures was also highlighted. Between-sample heterogeneity was observed for three tasks and the impact of participants’ characteristics on EFs was discussed. This meta-analysis confirms the necessity to assess, in patients living with TS, each EF by combining both visual and verbal tasks. Results also underline that, when studying girls with TS’ executive profile, it is important to explore the impact of moderator variables, such as IQ, parental socio-economic status, TS karyotype, psychiatric comorbidities, and hormonal treatment status.     

儿童白血病治疗的几点思考

儿童白血病是小儿发病率最高的恶性肿瘤.随着分子生物学、遗传学、免疫学的发展,抗白血病的新药物不断被发现,新的治疗方法不断被采用.在选择治疗方法时,应用哲学思想进行指导,显得尤为重要.     

Family Adjustment to Childhood Cancer: A Systematic Review

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.     

Maternal Directiveness in Childhood Survivors of Acute Lymphoblastic Leukemia

Parental intrusiveness is associated with internalizing problems in healthy children. Given the unique demands that childhood cancer places on parents, it is important to determine whether intrusiveness operates differently in survivors of childhood cancer. The current study tested whether cancer survivorship moderates the relation between maternal directiveness—one aspect of intrusiveness—and children’s internalizing problems. Survivors (7–12 years old) of acute lymphoblastic leukemia (ALL) (n = 25) and their mothers, and healthy controls (n = 22) and their mothers engaged in parent–child interactions. Mothers completed a measure of children’s psychosocial adjustment, and observations of 10-min parent–child interactions were obtained. Cancer survivorship moderated the relation between directiveness and children’s withdrawn/depressed symptoms. Maternal directiveness was associated with increased withdrawn/depressed symptoms for children in the control group. This association was not significant for survivors of ALL. Findings suggest that childhood cancer may alter the context in which children experience maternal directiveness.     

Executive Control Functions in Degenerative Dementias: A Comparative Review

This paper reviews the literature concerning executive control impairments in degenerative dementias. The construct of executive control functioning is examined, as is the neuroanatomy of frontal–subcortical networks, believed to underlie executive function (EF) impairments. The pattern of EF impairments in Alzheimer's disease (AD) which affects temporal and parietal brain regions most severely is contrasted with observed executive dysfunctions in patients with dementias involving degeneration of primarily frontal and frontal–subcortical brain areas. EF impairments are present in each of these types of dementing illnesses. Although EF impairments are present in AD, they are less prominent than the memory disorder in the neuropsychological profile of the disease and tend to become more pronounced later in the course of the illness. In contrast, patients with frontal or frontal–subcortical dementia may demonstrate executive dysfunction, which occurs earlier in the disease progression and may be initially more severe.     

Impact of Hyperbaric Oxygen Therapy on Cognitive Functions: a Systematic Review

Neuropsychology Review - Hyperbaric oxygen therapy (HBOT) is a modality of treatment in which patients inhale 100% oxygen inside a hyperbaric chamber pressurised to greater than 1...     

Executive Function and Theory of Mind in Children with ADHD: a Systematic Review

In developmental research, the relationship between Executive Function (EF) and Theory of Mind (ToM) has been extensively assessed, and EF has been considered a condition for ToM. However, few researchers have studied the relationship between EF and ToM in clinical populations, especially that of Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder characterized by symptoms of inattention and motor hyperactivity/impulsivity, in which EF is largely impaired. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, 201 English and Spanish articles evaluating EF and ToM in ADHD were chosen. Fifteen papers met the inclusion criteria and were selected for further analysis. The first study dates from 2001. Most of the studies’ designs are cross-sectional, include mostly male children, have a small sample size, and were conducted in European countries. Unlike tasks assessing EF, tasks assessing ToM were heterogeneous across studies. The EFs most correlated with ToM were inhibitory control, working memory, cognitive flexibility, and attention. Interest in studying the relationship between EF and ToM in ADHD is recent,but increasing based on new findings and tuning of ToM instruments. However, while an association between EF and ToM is indicated in ADHD, the degree of prediction and predictability of one over the other cannot yet be established because of the studies’ heterogeneity.     

Assessment and Development of Executive Function (EF) During Childhood

This review paper outlines the issues associated with the assessment of executive function (EF) in children and adolescents, and describes the developmental profile of executive processes across childhood. At the outset, EF is defined, and cognitive and behavioral impairments associated with executive dysfunction (EDF) are described. A developmental model of EF is proposed incorporating four discrete but inter-related executive domains (attentional control, cognitive flexibility, goal setting, and information processing) which operate in an integrative manner to enable “executive control”. Characteristics that constitute traditional EF measures are discussed, as are the problems associated with test interpretation. The ecological validity of EF tests and neuropsychological assessment procedures are examined, and adjunct methods of measurement are presented to enable a more comprehensive and valid assessment of EF. Based on developmental and normative studies, the maturation of executive domains is mapped. Attentional control appears to emerge in infancy and develop rapidly in early childhood. In contrast, cognitive flexibility, goal setting, and information processing experience a critical period of development between 7 and 9 years of age, and are relatively mature by 12 years of age. A transitional period is thought to occur at the beginning of adolescence, and shortly after “executive control” is likely to emerge. In order to confirm our current understanding of EF development and further enhance our understanding of brain-behavior relationships, longitudinal studies incorporating structural and functional neuroimaging are required.     

How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review

Neuropsychology Review - Perceptions about the causes and consequences of concussion, and individual representations and interpretations of these factors, can influence the post-concussive recovery...     

The Elusive Nature of Executive Functions: A Review of our Current Understanding

Executive functions include abilities of goal formation, planning, carrying out goal-directed plans, and effective performance. This article aims at reviewing some of the current knowledge surrounding executive functioning and presenting the contrasting views regarding this concept. The neural substrates of the executive system are examined as well as the evolution of executive functioning, from development to decline. There is clear evidence of the vulnerability of executive functions to the effects of age over lifespan. The first executive function to emerge in children is the ability to inhibit overlearned behavior and the last to appear is verbal fluency. Inhibition of irrelevant information seems to decline earlier than set shifting and verbal fluency during senescence. The sequential progression and decline of these functions has been paralleled with the anatomical changes of the frontal lobe and its connections with other brain areas. Generalization of the results presented here are limited due to methodological differences across studies. Analysis of these differences is presented and suggestions for future research are offered.     

老年急性髓系白血病的治疗

老年急性髓性白血病具有独特的生理及生物学特性。目前尽管治疗手段多样 ,但治疗效果不佳。从哲学的角度观察和分析老年急性髓性白血病的治疗特点 ,根据不同的预后因素选择不同的治疗方法 ,以期实现治疗的个体化和最优化     

Parent–Child Synchrony After Early Childhood: A Systematic Review

Clinical Child and Family Psychology Review - Parent–child synchrony, or the coordination of biological and behavioral processes between parent and child, is thought to promote healthy...     

Cognitive Assessment of Individuals with Multiple Sclerosis in the Arab World: a Systematic Review

Neuropsychology Review - The prevalence of multiple sclerosis (MS) is on the rise globally, and recent epidemiological studies have observed increased rates in the Arab world (i.e., countries of...     

Assessment of Behavioral and Emotional Problems in Infancy: A Systematic Review

Behavioral and emotional problems are highly prevalent in early childhood and represent an important focus of practice for clinical child and pediatric psychologists. Although psychological or psychiatric disorders are not typically diagnosed in children under the age of 2 years, recent research has demonstrated the appropriateness of assessing behavioral and emotional problems during the first 2 years of life (defined throughout as “infancy”). The current paper provides a systematic review of assessment procedures used to identify behavioral and emotional problems during infancy. Existing assessment procedures for infants take the form of parent- or caregiver-report questionnaires, observational coding procedures, and diagnostic classification systems. The questionnaires and observational coding procedures both had substantial psychometric evidence for use with infants, although observational coding may have limited utility in clinical practice. The classification systems have less empirical support for use with infants, and further research is necessary to demonstrate the appropriateness of these procedures with infants. Utilizing the reviewed procedures to assess behavioral and emotional problems in infants can have a substantial impact in research and practice settings, and further research is needed to determine the usefulness of these procedures in developing, testing, and implementing preventive and early intervention programs for infants and their families.     

Functioning in the Real World: Using Storytelling to Improve Validity in the Assessment of Executive Functions

Real-world contexts differ in the clarity of expectations for desired responses, as do assessment procedures, ranging along a continuum from maximal conditions that provide well-defined expectations to typical conditions that provide ill-defined expectations. Executive functions guide effective social interactions, but relations between them have not been studied with measures that are matched in the clarity of response expectations. In predicting teacher-rated social competence (SC) from kindergarteners' performance on tasks of executive functions (EFs), we found better model–data fit indexes when both measures were similar in the clarity of response expectations for the child. The maximal EF measure, the Developmental Neuropsychological Assessment, presents well-defined response expectations, and the typical EF measure, 5 scales from the Thematic Apperception Test (TAT), presents ill-defined response expectations (i.e., Abstraction, Perceptual Integration, Cognitive-Experiential Integration, and Associative Thinking). To assess SC under maximal and typical conditions, we used 2 teacher-rated questionnaires, with items, respectively, that emphasize well-defined and ill-defined expectations: the Behavior Rating Inventory: Behavioral Regulation Index and the Social Skills Improvement System: Social Competence Scale. Findings suggest that matching clarity of expectations improves generalization across measures and highlight the usefulness of the TAT to measure EF.     

Hoarding Disorder and a Systematic Review of Treatment with Cognitive Behavioral Therapy

Until recently, compulsive hoarding has been treated as a type of obsessive-compulsive disorder with mixed results. Little research exists on the efficacy of behavioral interventions specifically designed to treat hoarding disorder, and most existing research is limited with regard to the numbers of participants, their ethnic and cultural diversity, and study replication; therefore, the generalizability of findings is limited. This article reviews the prevalence of hoarding disorder, cognitive behavioral therapy treatment approaches, and measurement of symptoms. A systematic review compares the efficacy of various CBT methods, with particular attention to comparing therapy that is traditionally used to treat OCD with those designed specifically to treat hoarding disorder. Only clinical studies using CBT interventions designed to treat hoarding associated with OCD or hoarding disorder were included. Studies included participants of all ages, and articles were published in peer-reviewed journals. Case studies were excluded. After a comprehensive search and removing duplicates from databases and references, 65 articles were reviewed, of which 12 met criteria for review. Preliminary results demonstrate improvement in hoarding symptoms with CBT interventions that are both for OCD and those designed to specifically treat hoarding disorder; however, when compared to each other, the efficacy of these treatments is inconclusive, thus more research is needed.     

Systematic Review of Self‐Report Family Assessment Measures

A systematic review of self‐report family assessment measures was conducted with reference to their psychometric properties, clinical utility and theoretical underpinnings. Eight instruments were reviewed: The McMaster Family Assessment Device (FAD); Circumplex Model Family Adaptability and Cohesion Evaluation Scales (FACES); Beavers Systems Model Self‐Report Family Inventory (SFI); Family Assessment Measure III (FAM III); Family Environment Scale (FES); Family Relations Scale (FRS); and Systemic Therapy Inventory of Change (STIC); and the Systemic Clinical Outcome Routine Evaluation (SCORE). Results indicated that five family assessment measures are suitable for clinical use (FAD, FACES‐IV, SFI, FAM III, SCORE), two are not (FES, FRS), and one is a new system currently under‐going validation (STIC).