bluuebunny/crossref_metadata_2025 huggingface dataset:
The Many Faces of Infectious Mononucleosis: The Spectrum of Epstein-Barr Virus Infection in Children
Authors: Grose Charles
Published: December 2021

Infectious mononucleosis is a disease well known to every pediatrician. Who has not seen the previously robust teenager who slowly becomes less active, develops lowgrade fever and a sore throat, and complains of being tired all the time? Upon arriving at the physician's office with these complaints the teenager is usually given a "Mono-Spot" test (almost routinely). The test results are often strongly positive. The pediatrician then must discuss the diagnosis with both the teenager and the parents and must respond to the attendant questions. Is the disease really acquired by kissing? How serious is it? Are there any lasting effects? Will the feeling of tiredness ever go away? Is infectious mononucleosis a form of cancer? Can I have the disease more than once? Is there any therapy? The answers to many of the above questions have changed dramatically over the last 5 to 10 years. The spectrum of infectious mononucleosis continues to be expanded and now includes acute, subacute, and chronic disease states, each with its own separate set of problems. Subclinical disease can now be diagnosed in younger children with an obscure febrile illness. On rare occasions, overwhelming infectious mononucleosis results in death in some young children, especially boys.
Recognition of Acquired Immune Deficiency Syndrome (AIDS) in Children
Authors: Ammann Arthur J. , Shannon Kevin
Published: December 2021

The acquired immune deficiency syndrome (AIDS) has been diagnosed in a substantial number of children during the past 2 years. It is likely that many additional cases will be recognized as the clinical and laboratory features of AIDS become better known. We have emphasized the importance of careful epidemiologic, historical, and laboratory work-up of patients suspected of having AIDS. Management of the complications of severe immunodeficiency remains supportive and primarily involves ensuring adequate nutrition and aggresive treatment of infections. Prophylactic parenteral γ-globulin and oral trimethoprim/sulfamethoxazole may be helpful in reducing the incidence and severity of infections. The recent identification of a viral agent that appears to be the putative cause of AIDS should facilitate measures directed toward identification, prevention, and treatment of this disorder.
Neonatal Herpes Simplex Virus Infections
Authors: Whitley Richard J. , Hutto Cecelia
Published: December 2021

Infections caused by herpes simplex viruses have been recognized since ancient Roman times, when Herodotus associated mouth ulcers and lip vesicles with fever. However, neonatal herpes simplex infection was not identified as a distinct disease until centuries later. Only 50 years ago, the first written descriptions of neonatal herpes were attributed nearly simultaneously to Hass, who described the histopathologic findings in a fatal case, and to Batingani who described a newborn child with herpes simplex virus (HSV) keratitis. For several decades our understanding of neonatal infections with herpes simplex virus was predicated upon histopathologic descriptions of the disease. These indicated a broad spectrum of involvement in infants. In the mid-1960s, Nahmias and Dowdle demonstrated two antigenic types of herpes simplex virus, HSV-1 and HSV-2. Recognition of these types prompted a rapid series of developments leading to a better characterization of the biochemical and molecular characteristics of the virus. One consequence of these advances has been the development of methods of typing of viruses which have been utilized to define the epidemiology of HSV infections. Herpes simplex viral infections "above-the-belt," primarily of the lip and oropharynx, have been found in most cases to be associated with HSV-1, whereas infections "below-the-belt" are usually caused by HSV-2.
The Joy of Pediatrics
Authors: Nazarian Lawrence F.
Published: December 2021

When I was trying to get into medical school, part of my answer to the question about why I wanted to be a doctor was that I like people. I gave that response with some reservation because I had been warned not to come up with such a trite reply. But it was true, so I said it.

A major reason I chose pediatrics as a career is the joy I get from children. After 20 years in this work, I still get a tremendous kick from the unconditional smile of a 4-month old baby or the exuberant hug of a toddler.
Identifying and Coping With a Drug-Using Adolescent: Some Guidelines for Pediatricians and Parents
Authors: Schwartz Richard H. , Cohen Peter R. , Bair Glenn O.
Published: December 2021

The use of alcohol and drugs by American adolescents is a problem of epidemic proportions. Adults must consider repetitive psychoactive drug use by an adolescent as a possible cause of problem behavior, academic underachievement, chronic apathy, episodes of running away, serious accidents, and suicide attempts, regardless of the adolescent's family or social background. Parents must learn to be courageous enough to seek help to define the cause of such behavior, and the physicians to whom they turn must be knowledgeable of the diagnosis and management of a drug-using adolescent. The purpose of this paper is to provide information to help the pediatrician understand frequent drug use; its behavioral, social, emotional, and physical consequences for both the user and family; and to help affected families take an active role in the management of their drug-using adolescents.

FOUR PHASES OF CHEMICAL DEPENDENCY

Chemical dependency (an increasingly preferred term for compulsive use of mood-altering drugs) is an illness with psychosocial, spiritual, ethical, emotional, and physical components. It may occur in four stages of progressive severity: (1) experimentation—learning the euphoric "high;" (2) actively seeking drug-induced euphoria; (3) preoccupation with the self-perceived need to get "high" in order to cope with life's stresses. Usually, tolerance to the effects of the drug occurs, leading to use of larger quantities or "stronger" drugs to achieve the desired degree of euphoria;
Acute and Chronic Sinusitis: Diagnosis and Management
Authors: Wald Ellen R.
Published: December 2021

Acute (less than 30 days' duration) infections of the paranasal sinuses are seen in children, usually as complication of viral upper respiratory tract infections or allergic inflammation. Chronic (more than 30 days' duration) sinusitis may result when acute sinusitis is not recognized as such or is inadequately treated. Although there are few data on which to base an estimate of the frequency of these disorders, acute sinusitis is commonly encountered in pediatric practice, and chronic sinusitis is not rare.

EMBRYOLOGY, ANATOMY, AND PHYSIOLOGY

A brief review of the embryology, anatomy, and physiology of the paranasal sinuses will facilitate an understanding of the clinical manifestations of acute and chronic sinusitis. All of the sinuses develop as outpouchings of the nasal mucosa. The maxillary and ethmoid sinuses develop between the third and fifth months of gestation and are pneumatized soon after birth. Although the frontal and sphenoid sinuses also develop during gestation, they remain primitive for several years. The frontal sinuses are not distinct from the anterior ethmoid sinuses until they reach the superior orbital ridge at about 2 years of age; they assume a supraorbital position at 2 to 4 years of age and are in the frontal position at about 6 years of age. The sphenoid sinuses first become well pneumatized at 2 to 3 years of age.
Department of Additional Information
Authors: KENNA MARGARET A.
Published: December 2021

While reading the otherwise excellent article, "The Many Faces of Infectious Mononucleosis: The Spectrum of Epstein-Barr Virus Infection in Children" (Pediatrics in Review 1985;7:35-44), I noted that Dr Grose refers to the airway management of these children done at the Children's Hospital of Pittsburgh. Dr Snyderman's article to which Dr Grose refers (Pediatric Clinics of North America 1981;28:1011-1016), however, does not recommend nasotracheal intubation, as described by Dr Grose but, rather, placement of a nasopharyngeal airway. This tube does not enter the trachea between the vocal cords but, essentially, bypasses the enlarged adenoids and tonsils and rests in the posterior pharynx.
Pulmonary Function Testing: A Practical Guide to Its Use in Pediatric Practice
Authors: Eigen Howard
Published: December 2021

Pulmonary function testing is a useful and important method by which to evaluate patients with or suspected of having lung disease. Pediatricians in the past have taken too little advantage of these techniques in their offices or through referral to pediatric pulmonary function laboratories and, when they have used them, have all too often relied on laboratories designed for adult patients. As with such tests as tympanometry and audiometry, pulmonary function testing should be incorporated into the daily practice of the modern pediatrician. The outlay for equipment is within the means of all pediatricians, and the charges to the patient for testing are quite reasonable, especially because they may be offset by savings from fewer emergency room visits and from a reduction in hospitalizations.

One person in the office must function as "technician" and is referred to as such in this article. In most offices, this person will have other responsibilities as well, but having one person fill the role of pulmonary function technician will improve the reliability of the results of the pulmonary function tests performed.

Although new techniques are being developed for testing young children and infants, these are beyond the scope of office practice because of the time and equipment they require.
Cystic Fibrosis: Recent Developments in Diagnosis and Treatment
Authors: Stern Robert C.
Published: December 2021

Advances in diagnosis and treatment of cystic fibrosis have greatly extended life expectancy and have decreased morbidity. However, further progress requires knowledge of the fundamental genetic defect and how it is related to the pulmonary pathophysiology. Major new developments in both these areas are likely within the next 5 to 10 years.
Vulvovaginitis in the Child and Adolescent
Authors: Emans S. Jean
Published: December 2021

Vulvovaginitis is one of the commonest gynecologic complaints seen in pediatric practice. The young child is particularly susceptible to nonspecific infections secondary to poor hygiene but can also have specific infections from respiratory or enteric pathogens or sexually acquired organisms. The adolescent with vaginal discharge usually has a specific vaginal or endocervical infection, often sexually transmitted. In addition, symptoms of dysuria or urinary frequency suggestive of a urinary tract infection in the adolescent may frequently result from vaginitis or Chlamydia trachomatis genital infection. This article brings the pediatrician up to date since the review in Pediatrics in Review 5 years ago.1

CAUSES OF VULVOVAGINITIS IN THE PREPUBERTAL CHILD

In the newborn period, the vagina is well estrogenized from maternal hormones, and the hymen appears redundant, pink, and succulent. As the influence of maternal hormones wanes during the first few weeks of life, the vagina becomes reddened and atrophic, and the hymen appears as a thin membranous crescent (Fig 1). The pH is 6.5 to 7.5. Because of inadequate hygiene, the lack of protective hair and labial fat pads, and the lack of estrogenization, the vulvar skin is susceptible to irritation and is easily traumatized by medications and clothing. For example, if a child sits for a few hours in nylon leotards and tights, transient erythema and discomfort in the vulvar area may result.
Back in the Saddle Again
Authors: .H. R. J.
Published: December 2021

After a 2-year absence as Editor, during which Dr McKay provided superb leadership as Editor of Pediatrics in Review, it is a pleasure for me to resume this role. It was my privilege in serving as President of the American Academy of Pediatrics to travel throughout the land. I was especially pleased and impressed with the wide acceptance of Pediatrics in Review as a major vehicle for the continuing education of the pediatrician. The circulation in now more than 21,000 in the United States, including all pediatric residents. This acceptance of the journal was also true in Central and South America, where PIR has been distributed, in Spanish, to more 15,000 additional pediatricians for the last few years.
Bee, Wasp, and Hornet Stings
Authors: Maguire James F. , Geha Raif S.
Published: December 2021

Insect stings are a common pediatric problem. The vast majority of such stings are nothing more than a brief and relatively trivial annoyance, producing only a mild local reaction. However, allergic reactions to stings from venomous insects are not rare and can be potentially life threatening. Actuarial surveys indicate that at least 40 deaths per year occur in the United States as a result of severe reactions to venomous insect stings. This article will review the nature of reactions to stinging insects, discuss the diagnostic and therapeutic approaches to stinging insect allergy, and point out some of the problems that remain incompletely resolved in these areas.

STINGING INSECTS

Bees, wasps, and hornets (Figure) are members of the order Hymenoptera and account for the majority of anaphylactic reactions to venomous animals and insects in the United States. The apid family includes the bumblebee and the honeybee, both of which are relatively nonaggressive. The bumblebee is large, slow moving, and noisy, rarely accounting for stings. Honeybees cause problems particularly among beekeepers and their families but may also be encountered by people who are gardening or mowing lawns in aareas where the bees are pollinating flowers or clover. Children are most commonly stung by honey bees while barefoot.
Mushroom Poisoning: Identification, Diagnosis, and Treatment
Authors: Hall Alan H. , Spoerke David G. , Rumack Barry H.
Published: December 2021

Mushroom poisoning can cause a wide range of symptoms including gastroenteritis, euphoria or hallucinations, cholinergic or anticholinergic syndromes, disulfiram-like reactions (flushing, anxiety, palpitations, possible hypotension) when the mushrooms are ingested with ethanol, fulminant hepatic failure, seizures, hemolysis, and methemoglobinemia.

More than 5,000 species of wild mushrooms grow in the United States. It is not known what percentage of these mushroom species are potentially toxic. Some species are "toxic" to some individuals but not to others. Species identification can often be difficult, and the percentage of toxic species within genera varies considerably. More than 75% of Amanita species may contain some toxic substance, whereas less than 10% of Morchella species are potentially harmful. The frequency of occurrence of toxic species in a locale also changes the percentage encountered during any collecting foray.

Given the natural curiosity and hand-to-mouth behavior of young children, the desire of many to partake of "natural" foodstuffs, and the interest of some in ingesting "magic mushrooms" for their mind-altering properties, clinicians may easily be faced with the need to treat mush-room-poisoned patients.

In 1984, 4,742 of 5,806 total cases of mushroom exposure reported to the American Assiciation of Poison Control Centers National Data Collection System were in children less than 6 years of age.
Management of Nonfebrile Seizures
Authors: Vining Eileen P. G. , Freeman John M.
Published: December 2021

Single, nonfebrile seizures are not epilepsy, and although they often cause a major psychic trauma to the family they do not necessarily require hospitalization, CT scanning, or extensive workup. Anticonvulsant treatment is not obligatory and should, if used, be individualized. Only 30% of tonic-clonic seizures will recur, and most children who do require therapy can have it discontinued after 2 years.
Discipline and Permissiveness
Authors: Rosenfeld Alvin , Levine Dorothy
Published: December 2021

Discipline is education, not punishment. Be a good example to your children.

Numerous factors determine the child-rearing style individual parents select. Other than the overtly abusive, hostile, on grossly inconsistent style, no empirical research has shown some style of rearing to cause children serious damage or to be vastly superior. Much depends on the type of person the parents hope to rear.

Avoid the need to punish whenever possible. Reasonable limits and parental warmth and consistency are helpful to the child.

Although love may not be enough to enable a child to grow well, when it is combined with the child's day-to-day experience with an orderly adult who treats him or her warmly and fairly, the child will over the years, all by him or herself, with no great special effort from the parents, imitate that parents' behavior and incorporate their standards.
Tic Disorders in Childhood
Authors: Golden Gerald S.
Published: December 2021

Tic disorders in childhood vary in severity from transient simple tics to the most bizarre forms of Tourette syndrome. Early diagnosis is important to allow the child and family to understand the problem and to work with them to minimize the social disability caused by the disorder. Pharmacologic treatment will reduce symptoms in 80% to 85% of patients, but nearly one half of patients will have undesirable side effects from the drugs. Attention deficit disorder and learning disabilities are additional problems in between one third and one half of children. The treatment of attention deficit disorder with psychostimulants may exacerbate the tic disorder, making management of these children difficult. A substantial percentage of patients will either have a remission or a marked decrease in symptoms during the second half of adolescence. Because it is impossible to predict which patient will have a remission, and because there is no evidence that treatment will increase or decrease the chance for remission, management of the child and family must be close and continuous.
The Child With Persistent Cough
Authors: Morgan Wayne J. , Taussig Lynn M.
Published: December 2021

Chronic or persistent cough in the child is a common pediatric problem. While usually due to persistent airway irritation following common viral infections, it may be a sign of significant respiratory disease. The task is to separate the two and rule out or diagnose underlying conditions. This can be difficult, and an organized approach to potential etiologies of prolonged cough can be useful. In addition to addressing the problem of cough at face value, the practitioner should make sure that the parents do not have other hidden concerns about their child. Patient and parent education about the basic physiology of cough and the illnesses that may produce it can be useful in management. Therapy can then be directed to the underlying cause of the cough or used in a diagnostic manner, as in the case of a trial of bronchodilators.
Oral Rehydration Therapy and Dietary Therapy for Acute Childhood Diarrhea
Authors: Santosham Mathuram , Brown Kenneth H. , Sack R. Bradley
Published: December 2021

1. Oral rehydration therapy can be used to treat acute diarrhea of all ages, regardless of etiology and initial serum sodium value.

2. Vomiting is not a contraindication for oral rehydration therapy.

3. Intravenous fluids must be used in the initial management of children with severe dehydration.

4. Enteral feeding should be continued during diarrhea. If anorexia or malabsorption prevents sufficient intake during illness, compensatory nutritional therapy must be provided during convalescence to assure complete nutritional recovery.

5. Breast-fed infants should continue nursing during illness.

6. Infants who usually receive only cow milk or lactose-containing milkderived formula should be monitored for lactose malabsorption during diarrhea. Reduction in milk intake or a temporary change to a lactose-limited formula may be necessary in some cases.
Conversion Reactions in Adolescents
Authors: Prazar Gregory
Published: December 2021

Few situations in practice present as more frustrating for a busy pediatrician than an adolescent who appears for a ten-minute walk-in visit with a prolonged history of unexplained abdominal pain or headache. Obtaining a brief history of the symptom may contribute little to a timely diagnosis, and physical examination is often unrewarding in understanding the symptom. If the adolescent's demeanor suggests little discomfort, the pediatrician is often left with the impression that the pain is "psychosomatic" and/or that the adolescent is exploiting a physical symptom for some secondary gain. A diagnosis of conversion reaction is seldom considered. The focus of this article will be to aid the pediatrician in identifying conversion reactions, differentiating conversion reactions from other disorders (eg, hypochondriasis, malingering), and outlining an approach to the treatment and referral of patients with conversion reactions.

DESCRIPTION AND PREVALENCE

Conversion reactions represent a form of communication of the uncomfortable, or as Engel1 writes: "a psychic mechanism whereby an idea, fantasy, or wish is expressed in bodily rather than in verbal terms and is experienced by the patient as a physical symptom rather than as a mental symptom." The idea or wish is psychologically threatening to the individual or unacceptable for him or her to express directly.
The Pediatrician As Wage Earner
Authors: Nazarian Lawrence F.
Published: December 2021

When the statistics on physicians' earnings come out each year, the pediatricians are close to the cellar. Our colleagues in general practice make a little less; everyone else makes more. We were ahead of the psychiatrists, but they passed us a few years ago. Many of our colleagues have incomes that are multiples of ours.

I doubt whether the general public is aware of these figures. When the newspaper prints the median income for physicians, I wager that many readers would estimate ours even higher. They see our busy offices and decide, "He's rolling in it!" They are right, of course, except for what it is we are rolling in.
An Agenda for Improving Physician Reimbursement
Authors: Don Blim R.
Published: December 2021

In his commentary, "The Pediatrician as a Wage Earner," Dr Nazarian has expressed a concern well-known to all pediatricians. And, although most of us were aware of the economic facts of life before entering pediatrics, we were idealistic and/or altruistic enough that we ignored or at least minimized those facts. Subsequently, with long hours and hard work, most of us have managed to receive adequate monetary compensation, as well as extraordinary personal satisfaction—so much so that, if we had it to do over again, we would make the same choices.

Having said this, I would hasten to add that I think many physicians, particularly those dealing with procedural specialties, although equally dedicated, talented, and altruistic, receive an unconscionable income as a result of excessive charges.
Health Care Systems: A Pediatric Perspective
Authors: Don Blim R. , Matlin Nancy M.
Published: December 2021

The US health care system is undergoing a major transformation. The system is fiercely competitive and market driven. HMOs and PPOs are growing faster than anticipated, and the distinction between the two will blur as competition forces them to emulate each other. Those HMOs and PPOs that prove to be successful will control use, ensure quality, and restrain pricing. To survive, physicians must appreciate their need to assume control and must carve out their niche.
Management of the Infant of a Mother With Viral Hepatitis
Authors: Pickering Larry K.
Published: December 2021

Viral hepatitis includes a spectrum of conditions that result in clinically similar diseases that differ in etiology and epidemiology. An understanding of liver function tests and specific serologic tests is necessary to rapidly diagnose the cause of the hepatitis episode so that prophylaxis can be provided when appropriate. Hepatitis B virus infection is the best defined of the agents that cause viral hepatitis with regard to neonatal transmission and prophylaxis. Rapid diagnosis of pregnant women who are HBsAg carriers is critical so that prophylaxis can be given to their new-born infants to eliminate the carrier state and the potential for devastating future complications.
Infants with Cleft Lip/Cleft Palate
Authors: Suslak Lorraine , Desposito Franklin
Published: December 2021

A cleft of the lip and/or palate occurs approximately once in 750 live births with some variability among various racial groups. As an isolated defect, cleft lip with or without cleft palate is etiologically distinct from cleft palate alone. More than 250 clefting syndromes, most of them relatively uncommon, have been described. In 1970, less than 3% of all cases of cleft lip and/or palate were thought to be associated with identifiable syndromes. A recent survey from a major cleft palate center in New York showed that 30% of patients had recognizable conditions. Some of these included genetic syndromes and others like the charge association or those related to environmental agents were sporadic. Another 30% of cases had one or more associated anomalies, although a specific syndromic diagnosis or etiologic basis could not be identified. The remaining 40% had isolated clefts. A summary of syndromes with cleft lip and palate by etiology is given in Table 1. Approximately, half of the recognized syndromes are due to single-gene disorders with an equal distribution among autosomal dominant and autosomal recessive inheritance. Chromosomal abnormalities account for 18% of the clefting syndromes and would invariably be associated with other malformations, delayed development, and poor prognosis.
Atonic Seizures
Authors: Duchowny Michael S.
Published: December 2021

Seizures consisting of rapidly arrested movement are relatively common and account for approximately 12% of all episodes. Atonic seizure is the preferred designation for this form of clinical presentation, although more descriptive terms such as "drop attack" and "epileptic fall" are also popular. Many clinicians still use the term "akinetic seizure," but this is inaccurate because attacks of behavioral immobility with preserved muscle tone and consciousness cannot be differentiated from absence seizures. Furthermore, it is unlikely that neurophysiologic mechanisms can arrest behavior without altering muscle tone or compromising consciousness.

The accurate diagnosis and management of atonic seizures constitutes an important challenge for the practicing pediatrician. Whereas grand mal and petit mal seizures are well-known manifestations of epilepsy in childhood, seizures limited to the loss of muscle tone are more likely to go unrecognized. The large variety of nonepileptic conditions that mimic atonic seizures further adds to the difficulties of correct identification.

DESCRIPTION

Atonic seizures show considerable variation in presentation and severity. Typically, without warning, the voluntary muscles synchronously increase and then lose resting tone. No aura precedes these muscular changes. Both the myoclonic and atonic seizure components can cause the child to collapse limply to the ground. Massive myoclonus and loss of tone may even precipitate a violent fall from a sitting position (Fig 1), resulting in craniofacial injury, skull fracture, facial laceration, or dental trauma.
Pediatricians: Generously Caring or Self-Abnegating?
Authors: Conn Coulson A.
Published: December 2021

The essay in Pediatrics in Review, "Giving to Our Patients—Should We Draw the Line?," by Dr Larry Nazarian (1986;8:67), although thoughtful and making many good points, goes astray, I believe, when it deals with unfair demands placed on the pediatrician by parents. Dr. Nazarian succumbs to the tendency in each of us that creates so much frustration in practicing pediatricians: in caring for children we tend to adopt a parenting attitude, but then we inappropriately transfer this attitude to adults and also parent them. Too often, instead of dealing with parents as equals, we become paternalistic; of course, we deny this to ourselves and talk about being "caring" and putting ourselves in the child's place.
Nazarian's Response
Authors: Nazarian Lawrence F.
Published: December 2021

Dr Conn is right. Sometimes we do assume a parenting role in our dealings with the families under our care. Certain families encourage this attitude more than others, and some pediatricians are more comfortable with the situation than others. When this kind of relationship occurs, I believe it is more often helpful than harmful.

As a parent and as a teacher of parents, I practice and preach the establishment of limits and internalization of external controls, while encouraging the development of a child's personality and independence. The same principles apply to nurturing young parents as they struggle with unfamiliar responsibilities. I certainly do not encourage my children to make inappropriate demands, and the same goes for the parents of my patients.
Acute Respiratory Infections in Children: Etiology and Epidemiology
Authors: Denny Floyd W.
Published: December 2021

Acute respiratory infections are the most common affliction of humans, and their tendency to occur with much greater frequency in children makes them especially important to the pediatrician. A host of microbial agents can cause acute respiratory infections but only a few are responsive to antimicrobial agents. Because of the paucity of definitive laboratory tools that allow the easy recognition of the cause of acute respiratory infections, it is important for the practicing pediatrician to have other methods that aid in the clinical management of children with these infections. It is the purpose of this review to discuss the etiology and epidemiology of acute respiratory infections with emphasis on how this knowledge can guide the clinician in their management. The groundwork for the major emphasis of the paper will be laid by suggesting a classification of upper and lower respiratory tract infections. Causative agents will be enumerated and put into perspective. The major factors associated with the occurrence of acute respiratory infections will be discussed in some detail and several risk factors will be evaluated.

It is important for the reader to understand that the field of acute respiratory tract infections is so extensive and complex that a complete discussion of the entire field is not possible in this review.
Advances in Pediatrics
Authors: Zisman A.
Published: December 2021

A number of advances in behavioral and development pediatrics have occurred during the last 20 years that have changed pediatric practice. They should be added to the list of major advances by Dr Rapkin published last year (Pediatr Rev 1987;8:248).

Infant Temperament

The concept of infant temperament was formalized by Chess, Birch, and Thomas and popularized for pediatrics by Dr Carey. There are nine categories of temperament (activity level, rhythmicity or regularity of bodily functions, approach or withdrawal, adaptability, intensity of reaction, threshold of responsiveness, quality of mood, distractibility, and attention span and persistence). From this there has been a characterization of the difficult child: one who shows irregularity of bodily functions, intensity of reaction (of the negative kind), tendency to withdraw from new stimuli, and nonadaptability.
Colds That Were Colds and Those That Were Not
Authors: Stevens Mitchell
Published: December 2021

Gradually, through my interactions with children and their parents, through illness and health, I have acccumulated knowledge and developed skills that enable me to influence the establishment of a therapeutic relationship and thereby improve outcome, diagnosis, compliance, or a family's understanding and acceptance of the child's handicapping condition. For some reason, the plain old common cold, although it has defied a cure, perhaps can be put to some use as a crossroads for all that is important to the pediatrician and, I suppose, to the family. The child with the sneeze or stuffiness, with or without fever, crankiness, sore throat, earache, and/or trouble breathing, presents his or her parents with a possible question: Is this important?
Delinquency and the Pediatrician
Authors: Woolf Alan D.
Published: December 2021

Adolescents may be predisposed to delinquency by a double-jeopardy situation of clustering of risk factors in physical health (eg, perinatal or nervous system trauma, naurodevelopmental or cognitive dysfunction, neglected health problems) and the environment (eg, poverty, disordered family dynamics, poor education). Pediatricians must be attentive to neglected or previously undiscovered health problems in this population, such as overlooked cosmetic or congential defects, nutritional problems, substance abuse, vision and hearing difficulties, dental pathology, and sex-related conditions and diseases. Delinquents, especially during the transition into detention, are at particular risk for injuries, depression, and suicidal behavior. The complete health assessment of the delinquent should include a neurodevelopmental, cognitive, and educational progress assessment. This will facilitate implementation of an appropriate individualized remediation program. The pediatrician, in the dual role of health care provider for the family and child advocate in the community, can accomplish much toward the primary, secondary, and tertiary prevention of delinquency.
Attention Deficits in Adolescence: Description, Evaluation, and Management
Authors: Coleman William L. , Levine Melvin D.
Published: December 2021

Attention deficits may persist through childhood and into adolescence or they first may become manifest in adolescence. Their manifestations are often more subtle but Severe enough to exact a significant toll on academic performance. Associated learning disabilities, behavioral problems, and affective dysfunction, especially low self-esteem, are frequent concomitants or complications. On the other hand, some traits (such as creativity) of attention deficits may serve as redemptive features.

Evaluation necessitates a systematic gathering, synthesis, and interpretation of a vast amount of information as well as direct testing and observation. Compensatory strengths and other positive attributes should be elicited and mobilized.

Management should be individually tailored to the adolescent's specific needs and resources and implemented in a stepwise fashion. Intervention is usually multimodal, because attention deficits invariably affect several areas of function: academic, behavioral, social, and emotional. Management might include educational interventions, counseling, cognitive behavior therapy, behavior modification, and pharmacotherapy. Management should always include demystification, construction of a functional profile, specific advice-giving, encouragement, advocacy, and long-term follow-up, roles for which the pediatrician is especially qualified.

With increased awareness of the plight of adolescents with attention deficits, the pediatrician, working closely with other professionals, has an extraordinary opportunity to minimize the accusations, suffering, and maladaptive, self-destructive behaviors that have been so much a part of the adolescent's condition in the past. As we become more sensitive to the effects of endogenous dysfunction during adolescence, it will become increasingly possible to redeem the struggling young people in their own eyes and in the eyes of important adults in their lives.

Optimal evaluation and treatment is likely to be taxing, time-consuming, and expensive for all involved. However, the price of neglect, false attributions, and failure will be far higher.
Relationship and digital competencies of individuals in value creation in the Polish digitized environment
Authors: Ratajczak-Mrozek Milena , Wieczerzycki Marcin , Hauke-Lopes Aleksandra
Published: December 2021

The aim of this paper is to indicate how the relational and digital competencies of individuals impact value creation processes during a cooperation between companies in a digitized environment. The paper applies the case study method and analyzes a digitized small company operating in Poland and its cooperators (confectionery shops, end commercial businesses, and individual customers). The study contributes to the literature on individual and managerial competencies by addressing both the relational and digital competencies of individuals needed for value creation. It proposes a novel approach to the conceptualization of individuals’ relational and digital competencies needed for value creation in a digitized environment by companies from both digital and traditional industries. It also presents managerial implications and identifies the individual relational and digital competencies of Polish managers that are needed to create value in a dynamic, digitized environment.
The impact of perceived organizational support on knowledge sharing: A meditation analysis through an SEM approach
Authors: Winarno Alex , Prasetio Arif Partono , Dudija Nidya , Pratami Ciptaresmi Nadya , Liu Ran
Published: December 2021

Mobile cellular providers need to continuously upgrade their human resources capability to cope with market demand. In a high technology organization, knowledge is crucial to beating the competition. To accelerate knowledge dissemination, organizations can optimize their employees to share their experience and knowledge with others. This study examines the role of organizational support and affective commitment in enhancing knowledge-sharing willingness. We used a questionnaire to collect data from cellular companies in Jakarta, Indonesia, receiving 237 useable responses. The study reveals that if employees perceive that the organization provides adequate support, they become more willing to share their knowledge with others. Adequate support also increases emotional commitment, which in the end proves valuable to drive the willingness to share. Thus, affective commitment plays a mediating role in the relationship between perceived organizational support and knowledge sharing. These findings provide new insight into how to enhance the spirit of sharing between employees.
Institutional pressures, legitimacy, risks, uncertainty and voluntary adoption of IFRS for SMEs in Vietnam
Authors: Hiep Thien Trinh , Xuan Hung Nguyen
Published: December 2021

The purpose of this study was to determine the impact of institutional variables, risks, and dependence on the voluntary application of international financial reporting standards. The study used a quantitative research method based on regression analysis, with data obtained from a survey from among Vietnam's small and medium businesses. The findings confirmed that legitimacy, dependence, consistency, time, international trade, uncertainty, operational risk, financial risk, and industry all have a positive impact on the ability to voluntary application international financial reporting standards, with the exception of flexibility, which has a negative impact. The findings of the study have consequences for stakeholders in making proper policy decisions about the application of the International Financial Reporting Standards.
An assessment of the interrelations between country risk, economic growth and good governance: The case of the Visegrád four
Authors: Meyer Daniel Francois
Published: December 2021

nvestors assess the environment and the level of risk before they invest in a specific region or country. Several country risk indexes have been developed since the beginning of the 1990s, using risk factors such as politics, the economy and sovereign risk factors. This study aims to determine the relationships between the country risk index, economic performance and good governance. The study implemented a quantitative research methodology with panel data, focusing on the four Visegrad countries, using time-series data from 1996 to 2019. The results indicate both long- and short-run relationships. Both GDP and good governance significantly impact the country risk index with coefficients of between 0.17 to 0.31 and 0.02 to 0.15 according to different estimation models. The Granger causality results indicated that both GDP and good governance cause changes in the country risk indexes of the countries, and good governance causes increased economic performance. In conclusion, the study showed clear evidence that a lower country risk index is important to attract investment and sustained economic growth and good governance is critical in this process.
A model for assessing the digital transformation readiness for Vietnamese SMEs
Authors: Nguyen Thi Xuan Hoa  , Tuyen Nguyen Thanh
Published: December 2021

The paper aims to develop an econometric model for the routine diagnosis of enterprises' level of readiness for digital transformation (DT) on the example of small and medium-sized enterprises (SMEs) in Vietnam. The use of questionnaires allowed obtaining quantitative estimates of SMEs' level of readiness for DT in Vietnam. Factor analysis with the principal component method determines the list of factors of SMEs' readiness for DT. The ranges of the level of preparedness in Vietnam were determined, resulting in the classification of enterprises in the groups of "Newcomers," "Learners," and "Leaders" according to their use of digital technology and smart manufacturing. The integral index made it possible to quantify the impact of DT's readiness on SMEs' sustainability. The study results revealed that the nature of the impact depends on the level of SMEs' readiness for DT.
İslam’da Hac İbadetinin Psiko-Sosyal Boyutu
Authors: ÖZ Nedim
Published: December 2021

Bu çalışma, hac ibadetinin sosyal boyutunu sosyolojik perspektiften hareketle dokümantasyon yöntemiyle ele almaktadır. Amaç, hac ibadeti üzerinden insanın sosyal kazanımlarını belirlemektir. Din, gündelik hayatında insanın her bakımdan ihtiyaç duyduğu bir kurumdur. Zira din, birey ve toplumu derinden etkileyen kurumlardan biridir. Temelde akide, ibadet, dini cemaat şeklinde varlığını sürdüren dinin, sosyolojik anlatım şekillerinden olan hac, itikadın güçlenip pekişmesine, kardeşlik duygularının hissedilmesine vesile olmaktadır. Örneğin Kur’an’da, sosyo-kültürel bütünleşmeye yönlendiren mesajlar yanında hac ile namaz, oruç, zekât gibi ibadetler vasıtasıyla bütünleşmenin manevi temelleri atılmaktadır. Buna göre hac, psikolojik etkileriyle birlikte İslam toplumunun oluşmasında ve sürdürülmesinde kardeşlik, dayanışma, birbirini koruyup gözetme, birlikte sıkıntılara tahammül etme, iyilik ortak paydasında buluşarak toplumsal paylaşmayı gerçekleştirme gibi sosyal boyutları insanlara kazandırmaktadır. Bu yönüyle haccın, İslam dünyasının tarihsel, sosyal, siyasal, iktisadi sorunlarının konuşulduğu ve çözüm üretildiği bir niteliğe yeniden kavuşması gerekir. Dolayısıyla hac ibadetinin, sadece bireyleri, aileleri, grupları etkilemekle kalmayıp, toplumların ulusal ve ulus ötesi hayatını da düzenlemesi beklenmektedir.
Learning Optimal Decision Sets and Lists with SAT
Authors: Yu Jinqiang , Ignatiev Alexey , Stuckey Peter J. , Le Bodic Pierre
Published: December 2021

Decision sets and decision lists are two of the most easily explainable machine learning models. Given the renewed emphasis on explainable machine learning decisions, both of these machine learning models are becoming increasingly attractive, as they combine small size and clear explainability. In this paper, we define size as the total number of literals in the SAT encoding of these rule-based models as opposed to earlier work that concentrates on the number of rules. In this paper, we develop approaches to computing minimum-size “perfect” decision sets and decision lists, which are perfectly accurate on the training data, and minimal in size, making use of modern SAT solving technology. We also provide a new method for determining optimal sparse alternatives, which trade off size and accuracy. The experiments in this paper demonstrate that the optimal decision sets computed by the SAT-based approach are comparable with the best heuristic methods, but much more succinct, and thus, more explainable. We contrast the size and test accuracy of optimal decisions lists versus optimal decision sets, as well as other state-of-the-art methods for determining optimal decision lists. Finally, we examine the size of average explanations generated by decision sets and decision lists.
DP, NP, or neither? Contours of an unresolved debate
Authors: Blümel Andreas , Holler Anke
Published: December 2021

Glossa’s Special Collection New perspectives on the NP/DP debate brings together syntactic analyses of various phenomena of complex nominals, shedding light on the central problem of their syntactic category label. In this paper, we survey arguments and analyses offered in the Special Collection, classifying their underlying assumptions and highlighting their relevance to syntactic theory more generally.
Estate Planning and Wills Across Borders: Sometimes a Quagmire in the Making
Authors: Nel Eben
Published: December 2021

In this article a synoptic evaluation is made in respect of the estate planning and wills of South African nationals working, investing or living in foreign jurisdictions, in the broader context of globalisation and internationalisation. Estate planners and testators may inadvertently leave family members in a financially vulnerable position or diminish family assets due to a non-appreciation of international private law. The importance of international wills, the role of testamentary trusts, and the potential impact and reciprocity of international instruments are considered. The most applicable Hague Conventions and the EU Succession and Matrimonial Property Regulations are discussed in an attempt to give an overview of the current legal position. In discussing the role of international private law, its practical application is illustrated by way of reference to a few jurisdictions popular among South Africans with multi-jurisdictional estates, namely Malta, Portugal, the Netherlands and the United Kingdom. Although there may be more popular emigration jurisdictions amongst South Africans, this contribution focusses on the South African who lives, works and plays in a European context, without necessarily cutting his or her ties with the homeland. Not all attempts to harmonise wills, deceased estates, succession and matrimonial property regimes have been met with the same levels of enthusiasm by the international community. Contributing hereto may be the fact that fiduciary law deals with sensitive and very personal aspects of individuals and is closely linked to the different worldviews of communities. It is argued that not only fiduciary advisers and will drafters, but also attorneys and notaries involved with prenuptial agreements, should be proficient in the workings and implications of the applicable international instruments. Lastly, an argument is made for more pragmatic and commercial style thinking in the arena of fiduciary law.
Montessori Education: Teacher Perceptions of Challenges in Transitioning to Virtual Instruction
Authors: Scott Catherine M. , Myers Brooke
Published: December 2021

In 2020, Montessori teachers and families across the world had to adjust as schools were closed because of the rapid onset of the COVID-19 pandemic. Those working in the Montessori classroom, which typically favors a hands-on approach and limited use of technology, had to devise new ways to engage with students in the virtuallearning environment. How do teachers perceive that the transition to online learning affected their instruction? This descriptive case study examined the ways in which a school’s Lower and Upper Elementary Montessori teachers adjusted their instruction to meet student needs online, as well as the benefits and challenges that the teachers felt they and the students experienced as a result.