Large multifocal cardiac myxoma causing the sudden unexpected death of a 2-month-old infant--a rapidly growing, acquired lesion versus a congenital process?: a case report

We report the occurrence of a clinically undiagnosed biatrial myxoma with left ventricular involvement in a 2-month-old male infant, resulting in sudden death. During a routine well-baby examination, a grade (34) holosystolic murmur was detected at the left sternal border with radiation to the axilla and back. On the following day, the patient collapsed and died suddenly. An autopsy revealed a large multifocal neoplasm diffusely involving the aortic valve while displaying mitral, tricuspid, and left ventricular extensions. The ensuing histopathologic and immunohistochemical studies were diagnostic for myxoma. We discuss the occurrence of cardiac myxoma within the pediatric population and review the literature as to theorize whether this lesion was a congenital process versus a rapidly growing tumor that developed after the child was born. Lastly, we address the potential for sudden death in patients with such tumors.     

Examination of the Relationship Between Parental Satisfaction and Child Maltreatment Potential While Considering Social Desirability

Parental dissatisfaction with children appears to be associated with child maltreatment. However, little is known regarding the specific domains of parental dissatisfaction that may increase child maltreatment potential, particularly in perpetrators of child maltreatment where substance abuse is present. In this study, responses to the Child Abuse Potential Inventory (CAPI) and a scale measuring parental satisfaction in 11 domains were examined in a sample of 82 mothers who were referred for treatment of substance abuse and child neglect by the local child protective service agency. Results indicated that mothers were relatively most satisfied with their children overall, and least satisfied in domains that were relevant to discipline (i.e., following house rules, compliance, reaction to redirection and punishment, completion of chores). Five of the 11 areas of parental satisfaction that were assessed evidenced negative correlations with child abuse potential, indicating that as satisfaction increased, abuse potential decreased. However, when correlation analyses excluded participants with elevated CAPI Lie scale scores (a measure of social desirability), only overall happiness demonstrated a significant negative correlation with child abuse potential. These results suggest that while associations are present among measures of parental satisfaction and child abuse potential, these associations are moderated to some extent by social desirability, which may help explain some of the inconsistencies reported in prior studies of parental satisfaction and child maltreatment potential.     

Using iPhones? to Enhance and Reduce Face-to-face Home Safety Sessions within SafeCare?: An Evidence-based Child Maltreatment Prevention Program

Innovative handheld technologies are changing the possibilities for public health interventions. The present research describes a preliminary examination of the iPhone? when used as an assessment tool and an enhancement to an evidence-based, in-home child safety intervention. Three families with young children received an augmented version of the Safety module of SafeCare, a home-visiting child maltreatment prevention program. Specifically, parents were trained to use an iPhone to video rooms in their homes, as well as communicate feedback, logistics, and safety content between the home visitor and parent. The effectiveness of iPhone and video was examined using a multiple baseline design across in-home settings replicated across families. Home hazards were reduced dramatically across rooms and across participants. Face-to-face time of the home visitor was progressively reduced and replaced by video data collection. These data suggest smartphones are promising for data collection and for augmenting face-to-face interactions. Implications for reducing costs as smartphones become increasingly ubiquitous and for engaging and retaining participants are discussed.     

The relationship of violent fathers, posttraumatically stressed mothers and symptomatic children in a preschool-age inner-city pediatrics clinic sample

This study aims to understand if greater severity of maternal posttraumatic stress symptoms (PTSS), related to maternal report of interpersonal violence, mediates the effects of such violence on (a) child PTSS as well as on (b) child externalizing and internalizing symptoms. Study participants were mothers (N = 77) and children 18 to 48 months recruited from community pediatric clinics. Data were analyzed continuously via bivariate correlations and then multiple linear regression. Post hoc Sobel tests were performed to confirm mediation. Paternal violence accounted for 15% of the variance of child PTSS on the PCIP-OR (β = .39, p ≤ .001). While the child's father being violent significantly predicts child PTSS related to domestic violence, as mentioned, when maternal PTSS is included in the multiple regression model, father's being violent becomes less significant, while maternal PTSS remains strongly predictive. Sobel tests confirmed that maternal PTSS severity mediated effects of paternal violence on clinician-assessed child PTSS as well as on maternal report of child externalizing and internalizing symptoms. When presented with a preschool-aged child who is brought to consultation for behavioral difficulties, dysregulated aggression, and/or unexplained fears, clinicians should evaluate maternal psychological functioning as well as assess and treat the effects of interpersonal violence, which otherwise may be avoided during the consultation.     

History of interpersonal violence, abuse, and nonvictimization trauma and severity of psychiatric symptoms among children in outpatient psychiatric treatment

In a clinical sample of child psychiatry outpatients, chart review data were collected for 114 consecutive admissions over a 1-year period at a Child and Adolescent Outpatient Psychiatry Clinic. Data included history of documented maltreatment, potentially traumatic domestic or community violence, neglect or emotional abuse, and noninterpersonal stressors as well as demographics, psychiatric diagnoses, and parent-rated child emotional and disruptive behavior problems. On a bivariate and multivariate basis, any past exposure to interpersonal violence-but not to noninterpersonal traumas-was related to more severe disruptive behavior problems, independent of the effects of demographics and psychiatric diagnoses. Noninterpersonal trauma and psychiatric diagnoses were associated with emotional problems; exposure to interpersonal violence appeared to partially account for this relationship despite not being independently associated with emotional problem severity. History of exposure to interpersonal violence warrants clinical and research attention as a severity marker and potential treatment focus in psychiatric outpatient services for children, particularly those with disruptive behavior problems.     

SETTLEMENT‐FOCUSED PARENTING PLAN CONSULTATIONS: AN EVALUATIVE MEDIATION ALTERNATIVE TO CHILD CUSTODY EVALUATIONS

The divorce mediation field has recently seen the development of several “hybrid” alternative dispute resolution approaches to child custody disputes. The “settlement‐focused parenting plan consultation” (SFPPC) is a form of evaluative mediation, conducted by a “parenting plan consultant” (PPC), who possesses the combined expertise of a mediator and child custody evaluator. This hybrid model is a more expedient and considerably less expensive approach than a child custody evaluation, but preserves the hallmark mediation principle of self‐determination. The article describes the theory underlying the SFPPC, delineates the role requirements, procedures, and techniques of the parenting plan consultant, and addresses legal and ethical issues.     

Translating into Votes: The Electoral Impacts of Spanish‐Language Ballots

This article investigates the impact of one election procedure designed to enfranchise immigrants: foreign‐language election materials. Specifically, it uses regression discontinuity design to estimate the turnout and election impacts of Spanish‐language assistance provided under Section 203 of the Voting Rights Act. Analyses of two different data sets—the Latino National Survey and California 1998 primary election returns—show that Spanish‐language assistance increased turnout for citizens who speak little English. The California results also demonstrate that election procedures can influence outcomes, as support for ending bilingual education dropped markedly in heavily Spanish‐speaking neighborhoods with Spanish‐language assistance. Small changes in election procedures can influence who votes as well as what wins.