Objectives:
Norwegian Centre of Expertise for Neurodevelopment Disorders and Hypersomnia (NevSom) has since 2010 followed up children who developed narcolepsy after 2009 (+/- swine flu (H1N1). High prevalence of psychiatric symptoms has previously been reported in narcolepsy patients. School observations and clinical consultations have revealed severe school problems in the cohort. We now conduct a study assessing psychiatric- and cognitive issues in order to characterize their psychiatric comorbidity and academic difficulties.

Methods:
The study explores parent`s assessment of their child’s psychiatric disorders and executive function after onset of disease. Total 33 children/adolescents, age from 7-19 years, with narcolepsy, 30/33 taking medication for their narcolepsy. Parents filled out Behavior Rating Inventory of Executive Function (BRIEF), and experienced clinicians (first authors) completed the diagnostic interview Schedule for Affective Disorder and Schizophrenia -present and lifetime version (Kiddie-SADS-PL), providing DSM 5 psychiatric diagnoses, with parents, and rated adaptive function by Children’s Global Assessment Scale (CGAS).

Results:
Parents of 10 children (33.3%) reported at least one present psychiatric condition in their child: the most common being ADHD n=4 (13.3%), anxiety n =3 (11.4%), major depressive disorder n = 3 (8.6 %), autism spectrum disorder n=2 (6.7%), tics disorder n=3 (10.0%). On the BRIEF 22/33 had clinical significant abnormality (T score >65) in at least one of the eight subdomains scores. The most frequently affected subdomain was working memory (54,5%), followed by plan/organize (36,4%). Having a psychiatric comorbid condition, and total scores on the BRIEF was significantly associated with impairment on CGAS (p=0,001 and p<0,001 respectively)

Conclusions:
Even on medication children/adolescents with narcolepsy have high prevalence of psychiatric comorbidity and executive dysfunction.
Moreover, having a psychiatric comorbidity and executive dysfunction were both significantly associated with worse overall adaptive function.
Clinicians need to consider and take care of both core narcolepsy symptoms, psychiatric comorbidity and cognitive difficulties in order to improve daily life and enhance better facilitation for the patients.

Introduction:
Rates of incontinence are higher in persons with genetic syndromes than in typically developing peers. They are associated with the level of intellectual disability (ID). So far, incontinence was examined only in specific syndromes. The aim of this study was to compare the rates of incontinence over the life span and to identify risk factors in a large cohort of several syndromes using the same methods.

Methods:
Parents/carergivers of persons with Down Syndrome (DS), Williams Syndrome (WBS), Noonan Syndrome (NS), Angelman Syndrome (AS) and Mowat-Wilson Syndrome (MWS) filled out two questionnaires on incontinence, as well as the Developmental Behavior Checklist (DBC). Data from 773 individuals aged 4-59 years (nDS=317, nWBS=231, nNS=29, nAS=153, nMWS=43) in 3 age groups (children: 4-12 years; teenagers: 13-17 years; adults: >18 years) were evaluated.

Results:
The overall rate of incontinence ranged between 21.7% (WBS) and 97.5% (MWS) (DS=25.5%; NS=29.2%; AS=85.6%). Incontinence rates decreased significantly over the age groups in DS (64.0% - 10.3% - 14.0%), WBS (51.5% - 19.4% - 4.7 %) and AS (96.6% - 92.6% - 74.0%), but not in NS (50.0% - 14.3% - 16.7%) and MWS (95.7% - 100 % - 100%). Constipation was found in NS only in childhood (30%), while there was a significant increase with age in MWS (13.0% - 55.6% - 50.0%). In DS, WBS and AS, the rates remained constant through the lifetime. Incontinence is associated with psychological symptoms in WBS and DS, with epilepsy in AS and with physical disability in DS.

Conclusion:
This is the largest study on incontinence conducted in persons with genetic syndromes, so far. Incontinence is common and remains a problem from child- to adulthood, especially in syndromes with severe ID. Not only ID, but also other medical influences (anomalies/malformations, epilepsy, dementia, psychiatric disorders) are involved as risk factors for incontinence.

Objectives: Today, biomedical technologies can defy the laws of “natural” growth and procreation, by enabling transgender persons not only to reach their true identity as a subject, but also to access parenting. Biotechnologies applied to gender dysphoria improve adolescent well-being via gender transition. Assisted reproductive biotechnologies help couples that cannot have children via “natural ways” to access parenting. In each domain, ethical aspects have been studied and are still debated given the societal impact.
Based on clinical multidisciplinary seminars gathering child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART and endocrinologists interested in pubertal suppression, we explore how new biotechnical opportunities - be it in gender transition or procreation - make new cycles of life possible.

Methods: This research was carried out by a systematic analysis of the articles published on this topic since 2011, by keyword entries on the pubmed database. These key words were Transgender people, Gender Dysphoria, Assisted Reproduction Technology, Gender transition, Ethics, LGBT Health. The references mentioned by these papers in relation to the topic were then also analyzed. The whole was discussed at the clinical multidisciplinary seminars.

Results: After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for human beings to access self-actualizing and parenting, by defining new cycles of life, introduce a real improvement to the condition of these people (and to the human condition as a whole through greater equity) but also some disjunction points in the habitual patterns of traditional thinking, shaking the symbolic marking of many.

Conclusion:
Finally, we discuss the ethical issues that accompany the arrival of these "children of science" and provide creative solutions to help society cope with, accept and support, the developments already made in this area.

OBJECTIVES: The aims of the study were: (1) to evaluate the prevalence of psychiatric, behavioral and emotional disorders; (2) to determine the relationships between the occurrence of psychiatric symptoms and their clinical and sociodemographic correlates.

METHODS: 56 children with perinatal HIV infection at the age of 6-18 years were qualified to the experimental group (PHIV+). Two groups, matched for age and sex, were recruited as reference groups: (1) group PHEU included 24 healthy children perinatally HIV-exposed but uninfected; (2) group HIV-nA consisted of 43 healthy children of uninfected parents. Behavioral and emotional problems were evaluated by the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR). Diagnostic interview (K-SADS-PL) was used to assess symptoms of mental disorders according to DSM-IV criteria.

RESULTS: 22 (40%) children PHIV + were diagnosed with at least one psychiatric disorder in the course of the project, and 29 (52.7%) were diagnosed during the lifetime. Anxiety disorders (21.8%), externalizing disorders (18.2%) and mood disorders (16.4%) were diagnosed in this group most often. Psychiatric disorders were more observed in patients whose antiretroviral (ARV) treatment was started after the 12 months of age. The prevalence of psychiatric disorders, externalizing and internalizing disorders in children PHIV + was not significantly higher than in both control groups (PHEU: 37.5%, p=0,993; HIV-nA: 23.2%, p=0,43). Children from the PHIV + group scored below the clinical range for all scales in CBCL and YSR. However, parental reports, of PHIV+ group revealed higher severity of problems on withdrawal, social and attention problems scales compared to PHEU group. Increased severity of problems in the YSR problems scales: delinquent behavior, aggressive behavior and externalizing behavior problems was found in subjects with other than C class of HIV infection.

CONCLUSIONS: The prevalence of psychiatric disorders in PHIV + group and the PHEU group is higher in comparison with HIV-nA group, but the profile of the diagnosis is characteristic for the general population. Greater severity of internalizing problems is observed in PHIV+ children compared to PHEU group as well as externalizing problems compared to HIV-nA group.

1. Background/ Objectives and Goals

Over the decade of child care development center have been establish in Thailand’s society.
There are approximately 22,000 child care centers under the management of department of Local Administrations, Ministry of Interior. In 2013 the Thai Health Promotion Foundation funding the research project named “the Capacity of Community treasures (COACT)”. The COACT project is aiming to develop the model for improves the quality of child care centers. There are fifteen child care centers in Thailand and three child care centers in Northeastern were participating in COACT project.

2. Methods
Utilizing the method of Participatory Action Research (PAR) working alongside with the three local administration organizations as following, Ban Phu district Udonthanee Province, Wapee Partum district Sarakam Province and Kud Khon Kaen district Khon Kaen Province. This research project was conducted during May 2013 until July 2016.

3. Expected Results/ Conclusion/ Contribution
The Bench-marking model was employed for step learning. There were 52 categories of child care’s key performance index. The group learning is key main success for the model development. The two prototype of standardize child care centers were reveled and certified. In conclusion, the prototype child care centers in Northeastern of Thailand now establish the net working in order to improve other child care centers in Northeastern of Thailand.

Keywords:
1. Bench-marking
2. Model development
3. Standardize Child care center