"We thought we were stronger than we were": adopters' narratives about the adoption journey and disruption.

Introduction: Although the majority of adoptive families remain stable, some of them break up prematurely. Methods: Adopting a qualitative approach, this study gave voice to seven adoption applicants who began the adoption journey with one or more children but did not complete the legal process. Our goal was to understand their experiences throughout the adoption process and disruption. Results: The results show how adoption applicants went, in a short period, from the excitement of finding a child or sibling group to disillusionment and trauma. The main risk factors that hinder adoption stability include unrealistic expectations, intuitive choice of the child in the absence of accurate information, challenges posed by the child's particular characteristics, and lack of professional support. Discussion: Our study highlights the need for adopters to be assisted throughout the entire process by specialists, to be better prepared to deal with the complex needs of children in the protection system, and to facilitate their access to a complex of specialized services to meet the different needs of every family.

Return to work after chronic disease: A theoretical framework for understanding the worker-employer dynamic.

OBJECTIVES: Return to work after chronic disease is important for workers, employers and society. The process, however, is challenging. This article provides an analytical and theoretical framework for explaining this process informed by the person-environment fit theory. METHODS: This article uses a narrative method to (1) review the key concepts, benefits and influencing factors in the literature on return to work after chronic diseases, (2) analyse and critique the most important theoretical models used for explaining return to work after chronic diseases, and (3) review the person-environment fit theory and how it has been used so far. RESULTS: The existing models highlight different aspects, but they overlook the relationship between the worker and the employer. An analytical and theoretical framework is proposed to comprehensively explain the worker-employer dynamic. The framework also considers the role of broader factors (policy, labour market) and other stakeholders (health professionals, civil society actors) emphasising the idea that return to work is a phased and cyclical process. DISCUSSION: The framework can be used to guide future qualitative and quantitative studies, or as a map for identifying problematic areas related to the worker or the work environment. The model should be empirically tested in future studies.

Use of Repetitive Transcranial Magnetic Stimulation in Child Psychiatry.

Objective: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive diagnostic and therapeutic technique that has showed benefits in various psychiatric disorders. Although there is a large body of literature available on its use in adult populations, existing research in pediatric populations is very limited. Current research has primarily focused on its use in adolescent treatment-resistant depression. However, recently, rTMS has gained attention among researchers to find its utility in other neuropsychiatric disorders, such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), tics, and psychosis. There is a lack of systematic data on the safety of rTMS in children and adolescents. The aim of this article was to present an overview of the existing literature on the use of rTMS in children and adolescents and examine the relevant safety considerations. Methods: We conducted a literature review of the English literature in PubMed on TMS in children and adolescents, using comprehensive search terms and expanding our review to include sources cited by these reports. We reviewed the application of rTMS in psychiatric disorders in the pediatric population. Results: rTMS has been used for depression and anxiety disorders, OCD, ADHD, Tourette syndrome/tics, ASD, and schizophrenia, with variable results. Conclusion: rTMS is a promising treatment in children and adolescents with psychiatric disorders, although larger, sham-controlled, randomized, controlled trials (RCTs) will be required to definitely demonstrate efficacy, as well as to support a safety profile.

Medicolegal Implications of Mild Neurocognitive Disorder.

INTRODUCTION: The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications. METHODS: We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports. RESULTS: Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual's abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving. CONCLUSION: Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.