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Biomedical subjects

D L Coury

Publications and source records attributed to D L Coury.

At least 19 recordsLinked to original sources
PubMed1994

Blowing away shot pain: a technique for pain management during immunization.

OBJECTIVE: To study the effect of an active distraction technique on pain in preschool children receiving diphtheria, pertussis, and tetanus immunization. DESIGN: Randomized, unblinded controlled study. SETTING: Columbus Public Health Department Immunization Clinics. PARTICIPANTS: One hundred forty-nine 4- to 7-year-old children. INTERVENTION: Children were taught to blow out air repeatedly during the injection, as if they were blowing bubbles. RESULTS: Children who were taught to blow out air during their shots had significantly fewer pain behaviors (P < .04) and demonstrated a trend toward lower subjectively reported pain (P = .06). There was no significant difference in the nurse or parent visual analog scale scores. CONCLUSIONS: A simple distraction technique can be effective in helping children cope with the pain of immunization. The use of such a technique to relieve the pain and distress associated with even a brief painful procedure should be encouraged.

Child↗
PubMed1992

Educators' knowledge and attitudes regarding stimulants in the treatment of attention deficit hyperactivity disorder.

Educators often are asked to provide information regarding students' responses to medication used for the treatment of attention deficit hyperactivity disorder (ADHD). We designed a questionnaire to determine the knowledge and attitudes of educators regarding stimulants. Two hundred ninety-one regular classroom and special education teachers in two Ohio school systems received the questionnaire; the overall response rate was 65%. Our findings suggest that educators generally believe stimulants are useful for students with ADHD and that they frequently recommend them to parents. However, educators indicated their knowledge of the effects of stimulants was limited and that they had received little education about stimulants. Physicians requesting input from educators regarding students taking stimulants should be aware of the limitations of educators' knowledge and participate in the development of programs to improve that knowledge.

Attention Deficit Disorder with Hyperactivity↗
PubMed1991

A guide to critical reading of the literature in behavioral and developmental pediatrics.

The field of behavioral-developmental pediatrics covers a wide range of topics, problems, and conditions. A variety of professionals including pediatricians, psychologists, child psychiatrists, social workers, nurses, and educators are involved in research and clinical care. Each of these disciplines uses a variety of methodologies, each of which has its advantages and disadvantages. Different categories of research and methods of critiquing the literature in behavioral and developmental pediatrics are described.

Child↗
PubMed1988

Characteristics of fatal gunshot wounds in the home in Oklahoma: 1982-1983.

Children are a unique group at risk of injury from firearms because of their immaturity, curiosity, and imitative behavior. All unintentional firearm deaths in persons younger than age 20 years that occurred in Oklahoma in 1982 and 1983 were reviewed. There were 32 unintentional deaths from firearms in children from birth to age 19 years. The death rate in rural counties was four times that of urban counties. Twenty-seven deaths (85%) occurred at home, with an adult present in only two cases. The home death rate for males was 5.2 times that of females, with 15- to 19-year-old males most at risk. The rates among whites and Native Americans were similar, at 1.5 and 1.2 per 100,000, respectively, with no deaths among the black population. This review concurs with previous studies that firearms are a significant cause of mortality in the pediatric age group. Counseling parents about the hazards of firearms may prevent deaths through better supervision and more responsible gun care and storage.

Accidents, Home↗
PubMed1988

Bruising and hemophilia: accident or child abuse?

Recognition and prompt reporting of suspect child abuse or neglect is necessary to institute programs aimed at preventing further neglect, re-injury or possible death. The families of children with chronic medical conditions, such as hemophilia, may be affected by economic and emotional stresses which may be expressed as abuse or neglect. Because the manifestations of even slight trauma are so common in children with bleeding problems, the physician may not routinely inquire about the cause of injury, delays in seeking medical attention, or accident prevention efforts in the home. Early referral of children with hemophilia to a multidisciplinary team providing medical, psychological, and social care is recommended.

Accidents, Home↗
PubMed1987

The Children's Depression Rating Scale for normal and depressed outpatients.

The Children's Depression Rating Scale (CDRS) was devised by Poznanski, Cook, and Carroll in 1979, to diagnose depression in 6- to 12-year-olds. The authors state a score of 30 indicates significant depression, with scores in the 20 to 30 range indicating borderline depression. Normative outpatient data for the CDRS have not, however, been established. In this study, 25 apparently well-adjusted children from a pediatric primary care unit were evaluated by the CDRS. Their scores (ranging from 16 to 18) differed significantly from the normal values noted by the founders of the scale, based on the study of inpatients. On the other hand, a study of six of our clinically depressed children indicated scores of 22 to 49. With this definition of the normal score the outpatient child who scores greater than 20 is classified as in need of close follow up to determine if he is depressed.

Child↗
PubMed1987

Test-retest reliability of the Revised Children's Manifest Anxiety Scale.

Test-retest reliabilities of the Revised Children's Manifest Anxiety Scale over 1- and 5-wk. intervals were examined for two samples of students, 73 boys and 88 girls in regular sixth, seventh and eighth grade classrooms (11 yr. to 14 yr.). For raw scores the test-retest Pearson r was .88 (1-wk.) and .77 (5-wk.), indicating good reliability. For both samples there was a small difference between test (12.2 for 1-wk. sample; 11.4 for 5-wk. sample) and retest (11.2 for 1-wk. sample; 9.8 for 5-wk. sample) mean raw scores. Implications for test use are discussed.

Adolescent↗
PubMed1981

Cardiac manifestations of Rocky Mountain spotted fever.

An increasing incidence of Rocky Mountain spotted fever is being noted across the United States. From 1955 to 1978 80 children with this disease were seen in a children's hospital. Autopsies were performed in six of the nine fatal cases, and cardiac lesions were seen in each. Multifocal myocarditis with petechiae was present in four cases, and in two of them there were areas of myocardial necrosis. In four of the necropsied cases there were electrocardiographic changes and cardiac enlargement on chest roentgenogram. Among survivors five patients manifested at least one cardiac abnormality. ST-T changes were noted in two patients, atrioventricular conduction disturbance in two, and severe left ventricular hypertrophy in one patient. Cardiomegaly was observed in three patients, and one had severe cardiac failure that responded to medical management. Cardiac involvement is frequently present in Rocky Mountain spotted fever, and close observation seems to be warranted.

Adolescent↗
PubMedDate not supplied

Evaluating medication response in ADHD: cognitive, behavioral, and single-subject methodology.

Although evidence supports the use of double-blind placebo medication trials to evaluate methylphenidate (MPH) effects on the core behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD), few studies have demonstrated their utility in examining MPH effects on the cognitive deficits associated with ADHD. This article presents a technique for evaluating behavioral and cognitive dose-response relationships at the single-subject level of analysis. Case study results and multivariate analyses suggest that systematic evaluation of behavioral and cognitive MPH dose-response relationships could lead to more accurate MPH titration and greater long-term multimodal treatment efficacy.

Adolescent↗
PubMedDate not supplied

Temperament as a predictor of behavior during initial dental examination in children.

Temperament refers to children's behavioral style, or the manner in which they interact with their environment. Temperament has been quantified into nine temperament categories and five temperament constellations by Thomas and Chess. Temperament categories and constellations of children can be measured using one of several parental questionnaires, each of which focuses on age-appropriate behavior. For this study the Behavioral Style Questionnaire (BSQ) was administered to the parents of 50 healthy children (mean age 48.8 months) receiving initial dental examinations. The examinations were videotaped and The Ohio State Behavior Rating Scale (OSUBRS) was used to rate each child's behavior into one of four behavioral categories: 1) quiet; 2) crying only; 3) disruptive movement only; and 4) crying and disruptive movement. For data analysis the percentage duration of each behavioral category was calculated. Using one-way ANOVA, significant differences between constellations were found for quiet (P = 0.03) and combination behavior (P = 0.03). Using a stepwise linear regression, the temperament category of approach/withdrawal was found to predict the percentage of quiet (multiple R = 0.42357, R2 = 0.17941, and P = 0.002), crying (multiple R = 0.42124, R2 = 0.17744, and P = 0.002), and combination behaviors (multiple R = 0.30008, R2 = 0.09005, and P = 0.03). Additionally, significant regressions were found with temperament categories predicting behavioral categories depending on the child's age. The results of this pilot study suggest that the BSQ temperament constellations and categories appear to be modest predictors of a child's specific behaviors in the dental environment. Knowledge of a child's temperament may prepare the clinician to predict patient behaviors in the dental environment.

Analysis of Variance↗