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Biomedical subjects

E Waters

Publications and source records attributed to E Waters.

At least 55 records · Page 3Linked to original sources
PubMed1999

Prevalence of emotional and physical health concerns amongst young people in Victoria.

OBJECTIVE: To describe the emotional and physical health concerns of young people, and identify the concerns for which young people are more likely to seek help. METHODS: We surveyed a representative cross-sectional samples of students from 11 to 18 years of age from 24 Victorian secondary schools in late 1997 within the Health of Young Victorians Study. Included in this survey were items describing worries or concerns of physical and emotional health. Prevalence rates, Chi-square, and logistic regression analyses were used to describe relationships. RESULTS: 2361 questionnaires were completed (53% male, response rate 70%). Overall, most frequent reports concerned feelings of depression (40%), worries about weight (37%), worries about self confidence (34%), and trouble falling or staying asleep (30%). Females tended to report a greater range of health concerns. The most frequent reports, by gender, were worries about their weight (52% females), and feelings of depression (30% males). Feelings of being bullied (20%), and concerns about sex, drugs and alcohol (7-11%) were reported equally frequently by males and females. In contrast to the high levels of health concerns reported, few students also reported seeing someone about them other than parents or friends. This finding appeared consistent across ages and for both sexes; with higher rates of seeking help for their physical rather than emotional health concerns. DISCUSSION: These results show that adolescents across Victoria are reporting high levels of concerns or worries about their health which differ across age and gender. They are more likely to report concerns about emotional health, but less likely to seek professional help than for physical concerns.

Adolescent↗
PubMed1998

The ethical imperative of child health population-based data a top-down/under-up analysis from the United Kingdom and Australia.

The policy move in both the United Kingdom and Australia to competitive primary care child health services (including preventive services and surveillance) has many advantages, but without secure and epidemiological information systems has the potential to put children at risk. More fundamentally, it produces the perverse effect of operating directly in opposition to the desirable policies of audit, outcomes studies, and evidence-based health care. Moreover, generations of children stand to be disadvantaged if environmental and ecological risk factors, as well as adverse clinical outcomes, cannot be identified quickly. Health informatics, linked to professional duties of clinical and fiduciary accountability, provide a way out of this conundrum. Standard clinical data sets, linked to invoicing procedures, would enable the development of summary records which could underpin integrated surveillance whilst also fuelling the new public health. Appropriate professional supervision, confidentiality and security measures, and agreement of data sets, would be necessary but not difficult in informatics terms. As health policy and delivery move forward, it is important not to lose the best aspects of previous systems and opportunities of future technologies.

Australia↗
PubMed1997

Improving clinical effectiveness: a practical approach.

The publication of the government white paper 'Working for Patients' (1989, HMSO) and implementation of subsequent NHS reforms has led to the development of a great number of initiatives designed to improve the quality of patient care and to make the provision of care more clinically and cost effective. Many of these initiatives, whilst laudable, have been developed in isolation and often without proper consideration of how they relate to one another or might practically be implemented throughout the NHS. It has commonly been the case that attempts to transfer the initiative from an environment of high enthusiasm and, often, high resource to the NHS in general has either failed or led to poor application. Strategies to improve clinical effectiveness have not become a feature of the everyday practice of many, let alone most or all, clinicians in the NHS. The result has been their failure significantly to raise standards of care across the NHS as a whole. It is suggested that many of the initiatives are closely related, and more effective implementation in the NHS as a whole may follow attempts to integrate them in a more practical approach to care management within an organization-wide clinical effectiveness strategy. It is further suggested that this is best achieved by a continuous quality improvement approach focusing on the care process as the centrepiece of the initiative, and that this method will lead to significant improvements not only in clinical effectiveness but also in cost effectiveness. This paper describes a proposed method of achieving these goals.

Cost-Benefit Analysis↗
PubMed1996

Discriminant validity of the adult attachment interview.

The Adult Attachment Interview is a semi-structured interview developed to investigate adults' attachment representations. Subjects are asked to describe their parents as caregivers, explain these descriptions, describe how their parents typically responded to distress, and discuss their current relationships with their parents. They are also asked to describe any significant losses and/or instances of abuse during childhood. Scoring focuses on the accessibility of early experiences to memory and the coherence and plausibility of the subject's narrative. Discriminant validity is always an important issue with such measures because IQ and other cognitively loaded variables offer plausible alternative interpretations or represent important correlates that should be treated as covariates when the measure is used. In addition, complex, multifaceted interviews always pose the risk of assessing general social adjustment rather than a more narrowly defined construct. This study examines the discriminant validity of the AAI vis(-)à-vis intelligence, social desirability, discourse style, and general social adjustment in a sample of 53 native-English-speaking, married women with preschool children. They were assessed with the AAI, a written IQ test, the Social Adjustment Scale, the Employment Experience Interview (discourse style), and a measure of social desirability. There were modest but significant correlations with IQ scores and social adjustment. There was no relation between AAI classifications and discourse style or social desirability. These results substantially strengthen the case for interpreting the AAI as an attachment-related measure.

Adult↗
PubMed1995

Toxic synovitis of the hip in children.

Toxic synovitis, an acute inflammatory condition of the hip, is the most common cause of limp and acute pain of the hip in children under 10 years of age. Usually, the synovitis and joint effusion are present unilaterally. The etiology of the condition is unknown, although in a few cases a recent history of an upper respiratory tract infection may be present. The child with toxic synovitis may complain of a limp and pain in the hip, the anteromedial aspect of the thigh, and the knee. The white cell count and erythrocyte sedimentation rate may be slightly elevated, as is the body temperature. Ultrasound is recommended as the primary imaging tool in the diagnosis and treatment of toxic synovitis. Septic arthritis, Perthes disease, and osteomyelitis are a few of the differential diagnoses that the practitioner should consider. Most cases can be managed with bed rest at home and administration of a nonsteroidal anti-inflammatory medication. Follow-up care should occur 2 weeks after diagnosis to ensure there is no recurrence of the joint effusion or progression to avascular necrosis. Radiographs of the hip should be repeated at 1 month and 3 months to complete the patient follow-up.

Child↗
PubMed1994

Complex karyotypic mosaicism as a result of non-disjunction and subsequent centromere fission.

Karyotypic discrepancy among four different cell types is described in tissues derived from a pregnancy terminated because of chromosomal anomalies. Chorionic villus cells demonstrated 46,XX (direct preparation) and 46,XX/47,XX,+mar1 (cultured cells) karyotypes, while fetal skin fibroblasts had a karyotype of 47,XX,+18 and the placenta showed a triple mosaicism of 47,XX,+18/47,XX,+mar1/48,XX,+18,+mar2. The origin of this complex chromosomal distribution and its significance are discussed in comparison with findings in similar cases.

Abortion, Induced↗
PubMed1994

The development of attachment: from control system to working models.

After two decades of theoretical and descriptive work, we know a great deal about the developmental course of early attachment relationships. We know considerably less about the mechanisms underlying consistency and change. Indeed, the most pressing issue in attachment theory is to explain well-replicated correlations between early care and subsequent patterns of secure base behavior, and between secure base behavior in infancy and subsequent behavior with parents and siblings, social competence, self-esteem, and behavior problems. As a step in this direction, we examine Bowlby's developmental outline, with an eye toward providing greater detail and incorporating traditional learning mechanisms into Bowlby's attachment theory.

Humans↗
PubMed1992

An unusual mosaic karyotype detected through prenatal diagnosis with duplication of 1q and 19p and associated teratoma development.

A 40-year-old white woman underwent amniocentesis for advanced maternal age at 15.4 weeks gestation. Fetal chromosome analysis demonstrated two distinct cell lines: [46,XX,t(1;19)(p11;p11)]--10%; and [47,XX,t(1;19)(p11;p11) + der(1)t(1;19)(p11;q11)]--90%. The latter karyotype was trisomic for both 1q and 19p. The mother carried the balanced translocation; the father had a normal karyotype. Amniotic fluid alpha-fetoprotein level was elevated and an acetylcholinesterase band was detected. Level II ultrasonography at 17 and 24 weeks revealed several abnormalities, including a large facial cleft and a probable facial teratoma and intracranial tumor. Autopsy following pregnancy termination confirmed the presence of both. Chromosome evaluation of 172 metaphases of both the epignathus and the intracranial teratoma demonstrated a predominance of the cell line with 47 chromosomes (166/172 = 96.5%), while from nonteratoma tissue (lung, liver, skin, and brain) only the balanced karyotype was detected. These observations suggest that the chromosomal imbalance is instrumental in the etiology of the teratoma.

Abnormalities, Multiple↗
PubMed1991

Marital adjustment, parental disagreements about child rearing, and behavior problems in boys: increasing the specificity of the marital assessment.

2 studies were conducted to illustrate how measuring a specific aspect of marriage, namely, child-rearing disagreements, provides a better understanding of the link between marriage and boys' behavior. In Study 1, 200 mothers of 3-year-old boys completed unstandardized measures of marital functioning and child behavior. An index of child-rearing disagreements: (1) correlated with a greater variety of behavior problems than nonchild disagreements, and (2) improved upon the prediction of behavior problems after accounting for nonchild disagreements as well as after accounting for boys' exposure to marital conflict. In Study 2, 87 mothers with 4-6-year-old sons completed the index of child-rearing disagreements used in Study 1 as well as standard measures of marital functioning and child behavior. Child-rearing disagreements: (1) predicted a greater variety of behavior problems than global marital adjustment, and (2) improved upon the prediction of internalizing problems after controlling for global marital adjustment as well as after controlling for boys' exposure to marital conflict.

Adaptation, Psychological↗
PubMed1990

Attachment behavior at home and in the laboratory: Q-sort observations and strange situation classifications of one-year-olds.

This article reports Attachment Q-set data and Strange Situation classifications of 58 1-year-old middle-class infants. Security, dependency, and sociability were scored from Q-sort reports of home observations. The primary analyses involve comparisons between securely attached infants (Group B) and anxiously attached infants (Groups A and C combined). Additional analyses compare anxious-resistant with anxious-avoidant infants. Secure classification in the Strange Situation was associated with quality of secure-base behavior at home (i.e., higher Q-sort security scores) and with sociability, but not with dependency scores. Descriptive analyses of individual Q-set items support the secure-base interpretation of Strange Situation security classifications. Relations between home security scores and interactive behavior scores from the Strange Situation were also examined by multiple regression analysis.

Arousal↗
PubMed1989

Security of attachment and preschool friendships.

Attachment theory proposes that the quality of the mother-child tie predicts the quality of a child's other close relationships. The purpose of this study was to test whether security of attachment to mother is related to the quality of a preschooler's best friendships. 33 4-year-old and their best friends participated (mean age = 46 months). Attachment Q-set data were collected to score security of mother-child attachment. Security data were used to classify the friend pairs as secure-secure or secure-insecure. Best friend dyads were observed for a 1-hour free-play session. Each pair's behavior was described with the Dyadic Relationships Q-set, a measure designed to describe the behavior of a pair of children. Secure-secure pairs were more harmonious, less controlling, more responsive, and happier than secure-insecure pairs. The results are related to previous work on attachment and social competence.

Child, Preschool↗
PubMed1989

Maternal responsiveness and child compliance: the role of mood as a mediator.

Parpal and Maccoby demonstrated that responsive maternal play increases children's compliance. They suggested that positive mood induction might be one mechanism mediating this effect. Study 1 tested the hypothesis that a responsive maternal play procedure would indeed induce a positive mood. 32 4-year-olds and their mothers participated. Half of the mothers were trained in a responsive play technique prior to a laboratory play session; half of them were not trained. Postplay self-reports of mood indicated that responsive play increased positive mood but did not affect arousal levels. Study 2 tested the hypothesis that experimentally induced positive mood increases compliance in the types of tasks reported in the Parpal and Maccoby's research. 24 4-year-olds were randomly assigned to either a positive or negative mood induction and then tested for response to maternal compliance demands. Children induced into positive moods complied more and complied with shorter latencies than children induced into negative moods. The fact that maternal responsiveness induces a positive mood points to a mechanism that may be significant in both attachment and socialization beyond infancy.

Adult↗