Search PubMed⌕ Search

Biomedical subjects

F D Armstrong

Publications and source records attributed to F D Armstrong.

27 records · Page 2Linked to original sources
PubMed1993

Pediatric HIV infection: a neuropsychological and educational challenge.

Pediatric acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection will soon be the primary infectious cause of perinatally acquired developmental disabilities in the United States. HIV encephalopathy and a variety of opportunistic infections, neoplasms, and vascular changes associated with pediatric HIV infection create a high probability of neuropsychological impairment among preschool and school-age children infected perinatally. Although the use of antiretrovirals may moderate some of the functional difficulties faced by these children, specific neuropathological and neuropsychological deficits are likely to remain. Treatments that prevent the central nervous system (CNS) effects of HIV have yet to be identified. As the epidemic progresses among women of child-bearing age, well-controlled developmental studies are needed to further clarify the relationship between HIV and child development, and to aid professionals in developing appropriate, school-based educational plans.

AIDS Dementia Complex↗
PubMed1993

Differential medication of child versus adult postoperative patients: the effect of nurses' assumptions.

We examined nurses' assumptions concerning children and analgesia that have been hypothesized to explain the differential medication of postoperative child and adult patients. One hundred fourteen nurses from various pediatric and adult inpatient units of a large, urban teaching hospital were included in the study. A questionnaire consisting of four vignettes describing two hypothetical postoperative situations involving a child and adult patient, questions concerning choice of analgesic and assessment of pain for the hypothetical patients, and questions concerning the nurses' assumptions about children and analgesia was distributed to each nurse. The findings illustrate a pattern of differential medication of hypothetical child relative to hypothetical adult postoperative patients. The belief that children feel less pain than adults and concern about respiratory depression were associated with nurses' analgesia decisions.

Adult↗
PubMed1992

Impact of children's sickle cell history on nurse and physician ratings of pain and medication decisions.

The process of assessing and treating recurrent and unpredictable pain in children with sickle cell disease (SCD) is complex. A conceptual model is presented to aid in understanding the influence of mediating factors such as professional knowledge, attitudes and beliefs about pain, and learning history on the interpretation of objective data and resulting treatment decision. One aspect of this model, the effect of disease history on pain assessment and treatment decisions, is tested in an experimental study of SCD pain in children. Results suggest that nurses, but not pediatric residents, provide lower doses of narcotic analgesics to children with histories of frequent, as opposed to occasional, hospitalization for pain, although they do not differ in their ratings of the pain of children with these histories. Neither professional experience and training nor reported attitudes and beliefs about pain in children are related to this pattern of decision making. Results are discussed in terms of the aversive impact of repeated exposure to a noxious stimulus (pain behaviors) on caregiver interpretation of pain cues.

Adaptation, Psychological↗
PubMed1989

Effects of parent presence on children's reactions to injections: behavioral, physiological, and subjective aspects.

Observed 47 children ranging in age from 13 months to 7 years 9 months receiving injections as part of a regular visit to a pediatric clinic. Twenty-three children were randomly assigned to a condition with parent (mainly mothers) present and 24 to a condition with parent absent. During the medical procedure, the child's reactions were observed via videotape (for later behavioral coding) and physiological recording (to measure heart rates). Following the injection, data were collected on the child's preference of condition (either parent present or parent absent) for future injections. Older children (but not younger ones) showed significantly more behavioral distress when the parent was present. However, the oldest children's preference of condition for future injections was overwhelmingly that of parent present (86%).

Arousal↗
PubMed1986

Preparing children for medical examinations: the importance of previous medical experience.

The relationship between past medical experience and children's response to preparation for medical examinations was investigated in 79 pediatric outpatients aged 3 to 12 years. Children were randomly assigned to one of five preparation conditions prior to receiving a medical examination and a throat culture: sensory information about the exam, training in coping skills (deep breathing and positive self-talk), combined sensory information and coping skills training, attention control, and no-treatment control. The results indicated that children with previous negative medical experiences demonstrated more behavioral distress during a throat culture examination that did children with previous positive or neutral medical experiences. In addition, the attention control condition appeared to increase the distress of children with previous negative medical experiences. Amount of past exposure to the specific medical procedure was not related to observed distress. The implications of these findings for the preparation of children for medical procedures are discussed.

Affective Symptoms↗
PubMed1985

Behavioral management of children's distress during chemotherapy.

Three children, aged 11-14, undergoing cancer chemotherapy were coached in cue-controlled muscle relaxation, controlled breathing, pleasant imagery and positive self-talk during chemotherapy venopunctures. Using a multiple baseline across subjects design, 46-68% reductions from baseline levels of observed behavioral distress during venopunctures were found during intervention. Medical personnel and self-report ratings of the children's distress during venopunctures also decreased during intervention. Parental ratings of children's distress, however, did not change. Methodological issues in inpatient treatment of cancer patients and the self-report assessment of children's distress are discussed.

Adolescent↗
PubMedDate not supplied

Brief report: relationship between HIV infection and WPPSI-R performance in preschool-age children.

OBJECTIVE: To determine the neurodevelopmental effects of perinatally acquired HIV infection on children of preschool age. METHODS: Participants included 40 children infected with HIV between the ages of three and five and an equal number of noninfected controls individually matched according to ethnicity, age, sex, and prenatal drug exposure. Participants were administered the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), upon which an analysis of subtest distribution was conducted. RESULTS: Whereas both groups evidenced mean IQ and subtest scores significantly below published norms, an effect for HIV group status was not found when a factor combining Performance IQ (PIQ) and Verbal IQ (VIQ) was analyzed. However, the group infected with HIV scored significantly lower than controls on the Block Design subtest. CONCLUSIONS: Gross cognitive deficits are not evident among preschool children infected with HIV relative to matched controls. However, this study does provides some evidence for more focal deficits. Further investigation with older children should be conducted.

Case-Control Studies↗
PubMedDate not supplied

Hospitalizations for painful episodes: association with school absenteeism and academic performance in children and adolescents with sickle cell anemia.

Painful episodes have been identified as one of the most frequent manifestations of sickle cell anemia (hemoglobin HbSS). This retrospective study compared the frequency of hospitalization and the academic performance of two groups of children with HbSS (ages 8 to 18 years) with differing frequencies of pain. A high frequency (HF) group (n = 10) was composed of children who had four or more hospitalizations for pain in the study period; those in the low frequency (LF) group (n = 11) had one or no hospitalizations for pain during the study period. The two groups were matched on age (within 6 months), gender, and ethnicity. Standardized assessments of academic achievement and school records of attendance and class grades were obtained for all participants. The standardized academic achievement for both groups was approximately one standard deviation below the normative mean of the population sample, and class grades were below a C average. School absence was frequent in both groups (LF mean = 16.8 days/year; HF mean = 35.4 days/year), and children in the HF group had significantly more absences than children in the LF group. The lack of difference in academic performance between the two groups suggests that there may be factors other than school absenteeism that affect academic achievement, which require further investigation.

Absenteeism↗