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H Davis

Publications and source records attributed to H Davis.

At least 127 records · Page 7Linked to original sources
PubMed1991

Self-harming behavior in incarcerated male delinquent adolescents.

This report describes self-harming behavior in males in a juvenile incarceration center. Three groups of adolescents were examined: self-harmers, those referred for a psychiatric examination, and the incarcerated general population. Compared to the general population, the youth in the two mental health groups were younger, had greater family needs, had more educational problems, were more likely to have escaped from a previous placement, and committed more rule violations. The self-harming group, when compared with the psychiatrically referred group, had a greater number of prior offenses, were more disruptive in school, performed worse on a problem-solving task, and committed more rule violations. Issues of psychopathology and treatment are discussed.

Adaptation, Psychological↗
PubMed1991

Child psychopathology and environmental influences: discrete life events versus ongoing adversity.

Patterns of exposure to distinct types of life stressors were compared between 134 children attending a military child psychiatric clinic and a matched military community control sample. Compared with the community sample, clinic-referred children had experienced significantly higher levels of normative stressful events as well as events confounded with their own adjustment and events related to parental psychosocial functioning. Differences in levels of normative stressful events were no longer significant, however, when controlling for events related to parental functioning. Ratings of stressful events during the past year significantly underestimated the lifetime stress exposure differences between clinic and community control children. Although normative stressful events, parent-related events, and parent symptomatology ratings were significantly related to child behavior problem ratings, normative stressful events did not contribute to predictions of child behavior problems beyond the variance attributable to parent-related events and parent symptomatology. Implications of these findings for life stress and child maladjustment research are discussed.

Adaptation, Psychological↗
PubMed1991

Counselling and supporting parents of children with developmental delay: a research evaluation.

This paper describes an evaluation study of a home-based, family-focussed counselling scheme providing support for English-speaking and Bangladeshi families of children with intellectual or multiple disabilities. Mothers and children in the intervention groups showed significant and positive changes compared to randomly allocated controls. The greatest benefits were derived by the more deprived and initially less well-supported Bangladeshi families. Mothers changed positively in ratings of perceived support and family functioning, and in their constructions of their child, themselves, husbands and family relationships. Although systematic teaching was not included, their children also showed improvements in developmental progress and behaviour problems.

Adolescent↗
PubMed1991

Indices of drug misuse for prescription drugs.

Few studies of prescription-drug misuse have taken into account the numbers of prescriptions dispensed for specific drugs. Using data from the Drug Abuse Warning Network (DAWN) and the National Prescription Audit, we calculated indices of drug misuse for specific prescription drugs that are used mainly in outpatient settings and are either benzodiazepines, barbiturates, other sedative-hypnotics, analgesics, or CNS stimulants. In 1983-1985 the drugs associated with the highest numbers of DAWN medical examiner-reported drug-misuse deaths were codeine, diazepam, propoxyphene, phenobarbital, and secobarbital. However, the drugs with the highest indices of DAWN medical examiner-reported drug-misuse deaths/100,000 dispensed prescriptions were methamphetamine, methaqualone, amobarbital, secobarbital, and glutethimide. An index of fatality risk, calculated as 100 x DAWN medical examiner-reported drug-misuse deaths/DAWN emergency room-reported drug-misuse episodes, suggested that the risk of death from a glutethimide-associated drug-misuse episode had increased 92% from 1975-1979 to 1983-1983 and in 1983-1985 was the highest for the drugs studied. These indices might assist public health authorities attempting to design effective strategies to efficiently address the problem of prescription-drug misuse.

Cause of Death↗
PubMed1991

Breaking bad news.

Explore the source record for details and available documents.

Clinical Competence↗
PubMed1990

Force necessary to fracture the orbital floor.

Current thought on the pathophysiology of orbital wall fractures postulates either a "hydraulic" or a "buckling" mechanism. Evidence from cadaver, dried skull, and theoretical model studies supports both theories. No in vivo data, human or nonhuman primate, are available that quantitate the force necessary to fracture the orbital floor by either of the two mechanisms. We developed an apparatus that delivers quantifiable force only to the globe, without occluding the orbital opening or striking the orbital rim. We used it on 11 anesthetized Macaca fascicularis monkeys. Following a single bilateral application, the orbits were exenterated, and the orbital walls and orbital contents were examined to determine the extent of injuries. Fractures were described, diagrammed, and photographed. Fracture of the orbital floor was consistently produced at and above a force of 2.08 J. Posterior ruptures of five eyes occurred over the same range. We provide the first accurate measurements of the force required to produce orbital blow-out fractures in a live primate model. We show that orbital floor fractures can occur at low energies with direct ocular trauma only ("pure" hydraulic mechanism). Orbital wall fractures failed to protect the globe from rupture in 23% of cases.

Animals↗
PubMed1990

Children at risk: I. Risk factors and child symptomatology.

The authors compared 134 6- to 12-year-old children from a military psychiatric clinic with a control sample to determine the salience of various risk factors in predicting levels of child psychopathology. Parents provided demographic information and completed standardized questionnaires on themselves and their children, while children completed two self-report symptom inventories. Results indicated that all hypothesized risk factors mediated effects on child psychopathology, but the effects of various risk factors differed as a function of the rater and type of psychopathological construct being measured. Generally, parental psychopathology and life stress mediated the greatest effects on overall child symptoms levels. Furthermore, the clinical and community samples differed in the presence and extent of risk factors. Results indicate the need for caution in studies of child psychopathology using only clinical samples and may suggest the importance of therapies based on environmental manipulations for a substantial proportion of patients seeking child psychiatric assistance.

Child↗
PubMed1990

Children at risk: II. Risk factors and clinic utilization.

Using a strategy involving multiple raters and instruments, the authors compared 134 clinic subjects with controls matched on sex, age, and socioeconomic status to determine how various risk factors are related to clinic utilization apart from their effects on children's symptomatology. Parental psychopathology, family size, and marital status were most predictive of children's symptom levels, while stress levels, family size, and marital status were most predictive of clinic utilization. Although children's total symptom levels explained 27.6% of the variance in clinic utilization, other factors (family size, family history of divorce, stress, and parental psychopathology) explained an additional 13.2% of the variance. Findings indicate that clinicians and health care planners must carefully assess variables other than children's symptom levels in order to better understand children's mental health services utilization, develop more robust models of risk, and increase the effectiveness of our efforts directed towards prevention and intervention.

Child↗
PubMed1990

Plasma elevations of histamine and a prostaglandin metabolite in acute bronchiolitis.

Acute bronchiolitis (AB) is a common lung disease in infants manifested clinically by dyspnea and wheezing. The purpose of this study was to measure simultaneous plasma levels of histamine and a stable prostaglandin F2 alpha metabolite [13,14-dihydro-15-keto-PGF2 alpha (PG metabolite)], by radioenzymatic and radioimmunoassays, respectively, during and after recovery from AB. Blood was obtained from 15 infants during AB and from 14 and 9 of these infants when re-evaluated 6 and 18 months later, respectively. Mean (+/- 1 SEM) pre- and posttherapy (inhaled isoetharine) histamine levels (pg/ml), 1,923 +/- 980 and 1,035 +/- 250 during AB, respectively, were markedly higher than those of the same nonwheezing subjects at 18 months, 360 +/- 125, but unexpectedly lower than those at 6 months, 9,210 +/- 5,242. Of the 14 infants evaluated at 6 months, 7 had elevated histamine levels along with histories of recurrent wheezing after AB. Similarly, pre- and posttherapy PG metabolite levels (pg/ml), 1,033 +/- 419 and 1,613 +/- 527, respectively, were significantly higher than those of the same children when asymptomatic at 6 (27 +/- 7) and 18 months (68 +/- 25). Pre- and posttherapy levels of histamine and PG metabolite were higher than those of normal and sick, nonwheezing infants. These data indicate that histamine and PG metabolite are detectable in plasma during AB and suggest a role for histamine and PGF2 alpha in the pathogenesis of airways inflammation in AB.

Bronchiolitis, Viral↗
PubMed1990

Dietary assessment instruments for preschool children: reliability of parental responses to the 24-hour recall and a food frequency questionnaire.

Nutrient intakes of preschool-age children were assessed with a 24-hour dietary recall and a 3-month food frequency questionnaire (FFQ). Parents of 55 preschoolers (mean age = 4.25 +/- 0.59 years) completed the recall and FFQ on two occasions 1 week apart. The recalls and FFQs were analyzed for energy, cholesterol, protein, total carbohydrate, calcium, sodium, potassium, and saturated, polyunsaturated, and monounsaturated fats; each nutrient was expressed as raw value, value per kg body weight, and value per 1,000 kcal. Test-retest reliability estimates for the 24-hour recall indicated significant variability in reported total energy intake, but stable reports of intake were observed for one or all units of expression for polyunsaturated fats, cholesterol, protein, total carbohydrate, calcium, and potassium. The FFQ showed significant positive test-retest reliability estimates for all nutrients for all units of expression. Comparison of the recall and FFQ data showed similar percentages of intakes of energy from fat, carbohydrate, and protein and significant correlations for reported intakes of cholesterol, protein, calcium, and potassium. Comparison of the recall and FFQ data with recall data from a comparable cohort showed lower reported intakes for our sample, with the exception of protein, carbohydrate, calcium, and potassium. If validation studies are successful, the FFQ may be useful in epidemiological studies of preschoolers' intakes over extended periods. The recall may prove to be a useful tool in the assessment of day-to-day variations in macronutrient intakes.

Calcium, Dietary↗
PubMed1989

Diagnosis and treatment of attention deficit disorder in two general hospital clinics.

In two clinics in military general hospitals, the charts of all children with a presumptive diagnosis of attention deficit disorder who were prescribed psychostimulants (N = 68) were audited to assess the quality of the primary physicians' evaluation and treatment. The audit instrument, constructed by a multidisciplinary team, indicated high interrater reliabilities, high face and concurrent validity, and moderate internal consistency. The audit found that only 51.5 percent of the children being treated with psychostimulants met the audit criteria for attention deficit disorder. A school intervention plan was documented in only 16.2 percent of the cases, and a psychotherapy intervention in only 19.1 percent; low rates were also found for other treatment and follow-up criteria. Overall, the assessment, the follow-up care, and the overall quality of care were found to be inadequate or less than adequate in about two-thirds of the cases.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Critical carotid stenoses: morphologic and chemical similarity between symptomatic and asymptomatic plaques.

To identify microanatomic and chemical features that may mark the transition from asymptomatic to symptomatic atherosclerotic carotid lesions, we evaluated 62 carotid artery bifurcation plaques including 45 high-grade stenoses removed at endarterectomy and 17 nonstenotic plaques recovered at autopsy. Morphologic features were evaluated on multiple-interval histologic sections and were graded for the presence of hemorrhage, ulceration, thrombosis, lumen surface irregularity, and calcification. Plaque hemorrhage, recent and remote, was found in most of the specimens, and did not discriminate between symptomatic and asymptomatic stenotic plaques. High-grade carotid stenotic plaques were associated with a significantly higher incidence of ulceration (53%), thrombosis (49%), and lumen irregularity (78%) when compared to nonstenotic asymptomatic plaques (6%, 0%, and 17%, respectively; p less than 0.01). Although these features were more prominent in lesions that produced symptoms, they were present in 80% of the stenotic bifurcations, and did not distinguish between symptomatic and asymptomatic endarterectomy plaques. No significant differences were found between symptomatic and asymptomatic high-grade lesions with respect to collagen, DNA, total cholesterol, fibrinogen, lipase, elastase, or collagenase content. We conclude that intraplaque hemorrhage is commonly seen in carotid plaques even without severe stenosis, and it does not appear to be a dominant determinant of symptoms. Ulceration and surface thrombi that may lead to cerebral embolization are prominent features in markedly stenotic plaques even when symptoms are absent. The disruptive processes that underlie plaque instability appear to be closely associated with plaque size and stenosis rather than plaque composition.

Adult↗
PubMed1989

Validation of a heart rate monitor with children in laboratory and field settings.

The validity of the Sport Tester PE 3000 portable heart rate monitor for use with children was assessed by comparing readings with simultaneously recorded ECG heart rates in three studies, two using laboratory tasks and one in a field setting. Study 1 examined the validity of the Sport Tester with a sample of ten 10-yr-olds performing a cycle ergometer exercise task. Sport Tester readings taken during three 3-min exercise loads were correlated from 0.97 to 0.99 with simultaneously recorded ECG heart rates. In study 2, 23 children from 4 to 6 yr of age performed treadmill exercise for three 1-min intervals while Sport Tester and ECG heart rate data were obtained. Correlations for the three intervals ranged from 0.94 to 0.99. Study 3 obtained ECG and Sport Tester heart rates in 14 7- to 9-yr-olds who engaged in 3-min periods of standing, walking, jogging, throwing a ball, batting a ball, and playing on a jungle gym. Significant correlations of at least 0.98 between Sport Tester and ECG heart rates were obtained during all six activities. For all three studies, standard errors of estimate were low, ranging from 1.1 to 3.7 beats.min-1. For individuals, maximum differences ranged from 0 to 12.4 beats.min-1. Collectively, these findings indicate that the Sport Tester provides valid readings of young children's heart rates across a wide range of exercise involving upper- and lower-body movements.

Child↗
PubMed1988

A personal effectiveness and stress management course for community health workers: a pilot study.

Since the role of a community health worker in an inner city area is potentially very stressful, there is a requirement to provide help, support and training to enable them to function successfully. An individual who has learned coping skills might also feel confident about teaching these skills to clients. This paper describes a short course intended to enable professionals such as health visitors, speech therapists, community nurses and physiotherapists to cope better with stress and to be more effective in their daily work with colleagues as well as in sharing skills with clients. The initial, actual knowledge of the participant and confidence in perceived knowledge and ability was assessed before and immediately after the training and at a 4-month follow-up and this was replicated in a second nurse. The preliminary results suggested that the course brought about highly significant changes which were generally maintained at follow-up.

Adaptation, Psychological↗
PubMed1988

Fetal lung maturity in diabetic pregnancies: relation among amniotic fluid insulin, prolactin, and lecithin.

Insulin, prolactin, and lecithin phosphorus levels were measured in 97, 62, and 44 amniotic fluid samples from third trimester normal, gestational diabetic, and insulin-dependent diabetic patients, respectively. There was no difference in lecithin phosphorus concentration (index of fetal lung maturity) among the three groups. The amniotic fluid insulin level was significantly higher in insulin-dependent diabetic patients, whereas there was no difference in amniotic fluid prolactin levels among the groups. Correlations of amniotic fluid prolactin levels with both lecithin phosphorus and insulin levels were not statistically significant in any of the groups. This is probably because amniotic fluid prolactin is decidual, rather than fetal, in origin. Even though amniotic fluid insulin levels, which reflect fetal levels, were significantly higher in insulin-dependent diabetic patients, there was no difference in the amniotic fluid lecithin phosphorus concentration in diabetic pregnancies compared with that in normal pregnancies. Moreover, there was a positive, and not a negative, correlation between amniotic fluid insulin and amniotic fluid lecithin phosphorus levels in diabetic pregnancies. These results do not support the theory that fetal hyperinsulinemia results in delayed pulmonic maturation in diabetic pregnancies.

Adult↗