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Biomedical subjects

H L Britton

Publications and source records attributed to H L Britton.

16 recordsLinked to original sources
PubMed2001

Maternal postpartum behaviors and mother-infant relationship during the first year of life.

OBJECTIVE: To assess the hypothesis that maternal postpartum behaviors toward the newborn may predict the quality of the maternal-infant relationship during the first year. DESIGN: Prospective, non-randomized, longitudinal cohort study of 174 maternal-infant dyads. METHODS: A Postpartum Parenting Behavior Scale (PPBS) was formulated to measure clearly defined observed maternal behaviors toward the infant shortly after birth. The quality of the maternal-infant relationship was assessed at 6 months after birth with the Nursing Child Assessment Satellite Training (NCAST) Feeding Scale and at 12 months after birth with the NCAST Teaching Scale and Ainsworth Strange Situation. RESULTS: The PPBS score correlated significantly with the Feeding Scale score (r =.27, P <.005) and with the Teaching Scale score (r =.23, P <.01). Mothers whose infants were later classified as securely attached in the Ainsworth Strange Situation had higher PPBS scores than mothers of infants classified as insecurely attached (mean +/- SD: 5.18 +/- 1.51 vs 4.63 +/- 1.69, respectively, P <.05). In regression models adjusting for social and demographic factors, the PPBS remained a significant predictor of the Feeding Scale score, the Teaching Scale score, and security of attachment. CONCLUSIONS: Maternal behaviors in the immediate postpartum period may aid in predicting quality of the maternal-infant relationship during the subsequent 12 months, suggesting the potential for early identification of suboptimal parenting.

Adolescent↗
PubMed1999

Early perinatal hospital discharge and parenting during infancy.

OBJECTIVE: To evaluate the relationship between early perinatal hospital discharge and several parenting outcomes during infancy, including breastfeeding, mother-infant interaction, and mother-infant attachment. STUDY DESIGN: A prospective, longitudinal, nonrandomized study of mother-infant dyads discharged </=36 hours after birth (early discharge), compared with those discharged >36 hours after birth (late discharge). METHODS: Demographic, perinatal, and psychosocial factors were determined from medical record review and maternal questionnaires. Questionnaires also assessed maternal perceptions of the hospital stay and breastfeeding rates. Mother-infant interaction was assessed at 3 months after birth using the NCAST Feeding Scale and at 9 months after birth using the NCAST Teaching Scale. Security of attachment was measured in the Ainsworth Strange Situation at 12 months after birth. RESULTS: Early and late discharge groups were similar with respect to major demographic, perinatal, and psychosocial characteristics and perceptions of the hospital stay. Even after adjusting for these factors in regression analyses, no significant association was found between early discharge and breastfeeding at 3 months, NCAST scores at 3 and 9 months, and security of attachment at 12 months. CONCLUSION: Parenting outcomes, such as breastfeeding, mother-infant interaction, and attachment, are not influenced by early perinatal hospital discharge.

Adult↗
PubMed1998

Perinatal screening for child abuse and neglect.

An increased awareness of the frequency and severity of child abuse and neglect in our society has prompted consideration of the feasibility of perinatal screening and early intervention for this problem. This article reviews the available information on screening and early intervention for high-risk parenting in the perinatal period. The advantages, disadvantages, and cost-effectiveness of screening and intervention for children and families at risk for abuse and neglect are also discussed.

Attitude↗
PubMed1996

Neonatal mortality and length of newborn hospital stay.

OBJECTIVE: To investigate the effect of hospital discharge time on neonatal mortality of term newborns. DESIGN: Infants who were discharged home at 5 days of age of younger and who subsequently died were compared with control infants using a retrospective case-control design. Descriptive information was collected from records of infants who were not discharged home from the hospital of birth (because of death or transfer to a tertiary care hospital) to determine the age at which their illnesses presented. METHODS: We reviewed death certificates for all infants with birth weights of 2500 g or greater born at 37 weeks' gestational age or greater who died in the first 28 days of life and who were born in one of four Utah counties (1985 through 1989). Of the 109,256 eligible births, 115 infants were found who had died in the neonatal period. Eighty-four infants had not been discharged home from the hospital of birth, 5 infants had had hospital stays of more than 5 days, 9 records could not be located, 17 presumed healthy infants were discharged from the hospital at 5 days of age or younger. These 17 infants were each matched with 3 control infants. Newborn nursery charts were reviewed to determine hospital discharge times for case and control infants. Descriptive information regarding the time of presentation of illness was collected for the other 89 infants. RESULTS: The mean age of hospital discharge was 43 +/- 21 hours for the 17 case infants and 47 +/- 25 hours for the 51 control infants. The odds ratio for neonatal mortality for discharge at less than 24 hours was 1.65 (95% confidence interval, 0.42 to 3.34) and for discharge at less than 48 hours was 1.16 (95% confidence interval, 0.4 to 3.34). Of the 84 infants who were not discharged home from the hospital of birth, 93% had been symptomatic by 12 hours of age, and 99% were symptomatic by 18 hours. CONCLUSIONS: Most full-term infants who die in the neonatal period are symptomatic within the first 18 hours after birth. We could not demonstrate an association between early hospital discharge and neonatal mortality in those infants who died after discharge home.

Age of Onset↗
PubMed1994

Early discharge of the term newborn: a continued dilemma.

OBJECTIVE: To provide the pediatric practitioner with a summary of available data regarding the appropriate time of hospital discharge of the term newborn. METHODOLOGY: Published series on early discharge were critically reviewed. RESULTS: Heterogeneity and limitations of methodology and study design substantially limit conclusions that may be drawn from published studies. CONCLUSION: Early discharge recommendations of the American Academy of Pediatrics remain appropriate, and decisions regarding the timing of discharge of the well term newborn should be individualized and made by the practitioner based upon the medical, social, and economic aspects of each case.

Humans↗
PubMed1993

Weight, length, head and chest circumference at birth in Phoenix, Arizona.

Standard percentile curves are presented for weight, length, head circumference and chest circumference at birth for a population of 27,963 singleton infants born between the gestational ages of 26 and 42 weeks at a large, private hospital in Phoenix, Arizona. At term, all four growth parameters were significantly greater in male than in female infants. These parameters were significantly reduced in infants born to mothers who smoked and increased in infants born to mothers with diabetes. Percentiles in all parameters were higher than in those of previous studies, suggesting that continued use of growth curves based on older data may result in misclassification of infants with respect to appropriateness of growth-for-gestational age.

Analysis of Variance↗
PubMed1991

Use of nonanatomical dolls in the sexual abuse interview.

Controversy exists regarding use of anatomically detailed dolls in child sexual abuse evaluations because of concerns that such dolls may provoke false positive demonstrations of sexually explicit behavior. This study shows that children referred for medical evaluation of sexual abuse will use sexually explicit behavior to demonstrate what has happened to them with nonanatomical dolls as frequently as when they are interviewed with anatomically detailed ones. Over a two-year period, 136 children (aged 24 months to 10 years) were interviewed by the same pediatric interviewer. During the first year sexually anatomically detailed dolls (SAD) were used, and in the subsequent year nonanatomic dolls (NAD) were used. Data was analyzed according to age, sex, and demonstration of sexually explicit behavior. There were 67 children in the NAD group and 69 in the SAD group. Of the NAD group, 72% showed sexually explicit behavior compared to 68% in the SAD group. Comparisons using chi-square analysis revealed no significant differences between NAD and SAD. Results indicated that in the sexual abuse interview setting, use of sexually detailed dolls did not increase children's use of sexually explicit behavior to describe what had happened to them when compared to use of nonanatomical dolls, and that use of either type of doll provides similar information in the interview setting.

Child↗
PubMed1988

High-dose methylprednisolone as initial therapy in patients with acute bronchospasm.

The use of steroids in treating acute respiratory obstruction is still controversial. In this double-blind controlled trial, we decided to examine the beneficial effects of a single large dose of methylprednisolone (MSSP), using objective criteria. In the emergency setting, methylprednisolone (30 mg/kg) has been shown to decrease the need for hospital admission in patients with acute bronchospasm. No difference in this improvement was seen among patients in the steroid-dependent or non-steroid-dependent populations. Based on our findings, we suggest that the early use of single-dose steroid therapy is appropriate treatment for patients with acute bronchospastic attacks.

Acute Disease↗
PubMed1984

Efficacy of early newborn discharge in a middle-class population.

The safety of early newborn discharge was assessed by determining the incidence, time of onset, and nature or problems requiring hospitalization that appeared in the first two weeks of life among 1,735 consecutively born term infants in a private metropolitan hospital. Infants with and without abnormalities during the initial six-hour transitional period were compared. Of 1,583 initially well infants, 11 (0.7%) had problems other than jaundice develop that required hospitalization in the first three days of life. In contrast, 42 (28%) of the 152 infants with abnormal transitional periods required prolonged hospital care; this was statistically significant. The nature of the problems occurring before and after 72 hours was similar, jaundice being the most common and occurring with equal frequency in both periods. Most illness requiring hospitalization in the first three days of life could have been safely detected during an outpatient visit; these findings, in addition to a cost-benefit estimate, suggest that early discharge of initially well infants with careful follow-up may be an effective alternative to a traditional three-day stay.

Arizona↗
PubMed1981

Cost containment through restriction of cephalosporins.

The effect of a program designed to reduce hospital drug costs by limiting the selection of injectable cephalosporins and promoting the rational use of the selected agents was studied. Cefazolin sodium was chosen as the primary injectable cephalosporin, and guidelines for proper dosing were approved. Strict guidelines for the use of cephapirin sodium, cefamandole nafate, and cefoxitin sodium were also adopted; cephalothin sodium was deleted from the formulary. Clinical pharmacists reviewed all cephalosporin orders and consulted with prescribers whose orders did not conform to the guidelines. Total cephalosporin purchases for the first fiscal year of the program were $64,914, a decrease of $55,715 or 46.2% from the previous year's total of $120,629. Cost per patient day for cephalosporins decreased from $0.921 to $0.519 (43.6%) over the same period. The number of milligrams of cephalosporins used per patient day decreased from 398.16 to 178.77 (55.1%), while the number of patient days decreased by only 4.45% during the same interval. The estimated annual cost of monitoring the program was $1500. This program demonstrates that substantial cost savings can be achieved if guidelines for the use of injectable cephalosporins are clearly outlined and strictly enforced.

Cefazolin↗