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Biomedical subjects

I B Pless

Publications and source records attributed to I B Pless.

At least 91 records · Page 5Linked to original sources
PubMed1989

Predicting traffic injuries in childhood: a cohort analysis.

Data from a sample of more than 16,000 children born in the United Kingdom in 1958 were studied to identify factors that may affect the risk of having a traffic injury. Five sets of risk factors were examined: physical, developmental, educational, behavioral, and family. Information about these factors were obtained systematically from parents, teachers, and physicians when the children were 7 and 11 years of age. The results were related to traffic injuries occurring for the first time during each subsequent 4-year period. Between 8 and 11 years of age, 431 children had a traffic injury requiring medical attention, and between 12 and 16 years the number was 590. Logistic regression analyses identified a small number of factors associated with injuries, which varied according to the age and gender of the child. When all these factors were entered into a final model, only five remained: fidgety, abnormal behavior, and three measures of family disruption or disadvantage--crowding, family problems, and being removed from the family and placed in the care of the local authority. These findings suggest that it may be unwise to place much reliance on "high risk" preventive strategies by measures of this kind. Instead, more emphasis should be placed on community-based passive and environmental strategies.

Accidents, Traffic↗
PubMed1989

Chronic physical illness in childhood: psychological and social effects in adolescence and adult life.

A national birth cohort followed for 36 years was used to compare the life chances of individuals with chronic physical illness in childhood with those of controls. The majority of those who had been chronically physically ill in childhood were found to differ very little in social and psychological circumstances by 36 years of age, but earlier in adult life there had been signs of difficulties. However, there was a disturbing tendency for those from lower social-group families to be in significantly worse social and psychological circumstances, and by 36 years they showed signs of relatively poor life chances and of basic social support, including the death of both parents.

Activities of Daily Living↗
PubMed1989

A case-control study of pedestrian and bicyclist injuries in childhood.

We identified children ages 0 to 14 years injured in traffic as pedestrians or bicyclists in Montreal, Canada. Two hundred children with injuries who received a score of 2 or more on the Maximum Abbreviated Injury Severity scale were considered as cases and compared with 400 uninjured children seen in the same hospitals for non-traumatic reasons. Systematic, blinded interviews and tests were conducted with parents to determine the role of a series of social, familial, personal, and behavioral characteristics. After adjustment for age, gender and socioeconomic area of residence, logistic regression analyses showed higher risks of injury to be related to fewer years of parents' education, a history of accident to a family member, an environment judged as unsafe, and poor parental supervision. Absence of physical health problems, fewer family preventive behaviors and reported lack of cautiousness were also related to a higher risk, whereas neither aggressivity nor behavioral disturbance, whether internalizing or externalizing, showed any such relation. These data suggest that the child's personality and behavior are weaker risk factors for pedestrian and bicyclist injuries than are family and neighborhood characteristics.

Accidents, Traffic↗
PubMed1989

Feeding and temperament as determinants of early infant crying/fussing behavior.

In the first 3 months of life, crying and fussing in normal infants tend to increase until 6 weeks of age and decrease progressively thereafter. To determine whether feeding choice and early infant temperament are predictors of early crying, 374 healthy, full-term infants were observed prospectively from birth to 6 weeks of age. Feeding choice and sociodemographic characteristics were ascertained in the first few days postpartum. Parents completed a 17-item early infant temperament questionnaire at 2 weeks of age and a 24-hour behavior diary for 8 days at 6 weeks of age. Initially breast-fed infants cried and fussed more frequently throughout 24 hours compared with those who were formula fed, and increased frequency and duration of crying and fussing were predicted by "more difficult" temperament. Furthermore, a different pattern of crying and fussing within the day was found for infants who were changed from breast- to formula feeding. However, according to stepwise multiple regression models, daily duration of crying/fussing was significantly predicted only by the temperament score (but not initial feeding choice), which accounted for 7% of the variance. Frequency of crying/fussing were predicted only by socioeconomic status, temperament, and feeding frequency, which accounted for 12% of the variance. Breast- or formula feeding at 6 weeks of age was independently associated with crying/fussing only during the evening. It was concluded that early infant temperament predisposes to early crying and fussing but is of limited use as a clinical predictor. Later crying/fussing behavior is not predicted by initial feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Bottle Feeding↗
PubMed1988

Risk factors for injury in a 3-year-old birth cohort.

The purpose of this study was to identify factors associated with injuries in the first three years of life and to assess their predictive utility. The parents of 918 children (82% of an eligible birth cohort) completed a telephone interview to document injury histories. The occurrence of injury was then linked to previously obtained information characterizing early childhood. Several determinant associations were found for injuries seen by a physician and for those requiring treatment. Maternal factors (single, unemployed, smoking) were dominant in both instances. From these factors, logistic regression models were developed from which adjusted relative risk estimates were derived. The presence of all three maternal factors, as well as the absence of a younger sibling, increases the probability of an injury from 20% to over 60%. These findings may be used to assist in the development of preventive programs by targeting children at increased risk. They also provide a basis for further studies that will permit a better understanding of the causal mechanisms linking maternal factors to preschool injury.

Adult↗
PubMed1988

Preschool behavior disorders: their prevalence in relation to determinants.

The occurrence of behavior disorders was investigated in a prospectively followed 3-year-old birth cohort. Of 1116 eligible children, the parents of 918 were successfully contacted. All agreed to complete a telephone interview and were mailed a Childhood Behavior Checklist (CBCL) standardized for 2- to 3-year-old children; 756 (82%) returned the CBCL. The prevalence of one or more of the deviant behavior syndromes identified by the CBCL was 11.1%. From a number of subject characteristics recorded throughout infancy, age-specific determinants for the occurrence of these deviant behaviors were identified. Characteristics most consistently associated with preschool psychopathology included the mother's ill health and lack of social support, the presence of chronic illness in the child, and the frequent use of hospital emergency services. These and other determinant (risk) indicators were entered into logistic regression (LR) models to derived adjusted relative risk estimates for the occurrence of a behavior disorder. The derived LR equations emphasize the important role of both the mother as well and the father and the health of the child.

Affective Symptoms↗
PubMed1988

Parental diary of infant cry and fuss behaviour.

Despite their common use parental diaries of infants' cry and fuss behaviour have not been compared with objective methods of recording. To understand what is meant by the descriptions of crying and fussing in the diaries, the diaries of 10 mothers of 6 week old infants were compared with tape recordings of vocalisations made by the babies over a 24 hour period. There were moderately strong correlations between the frequency of episodes (clusters of 'negative vocalisations') on the audiotape and episodes of 'crying and fussing' in the diaries, and between the duration of episodes on the audiotape and episodes of 'crying' in the diaries. To assess the acceptability of the diaries for recording information for clinical and epidemiological research, they were then used in a population study of a wide socioeconomic group. Usable data were obtained from 91% of the sample. The results suggest that despite pronounced differences between recording methods, these diaries may provide valid and useful reports of crying and fussing in the short term.

Child Behavior↗
PubMed1988

Expected diabetic control in childhood and psychosocial functioning in early adult life.

This study examined relationships between the extent to which doctors seek to achieve good (i.e., tight) diabetic control during childhood and the frequency of psychosocial problems in later life. A sample of 225 young adults with insulin-dependent diabetes mellitus was studied by use of a systematic interview. A measure of the level of control the doctor was attempting to achieve was developed from questionnaires administered to the doctors who provided most of the patient's care during childhood. The results were compared with scores on three indices of psychosocial functioning based on responses given in structured interviews with the patients. Although potentially important psychosocial problems were found for 10-20%, there was no statistically significant relationship between any of these problems and the doctors' desired levels of control. Thus, efforts to achieve good control during childhood, whether successful or not, may not be followed by psychosocial problems in later life. This finding should help support clinicians' attempts to obtain the levels of control during childhood judged to be essential in preventing serious organic complications.

Adaptation, Psychological↗
PubMed1988

Decline in mortality among young Americans during the 20th century: prospects for reaching national mortality reduction goals for 1990.

A review of mortality data for persons younger than 25 years of age in the United States reveals striking declines in death rates since the turn of the century. Mortality among infants during their first year of life decreased from 1 in 6 in 1900 to 1 in 100 in 1986. Between 1900 and 1984 the annual death rate for children 1 through 4 years of age decreased from 1 in 50 to 1 in 2,000, for children 5 through 14 years of age, from 1 in 250 to 1 in 4,000, and for persons 15 through 24 years of age, from 1 in 165 to 1 in 1,000. Public health measures, advances in medical science, legislative initiatives, and the organization and delivery of health care have all contributed to these improvements in varying degrees during different decades. For the decade 1975 through 1984, the overall death rate decreased by 20%, with declines for all causes except suicide, cardiovascular diseases, and renal diseases. All of the surgeon general's mortality reduction goals for 1990 for America's youth should be reached except those for infant mortality and suicide. Improvement in these death rates will require better access to health care by those in need and reductions in environmental stress.

Accidents↗
PubMed1987

A reappraisal of the frequency of child abuse seen in pediatric emergency rooms.

This study was conducted to determine the frequency of abuse and neglect among infants and preschool children seen in the emergency department of a large children's hospital. A case-finding system was introduced using a checklist (Accident-SCAN) to remind the attending nurse and physician to consider the possibility of maltreatment in the etiology of each apparent accident. Thirty-nine of 2,211 accident patients were evaluated systematically during an 18-week study period and referred to a child protection team for investigation. Twenty-eight (1.3%) were presumed to be victims of abuse or neglect. This figure differs substantially from the widely quoted estimate of 10%. The marked discrepancy between this result and previous findings suggests that either important variations exist in the rates of abuse and neglect in different populations or that the earlier figures are overestimates.

Child↗
PubMed1987

Improvements in self-concept after treatment of nocturnal enuresis: randomized controlled trial.

To determine whether changes in attitude and behavior occur after treatment of nocturnal enuresis, we randomly assigned 121 children aged 8 to 14 years to receive conditioning therapy (n = 66) or a 3-month waiting period (n = 55). All children completed the Piers-Harris Self-Concept Scale (P-H), the State-Trait Anxiety Scale (STAIC), and the Nowicki-Strickland Locus of Control test (NSLC) at entry and after treatment or delay. Parents completed the Achenbach Child Behavior Checklist (CBCL). There were no significant group differences in background demographic variables. Significant improvements in the P-H Scale (P = 0.04) and three of its subscales occurred in children in the treatment group compared with those in whom treatment was delayed. The changes were greatest for those who had the largest decreases in wetting frequency. Changes in CBCL, STAIC, and NSLC scores were not statistically significant. We conclude that there may be mental health benefits in children helped to master the symptom of enuresis, which in this age group is probably a chronic stressor.

Adolescent↗
PubMed1987

The epidemiology of road accidents in childhood.

We report the incidence of traffic injuries to children in Montreal: 33.4 per 10,000, 57 per cent pedestrians, 24.5 per cent passengers, and 18.4 per cent bicyclists. Nearly 20 per cent were hospitalized and 1.2 per cent died. One-third had MAIS scores of 2 or more with the highest rate of severe injuries found among pedestrians. Pedestrian and bicycle (but not passenger) injuries in low income areas were four to nine times greater than those in more affluent areas.

Accidents, Traffic↗