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Biomedical subjects

M A Rapoff

Publications and source records attributed to M A Rapoff.

26 records · Page 2Linked to original sources
PubMed1984

Improving compliance with medical regimens: case study with juvenile rheumatoid arthritis.

There is ample literature to suggest that a high percentage of pediatric patients with chronic diseases fail to comply adequately with their medical regimens. This study examined the effectiveness of a token reinforcement program in improving the compliance of a 7-year-old girl with juvenile rheumatoid arthritis. The parents were taught to manage the program in the home. The patient earned tokens for complying with her treatment regimen and lost tokens when she failed to comply. Tokens were exchanged for routine and special privileges. Compliance with medications, splint wearing, and lying prone was assessed by observation. Baseline data showed low levels of compliance, particularly with splint wearing and prone lying. Introduction of the token reinforcement program resulted in immediate improvement in compliance; improvement was maintained during 10 weeks of follow-up.

Arthritis, Juvenile↗
PubMed1980

Suppression of self-injurious behaviour: determining the least restrictive alternative.

In keeping with recent ethical and legal guidelines regarding the use of aversive treatment procedures, a number of alternatives for the treatment of self-injury have been suggested. The present study provides an example of the determination of the least restrictive but most effective treatment with a case of self-injury. Employing a combination of multiple baseline and reversal designs, the effects of DRO, overcorrection, lemon juice, and aromatic ammonia on the rate of self-poking in a profoundly retarded child were examined. DRO and overcorrection were both ineffective. Although lemon juice suppressed and stabilised the rate of poking, aromatic ammonia produced greater suppression. Implications for the testing of treatments for SIB are discussed.

Behavior Therapy↗
PubMedDate not supplied

Evaluating outpatient pediatric psychology services in a primary care setting.

OBJECTIVE: To provide descriptive and outcome information of an outpatient pediatric psychology clinic based in a medical center in a major metropolitan area. METHODS: We coded the characteristics and outcomes of 100 patients prospectively on a number of dimensions. Surveys and interviews were used to gather follow-up information. RESULTS: The majority of patients were Caucasian boys (n = 56 out of 100) between 2 and 12 years of age. The most common reasons for initiating contact with the clinic were assessment of school problems, behavior problems, anger, attention problems, depression, and temper tantrums. Eighty-one percent of the patients saw a therapist for brief treatment, between one and five sessions, and behavioral treatments were administered for the majority. The children's behavior for which the parents sought treatment improved significantly from pre- to posttreatment, as rated by parents and therapists. CONCLUSIONS: Overall, parents were satisfied with the services received and indicated that the recommendations given during therapy were helpful and easy to implement. This study provides general evidence for the effectiveness of pediatric psychology services.

Adolescent↗
PubMedDate not supplied

Enuresis treatment.

Explore the source record for details and available documents.

Child↗
PubMedDate not supplied

Relationship between pain severity and serum beta-endorphin levels in postoperative patients.

STUDY OBJECTIVE: To examine the relationship among postoperative pain severity, serum beta-endorphin level, and serum morphine level in pediatric patients after posterior spinal fusion with instrumentation. DESIGN: A prospective study. SETTING: University-based medical center. PATIENTS: Ten patients age 13-17 years admitted for posterior spinal fusion with instrumentation. INTERVENTIONS: Each subject was administered an initial dose of intravenous morphine 100 micrograms/kg, followed by a constant infusion of 50 micrograms/kg/hour. The primary physician was allowed to titrate the dosage as required to meet the patient's requirement for analgesia. Whole blood was obtained for the analysis of serum morphine and beta-endorphin levels preoperatively, after the initial morphine dose, 24 hours after initiation of the infusion, and before any change in dosage. At each blood sampling time, pain severity ratings were obtained from the subject, nurse, and parent using a 10-point linear scale. MEASUREMENTS AND MAIN RESULTS: No statistical difference between serum beta-endorphin values preoperatively and after the initial dose of morphine was observed; mean values were 68 and 60 pg/ml, respectively. The relationships between serum beta-endorphin level and pain scores were statistically significant only for self (subject) pain scores (p = 0.014, r = 0.30). Mean serum morphine level was 21.9 ng/ml for patients with self pain scores of 4 or less. CONCLUSION: The clinical usefulness of serum beta-endorphin as a measure of pain severity was not established under the experimental conditions of this study.

Adolescent↗