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Biomedical subjects

M Weitzman

Publications and source records attributed to M Weitzman.

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

School Breakfast Program and school performance.

To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children.

Absenteeism↗
PubMed1988

Bicycle-mounted child seats. Injury risk and prevention.

Little information is available about bicycle-mounted child seats despite their general use for a decade. We analyzed two existing data sets to gain information about frequency, trend, and characteristics of bicycle-mounted child seat injuries to children 5 years old and younger. Available data suggest an increased frequency of these injuries, with the rate of passenger injuries rising from 17% to 28% of all reported bicycle-related injuries to children in this age group in California during the years 1977 to 1986. In a detailed sample of 52 injuries related to the use of bicycle-mounted child seats, 42% occurred when the bicycle crashed or tipped over and 25% occurred when the child fell out of the seat. Sixty-five percent involved the head and face, and 27% of the head injuries were serious. Substantial morbidity associated with these injuries could be amellorated if children using these seats wore appropriate bicycle helmets.

Athletic Injuries↗
PubMed1988

Violence counseling in the routine health care of adolescents.

Intentional violence is a leading cause of mortality among teenagers and young adults. Whereas violence-related mortality is fairly well recognized among medical practitioners, the literature contains little information regarding violence-related morbidity or medically oriented approaches to preventing violence. Violence-related morbidity data for adolescents from one community revealed that 50% of the male respondents experienced at least one pushing or shoving fight per year, and that by age 16 25% had already been threatened by a weapon. These findings provided the impetus to incorporate regular violence counseling into the routine health care maintenance of adolescents at one health center. Our approach to violence-prevention counseling, obtaining a history of violence, and devising a treatment plan is described and advocated.

Adolescent↗
PubMed1988

Divorce and children.

The divorce rate in the United States is currently half the rate of marriages. Whether this rate will continue is not known. Millions of American children have already experienced their parents' divorce and millions more are likely to share the experience in the future. This makes divorce a problem that frequently appears in a pediatrician's patient population. Most children of divorce will experience it at the least as a potent transient stress that disrupts virtually all aspects of their lives. Many will accommodate to their new life circumstances successfully, but a substantial percentage will suffer long-term negative effects. Many of the problems of these children and their families can be anticipated, prevented, or alleviated by thoughtful and timely intervention. The pediatrician can be helpful by serving as the child's advocate, offering anticipatory guidance, helping the family weather the turmoil of the acute stage, screening for maladjustment or maladaptive behavior of children and parents, providing counseling, and referring the children and family for more specialized mental health input when indicated.

Adaptation, Psychological↗
PubMed1988

Clinical experience with COP-1 in multiple sclerosis.

COP-1 is one of a series of polypeptide preparations developed to stimulate myelin basic protein (MBP), a natural component of the myelin sheath. MBP in Freund's complete adjuvant induces experimental allergic encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). In saline, MBP suppresses EAE. This is the rationale for the use of COP-1 in MS.

Adult↗
PubMed1987

Social barriers faced by adolescent parents and their children.

Pregnancy and childbearing are well recognized as having significant, long-term consequences for teenagers. Recent literature documents an array of negative outcomes for children born to adolescents, with a range of factors identified as contributing to the problems observed in these children. These include (1) the characteristics of those teenagers most likely to become parents, (2) the social and economic consequences of early childbearing, (3) the increased biologic vulnerability of children born to teenagers, and (4) the nature of parenting by teenagers. It has been acknowledged that adolescent parents tend to come from high-risk families, have poor academic achievement, and live in our most disadvantaged communities and therefore, biologic, economic, and behavioral factors contribute to the increased likelihood of teenagers having children who are vulnerable to physical and developmental problems. Teenaged parents face many obstacles to economic and social success, and these further influence the environment in which their children grow up. Adolescents also experience many difficulties in adjusting to parenthood and display a range of suboptimal parenting practices. Whereas some of these factors appear highly resistant to change, others have clear clinical, programmatic, and policy implications.

Achievement↗
PubMed1987

A pilot trial of Cop 1 in exacerbating-remitting multiple sclerosis.

Cop 1 is a random polymer (molecular weight, 14,000 to 23,000) simulating myelin basic protein. It is synthesized by polymerizing L-alanine, L-glutamic acid, L-lysine, and L-tyrosine. It suppresses but does not induce experimental allergic encephalomyelitis, an animal model of multiple sclerosis. It is not toxic in animals. In a double-blind, randomized, placebo-controlled pilot trial, we studied 50 patients with the exacerbating-remitting form of multiple sclerosis, who self-injected either 20 mg of Cop 1 dissolved in 1 ml of saline or saline alone daily for two years. Six of 23 patients in the placebo group (26 percent) and 14 of 25 patients in the Cop 1 group (56 percent) had no exacerbations (P = 0.045). There were 62 exacerbations in the placebo group and 16 in the Cop 1 group, yielding two-year averages of 2.7 and 0.6 per patient, respectively. Among patients who were less disabled on entry (Kurtzke disability score, 0 to 2), there were 2.7 exacerbations in the placebo group and 0.3 in the Cop 1 group over two years. Among patients who were more affected (Kurtzke disability score, 3 to 6), there was an average of 2.7 exacerbations in the placebo group and 1.0 in the Cop 1 group. Over two years, less disabled patients taking Cop 1 improved an average of 0.5 Kurtzke units; those taking placebo worsened an average of 1.2 Kurtzke units. More disabled patients worsened by 0.3 (Cop 1 group) and 0.4 (placebo group) unit. Irritation at injection sites and rare, transient vasomotor responses were observed as side effects. These results suggest that Cop 1 may be beneficial in patients with the exacerbating-remitting form of multiple sclerosis, but we emphasize that the study is a preliminary one and our data require confirmation by a more extensive clinical trial.

Adult↗
PubMed1987

Why adolescents do not attend school. The views of students and parents.

Despite the magnitude and importance of the problem, little is known about why many students are absent from school. This study assessed what a sample of excessively absent students and their parents believed were the reasons for the students' absences. In response to an open-ended question about their main reason for absence, almost half of the students reported a health-related reason. When asked whether any of 15 potential problems contributed to their absence, many reported common and acute physical illnesses, headaches or stomachaches, and other aches or pains. Half mentioned factors relating to low motivation or a concern about the school environment. The parents' responses were remarkably similar except they were more likely to cite emotional problems of the student, school violence, and racial problems. When individual student's responses were compared with those of his or her parents, agreement on individual items were little better than would be expected by chance.

Absenteeism↗
PubMed1986

School absence rates as outcome measures in studies of children with chronic illness.

Health care providers are caring for growing numbers of children with chronic illnesses and research on the effects of various interventions with these children are being increasingly published. Data from a variety of sources indicate that children with chronic illness miss more school than their healthy peers. The relative ease with which school attendance data can be obtained and analyzed and the implications of excessive school absence for children's academic performance, social adjustment, and ultimate capacity to function in society suggest that school absence rates deserve to be more broadly emphasized in research on chronic illness in childhood. Although school absence rates have not been widely used as outcome measures in such studies they do reflect a wide variety of aspects of children's health status and have been shown to be responsive to interventions with children with various physical and mental health problems. Since these rates reflect both health and non-health related factors it is important that investigators recognize the nonspecific nature of this measure and account for non-health related influences either by sampling or analytic techniques.

Absenteeism↗
PubMed1986

Chronic illness, psychosocial problems, and school absences. Results of a survey of one county.

The number of days absent from school during the 1979-80 school year for 573 children aged 6-17 years in Berkshire County, Massachusetts was ascertained by parent reporting in a random household survey. Children with a wide range of chronic health impairments were reported as missing more school than their healthy peers (8.7 days vs. 5.8, p less than .001). Although there was a trend for children reported as having functional impairments to miss more school than those with chronic conditions without functional impairments (11.0 vs. 8.1), the difference was not statistically significant. Children with a variety of reported psychosocial difficulties missed more school than those without psychosocial difficulties for the sample as a whole and for those with reported chronic conditions. These findings document support for the assumption that children with a wide range of physical and psychological problems miss more school than their healthy peers and illustrate that the etiology of school absences is multifactoral and reflects behavioral as well as purely physical phenomena.

Absenteeism↗
PubMed1986

High-risk youth and health: the case of excessive school absence.

Excessive school absence is a major educational and social problem in the United States, yet very little is known about its etiology or how to prevent or ameliorate it. This paper reports results from a series of related studies conducted in seven Boston middle schools (grades 6, 7, and 8) to test the hypotheses that health problems and unmet health needs are major characteristics distinguishing excessively absent students from regular attenders and that a health-oriented approach using medically mediated interventions is effective in reducing absences among excessively absent students. There were no significant differences between regular attenders and excessively absent students on multiple measures of student and family health status, health habits, and health service utilization patterns in a case-control study. The intervention program was not associated with a significant decrease in absence school-wide or for participating students. We conclude that demographic and educational characteristics of students exert a greater effect on their behavior in regard to absence from school than do health status or receipt of health services and that a health-oriented approach, such as the one used here, will not have a major impact on what remains one of the most profound educational and social problems involving children in the United States today.

Absenteeism↗
PubMed1986

Factors associated with excessive school absence.

Excessive school absence is a major educational and social problem in the United States which is most pronounced in urban school systems. A case control study of excessively absent inner-city middle-school students and regular attenders failed to demonstrate any differences between groups in terms of health status, health-related behaviors, or utilization of health services. These results contrast dramatically with the findings of a previous study which identified a number of educational and demographic characteristics which clearly distinguish excessively absent students from regular attenders. It is concluded that educational and demographic factors are far more important in influencing excessive absence behavior than are health-related factors. The implications of these findings for the pediatrician are discussed.

Absenteeism↗
PubMed1984

Use of health services by chronically ill and disabled children.

Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities. The major share of health care used by children with chronic conditions was attributable to a small subset of children: All hospital care was accounted for by one third of the children, and three quarters of all outpatient care was accounted for by one quarter of that sample. Hospital care was used at similar rates by the four diagnostic groups. However, amount and type of outpatient care varied by diagnosis, level of functional impairment, race, and income. Estimated average expenditure for health services used by the chronically ill or disabled sample was 10 times that of the comparison sample. Relative distribution of estimated expenditures across types of services differed for the two samples as well as among diagnostic categories.

Adolescent↗