Biomedical subjects

Michael O'Callaghan

Publications and source records attributed to Michael O'Callaghan.

25 records · Page 2Linked to original sources

PubMed2003

An examination of the needs of parents of hospitalized children: comparing parents' and staff's perceptions.

The needs of parents of hospitalized children have received some attention in the health literature, but few studies have compared parents' perceptions of needs with staff's ideas about parents' needs. The aim of this study was to examine differences between the perceptions of the needs of parents of hospitalized children held by staff - nurses, doctors and allied health staff, and parents in a 150-bed paediatric hospital in Sweden. The convenience sample comprised 132 staff - nurses, doctors and allied health staff and 115 parents of children admitted to all the wards except intensive care. Kristjánsdóttir's "needs of parents of hospitalized children" questionnaire (NPQ) was the instrument of choice and was modified slightly for use with staff. Results indicated significant differences in perceptions of the importance of different needs of parents, of how well they were being met in the hospital and how much help the parents needed to have them filled. Differences between parents' and staff's perceptions of the importance of parental needs were found in areas relating to psychosocial needs, but in general, in that hospital, the needs were being adequately met. The main differences between staff's and parents' results were in the degree of independence shown by parents in requiring help to have their needs met. This demonstrates either that parents are much more independent than appraised by staff, or, that parents are sometimes unaware of the level of assistance available.

Adaptation, Psychological↗

PubMed2003

A mother's attitude towards her infant and child behaviour five years later.

OBJECTIVE: The relationship between maternal attitude to the infant at 6 months of age and behavioural outcomes at 5 years is explored, controlling for numerous demographic, child and psychosocial family factors. METHOD: Data was used from the Mater-University Study of Pregnancy, an Australian longitudinal study of over 7000 mothers and children followed from pregnancy to when the children were 5 years. Measures ranging from the key variables of maternal attitude and child behaviour as well as numerous confounders were dichotomised. Logistic regression analyses were performed to examine the relationship between maternal negative attitude toward the infant and clinically significant levels of child behaviour problems and other infant risks, early social risks, and concurrent social risks. RESULTS: The results suggest that maternal negative attitude towards the infant at 6 months is an independent predictor of child behaviour problems at 5 years. This association remained significant for boys' externalizing behaviours and girls' internalizing behaviours. CONCLUSIONS: The findings lend support to the concept of a sensitive period in early infancy; the need for a broad perspective in the assessment of the mother-infant relationship and the need for early intervention with dysfunctional mother-infant dyads.

Adult↗

PubMed2003

Learning, cognitive, and attentional problems in adolescents born small for gestational age.

OBJECTIVE: To determine whether the presence, severity, or symmetry of growth restriction in term infants is an independent risk factor for learning, cognitive, and attentional problems in adolescence. METHODS: A total of 7388 term infants have been followed prospectively since birth. At 14 years, 5059 mothers completed a Child Behavior Checklist and provided information on their child's school progress. A total of 5051 adolescents completed a Youth Self Report, with 3703 also undergoing psychometric testing with Ravens Progressive Matrices and Wide Range Achievement Test (WRAT) reading subtest. Outcomes were compared on the basis of birth weight groups and measures of body symmetry and were adjusted for the level of social risk at birth. RESULTS: Adolescents who were born small for gestational age (SGA), when compared with their appropriately grown counterparts (>10th percentile), were more likely to experience learning difficulties, with a higher prevalence in those of birth weight < or =3rd percentile. Girls of birth weight < or =3rd percentile were more likely to have attentional problems and low WRAT reading scores. There was no significant difference in Ravens IQ or mean WRAT reading scores between SGA and non-SGA groups. There was no association between body symmetry and any of the outcomes studied. CONCLUSIONS: SGA status seems to have only modest independent effects on learning, cognition, and attention in adolescence. Severity but not symmetry of growth restriction predicted learning difficulties.

Adolescent↗

PubMed2002

Globotriaosylceramide accumulation in the Fabry kidney is cleared from multiple cell types after enzyme replacement therapy.

BACKGROUND: Fabry disease, a lysosomal storage disease caused by deficient lysosomal alpha-galactosidase A activity, is characterized by globotriaosylceramide (GL-3) accumulation in multiple cell types, particularly the vasculature, leading to end organ failure. Accumulation in the kidney is responsible for progressive decline in renal function in male patients with the classical phenotype, resulting in renal failure in their third to fifth decades of life. With the advent of recombinant protein synthesis technology, enzyme replacement therapy has become a viable alternative to dialysis or renal transplantation, previously the only available treatment options for end-stage renal disease. METHODS: The pre- and post-treatment renal biopsies were analyzed from fifty-eight Fabry patients enrolled in a Phase 3 double-blind, randomized, placebo-controlled trial followed by a six-month open label extension study of the recombinant human enzyme, alpha-galactosidase A (r-halphaGalA), administered IV at 1 mg/kg biweekly. The purpose of this investigation was to detail the pathologic changes in glycosphingolipid distribution and the pattern of post-treatment clearance in the kidney. RESULTS: Baseline evaluations revealed GL-3 accumulations in nearly all renal cell types including vascular endothelial cells, vascular smooth muscle cells, mesangial cells and interstitial cells, with particularly dense accumulations in podocytes and distal tubular epithelial cells. After 11 months of r-halphaGalA treatment there was complete clearance of glycolipid from the endothelium of all vasculature as well as from the mesangial cells of the glomerulus and interstitial cells of the cortex. Moderate clearance was noted from the smooth muscle cells of arterioles and small arteries. Podocytes and distal tubular epithelium also demonstrated evidence for decreased GL-3, although this clearance was more limited than that observed in other cell types. No evidence of immune complex disease was found by immunofluorescence despite circulating anti-r-halphaGalA IgG antibodies. CONCLUSIONS: These findings indicate a striking reversal of renal glycosphingolipid accumulation in the vasculature and in other renal cell types, and suggest that long-term treatment with r-halphaGalA may halt the progression of pathology and prevent renal failure in patients with Fabry disease.

Adolescent↗

PubMed1997

Bronchopulmonary dysplasia: a comparative study of motor development to two years of age.

This study investigated the influence of bronchopulmonary dysplasia (BPD) on the motor development of children in the first two years of life. Sixty-four children with BPD and 53 control infants were assessed at eight months and two years corrected for prematurity using the neuro-sensory and motor development assessment (NSMDA). Results indicated a significant delay in gross motor performance of the study children at eight months. By two years, considerable catch-up had occurred, but a significant difference in postural control and balance between the study and control groups was identified. When corrected for periventricular haemorrhage and ventricular dilatation, although substantial, the difference was not statistically significant. When growth <10th centile was considered in the study infants, postural control, overall motor performance and neurological status were significantly less than in those whose growth was within normal limits.

Journal Article↗

PubMed1997

Neuromotor behavioural assessment of preterm infants at risk for impaired development.

This study was undertaken to evaluate the effectiveness of a new neuromotor behavioural assessment in identifying preterm infants whose development was potentially at risk as a result of their early birth and immediate postnatal experiences. All infants born at less than 30 weeks gestation or who weighed less than 1000g at birth and cared for in the Mater Hospital's Neonatal Intensive Care Unit in Brisbane over a two year period were included in the study. Infants were assessed in their third week of life and again at 36 weeks gestational equivalent age, or prior to discharge, whichever occurred sooner. Results indicate that the assessment is effective in differentiating those infants who suffered from adverse neonatal events from those who did not, when assessed between 30 and 36 weeks gestational equivalent age. The assessment did not prove useful for infants of less than 30 or greater than 36 weeks gestational equivalent age.

Journal Article↗

PubMedDate not supplied

Asthma and internalizing behavior problems in adolescence: a longitudinal study.

OBJECTIVE: Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence. METHODS: Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report). RESULTS: Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14. CONCLUSION: Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.

Adolescent↗