Motor skill acquisition in nursing.
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Biomedical subjects
Publications and source records attributed to R Hanson.
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A group of 355 children who were seen after a first febrile convulsion at the Kaiser Foundation Foundation Hospitals in Southern California from 1970 to 1975 were randomly assigned to three treatment groups-daily phenobarbital, "intermittent" phenobarbital given at the onset of fever, and no phenobarbital. We found that 42% had a relative with a febrile seizure and 16% a relative with an afebrile convulsion. 13% had seizures which were either lateralized or longer than ten minutes. Parents were unaware of the fever prior to the seizure in about 30% of the cases. In 81% the preseizure duration of fever was less than 24 hours. The mean follow-up was 28 months, with a range of 6 to 70 months. There was no significant difference in the recurrence rate between children receiving "intermitent" as compared with no phenobarbital. The recurrence rate in children receiving daily phenobarbital was significantly decreased compared to either of the other two groups. Severe recurrent febrile seizures occurred in no children on daily phenobarbital and in 4.4% of the children receiving either intermittent or no phenobarbital. Parental resistance, compliance, and reversible hyperactivity were the main problems encountered with the continuous phenobarbital regimen.
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The self-reported child-rearing practices of 214 parents of battered babies were characterized in a few but not all respects by demanding behaviour which exceeded that to be expected in relation to their social class and age. Inconsistency in child management was noted in the comparison between lack of demonstrativeness and emotional over-involvement, and between physical punishment and a tendency to be lax in the supervision of the child, and was reminiscent of parents of delinquents. Unhappiness and hostility in relationships with members of their families of origin, with unsupporting partners and with people in general were other important features. Generally, identified perpetrators were characterized by features significant for the sample as a whole.
A controlled investigation of 134 battered children showed that nearly half had serious injuries and 21 died. Sixty-five had been battered more than once, 20 had permanent neurological sequelae, a quarter were low birth weight babies, and 10 had serious congenital defects. Twenty-three had been previously admitted to hospital with failure to thrive and the overlap with physical neglect was considerable. Mortality and morbidity among their siblings was also high. Difficulties with the child were attributable to interaction with neurotic mothers.The risk of battering diminishes after a child's second birthday. The establishment of specialized hospital teams to tackle the overall problem is suggested as a method of improving management. Prevention may lie in educating mothers in the basic physical and psychological requirements of children and overcoming their reluctance to avail themselves of medical care.
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A controlled investigation of 214 parents of battered babies shows that they were young and predominantly of lower social class. Premature parenthood is an associated feature. Among the mothers 76% had an abnormal personality and 48% were neurotic. Nearly half were of borderline or subnormal intelligence; 11% had a criminal record. Of the fathers 64% had an abnormal personality, more than half being psychopaths. Twenty-nine per cent. had a criminal record. Recidivism is an associated feature.The risk of battering possibly diminishes with time. The teaching of appropriate child-rearing skills, symptomatic relief, and social relearning are suggested as realistically based treatment methods and should be combined with a care order. When response to treatment appears unlikely permanent removal from parental care should be considered.
The method of moments, as presented by Isenberg and Dyson (1969; Biophys. J. 9:1337) has been shown to be a reliable way of obtaining the amplitudes and time constants of several simultaneously emitting species, even in the presence of an overlapping excitation. Recent improvements in the method include (a) a component incrementation test for determining the number of relaxations, (b) a procedure, which we call exponential depression, for dramatically improving convergence, and (c) a new algorithm for implementing the method of moments on a digital computer with a high degree of flexibility and efficiency. These improvements, as well as new general theory, are described and tested using both synthetic and real experimental data. Component incrementation consists of examining models with increasing numbers of exponential terms. Given adequate precision, we find that an analysis for N + 1 components, of data that are actually represented by N components, provides the correct amplitudes and time constants plus an N + 1 term with an insignificant amplitude. Exponential depression is a transformation in which the original excitation and fluorescence, E(t) and F(t), are multiplied by exp (-lambdat), where lambda is an arbitrary parameter. While the convolution is invariant to this transformation, the proper choice of lambda greatly reduces the number of iterations necessary to obtain the amplitudes and time constants and may even improve their accuracy. In addition, an appendix by John P. Mullooly presents a statistical analysis of the effect of counting error on the method of moments estimates of fluorescence decay parameters, applicable when data are obtained by the monophoton technique. Formulas are derived that give the approximate precision of the decay parameters for the general case of N exponential components, with calculational details for one and two component systems.
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