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Biomedical subjects

R Needlman

Publications and source records attributed to R Needlman.

10 recordsLinked to original sources
PubMed1998

To teach is to learn twice. Resident teachers learn more.

OBJECTIVES: To describe the formal teaching activities of pediatric residents and to assess how the act of formal teaching affects residents' acquisition and retention of knowledge. DESIGN AND METHODS: Randomized controlled trial. Forty-three pediatric residents in a university-based program were surveyed about their teaching activities, given a pretest on a predetermined topic (oral rehydration), then randomly assigned to either teach (n = 18) or listen to (n = 25) a 30-minute lecture on that topic; 6 to 8 weeks later they completed a posttest. The difference between [retest and posttest scores was calculated for each resident as an index of knowledge acquisition. RESULTS: The mean number of resident teaching events per year was 3.5 for interns (n = 16), 2.9 for junior residents (n = 11), and 6.9 for senior residents (n = 16). Self-reported comfort with the teaching role, ability to hold a group's attention, and desire to teach were similar across year of training. Prior to randomization, teachers (experimental group) reported less interest in oral rehydration that did listeners (control group) (P < .03). However, knowledge acquisition was significantly greater for teachers than for listeners (posttest score minus pretest score [mean +/- SD], 6.1 +/- 4.2 vs 3.2 +/- 2.5; P < .01). IMPLICATIONS: Among pediatric residents, formal teaching enhances knowledge acquisition relative to self-study and lecture attendance.

Adult↗
PubMed1998

Blood pressure in children exposed prenatally to cocaine.

Prenatal exposure to cocaine may alter autonomic nervous system function resulting in hypertension. Blood pressure was measured oscillometrically in a convenience sample of cocaine-exposed (n = 32) and nonexposed (n = 23) children, aged 8 to 26 months, by examiners unaware of exposure status. The exposed and nonexposed groups did not differ in systolic pressure (mean +/- SD 102.3 +/- 9.9 mmHg vs 119.1 +/- 19.4). Prenatal exposure to cocaine does not appear to be associated with elevated blood pressure in young children.

Autonomic Nervous System↗
PubMed1996

Use of diet history in the screening of iron deficiency.

OBJECTIVE: To determine the relationship between diet history and microcytic anemia, a proxy for iron deficiency, and the utility of a brief dietary history in screening for microcytic anemia. DESIGN: Cross-sectional study based on review of clinical records. SETTING: Urban academic primary care clinic. SUBJECTS: A total of 305 healthy, African-American inner-city children, presenting for well child care at 15 to 60 months of age. Children with recent minor illness or medicinal iron intake, hemoglobinopathies, chronic illnesses, failure to thrive, or elevated lead levels were excluded. METHOD: A brief dietary history was taken in the course of primary care visits. Dietary deficiency was defined as: (1) less than five servings each of meat, grains, vegetables, and fruit per week; (2) more than 16 oz of milk per day; or (3) daily intake of fatty snacks, sweets, or more than 16 oz of soft drink. Hematologic indices were obtained. RESULTS: The prevalence of microcytic anemia (hemoglobin, < 11 g/dL; mean corpuscular volume, < 73 fL) was 8% (24 of 305). The prevalence of low hemoglobin ( < 11 g/dL) with or without microcytosis was 12% (38 of 305). Dietary deficiency was associated with microcytic anemia (chi 2 = 26.8). As a screening test for microcytic anemia, dietary deficiency had a sensitivity of 71% (17 of 24), specificity of 79% (222 of 281), and negative predictive value of 97% (222 of 229). CONCLUSION: Microcytic anemia was associated with a deficient diet among low-income African-American children. A brief dietary history correctly identified children at low risk for microcytic anemia 97% of the time.

Black or African American↗
PubMed1993

Cerebrospinal fluid monoamine precursors and metabolites in human neonates following in utero cocaine exposure: a preliminary study.

BACKGROUND: Cocaine acts in the central nervous system by increasing dopamine release and inhibiting the reuptake of dopamine and other monoaminergic neurotransmitters. Prenatal cocaine exposure may cause neurochemical changes in developing monoaminergic neurons and might alter brain structure and function. No data have been published on central nervous system monoamine precursors and metabolites in human neonates exposed prenatally to cocaine. METHODS: Cerebrospinal fluid (CSF) was obtained from neonates undergoing lumbar puncture to rule out infection. The CSF was analyzed for the neurotransmitter precursors and metabolites tryptophan, tyrosine, 3-methoxy-4-hydroxyphenylglycol, homovanillic acid, and 5-hydroxyindoleacetic acid. Drug exposure was ascertained by medical record review and urine and meconium assays. RESULTS: Eleven neonates were cocaine-exposed, based on positive meconium or urine assays for benzoylecgonine; 20 were unexposed, based on both negative history and assay. The exposed and unexposed groups did not differ significantly in gender, perinatal stress, clinical illness, or exposure to other illicit drugs, but did differ in mean gestational age, growth parameters, and exposure to cigarettes. Cocaine-exposed neonates had significantly lower levels of CSF homovanillic acid (mean 148.1 vs 218.5 ng/mL, P = .01). The magnitude of this difference was similar after correcting for each of four potential confounding factors, although no longer statistically significant in all cases (P values ranged from .044 to .17). No significant differences were observed for tyrosine, tryptophan, 5-hydroxyindoleacetic acid, or 3-methoxy-4-hydroxyphenylglycol. CONCLUSIONS: These preliminary results suggest an association between prenatal cocaine exposure and decreased CSF homovanillic acid, the principal metabolite of dopamine. Prenatal cocaine exposure may result in changes in central dopaminergic systems in the human neonate.

Biogenic Monoamines↗
PubMed1991

Clinic-based intervention to promote literacy. A pilot study.

Educational research has shown that children become literate more easily if their parents read to them. A clinic-based program was designed to encourage early book use among parents of children at risk. It included (1) waiting room readers, (2) guidance about literacy development, and (3) provision of children's books at each visit. Seventy-nine parents of children aged 6 to 60 months were interviewed. Parents who had previously received a book were more likely to report looking at books with their children or that looking at books was a favorite activity (adjusted odds ratio, 4.05). This association was strongest among parents receiving Aid to Families With Dependent Children (odds ratio, 7.8). This preliminary study suggests that pediatricians can play a role in enriching children's early literacy environments, especially for children at high risk of school failure.

Aid to Families with Dependent Children↗
PubMed1991

Psychosocial correlates of severe temper tantrums.

Temper tantrums are common and distressing, but little epidemiological information is available about them. Attempts to identify psychosocial correlates of tantrums have used small samples and have not controlled for multiple concurrent behavior problems. We analyzed interviews from 502 English mothers of 3-year-olds. Tantrums were considered present if mothers reported tantrums three or more times a day or lasting 15 minutes or longer. Behavior problems were assessed using the Behavior Screening Questionnaire. Tantrums were reported in 6.8% of children, of whom 52% had multiple behavior problems. Factors independently associated with tantrums included maternal depression and irritability, low education, and use of corporal punishment, manual social class, marital stress, child care provided exclusively by the mother, and poor child health. Tantrums were not associated (at p less than 0.01) with gender, maternal employment, low social support, or single parenthood. Severe tantrums may indicate the presence of multiple behavior problems and psychosocial stressors.

Child Behavior Disorders↗