Stress and child health: an overview.
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Adaptation, Psychological↗
Biomedical subjects
W T Boyce
Publications and source records attributed to W T Boyce.
Playground equipment injuries in a large, urban school district.
We studied the epidemiologic features of playground equipment-related injuries occurring in a large, urban school district over a two-year period. Nurses in each of the district's 68 elementary schools completed self-coded reporting forms on all injuries meeting standardized criteria. A total of 511 equipment-related injuries were reported, an incidence of 8.9 injuries per 1,000 student-years. One-fourth of the injuries were severe, and climbing equipment was disproportionately represented among playground equipment associated with injuries. Extreme variability was found among school-specific rates of equipment injury, with schools at the two extremes separated by as much as a 40-fold difference in incidence. Two school characteristics--smaller student enrollments and the presence of alternative educational programs--were significantly associated with higher equipment-related injury rates.
Arizona↗
Epidemiology of injuries in a large, urban school district.
Injuries represent the single greatest threat to the health and well-being of US children. A large number of childhood injuries are sustained in schools, yet little is currently known of the epidemiologic features of school-related injuries. A surveillance of injuries occurring in a large, urban school district during a 2-year period was conducted. Nurses in each of the district's 96 schools completed reporting forms on all injuries meeting standardized criteria, and both principals and nurses completed questionnaires on school characteristics that were judged potentially important to the injury rate in individual schools. A total of 5,379 injuries were reported, among the district's 55,000 students, for an overall injury rate of 49 injuries/1,000 student-years. Injury rates were higher for boys than girls at all age levels. Self-caused and sports-related injuries comprised nearly half of all those reported, and 14% were related to use of playground or sports equipment. Eighteen percent of injuries were severe, and playground- and equipment-related injuries were significantly more likely to be severe (P less than .001). Rates of injury among individual schools varied markedly, with schools at the two extremes separated by a 25-fold difference in rates. Higher overall injury rates were found in schools with longer hours, alternative educational programs, less experienced school nurses, and lower student-to-staff ratios (P less than .0001).
Adolescent↗
The family routines inventory: theoretical origins.
This paper describes the conceptual foundation underlying the development of the Family Routines Inventory, a new instrument designed to measure the extent of predictability or routinization in the daily life of a family. The primary impetus for the development of this instrument is a theoretical perspective in which family routines are regarded as behaviors which may protect the health and well-being of family members by providing stability and continuity during periods of stressful change.
Activities of Daily Living↗
The family routines inventory: development and validation.
This report builds upon pertinent theoretical considerations regarding the nature and importance of routinization within families and describes the development and validation of a standardized inventory to measure family routines. The Family Routines Inventory (FRI) measures 28 positive, strength-promoting family routines, those observable, repetitive behaviours which involve two or more family members and which occur with predictable regularity in the daily life of a family. The 28 routines were selected from an extensive list of 104 routines obtained through family interviews. Scoring options for the inventory were identified based on their face validity and consistency with the underlying theoretical construct. The inventory was subsequently administered to a diverse group of families for reliability and validity testing. This testing identified an optimal scoring method (frequency score) for the inventory and revealed that the Family Routines Inventory, which measures the extent and importance of routinization within a given family, appears to be a reliable and valid measure of family cohesion, solidarity, order and overall satisfaction with family life.
Activities of Daily Living↗
Acculturation and changes in health among Navajo boarding school students.
This paper describes the relationship between cultural background and illness experience among Navajo students during their first year at a reservation boarding school. Sixty Navajo children were enrolled in a 9-month, prospective study in which three descriptors of change in health status were assessed: (a) number of dormitory aide contacts initiated by the child for an illness complaint; (b) number of clinic visits for an illness judged by the aide to require medical attention; and (c) number of psychosocial problems referred to the clinic or to the boarding school administration. Two measures of cultural background were developed to estimate the location of each child along a continuum of acculturation, ranging from a traditional Navajo cultural orientation to full assimilation into modern Anglo-American society. First, the home communities for all children in the study population were ranked by eleven Navajo informants on an equal-interval scale reflecting community differences in cultural identity. Second, a questionnaire assessing acculturative dimensions of family life style was administered to each child by a Navajo assistant. In addition, each student was assigned a score for cultural incongruity, defined as the degree of absolute difference between community and family measures of cultural background. The reliability and validity of each index of acculturation were confirmed using a variety of psychometric approaches. Controlling for the confounding effects of age, sex and family size, a significant positive association was found between the number of clinic visits and the degree of cultural incongruity. Boarding school students from families and communities which conflicted in cultural orientation experienced higher rates of clinic visits for illnesses requiring medical attention. This result is discussed in the context of current understandings of the epidemiological consequences of cultural change.
Acculturation↗
A controlled trial of a physical fitness program for fifth grade students.
The relative effectiveness of a structured physical fitness program was compared with that of the customary organized activities for fifth grade students. The level of fitness was compared at the beginning and end of the nine-month academic year as well as after the three-month summer recess during which time no structured program was offered. The experimental group showed significant improvement over the control group in flexibility, strength and endurance during the school year; part of that improvement was maintained over the summer months; the physical fitness program had a positive influence on the general activity level of the students and was adopted by nine of the other 10 classrooms in the experimental school.
Child↗
A survey of physician consultations in an urban school district.
A survey of physician encounters was conducted in a large, urban school district following the institution of consultative, rather than full-time, school physician services. Review of the encounter data over a six-month period revealed that: (a) the majority of consultations related to the problems of individual children; (b) there was a high prevalence of behavioral and psychosocial issues among the problems addressed; and (c) physicians were prominently involved in cross-disciplinary interactions. The survey provides an analysis of physician utilization under an emerging model of school health services in which physicians serve as consultant members of a medical and educational team.
Adolescent↗
Medical and developmental outcomes among Navajo infants from high-risk social environments.
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Growth↗
Interaction between social variables in stress research.
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Female↗
Influence of life events and family routines on childhood respiratory tract illness.
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Child↗
Maternal distress and discrepancy in reports of psychopathology in chronically ill children.
This article focuses on the relation between maternal distress and mother-child discrepancy in reports of child psychopathology, as assessed by a standardized structured interview. The sample includes 92 chronically ill children (mean age +/- SD = 12.5 +/- 2.7 years). Agreement between mother and child on the presence of any child psychiatric diagnosis was low. Maternal distress was correlated with the number of disorders identified by the mother but not with those identified by the child. Maternal distress was significantly higher in the mothers who identified a disorder but whose children did not. Choice of informant and maternal distress are significant factors in the evaluation of psychopathology.
Adolescent↗
Psychobiologic reactivity to stress and childhood respiratory illnesses: results of two prospective studies.
Psychological stress is thought to undermine host resistance to infection through neuroendocrine-mediated changes in immune competence. Associations between stress and infection have been modest in magnitude, however, suggesting individual variability in stress response. We therefore studied environmental stressors, psychobiologic reactivity to stress, and respiratory illness incidence in two studies of 236 preschool children. In Study 1, 137 3- to 5-year-old children from four childcare centers underwent a laboratory-based assessment of cardiovascular reactivity (changes in heart rate and mean arterial pressure) during a series of developmentally challenging tasks. Environmental stress was evaluated with two measures of stressors in the childcare setting. The incidence of respiratory illnesses was ascertained over 6 months using weekly respiratory tract examinations by a nurse. In Study 2, 99 5-year-old children were assessed for immune reactivity (changes in CD4+, CD8+, and CD19+ cell numbers, lymphocyte mitogenesis, and antibody response to pneumococcal vaccine) during the normative stressor of entering school. Blood for immune measures was sampled 1 week before and after kindergarten entry. Environmental stress was indexed with parent reports of family stressors, and a 12-week respiratory illness incidence was measured with biweekly, parent-completed symptom checklists. The two studies produced remarkably similar findings. Although environmental stress was not independently associated with respiratory illnesses in either study, the incidence of illness was related to an interaction between child care stress and mean arterial pressure reactivity (beta = .35, p < .05) in Study 1 and to an interaction between stressful life events and CD19+ reactivity (beta = .51, p < .05) in Study 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Antigens, CD↗
Life events, frontal electroencephalogram laterality, and functional immune status after acute psychological stressors in adolescents.
OBJECTIVE: Past studies have found that environmental stress affects cellular immune function and that extensive variability exists in the magnitude and direction of stress-induced immune changes. Past research also suggests that individuals with greater right, relative to left, resting frontal electroencephalogram (EEG) activation perceive environmental stress as more aversive and have lower baseline cellular immune function. In this study, we examined environmental stressors, resting frontal EEG laterality, and immune responses to short-term psychological stressors in adolescent boys. METHODS: A sample of twenty-four 14-16 year old right-handed boys underwent a recording of resting EEG and collections of blood taken before and after a laboratory protocol designed to induce psychological stress. Blood samples were used to measure changes in mitogen lymphoproliferative responses, natural killer (NK) cell activity, and T-cell phenotypic subsets. Life events were measured using self-report questionnaires. RESULTS: Life events and frontal laterality showed a first order interaction in predicting changes in lymphocyte proliferation to tetanus toxoid (R2 increment = .26, p < .01) and pokeweed mitogen (R2 increment = .25, p < .02). The interaction also predicted changes in NK activity (R2 increment = .24, p < .02). CONCLUSIONS: Changes in lymphocyte proliferation and NK activity were associated with negative life events only among individuals with greater left frontal cortical activation. Our results suggest that recent psychosocial stress and individual differences in resting frontal cortical activation are together linked to immunologic responses to acute psychological stressors.
Adolescent↗
The prevalence of genital Chlamydia trachomatis and mycoplasmal infections during pregnancy in an American Indian population.
The epidemiology of cervical infection with Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum among a group of pregnant American Indian women was investigated. The prevalences of these microorganisms were 24-30% for C. trachomatis, 50% for M. hominis, and 80% for U. urealyticum. These rates are unusually high for an unselected sample. Infection with C. trachomatis was correlated with younger age but not with primigravidity or educational level. Neither M. hominis nor U. urealyticum infection was correlated with younger age, primigravidity, or level of education. The possible consequences of the increased prevalences of C. trachomatis, M. hominis, and U. urealyticum in this group of American Indians are of concern and are being investigated.
Chlamydia Infections↗
Socioeconomic inequalities in health. No easy solution.
OBJECTIVE: Socioeconomic status (SES) is strongly associated with risk of disease and mortality. Universal health insurance is being debated as one remedy for such health inequalities. This article considers mechanisms through which SES affects health and argues that a broader and more comprehensive approach is needed. DATA SOURCES: Published articles surveyed using MEDLINE and review articles and bibliographies. METHODS AND RESULTS: Research is reviewed on the association of SES with health outcomes in different countries, including those with universal health coverage. Socioeconomic status relates to health at all levels of the SES hierarchy, and access to care accounts for little of this association. Other mechanisms are suggested and implications for policy and clinical practice are discussed. CONCLUSION: Health insurance coverage alone is not likely to reduce significantly SES differences in health. Attention should be paid both in policy decisions and in clinical practice to other SES-related factors that may influence patterns of health and disease.
Female↗