[Teaching functions of a medical school hospital].
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Thirty pre-school children with recurrent respiratory infections had a higher age adjusted mean serum IgG level than their siblings or a reference group. One index child had persistently low serum IgA, but mean serum IgA and IgM levels for the index children were normal. All of the 23 index children and 17 siblings studied had a four-fold or greater rise in virus neutralizing antibody titre. There was no correlation between serum immunoglobulin levels and frequency of infections. There was, however, a significant inverse correlation between salivary IgA levels when healthy and the number of infections experienced by each child in the study year. Salivary IgA levels rose considerably during acute infections.
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This investigation attempted to test Hanin's theory of optimal function in 15 female high school swimmers. Each swimmer completed the State Anxiety Inventory (STAI) and the Body Awareness Scale (BAS) under the following conditions: I) baseline; II) retrospective recall of "best", "usual", and "worst" performances; III) 24 h prior to an easy and difficult dual meet with instructions to respond as to "how you think you will feel 1 h before the meet"; and IV) 1 h before the meets utilizing the standard ("right now") instructional set. Success was determined in each meet by two methods: 1) objective ratings based on comparisons with the average of times from previous meets; and 2) subjective ratings of performance made by the coach. In the difficult meet significant (P less than 0.01) increases in precompetition anxiety and body awareness occurred, and the correlations between predicted and actual pre-competition were .95 (P less than 0.001) for both anxiety and body awareness. In the difficult meet swimmers subjectively classified as successful were more accurate (P less than 0.05) in predicting precompetition anxiety, and possessed pre-competition anxiety values that were closer to their recall of optimal pre-competition anxiety compared to the unsuccessful swimmers. No comparisons based on the objective classifications were significant, nor were any of the comparisons in the easy meet. The present findings support Hanin's optimal function theory.
Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.
This article examines the correlation of milder pre-school neuro-developmental functional delay and school learning abilities from a clinical and educational perspective. A positive high correlation was found. Developmental function was therefore judged to be highly relevant to learning skills. A screening and assessment scheme is suggested.
In this 6-month prospective study of 138 ninth-grade inner-city students, associations among different aspects of school-based social competence were examined. In addition, links between initial emotional adjustment and subsequent social competence at school were explored. Aspects of social competence examined included academic achievement, peer reputation, and teacher-related classroom behaviors. Emotional adjustment was measured based on self-reported internalizing and externalizing symptoms. Consonant with views positing continuity and coherence of development, high temporal consistency was found within each social competence domain. In addition, superior adjustment in one domain was sometimes associated with subsequent improvements in other spheres as well. Exceptions found to this pattern were that (a) both as an antecedent and as a consequent variable, peer-rated sociability was negatively linked with other indices of school-based functioning, and (b) among girls, high anxiety was related to improved performance at school over the year. Ecological influences in adolescent adjustment are discussed, and implications of the findings for future research are explored.
The present study evaluated alternative treatments for children (N = 112, ages 7-13) referred for severe antisocial behavior. Children were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client-centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. Notwithstanding the significant improvements, comparisons with nonclinic (normative) samples revealed that the majority of youth remained outside of the normal range of deviant behavior. Possible directions for improving treatment for antisocial youth are highlighted.
This article presents current roles and functions of the school-based occupational therapist that were identified through data analyses of surveys conducted during 1978. The major roles emerging from data are evaluation/screening, program planning, implementing intervention programs, supervision, and consultation. Functions of occupational therapy educational management for each of the roles are specified. The findings will be used in the development of competency-based educational programs to prepare the occupational therapist with the specialized competencies needed in the provision of services within school systems.
The purposeful integration of school and community efforts indeed may be the critical element in a formula to promote the health of school-aged children and youth. Obviously there are numerous strategies, policies, and methods to functionally integrate school and community activities. As concluded by the Director of the U.S. Office of Maternal and Child Health in a paper on "New Policies in School Health": What is required, then, are not new policies in school health, but, a reaffirmation and implementation of policies that have been with us for many years.
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The functional state of the organism of preschool-children during a school year has been investigated on the basis of the dynamics of statistical characteristics of the cardiac rhythm. It has been found out that it is more difficult for boys to get adapted to the conditions of a kindergarten than girls. During the school year children develop sex- and age-dependent fatigue. Cardiac rhythm studies data make it possible to assess the organism status of preschoolchildren in different periods of the school year and, on this basis, to correct educational work in the kindergarten.
This DataWatch explores the roles of human service sectors (mental health, education, health, child welfare, and juvenile justice) in providing mental health services for children. The data are from the first wave of the Great Smoky Mountains Study of Youth, a population-based study of psychopathology and mental health service use among children. The results show somewhat higher rates of mental health service use than has been reported previously, while continuing to show a substantial amount of unmet need, even among children with both a psychiatric diagnosis and functional impairment. The findings point to a significant role for the education sector, suggesting that schools may function as the de facto mental health system for children and adolescents.
BACKGROUND: Asthma is a major cause of morbidity in childhood, restricting activity and causing absences from school. Theophylline, although effective in managing chronic asthma, has been reported to cause deficits in cognitive functioning and school performance. We therefore examined the effect of asthma and its treatment on academic achievement in a large, representative population of school-age children; matched sibling controls were used for comparison. METHODS: We identified 255 consecutive children with asthma (mean age, 12.0 years) who had taken nationally standardized scholastic achievement tests administered routinely by the schools. One hundred one of these children had siblings without asthma with whom comparisons could be made in reading, mathematics, and a composite measure of achievement. RESULTS: Academic achievement among the children with asthma was similar to normative standards in Iowa and higher than national standards, as reflected in a mean composite T-score of 57.1 (expected mean [+/- SD], 50 +/- 10). For the 101 children with sibling controls, composite T-scores were 58.3 for the children with asthma and 57.5 for the siblings. Eighty-five of these 101 children with asthma were receiving daily maintenance medication for chronic asthma; 72 of these were receiving theophylline. The mean composite T-scores were 58.5 for the theophylline-treated patients and 58.4 for their siblings without asthma. None of the differences between the children with asthma and the sibling controls were statistically significant. CONCLUSIONS: Academic achievement among children with asthma, at least those whose status is closely monitored in a structured treatment program, generally appears to be unaffected by asthma or by its treatment with appropriate doses of theophylline.
The centralization of treatment for functional masticatory disturbances by the Copenhagen Municipality Children's Dental Service has made possible the present survey of symptoms and results of treatment in a child population. Over a period of four years, a total of 366 children, aged six to sixteen (two thirds girls), were referred for treatment. Their symptoms differed from those reported by adult patients by a marked attrition of the mandibular incisors and concomitant sensitivity to thermal and mechanical stimulation. Other symptoms of functional disturbance, such as reduced mandibular mobility and muscle tenderness, were similar to those reported for adult subjects. Treatment conformed to conventional principles with widespread use of soft bite-splints (Figure 5). Both symptoms and signs were eliminated in about 60 percent of the patients, while 34 percent were essentially symptom-free at the conclusion of treatment. The survey showed that functional disturbances in the mandibular apparatus occur in children, and that many can be treated with good results. The symptomatology, however, resembles that of a wide range of other ailments, especially with respect to headache and facial pain, necessitating a careful differential diagnosis before functional corrective treatment is started.