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PubMedDate not supplied

Strategies for joint appointments.

The structure and policies governing joint appointments discussed above, are developed primarily through cooperation and collaboration between nursing service and education institutions. The joint appointee participates in the process of negotiation of salary, benefits and role responsibilities and exploration of the implications of the appointment for personal career development. Implementation and maintenance of the appointment requires the collaborative efforts of the joint appointee with both contracting agencies. Factors influencing the functioning of joint appointees have been identified and strategies to facilitate functioning presented. The joint appointee must be independent in thought and action yet adaptable to work within the boundaries of two social systems with differing values and expectations. Nursing management, peers and students can provide the support needed to overcome the frustrations and to achieve the rewards inherent in successful implementation of an exciting and innovative role.

Academic Medical Centers↗
PubMedDate not supplied

[Asperger's syndrome--a separate nosologic entity or part of the spectrum of autism].

This paper describes Asperger's syndrome, a disease similar to the autistic disorder, delineated for the first time by Asperger in 1944, just a few months after L. Kanner described infantile autism. Although, according to the epidemiological data, it occurs far more frequently than infantile autism, in practice this diagnosis is rarely established. Asperger's syndrome is defined as autistic syndrome among children with relatively high degree of intellectual functions, with marked disorder of speech and motoricity and interest confined to a very specified area. Learning is mechanical and routine and games uninventive. Children lack the need for age peer company. Boys are affected ten times more frequently than girls.

Autistic Disorder↗
PubMed1997

Effectiveness of a prospective physician self-audit transfusion-monitoring system.

BACKGROUND: The purpose of this study was to search for a more effective transfusion-monitoring system than the existing system of retrospective peer review. STUDY DESIGN AND METHODS: This research used a study-control, preintervention and postintervention design, to evaluate the effectiveness of a prospective physician self-audit transfusion-monitoring system that functioned without the direct involvement of transfusion service physicians. This research also evaluated the effectiveness of issuing to physicians a memo with transfusion guidelines. Three process indicators were used to assess physician behavior at various stages of the blood-ordering process: 1) the number of crossmatches ordered per admission, 2) the transfusion-to-crossmatch ratio, and 3) the number of blood units returned to the laboratory after physician self-auditing. The study used two outcome indicators to reflect overall blood utilization: 1) the percentage of patients who received red cell transfusions and 2) the number of blood units transfused per recipient each month. RESULTS: The prospective physician self-audit system implemented at the study hospital did not reverse physician transfusion decisions, and the process of issuing to physicians a memo with transfusion guidelines at the control hospital failed to reduce blood usage. However, a transient reduction in blood utilization was observed at the study hospital. CONCLUSION: The reduction was hypothesized to be due to a Hawthorne effect, in which observed behavior is affected by the subject's awareness of the research study.

Blood Grouping and Crossmatching↗
PubMed1981

Effects of labeling and a child's reaction to punishment on subsequent disciplinary practices of adults and peers.

Effects of the label "mentally retarded" and a child's reaction to punishment on the severity of punishment administered by college students and fourth graders were examined using a video tape of an acting-out child in a classroom. Forty males and 40 females in each age group viewed one of four video tapes that were identical, with the exception of a segment in which the child responded to being disciplined by either making reparation, pleading, ignoring his punishment, or being defiant. One-half of the subjects in each condition were told that the child was mentally retarded. The subject decided how many points, representing varying intervals of "free time, should be given or removed contingent on the child's behavior. Results revealed that college students were significantly more punitive than were fourth graders, the labeled child received a significantly less severe punishment than did the nonlabeled child, and, in comparison with the other reaction conditions, the child received the most severe punishment when he reacted defiantly and obtained a reward when he responded with reparation. The results were discussed in terms of the protective function of the label and the bidirectional model of socialization.

Attitude↗
PubMed2002

Muscular control of the patella.

Patellofemoral patients are among the most common yet most challenging individuals presenting for orthopedic care. The key word in the previous sentence is individual. A single protocol of care is not sufficient for these special "individuals." Many concepts have been evaluated through review of the peer-reviewed literature with the following highlights: (1) the concept of VMO isolation through specific exercise should no longer be part of our lexicon; (2) patellofemoral patients improve when they are able to enhance quadriceps functional patterns by way of pain-free exercise; (3) patellofemoral patients do not fit into a single "box" but rather require an evaluation-based classification and specific interventional pattern. Many of the special techniques used by clinicians in treating these patients have not been well defined through research and also are lacking in evidence of clinical efficacy. We also must recognize, however, that good clinical observations can be the first step in defining what questions should be asked and how they can be answered. It is vital that we answer the questions without allowing "bad science" through dogma and anecdote to prevail. Likewise, we need to be diligent in determining our successes and failures through well designed and implemented clinical and research studies.

Exercise↗
PubMed2006

School experiences after treatment for a brain tumour.

BACKGROUND: Children surviving a brain tumour face major difficulties including learning problems, lengthy school absences and psychosocial problems, all of which can impact on school functioning. Our aims were to provide information for parents and teachers about the skills and resources of this group. Specifically, we aimed to: describe the special educational needs of these children; document the impact of diagnosis and treatment on school attendance; compare parent and teacher assessments of social, emotional and behavioural difficulties. METHODS: Forty families agreed to participate (response rate = 58.82%). The children (19 males and 21 females) were aged from 6 to 16 years and had completed treatment at least 2 years previously (range = 2 years-12 years 5 months). Questionnaires (Strengths and Difficulties and school experience) were completed by mothers and teachers. RESULTS: Survivors were experiencing a wide range of physical, learning and interpersonal difficulties, according to parent and teacher reports. Almost half the children (n = 19) had ongoing neurological problems that were significant enough to require special help at school. Literacy and numeracy were the most common learning difficulties. Parents also rated brain tumour survivors as having more behavioural and emotional problems than would be expected from population norms. For example, survivors were rated as having more Total Difficulties (t = 6.86, P < 0.001), Emotional Symptoms (t = 8.82, P < 0.001), Hyperactivity (t = 2.25, P = 0.03), Peer Relationship Problems (t = 7.58, P < 0.001) and poorer Pro-social Behaviour (t = -3.34, P = 0.002) than would be expected from population norms. These problems were also seen to be having a significant impact on the child's functioning (t = 3.95, P < 0.001). Teachers rated these problems as less serious than parents. CONCLUSION: These children experience significant problems in school some time after diagnosis and when they are considered medically cured. Closer school-hospital liaison is essential to maximize integration and achievement in these children.

Absenteeism↗
PubMed2004

Theory-of-mind development in oral deaf children with cochlear implants or conventional hearing aids.

BACKGROUND: In the context of the established finding that theory-of-mind (ToM) growth is seriously delayed in late-signing deaf children, and some evidence of equivalent delays in those learning speech with conventional hearing aids, this study's novel contribution was to explore ToM development in deaf children with cochlear implants. Implants can substantially boost auditory acuity and rates of language growth. Despite the implant, there are often problems socialising with hearing peers and some language difficulties, lending special theoretical interest to the present comparative design. METHODS: A total of 52 children aged 4 to 12 years took a battery of false belief tests of ToM. There were 26 oral deaf children, half with implants and half with hearing aids, evenly divided between oral-only versus sign-plus-oral schools. Comparison groups of age-matched high-functioning children with autism and younger hearing children were also included. RESULTS: No significant ToM differences emerged between deaf children with implants and those with hearing aids, nor between those in oral-only versus sign-plus-oral schools. Nor did the deaf children perform any better on the ToM tasks than their age peers with autism. Hearing preschoolers scored significantly higher than all other groups. For the deaf and the autistic children, as well as the preschoolers, rate of language development and verbal maturity significantly predicted variability in ToM, over and above chronological age. CONCLUSIONS: The finding that deaf children with cochlear implants are as delayed in ToM development as children with autism and their deaf peers with hearing aids or late sign language highlights the likely significance of peer interaction and early fluent communication with peers and family, whether in sign or in speech, in order to optimally facilitate the growth of social cognition and language.

Autistic Disorder↗
PubMed2003

Psychosocial functioning and stress-processing of children with asthma in the school context: differences and similarities with children without asthma.

OBJECTIVE: To characterize children with asthma by their stress processing at school and their psychosocial functioning. To establish similarities and differences between children with and without asthma. METHODS: Participants were 79 children with asthma and 359 children without asthma (ages 8-12). Children completed questionnaires on stress processing and their well-being at school. Parents filled in a questionnaire on behavior problems, and teachers provided data on school performance and absence rate. RESULTS: Children with asthma had higher scores on absence rates, teacher-rated well-being, internalizing behavior problems, occurrence of "rejection by peers," and use of aggression when coping with "problems with school work." However, using discriminant analyses, the groups could not reliably be distinguished from one another by these variables. CONCLUSIONS: Children with asthma are similar to other children with regard to their stress processing at school and their psychosocial functioning. The value of conducting multivariate analysis over several univariate tests is underscored.

Adaptation, Psychological↗
PubMed1999

One editor's views on conflict of interest.

The purpose of this article is to discuss the importance of recognizing conflict of interest or bias situations in the peer review and publication process of research papers and to identify some important guidelines or policies that help to minimize these situations. Communication of thoughts, ideas, and information is the basis of how we function as a society. Communicating research results requires us to clearly and accurately communicate all aspects of the research process, including the appropriate interpretation of results. A working definition for conflict of interest or bias with regard to publishing research results is that conflict of interest is a situation in which personal benefit (either direct or indirect) takes priority over the clarity and(or) accuracy of reporting research. These situations are ethical issues and can represent either real or assumed situations. It is true that the review and publication process is not perfect; thus, some bias probably is always present and can be brought to the review and publication process by either the author or those responsible for the process. However, conflict of interest or bias that detracts from the objective evaluation of research or the integrity of a scientific journal is inappropriate. Conflict of interest or bias situations can occur at all levels of the review and publication process and should be dealt with on a factual basis. This article describes several situations as examples and several important guidelines that help minimize the occurrence of conflict of interest or bias.

Bias↗
PubMed1975

Recognition of inverted photographs of faces by children and adults.

Inverted black-white photographs of the faces of highly familiar peers (classmates, fraternity brothers, etc.) were presented to 350 Ss ranging from 3 to 20 years of age. In an untimed test session, S tried to identify the person in the inverted photograph. Success in this task was positively correlated with age up to approximately 14 years, but performance deteriorated after this age; college-age Ss and preschool Ss' performances were approximately equal. This finding contrasts with the current view that the effects of disorientation on perception becomes less potent with age. A cognitive explanation is offered for the early rise in the performance curve; the subsequent reduction in level of performance is attributed to rigidity of the perceptual mechanism as a function of overlearning of a mono-oriented configuration.

Adolescent↗
PubMed1976

Aggressive behavior as a function of age and sex.

The present experiment investigated age and sex differences in aggressive behavior. With the use of an apparatus which delivered differentially noxious noise bursts, 40 male and female Ss of preschool and adolescent age aggressed against a male or female peer. Results indicated that aggression by and toward females was relatively stable over age, while aggression by males toward other males increased markedly (p less than .05). The implication of findings for reinforcement explanations of sex differences in aggression are discussed.

Adolescent↗
PubMed2005

Relationships between spatial activities and scores on the mental rotation test as a function of sex.

Previous results suggested that female college students' scores on the Mental Rotations Test might be related to their prior experience with spatial tasks. For example, women who played video games scored better on the test than their non-game-playing peers, whereas playing video games was not related to men's scores. The present study examined whether participation in different types of spatial activities would be related to women's performance on the Mental Rotations Test. 31 men and 59 women enrolled at a small, private church-affiliated university and majoring in art or music as well as students who participated in intercollegiate athletics completed the Mental Rotations Test. Women's scores on the Mental Rotations Test benefitted from experience with spatial activities; the more types of experience the women had, the better their scores. Thus women who were athletes, musicians, or artists scored better than those women who had no experience with these activities. The opposite results were found for the men. Efforts are currently underway to assess how length of experience and which types of experience are related to scores.

Adolescent↗
PubMed2002

Naturally occurring mentoring in Japan and the United States: social roles and correlates.

Although the word "mentor"has traditionally been used to describe a relationship between an older adult and a younger person, recent work has extended its usage to relationships with peers and groups rather than with individuals and uncoupled the instrumental and affective qualities of the role. This paper examines (a) the extent to which adolescents' relationships with significant others in different social roles are characterized by mentoring and (b) the extent to which mentoring and other relationship functions covary. Adolescents' naturally occurring social relationships are explored in two very different contexts-Japan and the United States-that differ in the norms and patterning of social interactions. College students (N = 365) used questionnaires to describe the extent to which relations with significant others were characterized by mentoring. Results indicate striking similarity in the patterning of results in the two countries and support the traditional view of mentoring. Mentoring is most likely to occur in relationships with adults (especially parents), rather than with peers, and with same-gender, rather than other-gender associates. Mentoring by parents appears to covary with other aspects of positive relationships, but be more independent in relationships with unrelated adults or peers. Although more of the variability in experienced mentoring is attributed to differences between associates than to differences between adolescents in both the United States and Japan, this is especially true of the United States. Results suggest that although "classic" mentoring is most common in both countries, mentoring is somewhat less constrained by social role differences in Japan than is in the United States.

Adolescent↗
PubMed1994

The content of narrative discourse in children and adolescents after early-onset hydrocephalus and in normally developing age peers.

The development of narrative content was studied in 100 children aged 6-15 years (49 with early-onset hydrocephalus and 51 age-matched controls) by analyzing transcripts of oral texts produced from their narrations of two fairy tales. In relation to those of their age-matched peers, the narratives of the children with hydrocephalus were less cohesive and less coherent. They conveyed less of the content needed for the narrative message, included more referentially ambiguous material, included uninterpretable or implausible content, and were more verbose and less economic in quality. In relation to their age-matched peers, then, children with hydrocephalus produce narratives that are difficult to process, unclear, uneconomic, and less fully elaborated for meaning. These data add to an emerging body of information that shows children and adolescents with early-onset hydrocephalus to be at risk for several types of discourse and pragmatic impairments. The language of children with hydrocephalus is discussed with reference to the theoretical distinction between interpersonal pragmatic conventions and constraints relating to textual rhetoric (processability, clarity, economy, and expressivity). By showing impaired textual rhetoric coexisting with apparently preserved interpersonal rhetoric in individuals with developmental anomalies of brain development, the present data provide some support for a functional dissociation between the two classes of pragmatic constraints.

Adolescent↗
PubMed2004

Overview of the psychosocial concerns of young adults with juvenile arthritis.

Young adults who develop juvenile idiopathic arthritis in childhood have a significant risk of long-term morbidity and continuing disease activity in adulthood. The impact of a physically restricting and painful chronic illness can make the transition from adolescence to adulthood more challenging. In this overview of the psychological and social impact of juvenile arthritis on young adults, particular attention is given to those areas that are of concern to this age group. The transition from adolescence to adulthood can be detrimentally affected not only by the attitudes of peers and parents, but also by the attitudes of the individual with arthritis. Chronic arthritis, including juvenile arthritis, is related to increased rates of anxiety and depression. In the face of functional restriction, pain, and poor body image, social and sexual relationships may be harder to develop and maintain. The family of the young adult may also be affected on many levels. Employment and financial security are common and well-founded concerns of young disabled adults.

Journal Article↗
PubMed1995

Mother father deaf: the heritage of difference.

Almost 90% of the children born to life-long profoundly deaf parents are hearing. Within this extraordinary family setting, hearing children of deaf parents are exposed to and interact with two differing cultural, social and linguistic systems: that of their deaf parents and the Deaf community, and that of hearing peers and adults. The present paper focuses on cultural identity and affiliation of hearing children of deaf parents--a population whose lives incorporate the paradox of being culturally 'Deaf' and yet functionally hearing. Data reported here are primarily based on interviews and life histories with 150 adult hearing children of deaf parents throughout the United States. The informants in this study provide an opportunity to explore the parameters and norms of Deaf culture as it contrasts and conflicts with those of Hearing culture.

Acculturation↗
PubMed2003

Early experience and depressive disorders: human and non-human primate studies.

This paper reviews evidence from both human and non-human primate studies concerning the role of early adverse experiences in the onset and course of adult depressive disorders. Despite accumulating evidence that stressful life events can play a major role in precipitating the onset of depressive episodes in humans, the mechanisms by which early experiences mediate and moderate the risk for later affective illnesses are not fully understood. Experimental paradigms in primates have documented the important role of undeveloped (social deprivation) or disrupted attachment systems (social separation). Effects of early social deprivation can be seen in many domains. Behavioral effects include repetitive idiosyncratic behaviors, increased self-directed behaviors, inappropriate expression of aggressive behaviors, non-modulated patterns of consumption, and inappropriate sexual and maternal behaviors. Cognitively, such animals require longer habituation time for any task and demonstrate increased perseverance on tasks following non-reward. Physiological effects include an altered hypothalamic-pituitary-adrenal response to stress, changes in diurnal temperature regulation, and alterations in immune function. Neurochemical effects include abnormalities in noradrenergic, serotonergic, and dopaminergic systems. Even neuroanatomical changes following early social deprivation have been reported. Studies with primates have also confirmed that early maternal and peer separations are major behavioral and neurobiological events with both short- and long-term consequences that parallel human depression. Future utilization of experimental paradigms in non-human primates may assist in better understanding the role of early experiences in predisposing to the development of affective illnesses in humans. This review concludes by presenting a model for understanding a developmentally based vulnerability to adult depressions.

Animals↗
PubMed2003

Biopsychosocial issues and risk factors in the family when the child has a chronic illness.

Between 10 and 20 million American children and adolescents have some type of chronic health condition or impairment. There has been a recent interest in the psychological aspects--emotional and behavioral--of chronic illness in children and adolescents. Major new areas of science, such as behavioral medicine, have emerged to address the research and clinical demands of this field. Several studies already have demonstrated the increased risk for psychiatric problems in children with chronic health conditions to be three to four times greater than their healthy peers. The proposed perspective shifts from a traditional sole reliance on medical diagnosis to a focus more on the dimensions of adjustment, socioeconomic status, visibility of condition, social support, and family functioning.

Adaptation, Psychological↗