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PubMedDate not supplied

Interactions between children with juvenile rheumatoid arthritis and their mothers.

OBJECTIVE: To determine the degree to which mothers of children with juvenile rheumatoid arthritis (JRA) show an overprotective or highly controlling interaction style. METHOD: We videotaped 84 mother-child pairs (42 JRA and 42 healthy, ages 6 to 13) while working on a collaborative problem-solving task. Based on physical therapy evaluations, children in the JRA group were assigned to "more severe" (n = 19) and "milder" (n = 22) arthritis subgroups. RESULTS: Results showed numerous differences between mothers of children with more severe arthritis and the other mothers (no differences between the milder arthritis and healthy comparison groups were found). Compared to mothers in the other two groups, mothers of children with more severe arthritis were more directive of their children's behavior during the task, showing higher rates of structure and rule setting, general clues, and prompting the child for an answer. DISCUSSION: Sequential analyses showed that mothers in the more severe group appeared to treat the task in a more evaluative manner, being more likely than other mothers to respond to correct answers with positive feedback and to incorrect answers with structure and rule setting. Mothers in the other groups were more likely to respond to both correct and incorrect answers with specific clues. CONCLUSIONS: We discuss how these differences in interactional style might impact the social development of children with JRA.

Adolescent↗
PubMed1998

Deinstitutionalization and schizophrenia in Finland: I. Discharged patients and their care.

Finland has experienced one of the most rapid psychiatric deinstitutionalization processes in the world. Since 1980, the use of psychiatric beds has decreased about one-third. The effects of this deinstitutionalization were studied in the national Discharged Schizophrenia Patient Project. The study used three representative samples of patients with schizophrenia who were discharged from mental hospitals in 1982, 1986, and 1990, and followed them for 3 years. Patients with schizophrenia discharged at the beginning of the 1990s were older and more disturbed, and had been ill for a longer time than patients discharged at the beginning of the 1980s. The use of outpatient care increased and that of hospital care decreased, but because of the increased residential outpatient care, the total amount of residential care did not change during the study period. However, readmissions to the hospital increased. In patients with a long duration of illness, the increase in readmissions was exceptionally high; these patients also seemed to be losing their share of the residential outpatient services. On the whole, from the point of view of the psychiatric treatment system, deinstitutionalization seemed to have proceeded fairly successfully. The system proved able to redirect and use the available resources more effectively and to modify the structure of services according to the changing needs of patients discharged from hospitals. The well-developed social services have also supported this adaptation to the decreasing use of mental hospital beds.

Adolescent↗
PubMed1994

Nationalism, race, and gender: the politics of family planning in Zimbabwe, 1957-1990.

In line with a general tendency of nationalists to hold pro-natalist views, African nationalists in Zimbabwe took a hostile position to family planning upon its introduction in 1957, arguing that it was part of a conspiracy to control the black population. However, it was only after the unilateral declaration of independence in 1965 by the white settlers under Ian Smith that an official policy aimed at reducing African fertility emerged. The African nationalists waged a consistent propaganda campaign against this policy, and the facilities that were established under it, as well as their personnel, became military targets during the guerrilla war in the late 1970s. After independence in 1980, the triumphant nationalists tried to maintain their pro-natalist position. But, with a postwar 'baby boom' pushing the birth rate close to four per cent by the mid-1980s, the officials in charge of economic and social development concluded that society could not sustain such a high fertility rate. Consequently, there was a reversal of policy, and by 1990 Zimbabwe had become an internationally recognized leader of family planning among developing countries. For the most part, however, these changes have taken place without any real input by African women, who remained largely excluded from the male-dominated circles in which decisions about family planning were made.

Family Planning Services↗
PubMed2004

Health coverage instability for mothers in working families.

Using data from the National Longitudinal Survey of Youth, the authors examined the health insurance coverage stability of 1,667 women in working families over a three-year period (1995-1997). Findings revealed that coverage instability is common. Nearly one-half of low-income women experienced health coverage instability over the three-year study period, and low-income women with poor education, single marital status, low work hours, and frequent job changes were at even greater risk of coverage instability. The findings also imply that women affected by recent welfare reforms are likely to experience widespread health coverage problems. The implications for health care policy development, social work administration, and social work practice are discussed.

Demography↗
PubMed1993

Secondary reconstruction of abdominal wall defects associated with exstrophy of the bladder.

Exstrophy of the bladder is a spectrum of congenital anomalies that involve the structures of the lower abdominal wall. The classic bladder exstrophy results in a severe deformity. The purpose of the original surgery is to obtain a secure abdominal wall closure with urinary continence. In present times the abdominal wall is repaired shortly after birth. The occasional patient has residual anatomical deformities that impede their social development and interaction. Secondary reconstructive surgery can be helpful, and this patient report illustrates this.

Abdominal Muscles↗
PubMedDate not supplied

Global and specific behavioral measures of pain in children with cerebral palsy.

OBJECTIVES: The aim of this research was to validate global and behavioral observation methods for measuring pain in children with cerebral palsy (CP). MATERIALS AND METHODS: Nineteen children diagnosed with CP (2-21 years of age) and their primary caregivers participated in this study. Children and their caregivers were videotaped in their home before, during, and after a stretching exercise, and tests of cognitive and social development were administered. Children who were able to pass a training task were also asked to rate their experience of pain using a numerical rating scale (self-report NRS), but only 5 children (24%) passed so their self-report scores were not included. Healthcare professionals rated videotaped segments for each of the 3 time periods in a randomized order using an observer NRS and the Non-Communicating Children's Pain Checklist-Postoperative Version (NCCPC-PV). Raters trained in the Child Facial Coding System (CFCS) examined the same videotaped segments. RESULTS: Results showed significantly greater pain behavior (observer NRS, NCCP- PV) during the stretching procedure than during the baseline and recovery segments. There were no significant differences in CFCS scores, across time segments. CONCLUSIONS: These findings support the hypothesis that children with CP express discernible pain behaviors regardless of cognitive or language ability. These results contribute to multidimensional assessment of pain in children with neurologic impairment.

Adolescent↗
PubMedDate not supplied

The determinants of community health nursing in Taiwan: past, present, and future aspects.

There are many determinants that influence the development of community health nursing in Taiwan. Political reality and policy, economic development, social changes, universality of education, systematization of healthcare, and disease changes are among the main factors. The author individually describes these influences in reference to past and current situations. Then, the author discusses the future prospects of these influences on community health nursing in Taiwan.

Community Health Nursing↗
PubMed1999

Velocardiofacial syndrome in childhood-onset schizophrenia.

OBJECTIVES: Deletion of chromosome 22q11 (velocardiofacial syndrome) is associated with early neurodevelopmental abnormalities and with schizophrenia in adults. The rate of 22q11 deletions was examined in a series of patients with childhood-onset schizophrenia (COS), in whom early premorbid developmental and cognitive impairments are more pronounced than in adult-onset cases. METHOD: Through extensive recruiting and screening, a cohort of 47 patients was enrolled in a comprehensive study of very-early-onset schizophrenia. All were tested with fluorescence in situ hybridization for deletions on chromosome 22q11. RESULTS: Three (6.4%) of 47 patients were found to have a 22q11 deletion. All 3 COS patients with 22q11 deletions had premorbid impairments of language, motor, and social development, although their physical characteristics varied. Brain magnetic resonance imaging revealed increased midbody corpus callosum area and ventricular volume in relation both to healthy controls and to other COS patients. CONCLUSIONS: The rate of 22q11 deletions in COS is higher than in the general population (0.025%, p < .001) and may be higher than reported for adult-onset schizophrenia (2.0%, p = .09). These results suggest that 22q11 deletions may be associated with an earlier age of onset of schizophrenia, possibly mediated by a more salient neurodevelopmental disruption.

Abnormalities, Multiple↗
PubMed1990

Temperament risk factors in children: a conference report.

This review presents a report of an international conference and its published monograph, which dealt with three questions. What do we know about temperament risk factors that is useful? Depending on the "goodness of fit," risk factors may affect children's physical health, development, social behavior, or scholastic performance. What has been done or could be done with these findings? Practical applications have been made in pediatrics, psychiatry, and anticipatory guidance by psychologists. The greatest opportunity for wider use of temperament determinations will be in diagnosing and managing problems in behavior and scholastic performance, rather than in routine screening in the general population. What steps can we take in the future? Several are discussed, but the most obvious is further application of what we already know.

Achievement↗
PubMed1992

Assessing school readiness through the school-entry screening exam.

Although there exists no perfect screening tool that is predictive of a child's success in school, an office visit prior to school enrollment can detect potential problems. This visit should include a history and physical, and developmental assessment. The developmental assessment involves a sampling of a child's abilities in the areas of language, reasoning, gross and fine motor skills, and personal-social development. Providers must be alert to signs and symptoms indicating impediments to learning. Clinicians who are knowledgeable about trends in education regarding readiness testing, birth-date cutoffs and retention can serve as a valuable resource to parents. The clinician can also be a major contributor to the achievement of national education goals set forth by the Bush administration. Ten tools for assessing children are compared, and their appropriate use is discussed.

Child↗
PubMed1995

Pharmacotherapy of depression in children.

Depression can interfere with the overall functioning of children and adolescents. It can impair normal cognitive and social development. The use of antidepressant medications in children and adolescents has grown in the past decade. Newer antidepressant agents, the selective serotonin reuptake inhibitors, appear very promising, but their safety and efficacy have not been established for children. This review focuses on depression and the design of studies for its treatment with newer antidepressant drugs in children.

Adolescent↗
PubMed2006

Evidence-based overview of ophthalmic disorders in deaf children: a literature update.

BACKGROUND: Deaf children are heavily reliant on the sense of vision in order to develop efficient communication skills and explore the world around them. Any ophthalmic disorder may thus negatively impact on this process, especially if it is unrecognised in the early years of life. These disorders may be correctable (such as myopia) or treatable (such as cataract), and their early identification is of the utmost importance to optimise language development (spoken or sign, or both) and develop social cognition. Those children with non-correctable and non-treatable visual disorders, like retinitis pigmentosa in Usher syndrome, require multiple environmental adaptations and appropriate support services and information. AIM: : To review the accumulated scientific knowledge on ophthalmic disorders in deaf children and assess the quality of evidence published in the literature in order to contribute to better diagnosis and management of these conditions. MATERIAL AND METHODS: The project reviewed more than 1000 published papers and other sources. 191 papers complied with the aims of the study and were used in the project. From these studies, 95% were based on type III or IV evidence (mainly descriptive studies or case reports). Only 3% were based on type II evidence and 2% on type I evidence. RESULTS-CONCLUSIONS: The main conclusions of this project are: a) the overall quality of evidence in the literature concerning deaf children and their ophthalmic problems is very low, b) the prevalence of ophthalmic problems in deaf children is very high (approximately 40% to 60%) and these problems may remain undetected for years although they may have a serious impact on children's acquisition of communication skills, c) screening for ophthalmic problems in deaf children should be encouraged and specialist ophthalmic examination should be carried out as soon as the diagnosis of deafness is confirmed irrespective of age, and may need to be repeated at intervals following diagnosis, d) families should be informed about the nature of the screening process in discussion with the relevant professionals and appropriate information should be available in a range of formats and in different community languages, e) professionals administering the tests should be familiar with the needs of deaf children with ophthalmic problems and should be sensitive to the communication needs of the child, especially undertaking behavioural testing where their collaboration is needed, f) while orthoptists can perform the majority of psychophysical tests (visual and stereo acuity tests, ocular motility tests, etc.) a comprehensive opthalmologic assessment by slit lamp biomicroscopy, streak retinoscopy, direct and indirect ophthalmoscopy, intraocular pressure measurement etc is required. Electrophysiologic testing to help identification of Usher syndrome may also be required, and finally g) serial hearing assessments of children with dual sensory deficits are needed to monitor hearing thresholds, to optimise hearing aid use and to ensure timely referral for cochlear implantation for those who need it.

Child↗
PubMed2004

Assay for establishing whether microbicide applicators have been exposed to the vagina.

OBJECTIVES: To develop an accurate, rapid, and inexpensive method for verifying vaginal applicator use. GOAL: To develop a method for assessing compliance in microbicide clinical trials. STUDY DESIGN: Single use Microlax applicators containing a placebo formulation either were or were not exposed to the vagina. Three assays were developed to determine whether the applicators had been used vaginally. RESULTS: Blinded examiners were able to discern 63% of the time whether or not applicator tips had been exposed to the vagina. Optical density (to measure lactobacilli), increased in media exposed to used applicators but not in media exposed to unused applicators. When tips of applicators were stained with trypan blue, used applicators could be distinguished easily from unused applicators. CONCLUSION: Staining of applicator is accurate, simple, rapid, and inexpensive. This method could be be used in clinical settings in the developing world. Dying applicator tips could prove useful in excluding non-compliant subjects, analyzing data, or developing social intervention strategies to improve compliance.

Administration, Intravaginal↗
PubMed2005

Trunk position in supine of infants born preterm and at term: an assessment using a computerized pressure mat.

PURPOSE: Trunk position may influence motor, cognitive, and social development during infancy and early childhood and has not been quantitatively assessed. The purpose of this study was to assess the trunk positions of infants born at term and preterm in supine using a computerized pressure mat. METHODS: Trunk position was represented as a ratio of head and pelvis to trunk pressure. Eighteen healthy infants born preterm with a mean gestational age of 31.9 weeks (25.0-34.6) and fifteen healthy infants born at term with a mean gestational age of 38.9 weeks (37.3-40.6) were assessed at 38 to 43 weeks gestational age. RESULTS: Infants born at term spent more than two-thirds of the time in either flexed or neutral trunk positions. No significant differences were found between infants born preterm and those born at term in total duration of flexion or extension or in flexion event duration. CONCLUSION: This study provides evidence that infants born preterm may not exhibit greater trunk extension tendencies in supine than infants born at term. Results should be interpreted with caution, however, because of the small sample size and large variability observed within the subject groups. Infants born at less than 30 weeks of gestation may demonstrate greater extension tendencies than those born at more than 30 weeks of gestation.

Case-Control Studies↗
PubMed2004

Long-term follow-up of renal transplantation in children: a Dutch cohort study.

BACKGROUND: Few data exist on long-term morbidity, overall survival, and graft survival of pediatric renal transplantation. METHODS: The authors performed a long-term cohort study in all Dutch patients, born before 1979, with onset of end-stage renal disease (ESRD) between 1972 and 1992 at age 0 to 15 years. Data on graft survival and determinants of outcome were obtained by reviewing all medical charts. The health status was assessed by cross-sectional examination of surviving patients. RESULTS: Three hundred ninety-seven transplantations were performed in 231 of all 249 patients, of whom 25 died with a functioning graft. Cardiovascular disease was the most prominent cause of death. Graft survival estimates for all transplantations were 59.2%, 45.3%, 35.4%, and 30.3% at 5, 10, 15, and 20 years, respectively. In comparison with azathioprine, cyclosporine as the immunosuppressant was associated with increased graft survival in retransplantations but not in first transplantations. Cross-sectional examination was performed on 110 patients. In 44 patients, the most recent graft survival exceeded 15 years. Co-morbidity was found in 40% of all patients; motor, hearing, or visual disabilities were found in 19%. Bone disease, headaches, itching, and tremors were the most reported disabling problems. Cyclosporine use was associated with hypertension and a history of epilepsy. Compared with all age-matched Dutch inhabitants, the educational attainment was low, and unemployment and parental dependency were high. CONCLUSIONS: The authors' results emphasize the need for reducing cardiovascular disease and metabolic bone disease in pediatric ESRD, a policy toward less toxic antirejection therapy, a more strict treatment of hypertension, and more attention for schooling and social development toward independence.

Adolescent↗
PubMed2005

Child maltreatment, child protection and mental health.

PURPOSE OF REVIEW: This review summarizes advances in our understanding of child maltreatment and the implications thereof for physical, psychological and social development, with special emphasis on mental health aspects. RECENT FINDINGS: Methodological problems persist. These may be related in part to an over-emphasis on type of maltreatment, to the detriment of consideration of degree and extent of maltreatment. They may also be related to inadequate application of a comprehensive model of maltreatment and its consequences. Recent studies underline the inter-relatedness and cross-over between different types of child maltreatment and family violence. Research also underlines the extent to which child maltreatment is a major public health crisis internationally. Effects are seen on physical health and development as well as mental health, and it is becoming increasingly evident that these outcomes are inextricably linked to one another. There are encouraging signs that certain interventions are effective. SUMMARY: There is a need for a more sophisticated model of child maltreatment that includes not only degree but also the extent to which basic developmental needs are overridden when children are maltreated, and that includes children's responses to maltreatment as a mediating influence. More studies are needed of samples of children who have been maltreated in order to gain a better understanding of how maltreatment distorts the trajectory of normal development. Crucially, we need more research on intervention, including both case management and psychological treatment approaches.

Journal Article↗
PubMedDate not supplied

The relation between behavior problems and peer preference in different classroom contexts. Conduct Problems Prevention Research Group.

This study tested two alternative hypotheses regarding the relations between child behavior and peer preference. The first hypothesis is generated from the person-group similarity model, which predicts that the acceptability of social behaviors will vary as a function of peer group norms. The second hypothesis is generated by the social skill model, which predicts that behavioral skill deficiencies reduce and behavioral competencies enhance peer preference. A total of 2895 children in 134 regular first-grade classrooms participated in the study. Hierarchical linear modeling was used to compare four different behaviors as predictors of peer preference in the context of classrooms with varying levels of these behavior problems. The results of the study supported both predictive models, with the acceptability of aggression and withdrawal varying across classrooms (following a person-group similarity model) and the effects of inattentive/hyperactive behavior (in a negative direction) and prosocial behavior (in a positive direction) following a social skill model and remaining constant in their associations with peer preference across classrooms. Gender differences also emerged, with aggression following the person-group similarity model for boys more strongly than for girls. The effects of both child behaviors and the peer group context on peer preference and on the trajectory of social development are discussed.

Child↗
PubMed2005

Age of onset of drinking and the use of alcohol in adulthood: a follow-up study from age 8-42 for females and males.

AIM: To investigate longitudinally for both genders the relation between the age of onset of drinking and several indicators of alcohol use. DESIGN AND SETTING: In the Finnish Jyväskylä Longitudinal Study of Personality and Social Development, data have been collected by interviews, inventories, and questionnaires. Data on alcohol consumption was gathered at ages 14, 20, 27, 36 and 42 years; behavioural data at age 8. PARTICIPANTS: A total of 155 women and 176 men; 90.4% of the original sample consisting of 12 complete school classes in 1968. MEASUREMENTS: The age of onset of drinking was determined based on participants' responses that were closest to the actual age of onset of drinking. Four indicators of the adult use of alcohol were used: frequency of drinking, binge drinking, Cut-down, Annoyed, Guilt, Eye-opener (CAGE) and Malmö modified Michigan Alcoholism Screening Test (Mm-MAST). Socio-emotional behaviour at age 8 was assessed using teacher ratings and peer nominations. FINDINGS: Early onset of drinking was related to the four indicators of the use of alcohol in adulthood both in men and women. The level of adult alcohol use and alcohol problems was significantly higher in men. The risk for heavy drinking was highest in men and women if drinking was started at less than age 16 years. Socio-emotional behaviour and school success at age 8 did not predict the age of onset of drinking. CONCLUSIONS: Delaying the initiation of drinking from early adolescence to late adolescence is an important goal for prevention efforts. No clear risk group for early initiators of drinking could be identified on the basis of preceding behaviour among 8-year-olds.

Adolescent↗