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Dental health related behaviours in toddlers in low and high caries areas in St Helens, north west England.

The aim of this investigation was to compare the dental health behaviour of toddlers in low caries (A) and high caries (B) communities in St Helens. Parents of 60 children aged between 17 and 20 months in community A, and 68 in community B were interviewed at home. Using 24-hour dietary recall, sugar intake was recorded as sugar episodes-a sugar episode being a half-hour period during which any amount of non-milk extrinsic sugars (NMES) was consumed. Exposure to fluoride was recorded according to the number of times fluoride toothpaste was used and whether a fluoride supplement was given in the 24-hour period. The median sugar episode score for community A was 6 per 24-hour period (interquartile range 5 to 8), compared with 10.5 (7 to 13) for community B. Sixty per cent of parents in community A compared with 37% in community B reported brushing their child's teeth twice daily with fluoride toothpaste. The respective figures for use of fluoride supplements were 12% and 6%. It is concluded that patterns of dental health behaviour are established early in children's lives, and that marked differences exist between communities within the same district. Recommendations are made for oral health promotion policy.

Dental Care↗

Intranasal ketamine preinduction of paediatric outpatients.

A double-blinded, placebo-controlled study compared the outcomes of intranasal ketamine premedication with placebo in outpatients. Forty paediatric outpatients were assigned randomly in a prospective fashion to one of two separate study groups of equal size (20 patients per group). A placebo group received 2 ml of intranasal saline, 1 ml per naris. The study group received intranasal ketamine, 3 mg.kg-1, diluted to 2 ml with saline, 1 ml per naris. Using a cooperation index, a play therapist scored resistance to nasal instillation, separation of the child from parents at ten min, and acceptance of anaesthesia monitors and face mask at 15 min. Differences in age, weight, episodes of vomiting, recovery and discharge times among the two groups were not significant. Intranasal ketamine, 3 mg.kg-1, was associated with a significantly better (P = 0.013) cooperation index than intranasal placebo. Intranasal ketamine, permitted pleasant and rapid separation of children from their parents, cooperative acceptance of monitoring and of mask inhalation induction, and did not cause prolonged postanaesthetic recovery or delayed discharge home.

Administration, Intranasal↗

Play in two societies: pervasiveness of process, specificity of structure.

The present study compared Argentine (N = 39) and U.S. (N = 43) children and their mothers on exploratory, symbolic, and social play and interaction when children were 20 months of age. Patterns of cultural similarity and difference emerged. In both cultures, boys engaged in more exploratory play than girls, and girls engaged in more symbolic play than boys; mothers of boys engaged in more exploratory play than mothers of girls, and mothers of girls engaged in more symbolic play than mothers of boys. Moreover, in both cultures, individual variation in children's exploratory and symbolic play was specifically associated with individual variation in mothers' exploratory and symbolic play, respectively. Between cultures, U.S. children and their mothers engaged in more exploratory play, whereas Argentine children and their mothers engaged in more symbolic play. Moreover, Argentine mothers exceeded U.S. mothers in social play and verbal praise of their children. During an early period of mental and social growth, general developmental processes in play may be pervasive, but dyadic and cultural structures are apparently specific. Overall, Argentine and U.S. dyads utilized different modes of exploration, representation, and interaction--emphasizing "other-directed" acts of pretense versus "functional" and "combinatorial" exploration, for example--and these individual and dyadic allocentric versus idiocentric stresses accord with larger cultural concerns of collectivism versus individualism in the two societies.

Adult↗

Maternal self-esteem: from theory to clinical practice in a special care nursery.

Maternal self-esteem is examined from theoretical and clinical perspectives. The construct of maternal self-esteem is described, and infant and maternal factors affecting it are delineated. These factors include infant health, maternal perception of infant health, and newborn characteristics. Particular emphasis is placed on maternal perception of the infant's health and behavior. The preterm infant within the context of the special care nursery is used as a clinical illustration, thus bridging the gap from theory to clinical practice. General unit guidelines and clinical intervention strategies, for all disciplines, are suggested to enhance the maternal self-esteem of preterm mothers.

Female↗

Modifying maternal teaching style: effects of task arrangement on the match-to-sample performance of retarded preschool-age-children.

Twenty-one mothers and their retarded preschool-age children were observed during six teaching sessions. Following the first three sessions, each mother-child dyad was assigned to one of the three groups. Groups were matched on measures of mother and child behavior and on measures of various mother and child background factors. Prior to the last three teaching sessions, mothers received instructions to modify certain aspects of their teaching style. The results indicated that children of mothers who had been instructed to present the materials of the task systematically obtained significantly higher performance scores during training than did children of mothers who either received no instruction or had been told to increase positive feedback for correct responses. Further, 6 of 7 children whose mothers had altered the manner in which they presented the task materials showed improvement on a test administered after training. These results suggest that nonverbal activities which precede responding are critical aspects of teaching style and deserve more attention than they have received in the past.

Child Behavior↗

Infant feeding practices of HIV-infected and uninfected women in Zimbabwe.

We surveyed infant feeding knowledge, attitudes, and practices in Zimbabwe to determine whether knowledge of HIV seropositivity influences infant feeding behavior. Questionnaires were administered to 97 women 1 and 4 weeks postpartum and prospective data on infant feeding practices were collected. Participants were pregnant women who consented to a HIV test. A total of 116 women participated of whom 99 women underwent voluntary HIV counseling and testing (VCT); 17 women agreed to blinded HIV testing but did not opt for VCT. The responses to questionnaires on infant feeding practices of HIV-positive and HIV-negative women who knew and did not know their HIV status at day 1 and week 4 postpartum were compared. We found that HIV-positive women who did not learn their status breastfed their infants less, introduced supplementary foods sooner, and planned to wean their babies earlier compared to other women (p = 0.005, p = NS, p= 0.02). HIV-positive women (30/97) more frequently reported a prior history of infant death and AIDS-related symptoms compared to HIV-negative women. We conclude that HIV-positive women who did not know their status made incorrect decisions with respect to infant feeding. These women may have suspected themselves to be HIV-positive and consequently underfed their infants or because these women were more symptomatic may have been less likely to breastfeed; decreased intake may increase the risk for malnutrition. Knowledge of HIV status may influence infant feeding decisions and reveal an urgent need to address infant feeding practices of pregnant women in Zimbabwe.

Adult↗

Attachment behaviors in mothers of premature infants: a descriptive study in Thai mothers.

Prematurity and the associated maternal-infant separation after birth can affect the attachment process. The role of nurses in facilitating the process of attachment should be based on an understanding of these behaviors. This descriptive study explored the attachment behaviors demonstrated by mothers during their first visit with their premature infant in the neonatal care unit. The results revealed that all mothers demonstrated most attachment behaviors (ie, inspection, facial expression, touching, verbal expression, and eye-to-eye contact) except holding during their first visit. However, some mothers spent little time with their infant. The findings suggest that nurses should encourage mothers to interact with their infants in order to enhance maternal-infant attachment.

Adaptation, Psychological↗

Resistance and inertia of endotracheal tubes used in infants during periodic flow.

To study the effects of a periodic pattern of gas flow on the dynamic behavior of infant endotracheal tubes, we measured the resistance (expressed as a function of gas flow) and inertia of endotracheal tubes of 2.5, 3.0, and 3.5-mm internal diameter under conditions of both periodic and quasisteady gas flow. We examined how resistance and inertia are affected by ventilatory rate, the direction of gas flow through the tube, and the expansion of the airway caliber at the junction of the tube and the trachea. The resistance of the endotracheal tubes was proportional to gas flow for ventilatory rates of 60, 90, and 120 breath/min and for quasisteady flow, indicating turbulence even at low flow rates. The resistance of the tubes was less sensitive to ventilatory rate, direction of flow, and expansion of the airway caliber than that of larger endotracheal tubes, a finding explained by the flow conditions defined by the Womersley and Reynolds numbers in these tubes. All tubes exhibited measureable inertia, as predicted from their small diameter. The resistive and inertial properties of the endotracheal tubes described in this report can be used to evaluate the contribution of the endotracheal tube to the dynamics of breathing in intubated infants.

Humans↗

Sex stereotypes in adult-infant play.

24 14-month-old infants played with adult strangers in a laboratory playroom. To examine the effects of sex-role labeling on adult behavior, each infant was introduced as a boy and as a girl in 2 different sessions. After controlling for the adult's scores on the Spence-Helmreich Attitudes toward Women Scale, the adults were found to engage in more Encouragement for Activity and more Male Role Toy Choice when playing with children designated as boys. They showed more Interpersonal Stimulation and more Nurturance Play when playing with children designated as girls. No significant differences were observed between the behavior of the real girls and boys. Men and women showed some differences in their style of play.

Attitude↗