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PubMedDate not supplied

Representation of self and socioemotional competence in kindergartners: differential and combined effects of attachment to mother and to father.

In the present study, we examined the differential predictive power and the joint or compensatory effects of representations of child-mother and child-father attachment for children's representation of self and their socioemotional competence. The representations of attachment were assessed by an attachment story completion task, completed once for mother and once for father (in counterbalanced order). Eighty participants (40 boys and 40 girls), aged between 55 and 77 months (M = 5 years 3 months), took place in the study. The socioemotional competence (peer social competence, disruptive behavior, anxious/withdrawn behavior, and school adjustment) and behavioral manifestations of self-esteem were evaluated by the kindergarten teacher. The inner representation of self (positiveness of self, perceived competence, and social acceptance) was assessed in a subgroup of 50 children. Results showed that the relative predictive power of child-mother and child-father attachments differed according to the domain of child functioning that was assessed. More specifically, it was found that the child's positiveness of self was better predicted by the quality of the child-mother attachment representation than by the quality of the child-father attachment representation. In contrast, the child's anxious/withdrawn behavioral problems were better predicted by the quality of the child-father attachment representation than by the quality of the child-mother attachment representation. With regard to the joint effects of child-mother and child-father attachment, it was found that a secure attachment to one parent can compensate for or buffer against an insecure attachment to the other parent. However, the buffering effect was not complete.

Affect↗

PubMed2005

Development of a measure of the health-related quality of life of children in public care.

OBJECTIVES: To validate PedsQL for children in public care and develop an 'in-care' module. DESIGN AND SETTING: Questionnaire development and validation. Questionnaires were completed in placement. A total of 69 children in public care (aged 8-18 years) and their carers were recruited through routine paediatric assessments, and 662 children not in public care were recruited from local schools. MEASURES: Self- and proxy-report versions of PedsQL generic module and the 'in-care' module. RESULTS: Cronbach's alpha for the generic module ranged from 0.66 to 0.88 and from 0.74 to 0.90 for self- and proxy-report respectively. Lower scores were reported for children in care compared with peers living at home for proxy- and self-report. Proxy- and self-report correlation ranged from 0.43 to 0.60 (P < 0.001). Cronbach's alpha for the in-care module was 0.87 and 0.91 for self- and proxy-report respectively. Proxy- and self-report scores showed significant correlation with generic module scores. The highest correlations were seen with sub-scales measuring Psychosocial Functioning (e.g. Emotional Functioning: Pearson's r = 0.67 and 0.59, P < 0.001 for self- and proxy-report respectively). Proxy- and self-report correlation was 0.45 (P < 0.001). CONCLUSIONS: We found PedsQL generic module and the newly developed 'in-care' module to have excellent internal reliability for self- and proxy-report. Validity was established for both measures and significant correlation found between child and proxy ratings. Although further testing of the measures is recommended, both have potential value in assessing the success of placements and could provide a reliable and valid tool for individual patient analysis in clinical practice and for research with this group.

Activities of Daily Living↗

PubMed2002

Randomized controlled trial of back school with and without peer support.

The aim of this trial was to determine whether social interaction between patients with long-lasting nonspecific back pain reduces subjective or objective disability. The participants were selected from persons visiting an occupational health care unit because of back pain. After a clinical examination in a university clinic, subjects without a specific diagnosis and having no disabilities preventing active rehabilitation were selected for study. The subjects (n = 108) were randomized into treatment (n = 54) and control groups (n = 54). Altogether 18 study groups, 9 treatment groups and 9 groups for controls, were formed. Before starting the back schools altogether 15 subjects dropped out. Both the treatment groups (n = 47) and the controls (n = 46) attended a back school consisting of 10 lessons and demonstrations supervised by a physiotherapist. The participants in treatment groups, but not the controls, had physical exercise and social intercourse with other members within the group. The clinical examination was repeated after 6 and 12 months. Both the treatment groups and the controls showed improvement in perceived functional capacity (assessed with Oswestry disability questionnaire) and in perceived life quality (assessed with 15D score). At the 6-month follow-up life quality had improved statistically significantly more among the participants in treatment groups than among the controls, and at the 12-month follow-up the Oswestry index showed corresponding improvement. Among subjects suffering from nonspecific back pain, social support improves the results of active rehabilitation.

Adult↗

PubMed1988

The role and function of professional journals in the transfer of information.

Professional journals are of great importance in the transfer of information about technology, providing most physicians and medical students with the majority of their new information. Professional journals have mission statements and goals and many editorial categories to help achieve their goals. In addition, news media, books, television, and computerized journals are important methods for changing physician knowledge. Physician behavior is changed by many factors of which poor patient outcome is probably the key. Quality of information and activities is best assured by clear definition, goals, proper peer review, and good management. Appropriate use of technology is best approached by separating wants from needs.

Attitude of Health Personnel↗

PubMedDate not supplied

Testing a model: a developmental perspective of adolescent male sexuality.

PURPOSE: This study tested a model of adolescent male sexuality and evaluated its usefulness for predicting sexual behaviors among a diverse sample. DESIGN AND METHODS: Secondary analysis using a national sample was conducted. Sexuality was conceptualized as depending on family, peers, and school. Neighborhood was hypothesized to influence sexuality indirectly. Sexuality was hypothesized to influence sexual behaviors and age at first sex. Structural equation modeling techniques were used with ethnic comparisons. RESULTS: Family was the strongest predictor of sexuality. Males who were closer to their family were sexually conservative; males closer to peers were sexually permissive. Neighborhood's influence was moderated through family and school. Ethnic differences were not found. PRACTICE IMPLICATIONS: Sexuality assessments and strengthening family relationships are essential.

Adolescent↗

PubMed1995

The effects of social skills instruction and parental involvement on the aggressive behaviors of African American males.

The purpose of this study was to investigate the effects of social skills instruction on identified acts of aggression. Five elementary-aged African American male students attending general education classes in an urban public school setting were taught social skills using modeling, role playing, corrective feedback, and differential reinforcement of alternative or incompatible behaviors. Parent training and parent notes were used for the maintenance and transfer of newly learned social skills. A multiple baseline design across students, combined with a withdrawal feature, was employed to assess the effectiveness of the social skills instruction. Data were collected in the classroom and cafeteria to assess generalization of the training to naturalistic settings. Results indicate the social skills instructional package to be functionally related to a decrease in aggressive behaviors with four of the five students and maintained by parental involvement.

Black or African American↗

PubMed1997

Physicians' experience with allegations of medical malpractice in the neonatal intensive care unit.

OBJECTIVE: To assess the personal experience of all practitioners of neonatal intensive care unit (NICU) medicine in the United States with the medical malpractice system; in particular, to assess the circumstances of malpractice allegations in which they themselves had personal experience, and to extrapolate from their individual experiences to the field of neonatology in general. DESIGN: Written survey of all MDs practicing NICU medicine in the US. PARTICIPANTS: Two thousand four hundred ninety-eight NICU physicians as determined from three sources: a) the American Board of Medical Specialists; b) the American Academy of Pediatrics Section of Neonatal/Perinatal Medicine; and c) a listing of neonatologists provided by Ross Laboratories. MAIN OUTCOME MEASURES: Responses to survey questions. RESULTS: We received 1813 responses, representing approximately 75% of all physicians practicing NICU medicine in the US. Overall, 43% of respondents had experienced at least one claim of malpractice against them. The probability of a malpractice allegation increased with years in practice, from approximately 20% for NICU physicians in practice </=5 years (65/337), to approximately 60% for NICU physicians in practice >15 years (276/469). Men and women were equally likely to have been sued, accounting for years in practice. Physicians practicing in community NICUs were more likely to be sued than those in university settings. On a scale of 1 to 4 (4 being most reasonable) the median assessment of the reasonableness of malpractice allegations was 1, mean 1.2. On a scale of 1 to 4 (4 being the highest) the median assessment of effectiveness of the current system in identifying true malpractice was 1, mean 1.4. The respondents believed that approximately 80% of malpractice allegations were inappropriate; conversely, they believed that approximately 80% of true medical malpractice escaped detection. On a scale of 1 to 4 (4 being the highest), the median assessment of the detrimental effect of the present malpractice system on health care was 4, mean 3.4. CONCLUSIONS: Most NICU physicians will be sued if they practice long enough. In this context, efforts to use malpractice claims to seek out evildoers (such as underlie the National Practitioners Data Bank) appear ill-conceived. Similarly, exhortations for physicians to become either more educated or more sensitive are unlikely to reduce malpractice claims. Our data suggest that malpractice in the NICU appears to function more like a lottery than like a mechanism for either quality assurance or just retribution.

Community Health Services↗

PubMed2004

Adolescent smoking and exposure to tobacco marketing under a tobacco advertising ban: findings from 2 Norwegian national samples.

OBJECTIVES: We examined the extent to which adolescents in Norway have been exposed to tobacco marketing despite an existing ban, and whether exposure is related to their current smoking or expectations they will smoke in the future. METHODS: Questionnaires were administered to nationally representative systematic samples of Norwegian youths aged 13 to 15 years in 1990 (n = 4282) and 1995 (n = 4065). RESULTS: About half in each cohort reported exposure to marketing. Youths reporting exposure were significantly more likely to be current smokers and to expect to be smokers at 20 years of age, after control for important social influence predictors. CONCLUSIONS: Adolescents' current smoking and future smoking expectations are linked to marketing exposure even in limited settings, suggesting the need for comprehensive controls to eliminate the function of marketing in promoting adolescent smoking.

Adolescent↗

PubMed1999

Consistency of hand use and sleep problems.

In this study, we measured the relationship between the consistency of hand use and three symptoms of insomnia, i.e., delayed sleep onset, frequent awakenings during sleep, and trouble returning to sleep after an awakening. For each of these insomnia-related symptoms, university students who were classified as inconsistent in the use of their hands (n = 30) were significantly more likely to report problems than their consistent hand-use peers (n = 30). These data were discussed both in relation to the literature on handedness classification and sleep problems and the emerging literature on consistency of hand use and health-related problems.

Adult↗

PubMed1982

WISC scatter and behavioral competence in high-risk children.

Examined the relationship between WISC scatter and school competence measures for 101 boys at risk for psychiatric disorder. This sample, shown in previous research to be less competent in school than controls, was predicted to have greater scatter than a standardization sample. Further, within the high-risk sample, an association was predicted between two measures of scatter and lowered school competence, as measured by Fisher's (1980) peer and teacher ratings. The results suggested that the mean scatter variable available for both samples is significantly higher in the high-risk group than in the intelligence test standardization sample. This scatter measure also measures. The second measure did not relate significantly to any of the school measures. These findings suggest that one of the two scatter measures is a valid index of less competent school functioning and may be in combination with other measures, a useful predictor of future psychopathology.

Child↗

PubMed2003

A qualitative exploration of rural feeding and weaning practices, knowledge and attitudes on nutrition.

AIM: An exploratory qualitative investigation was done to determine the feeding and weaning practices, knowledge and attitudes towards nutrition of mothers/caregivers of children up to 3 years old attending baby clinics in the Moretele district (South Africa). METHODOLOGY: Qualitative data collection on six relevant nutrition topics was done using focus group interviews. Trained moderators, using a pre-tested, structured interview schedule, interviewed participants in six age groups. Focus group interviews were taped, transcribed and translated. Content analysis produced systematic data descriptions and ethnography provided descriptive data. RESULTS: Breast-feeding was the choice feed and bottle-feeding was only given when breast-feeding was impossible. Solid food was introduced early (at 2-3 months) and a mixed family diet at 7-9 months. Milk feeds were stopped completely from 18-24 months. Weaning diets were compromised due to poor food choices, preparation practices and limited variety. The participant's nutrition knowledge regarding specific foods, their functions and recommended quantities was poor. The women adhered to their cultural beliefs regarding food choices and preparation practices. CONCLUSION: The data analysis revealed that inadequate nutrition knowledge and adherence to cultural practices lead to poor-quality feeding practices. Cultural factors and taboos have a powerful influence on feeding practices and eating patterns. Young mothers often find it impossible to ignore their ill-informed elders or peer group. Nutrition knowledge needs to be changed in a first step towards implementing improved feeding practices. Facilitated group discussions could focus on possible solutions for the identified nutrition-related problems.

Bottle Feeding↗

PubMed1984

Exercise programs for asthmatic children.

The role of exercise in the management of the asthmatic child is now understood to be essential for the child's overall health. With the medications available today, a child, even with complicating EIA, can expect to perform as well as his nonasthmatic peers. In fact, with appropriately set expectations, adequate medical management, and supportive parents, coaches and teachers, the asthmatic child can hope to achieve a physical fitness level compatible with a high quality of life. The physician's role is a key one requiring basic knowledge of medical management, as well as supervising the overall effort. One cannot overlook the satisfaction a doctor experiences when assisting the patient in functioning normally, despite underlying disease.

Adolescent↗

PubMed1994

[Role of pathology as clinical medicine: experience at Kawasaki Medical School].

The department of Pathology at Kawasaki Medical School was destined, from the outset of its foundation, to be one of clinical departments. To discuss the role of pathology as clinical medicine, the actual state of our department is described here with reference to its organization, principles, and quality assurance program in both surgical pathology service and hospital practice. The department at School also functions as a hospital pathology department and handles 10,000 surgical and 18,000 cytology materials as well as about 180 autopsies per year. Examination of the tissues and organs removed from the patients is wholly entrusted to our department in its full responsibility. All the tissue sections are examined by multiple certified pathologists and reports are returned by the third day. Case reviews are regularly done by peer reviewers and through the conferences held between pathology and relevant clinical departments. The latter conferences serve as a medical audit in the hospital as well. The pathologists sometimes participate in the performance of aspiration cytology, and muscle and nerve biopsy. It is hoped that the description of our experience in surgical pathology will provide some insights on the improvement of the system to concerned readers and cause lively discussion on this matter.

Humans↗

PubMed1981

Animal models and human depressive disorders.

Clinical depressive disorders are complex in presentation, dissimilar in origins and course, and often pleomorphic in character. An adequate understanding of their origins, biological substrates, and amenability to established and novel forms of therapy demands biological and social interventions which cannot always readily or ethically be carried out in a clinical setting. One useful complementary approach to clinical research utilizes preclinical models for laboratory investigations in parallel. The present paper reviews current approaches to modelling depression using animals, with particular emphasis upon phylogenetic constraints, systematic validity and reliability, and nosological limitations. Preclinical models are useful and necessary adjuncts for adequately understanding depression in humans. However, their utility remains a direct function of a continuing dialogue between clinical and laboratory research, and demands scrupulous observation and methodological rigor on the part of both clinicians and experimental researchers.

Animals↗

PubMed2002

Effects of minority status in the classroom on children's intergroup attitudes.

Three studies examined the effects of relative group size on the development of children's intergroup attitudes. The studies employed a novel group paradigm in which elementary school children attending a summer school program were assigned to larger (i.e., majority) or smaller (i.e., minority) novel groups in their classroom (denoted by colored tee-shirts). In each study, relative group size was situated within a different classroom context. Study 1 examined the effects of relative group size when teachers made functional use of the novel groups and were themselves members of the novel groups. Study 2 examined the effects of relative group size in the absence of functional use. Study 3 examined the effects of relative group size when the classroom environment contained implicit messages about group status. In each study, children's intergroup attitudes (e.g., trait ratings, group evaluations) were assessed following several weeks in the classroom. The effect of relative group size on in-group bias was complex, varying as a function of (a) the relative size and salience of groups, (b) the measure used to assess intergroup attitudes, (c) group status (higher or lower), and (d) children's age.

Attitude↗

PubMed2002

Management of intrinsic sphincter deficiency in adolescent females with normal bladder emptying function.

PURPOSE: Intrinsic sphincter deficiency is rare in adolescent females with normal bladder emptying function. Information regarding the long-term outcome of therapy in this group of patients is sparse. We report our long-term experience with 3 adolescent females with intrinsic sphincter deficiency and normal bladder function who were treated with an artificial urinary sphincter. We critically reviewed the literature regarding experience with anti-incontinence surgery in adolescent females, not only regarding the outcome of the surgical technique, but also issues not usually considered in older adults, including the impact of physical development and future childbearing. MATERIALS AND METHODS: The charts of 3 adolescent females with intrinsic sphincter deficiency were reviewed. In addition, relevant peer reviewed articles were selected by a MEDLINE search. The results of the artificial urinary sphincter, pubovaginal sling and periurethral injection of bulking agents were reviewed. Long-term efficacy, the complication rate, impact of pregnancy and physical development were assessed. RESULTS: The 3 patients had an excellent long-term outcome with the artificial urinary sphincter, including 1 with 2 pregnancies that ended in a normal vaginal delivery. The literature showed that a good long-term outcome was consistently achieved with the artificial urinary sphincter. An equally good outcome was achieved with the pubovaginal sling but long-term data are lacking. While periurethral injection of a bulking agent provides good initial results, they do not appear to be durable. In addition, the artificial urinary sphincter does not appear to impact pregnancy or physical development negatively. CONCLUSION: Data support the artificial urinary sphincter and pubovaginal sling as effective therapies in adolescent females with intrinsic sphincter deficiency. However, long-term data on the pubovaginal sling are not available. When considering the impact on future childbearing and physical development, the artificial urinary sphincter is a favorable option.

Adolescent↗

PubMed2001

Why does schizophrenia develop at late adolescence?

Schizophrenia is one of the most researched, yet still one of the least understood, of the mental disorders. One key area that remains comparatively neglected is the fact that schizophrenia typically develops at late adolescence. In common with people with psychotic disorders, around 25% of normal teenagers also report finding adolescence very distressing, and a substantial empirical literature shows that certain characteristics typical of adolescence such as conflicted family relationships, grandiosity, egocentrism, and magical ideation bear a distinct resemblance to phenomena seen in psychotic disorders. Indeed, such phenomena, as might be judged prodromal or symptomatic in first-onset schizophrenia, have been shown to be remarkably common in normal adolescents, generally in about 50% of samples. Furthermore, prodromal-like signs in normal adolescents appear to be functionally linked to psychological development. For most adolescents, such phenomena pass with successful psychological development. It is proposed that psychosis in late adolescence is a consequence of severe disruption in this normally difficult psychological maturational process in vulnerable individuals, and explanations are offered as to why and how this comes about. It is suggested that problems either in reaching psychological maturity with regard to parents or in bonding to peers or both, may lead to crucial self-construction difficulties, and that psychosis emerges out of such "blocked adolescence." This approach proposes therapeutic interventions that enable professional services to side with both parents and clients simultaneously, and is normalizing and stigma-free.

Adolescent↗

PubMed1997

Practical application of non-whole animal alternatives: summary of IRAG workshop on eye irritation testing. Interagency Regulatory Alternatives Group.

In November 1993, the Interagency Regulatory Alternatives Group (IRAG) sponsored a workshop to examine the current scientific status of alternatives to the Draize eye irritation test by assessing the current practical application of methods used to predict in vivo eye irritation. Laboratories from around the world were invited to submit detailed in vitro and in vivo data in parallel according to a specific set of guidelines in a consistent format. In vitro scores were compared with individual tissue scores. Over 60 data sets from 41 laboratories were received for 29 different test methods. Methods were grouped into five categories: organotypic models, chorioallantoic membrane-based assays, cell function-based assays, cytotoxicity assays and other systems. Data submissions and correlation analyses have been used to demonstrate the application of guidelines in method evaluations. Findings are summarized and future directions are indicated. A significant outcome of the workshop was the co-operation demonstrated among representatives of industry, academia and government in sharing test data on more than 2000 chemicals, products and product formulations for evaluation by their peers. Information obtained from this workshop will add to the weight of scientific evidence and scientific consensus about in vitro test methods and will establish credibility for regulatory acceptance of non-whole animal alternatives for ocular irritation.

Animal Testing Alternatives↗