摘要:

ABSTRACT.Medical, neurodevelopmental, and parenting effects of individualized developmental care were investigated in a three-center, randomized, controlled trial. A total of 92 preterm infants, weighing less than 1250 g and aged less than 28 weeks, participated. Outcome measures included medical, neurodevelopmental and family function. Quality of care was also assessed. Multivariate analysis of variance investigated group, site, and interaction effects; correlation analysis identified individual variable contributions to significant effects. The results consistently favored the experimental groups. The following contributed to the group effects: shorter duration of parenteral feeding, transition to full oral feeding, intensive care, and hospialization; lower incidence of necrotizing enterocolitis; reduced discharge ages and hospital charges; improved weight, length, and head circumferences; enhanced autonomic, motor, state, attention, and self-regulatory functioning; reduced need for facilitation; and lowered family stress and enhanced appreciation of the infant. Quality of care was measurably improved. Very low birth weight infants and their parents, across diverse settings, may benefit from individualized developmental care.

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Little is known about the current practices of primary care physicians regarding developmental surveillance and screening during pediatric preventive care visits. We conducted a mailed survey of a random national sample of pediatricians and family physicians to describe their practices and identify factors that predict use of developmental screening tools, an efficacious way of identifying children with developmental delays. Most physicians reviewed developmental milestones and prompted parents for developmental concerns at preventive care visits. Approximately half of the physicians used a formal developmental screening instrument. Female physician gender predicted higher rates of use of screening tools for family physicians, but not for pediatricians. Most physicians seemed committed to the early diagnosis of developmental delays. Substantial variability in surveillance and screening practices, barriers of time and reimbursement, and under-reliance on parent-completed questionnaires underscore areas for improvement.

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ABSTRACT.This study examined the prevalence and correlates of use of different types of complementary and alternative medicine (CAM) among a sample of children with suspected or recently diagnosed autism. The authors’ review of 284 charts of children seen at the Regional Autism Center of The Children’s Hospital of Philadelphia, Pennsylvania, found that more than 30% of children were using some CAM, and that 9% were using potentially harmful CAM. Having an additional diagnosis was protective against CAM use and being Latino was associated with CAM use. Having seen a prior provider regarding the child’s health condition was predictive of potentially harmful CAM use. Further research is required on cultural differences in treatment decisions about CAM, as well as the reasons for the association between the use of prior providers and CAM. The high prevalence of CAM use among a recently diagnosed sample indicates that clinicians should discuss CAM early in the assessment process.

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ABSTRACT.This study determines the relationship between psychosocial adjustment in school-aged children and one aspect of exposure to violence, theproximity of exposure, in terms of (1) “physical” proximity and (2) “emotional” proximity to the victims of violence. A convenience sample of 175 children aged 9 to 12 years from a primary care clinic of a large urban hospital were interviewed about their exposure to violence using the Children’s Report of Exposure to Violence. Psychosocial adjustment was measured through maternal reports using the Child Behavior Checklist (CBCL) and the Personal Adjustment and Role Skills Scale (PARS III). Children were categorized into three groups according to their closest proximity to exposure to violence (“victim” > “witness” > exposure through other people’s “report”) and two groups according to emotional proximity (victim was a “familiar person” or “stranger”). All children (23/175) who scored above the CBCL clinical cutoff (T score > 63) were witnesses or victims of violence. The CBCL total T scores (higher score = more maladjustment) showed that the “victims” group (mean 52.4) scored significantly higher than the “witness” group (mean 50.0) and “report” group (mean 47.4). The PARS III total scores (lower scores = more maladjustment) showed that the “victims” group (mean 87.5) scored significantly lower than the “witness” group (mean 93.1) and “report” group (mean 98.2). The relationship of the child to the victim was not associated with significantly different CBCL and PARS III scores. Children exposed to more proximal forms of violence as victims or witnesses exhibited more psychosocial maladjustment.

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ABSTRACT.This article discusses single-case experimental designs (SCEDs) and their relevance to developmental-behavioral pediatrics. Information concerning SCEDs have not been described in theJournal of Developmental and Behavioral Pediatrics, despite its relevance to the field. General issues related to the underlying logic and applications of SCEDs are reviewed with examples selected from the literature to illustrate the strengths and weaknesses of different design strategies. It is suggested that SCEDs can be a useful alternative to traditional between-group designs for clinical and evaluation research because the unit of the analysis is the individual; therefore the feedback to clinicians and families is direct about the effectiveness of a behavioral intervention or medication for that individual. In the field of developmental-behavioral pediatrics, SCEDs can be especially useful in the management of vague symptoms or poorly defined diseases to improve the confidence in a treatment decision for an individual patient. This report is intended to facilitate the understanding and use of single-case methodology so that clinicians are aware that flexible, true experiential designs exist to fill the gap in knowledge and also “do the best for my patient.”

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2003

数据来源: OVID