ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02249.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBetween March 1980 and March 1989 there were six identified cases of infant botulism. The presenting symptoms were predominantly poor feeding, lethargy and constipation, and the presenting signs were predominantly hypotonia, weak gag reflex and respiratory difficulty. All required intensive care and prolonged hospital stays. Recovery was eventually complete in all cases. Infant botulism is an uncommon condition but early recognition with adequate intensive care usually results in complete recovery.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00434.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractAn international study of health behaviour among school‐age children was co‐ordinated by the World Health Organization (WHO). The data were obtained from a self‐completion questionnaire examining key health behaviours and associated psycho‐social variables obtained from representative samples of young people in school aged 11.5, 13.5, and 15.5 years. The analysis focuses on the relationship between older (15.5 years) students' attitudes towards school and health behaviours such as regular smoking, alcohol use, physical activity and food choices. The data show a strong and progressive relationship between indicators of ‘alienation’ from school, and health compromising behaviours among school students from Australia and Wales. This relationship is most obvious with the ‘abusive’ behaviours of smoking and alcohol misuse. Summary data for nine other countries in the WHO study indicate that this relationship is found consistently across all countries in the study. This substantial minority of students (approximately 30% varying between countries) represents an important target population for efforts to promote healthy lifestyles. Traditional school health education is seen as insufficient to tackle this task and recommendations are made concerning change to the school environment and ethos, and the need to reach young people in their home and com

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02256.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractIn a follow‐up survey to a 1984 study, 339 paediatricians in Australia were invited to complete a brief questionnaire in 1990, in which they indicated their usual recommendations, practices and advice when managing children with Down syndrome. The response rate was 67%. The results indicated that the most frequent paediatrician‐initiated referrals were for early intervention and for discussion with other parents; these options were selected more frequently in 1990 than in 1984. While referral to a social worker was the next most frequent choice, it occurred less in 1990 than in 1984. Other increases in referrals were for physiotherapy and speech therapy. Paediatricians were more likely to support referral to a geneticist, speech therapist or cosmetic surgeon in response to a specific parental enquiry, and less likely to support referral to a social worker or to full‐time care. There had been significant increases since 1984 in the likelihood that paediatricians would order audiology and investigation of thyroid and cardiac function. There was less opposition to the use of sedatives, and virtual cessation of the use of tryptophan. Paediatricians were more optimistic about the likelihood of persons with Down syndrome living independently, caring for their own finances, and marrying, but not about other developmental

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00435.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe challenges and stresses faced by adolescents include entry into secondary school, the development of adolescent sexuality, family conflicts, parental mental illness, socio‐cultural factors, substance use and abuse, work and career abuse, social and antisocial behaviour, and the carry‐over of problems from childhood. The ways in which programmes through schools can address these issues, enhance resilience and promote adolescent mental health are discussed. The potential of personal development programmes could be utilized to this end, with targeted educational and group initiatives and evaluation of outco

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02258.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe aim of this study was to examine the level of knowledge about childhood asthma in paediatric nurses, pharmacists and general practitioners to assess their potential value as sources of accurate information for patients with asthma. The main outcome measure was the score obtained on an asthma knowledge questionnaire which had been validated previously. The maximum possible score was 31. Eighty‐three general practitioners had a mean score of 28.1 (range 14–31); 82 pharmacists scored a mean of 24.2 (range 15–30) and 30 paediatric nurses had a mean score of 25.5 (range 16–30). General practitioners scored well in most questions but had some worrying deficiencies, particularly in distinguishing preventive therapy from symptom relieving medication. Pharmacists and paediatric nurses had a number of problems in certain important areas. In particular pharmacists as a group were unaware of many of the clinical features of asthma, had misconceptions, such as the need to avoid cow's milk, and recorded incorrect responses to clinical scenarios of acute treatment. Paediatric nurses tended to overestimate the side effects of inhaled medications, and also the value of auscultation. They had poor knowledge of exercise‐induced asthma.The data overall suggest that specific educational strategies should be devised for different groups of health professionals who manage children with asthma and suggest that poor knowledge on the part of health care providers may contribute to

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00436.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractData are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP‐CP) forSalmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP‐CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positiveS. typhiculture in a febrile child (culture positivevsthe rest) showed the best model to be an O‐ and/or H‐titre of ≥ 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (>1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP‐CN patients really were typhoid but were missed by culture. The TYP‐CN patients showed a very similar clinical and age profile to TYP‐CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific ‘fever screen’ for typhoid although it will not identify all cases. In children, lower cut‐off points for O‐ and H‐titres should be used than

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00437.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractResilient adolescents are notable for their social competence, which enables them to form and maintain close relationships. The evidence is that adolescents' social competence is derived from their experience of close relationships within their family. On the basis of structured interviews, adolescents' working models of attachments can be categorized into secure, dismissive, or pre‐occupied. These attachment styles are associated with very divergent beliefs about the self and others, with differing patterns of emotion regulation and with differing risk profiles for maladjustment. Parenting styles and family relationships appear to have considerable influence on attachment behaviour. Further evidence for the importance of the family comes from research on ego development. Family level behavioural patterns have been discerned from family research interviews which are associated with stagnation or advancement in ego development during adolescence. Though the results suggest causal connections, the direction of effects is far from clear. Longitudinal research underpins the importance of childhood temperament as a contributing factor to the quality of the family environment that the child and then adolescent experience

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02259.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractFive adolescent girls with Turner syndrome (mean age 13.9 years, mean bone age 12.0 years) were treated with both recombinant human growth hormone (rhGH) and oxandrolone for 2 years with an average increment in height of 13.4 cm. The mean bone age advanced by only 1.2 years, providing an increase in the mean estimated mature height of 9.2 cm. We conclude that rhGH and oxandrolone benefit older teenagers with Turner syndrome because of an increased growth rate with slow progression of skeletal maturation.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb00438.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1993.tb02260.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY