ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01322.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01323.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractGeneral paediatricians across Australia were surveyed to determine whether their practice reflected the commonly held assumption that paediatrics was changing, with an increased emphasis on ambulatory and community care and involvement with conditions comprising the new morbidity. A 10 page questionnaire was mailed to every paediatrician in the Australian College of Paediatrics directory of members considered to be practising general paediatrics. Of a total of 287 questionnaires distributed, 224 were returned (response rate 80.9%). Two‐thirds of respondents practised in a capital city, while the remaining third were divided equally between isolated paediatricians and those who practised in a provincial city. Only 15 paediatricians (6.8%) spent more than half their time involved in inpatient care, while 60% spent less than one‐fifth of their time with inpatients. There was no correlation between inpatient involvement and length of paediatric practice, but surprisingly there was a significant trend (P= 0.007) for paediatricians practising in a capital city to do more inpatient work. Respondents were provided with a list of eight conditions held commonly to comprise the new morbidity, and there was a strong response indicating an increase in children seen with these conditions over the past 5 years, as well as a decrease in children with clearly identifiable organic disease. Furthermore, respondents indicated in absolute terms the numbers of patients seen in the past month with each of the conditions. Results confirmed the significant numbers of children seen with conditions comprising the new morbidity, their increased presentation to paediatricians in the past 5 years and the predominance of non‐inpatient work in consultant paediatric practice in Aust

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01324.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractA listing of all general paediatricians in the country was obtained from the directory of members of the Australian College of Paediatrics. Each of the 287 paediatricians identified was sent a questionnaire requesting information about morbidity patterns of patients seen in their practices and their views regarding paediatric training. The response rate was 80.9%. Half the respondents had been in practice for 10 years or less, while two‐thirds practised in a capital city. Respondents rated their training in each of 10 organic specialty areas, on average, as having been appropriate. However, when given a listing of nine areas related to child development and behaviour, chronic disease and counselling, 70% rated training in these areas as having been inadequate; this figure was even higher for recent graduates. Less than one‐third had formal training in developmental, behavioural and community paediatrics; the remaining two‐thirds of respondents acquired their knowledge by clinical experience, books or journals, professional contacts or meetings. This was despite the fact that almost 80% of respondents felt that practical experience was not an adequate substitute for formal training in developmental and behavioural paediatrics. There was an encouraging trend for paediatricians who had been in practice for 10 years or less to have had training in these areas, although the number was still less than half. Almost 90% of respondents felt that changes were needed in paediatric training to equip trainees for general paediatric practice, while 62% of respondents were of the opinion that the present FRACP training system mitigated against appropriate training for general paediatrics. Ninety‐three per cent of respondents agreed that paediatricians had a major role to play in the management of children with problems of development and behaviour. Respondents made a large number of pertinent comments regarding perceived deficiencies in their training. These data are discussed in terms of the need to address imbalances in training. It is suggested that steps need to be taken to address the conflict between hospital service and training needs, that more trainees should be exposed to experiences in ambulatory and community settings, and that it is important to consider the introduction of appropriate curricula in developmental and behavioural paediatrics into Australian training pro

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01325.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractConsecutive surviving children weighing less than 1501 g when born in 1966–70 were followed prospectively: 87% (146/168) attended normal secondary schools, 4% (7/168) attended schools for those with special needs and 9% (15/168) were untraced. The psychologist assessed 140 children at a mean age of 14.5 years. The mean WISC‐R Verbal Score of 89.7 was almost identical to that achieved by the children at 8 years of age (89.2). Thirty three children (24%) had delay in Reading Accuracy on the Neale Analysis of Reading Ability, whilst 66 children (48%) were delayed on the Comprehension Scale. Social class and duration of maternal education were significant predictors of the WISC‐R Verbal Scores and Reading Comprehension at 14.5 years but the total variance explained was small. The Bayley Development Index (MDI) available for half of the children at 2 years often underestimated their potential as defined by the WISC‐R Verbal Score at 14.5 years. The 8 year intelligence (WISC‐R) and reading measures (Neale) were significantly and highly associated with the corresponding measures at 14.5 years. It was concluded that 8 years was an appropriate age to evaluate the outcome of the children and to identify many of those needing educational intervention. The spasmodic nature and sometimes short duration of the help received by many of the children underlines the need for more appropriate intervention for children with learning dif

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01326.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThirty‐seven mothers, their very low birthweight infants and a matched group of term infants of normal birth‐weight and their mothers were seen when the infants were 12 months old (corrected for prematurity). Data were collected about infant behaviour and development, mother‐infant interaction in a free‐play situation, and parenting behaviour indicating child‐centred care. Findings for the mother‐infant dyads in the two birthweight groups were compared to determine the extent to which the data supported possible outcomes of: differences in behaviour/development only, differences in behaviour/development compounded by disturbances of interaction or parenting, or interaction/parenting disturbances despite apparently normal behaviour and development. Results of this analysis indicated significantly poorer scores for the very low birthweight infants on measures of behaviour and development only. Recent reports that interactional problems, which commonly exist early on, resolve through a process of mother‐infant adaptation are discussed in light of the findings of this study. The need to consider developmental problems and interactive failure jointly if early intervention is to be offered is

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01327.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractResults of disaccharidase assays in small bowel biopsies from 887 children over a 3 year period were analysed to establish normal values. Abnormal histology, the presence of giardia trophozoites or total absence of sucrase and isomaltase were found in 307 cases and these were excluded from further consideration. The results for maltase, sucrase and lactase from the remaining 580 children have been graphed as percentiles at various ages. They represent results which are as close to normal as it is possible ethically to obtain.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01328.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe population in Singapore is predominantly Asian, with Chinese forming the major ethnic group. The incidence of haemolytic disease of the newborn (HDN) due to Rh incompatibility is very low. The true incidence of HDN due to ABO incompatibility is unknown. Early discharge is practised in Singapore making it important to predict severe HDN due to ABO incompatibility as this would constitute the main cause of haemolysis next to G6PD deficiency. One thousand, six hundred and eight baby‐maternal pairs were typed for ABO, Rh, and tested for direct Coombs’test, maternal titre, cord bilirubin and haptoglobin levels. Two hundred and fifty‐one were found to be ABO incompatible, with 141 group A and 110 group B babies. The incidence of HDN due to ABO incompatibility was 3.7% of all group O mothers. Coombs’test, maternal antibody titre, cord bilirubin and haptoglobin levels were of low predictive value for severe HDN due to ABO incompatibility. The data further support the notion that it is not cost effective to screen for ABO incompat

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01329.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractStudy of the records of 100 children admitted sequentially to hospital with viral croup suggested that they were more likely to be admitted at night than during the day when compared with other common conditions. The actual day of the week was unimportant, suggesting that medical availability was not a factor.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01330.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractSeven ventilator‐dependent infants with severe bronchopulmonary dysplasia were treated with dexamethasone. Six of the seven infants were extubated within 12 days of commencing the dexamethasone, whilst the remaining infant continued to need respiratory support for apnoea, despite significant improvement in the pulmonary disease. All infants survived; although only two were neurologically intact. Of the other five survivors, two had mild developmental delay, two were blind (secondary to retinopathy of prematurity) and the other had a spastic quadriplegia (secondary to bilateral periventricular leukomalacia

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1988.tb01331.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY