Effect of hand splints on stereotypic hand behavior of girls with Rett syndrome: a replication study
Humans; Female; Child Preschool; Reproducibility of Results; Splints; Stereotyped Behavior; Hand; Rett Syndrome/rehabilitation; tone and motor problems; Rett syndrome; physical intervention; hand splints; hand wringing
The purposes of this study were to replicate a recent report of the positive effects of hand splinting on the stereotypic hand movement of children with Rett syndrome and to evaluate the generality of these results to a different setting. Two 5-year-old girls diagnosed with early Stage-III Rett syndrome were introduced to hand splints in accordance with the multiple-baseline design used in the Naganuma and Billingsley study. Splint wear ranged from 30 to 50 days for the two subjects. Data were analyzed as a percentage of time and as actual time in minutes. Unlike the previous study, in which a decrease in hand-wringing behavior was noted, neither subject in our study demonstrated a decrease in stereotypic hand behavior or a subsequent increase in independent feeding skills when wearing the splints. There was also no evidence of increased hand wringing following withdrawal of the splints. The differences in ages of the subjects and different functional levels (stages) may have been contributing factors to the conflicting results and should be considered in managing this group of children.
Tuten H; Miedaner J
Physical Therapy
1989
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/ptj/69.12.1099" target="_blank" rel="noreferrer noopener">10.1093/ptj/69.12.1099</a>
Effects of framing and level of probability on patients' preferences for cancer chemotherapy
Female; Humans; Male; Adult; Attitude to Health; Prognosis; Aged; Middle Aged; Patient Participation; Health Status; Probability; Informed Consent; adolescent; Non-U.S. Gov't; Research Support; Neoplasms/drug therapy/mortality/psychology; Random Allocation
Although most clinicians agree that patients should be informed about treatment alternatives, little is known about the way patients perceive probabilistic information about treatment outcomes and how it influences the choices they make. The purpose of this study was to examine the influence of level and framing of probability on preferences for cancer treatment alternatives in which tradeoffs between quantity and quality of life are made. 129 healthy volunteers and 154 cancer patients indicated their preferences for a toxic treatment over a non-toxic treatment at varying survival probabilities. Subjects responded to questions in one of three randomly assigned conditions: (1) a positive frame in which the probability of survival was given; (2) a negative frame in which the probability of dying was given; and (3) a mixed frame in which the probability of surviving and dying were both given. The cancer patients' preferences for the more effective toxic treatment was significantly stronger than the healthy volunteers. Both groups were significantly influenced by the level of probability that was presented. Preferences for the toxic treatment were weaker when the chance of survival dropped below 50%. This weakening preference below 50% survival was enhanced for subjects who responded in the negative frame. A negative frame or probability level below 0.5 would seem to stimulate a "dying mode" type of value system in which quality of life becomes more salient in decision making than quantity of life. The implications in eliciting informed consent from patients are discussed.
1989
O'Connor AM
Journal Of Clinical Epidemiology
1989
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Journal Article
<a href="http://doi.org/10.1016/0895-4356(89)90085-1" target="_blank" rel="noreferrer">10.1016/0895-4356(89)90085-1</a>
The undertreatment of pain in children: an overview
1989
Schechter NL
Pediatric Clinics Of North America
1989
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Journal Article
<a href="http://doi.org/10.1016/s0031-3955(16)36721-9" target="_blank" rel="noreferrer">10.1016/s0031-3955(16)36721-9</a>
Management of burn pain in children
Child; Humans; Analgesics; Patient Compliance; Analgesics/administration & dosage/therapeutic use; Bandages/adverse effects; Burns/complications/physiopathology; Opioid/administration & dosage/pharmacokinetics/pharmacology/therapeutic use; Pain/physiopathology/therapy
In spite of the many possible methods of pain control in the burned child satisfactory pain management may still be a problem, at times formidable. The most fruitful approach would seem to be frequent assessment of pain in the individual patient with a readiness to try alternative or additional measures when relief seems inadequate. In this way the most effective analgesic agent(s), route(s), and frequency of administration, as well as nonpharmacologic methods, can be determined for each child. Among those able to speak, pain estimation is usually easily accomplished. In infants and those intubated for supported ventilation, however, the task is more difficult. Nevertheless, careful observation of physiologic signs such as heart rate and blood pressure, facial expressions, body movement and position, and the quality of an infant's cries may in sum be sufficient to evaluate the intensity of pain. Monitoring of analgesic plasma levels to ascertain that they are within the ranges established for good analgesia and even determination of beta-endorphin blood levels may also aid in judging the adequacy of analgesia. By tailoring pain management methods to the needs of each child it may be possible to keep pain at acceptable levels in victims of burn injury.
1989
Osgood PF; Szyfelbein SK
Pediatric Clinics Of North America
1989
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Journal Article
<a href="http://doi.org/10.1016/s0031-3955(16)36733-5" target="_blank" rel="noreferrer">10.1016/s0031-3955(16)36733-5</a>
Spontaneous pneumothorax, pneumomediastinum, and pneumopericardium in a 16-year-old drug-abusing motorcyclist surrounded by a pack of coyotes
Humans; Male; Animals; adolescent; Mediastinal Emphysema/etiology; Motorcycles; Panic; Pneumopericardium/etiology; Pneumothorax/etiology; Smoke Inhalation Injury/complications; Substance-Related Disorders/complications; Wild
Numerous causes of pneumothorax, pneumomediastinum, and pneumopericardium have been described in the literature. The authors report a unique case in which one or more causes may have contributed to the patient's condition.
1989
Haines JD; Chop WM; Swyden SN
Postgraduate Medicine
1989
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Journal Article
<a href="http://doi.org/10.1080/00325481.1989.11704431" target="_blank" rel="noreferrer">10.1080/00325481.1989.11704431</a>
Preventing psychosocial impairment in siblings of terminally ill children
Child; Humans; Grief; Death; Sibling Relations; Stress; adolescent; Preschool; Adaptation; Psychological; Family/psychology; Parent caregivers; Psychological/prevention & control
A review of the literature provides the basis for a discussion of the impact of sibling death on healthy children whose emotional needs may be unattended both by parents and professionals. Factors which may deter hospice practitioners from delivering effective psychosocial care to siblings are identified and recommendations for preventive intervention are enumerated.
1989
Bendor SJ
The Hospice Journal
1989
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Journal Article
<a href="http://doi.org/10.1080/0742-969x.1989.11882661" target="_blank" rel="noreferrer">10.1080/0742-969x.1989.11882661</a>
Do we need another "stress and caregiving" study?
Humans; Health Services Research; Psychological; Stress; home care services
1989
Zarit SH
The Gerontologist
1989
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Journal Article
<a href="http://doi.org/10.1093/geront/29.2.147" target="_blank" rel="noreferrer">10.1093/geront/29.2.147</a>
Husbands and wives as caregivers: antecedents of depression and burden
Humans; Mental Health; Sex Factors; Depression; Regression Analysis; P.H.S.; Research Support; U.S. Gov't; Interviews; Alzheimer Disease/psychology; Marriage; Home Nursing/psychology
Contrasting predictors of depression among 101 men and 214 women providing care to spouses suffering from Alzheimer's Disease indicated that the sole predictor for husbands was ill health, whereas for wives less emotional investment was also predictive. While there were no significant predictors for burden among husbands, for wives, burden was associated with poorer health, less emotional investment, greater spouse impairment, and provision of more assistance with tasks.
1989
Pruchno RA; Resch NL
The Gerontologist
1989
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Journal Article
<a href="http://doi.org/10.1093/geront/29.2.159" target="_blank" rel="noreferrer">10.1093/geront/29.2.159</a>
Self-concepts, domain values, and self-esteem: relations and changes at early adolescence
Child; Humans; Adolescent Psychology; Interpersonal Relations; Self Concept; Social Values; Teaching; adolescent; Adolescent Transitions; Aptitude; Mathematics; Sports
We assessed how children's self-concepts of ability for mathematics, English, social, and physical skills activities, ratings of the importance of these activities, and general self-esteem change across the transition to junior high school. Three types of change were assessed: change in mean levels, change in stability, and change in relationships. Twice each year during the sixth and seventh grades, 1,450 children completed questionnaires. Mean levels of children's self-esteem were lowest immediately after the transition, but recovered during seventh grade. Self-concept of ability and importance ratings for math and sports activities showed linear declines. Self-concept of ability for social activities showed a cubic trend, but importance ratings for social activities declined in a linear fashion. Children's self-concepts of ability for math and English became less stable across the junior high transition, whereas beliefs about other activities and general self-esteem were more stable in seventh grade.
1989
Eccles JS; Wigfield A; Flanagan CA; Miller C; Reuman DA; Yee D
Journal Of Personality
1989
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Journal Article
<a href="http://doi.org/10.1111/j.1467-6494.1989.tb00484.x" target="_blank" rel="noreferrer">10.1111/j.1467-6494.1989.tb00484.x</a>
Combat experience and emotional health: impairment and resilience in later life
Humans; Male; Adult; Memory; Longitudinal Studies; Risk Factors; adolescent; P.H.S.; Research Support; U.S. Gov't; Adaptation; Psychological; Stress Disorders; War; Human Development; Non-P.H.S.; Veterans/psychology; Post-Traumatic/psychology; Assertiveness; Ego
War's influence on emotional health includes potential psychological gains as well as losses. In a sample of 149 veterans from longitudinal samples at the Institute of Human Development, University of California, Berkeley, this study explores two questions on the legacy of combat in World War II and the Korean conflict. The first concerns the subjective experience or meanings of combat that veterans hold in later life, with particular attention to how such accounts are linked to the severity of combat and postwar adaptations. The second question links these accounts to the psychosocial functioning of veterans before the war and in later life using reports from veterans and their spouses and Q-sort ratings in adolescence and at age 40. Findings center on veterans of heavy combat. Compared to the noncombatants and light combat veterans, these men were at greater risk of emotional and behavioral problems in the postwar years. In mid-life, they hold mixed memories of painful losses and life benefits associated with military experience. Clinical ratings show that heavy combat veterans became more resilient and less helpless over time when compared to other men. As in the case of life events generally, short- and long-term effects may impair and enhance personal growth.
1989
Elder GH; Clipp EC
Journal Of Personality
1989
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Journal Article
<a href="http://doi.org/10.1111/j.1467-6494.1989.tb00485.x" target="_blank" rel="noreferrer">10.1111/j.1467-6494.1989.tb00485.x</a>
How ketones spare protein in starvation
Humans; Proteins/metabolism; 3-Hydroxybutyric Acid; Carbon Isotopes; Hydroxybutyrates/therapeutic use; Ketone Bodies/biosynthesis/metabolism; Leucine/diagnostic use; Protein Biosynthesis; Starvation/drug therapy/physiopathology
1989
Nutrition Reviews
1989
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Journal Article
<a href="http://doi.org/10.1111/j.1753-4887.1989.tb02798.x" target="_blank" rel="noreferrer">10.1111/j.1753-4887.1989.tb02798.x</a>
Life threatening illness and hospice care.
Child; Humans; Attitude to Health; Parents; Professional-Family Relations; Longitudinal Studies; Hospices; Consumer Satisfaction; Respite Care; Family Health; adolescent; Preschool; Non-U.S. Gov't; Research Support; bereavement; retrospective studies; social support; Terminal Care/psychology; Marriage; Employment; Mental Disorders/psychology
A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening illness. Eighteen (72%) of the families felt they had been well supported by the hospice and valued the family like atmosphere, perceiving the staff to be friendly, approachable, and helpful. The actual nature of hospice care, in an environment with other terminally ill children, was, however, considered a drawback for a few families. A number of families still had unmet needs, notably appropriate child minding when away from the hospice. The impact of chronic life threatening illness on the families was substantial. The parents (particularly the mothers), the index children, and their siblings all experienced much higher levels of psychological symptomatology than would have been expected from normal samples. While families felt greatly helped over symptom control, a proportion remained very worried about certain symptoms, particularly breathlessness, seizures, and pain. A high proportion of families were experiencing financial and employment difficulties as a result of their children's illnesses.
1989
Stein A; Forrest GC; Woolley H; Baum JD
Archives Of Disease In Childhood
1989
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Journal Article
<a href="http://doi.org/10.1136/adc.64.5.697" target="_blank" rel="noreferrer">10.1136/adc.64.5.697</a>
Functional duodenal obstruction (superior mesenteric artery or cast syndrome) in cerebral palsy
Child; Female; Humans; Enteral Nutrition/methods; Cerebral Palsy/complications; Duodenal Obstruction/complications/physiopathology; Nutrition Disorders/diet therapy/etiology
An 8-yr-old girl with cerebral palsy who was chronically malnourished presented with functional duodenal obstruction (superior mesenteric artery or cast syndrome) proven by barium meal. Six months of feeding through a fluoroscopically positioned gastrojejunal tube generated sufficient weight gain and increase in body bulk to cure the functional obstruction.
1989
Vaisman N; Stringer DA; Pencharz P
Journal Of Parenteral And Enteral Nutrition
1989
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Journal Article
<a href="http://doi.org/10.1177/0148607189013003326" target="_blank" rel="noreferrer">10.1177/0148607189013003326</a>
Hospice day care standards development in Michigan
1989
Olson SL
American Journal Of Hospice Care
1989
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Journal Article
<a href="http://doi.org/10.1177/104990918900600217" target="_blank" rel="noreferrer">10.1177/104990918900600217</a>
Parent and health care provider communication and decision making in the intensive care nursery
Humans; infant; United States; Intensive Care Units; Attitude to Health; Parents; Professional-Family Relations; Communication; Neonatal; Interviews; decision making; Newborn; ICU Decision Making; social support; Best Practices (Davies); Life Support Care/psychology
This study investigated parents' and health care providers' perspectives of their communicative interactions when a seriously ill infant is treated in an intensive care nursery. Both parents and health care providers stressed the importance of keeping parents informed of their child's condition. Concerns regarding the provision of medical information to parents in an understandable manner, the lack of time health care providers have to spend interacting with parents, and the possibility that parents' emotional involvement interferes with their understanding of the child's condition were raised. Implications for pediatric health care providers relative to their interactions with parents of young chronically ill children are raised.
1989
Abel-Boone H; Dokecki PR; Smith MS
Children's Health Care
1989
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Journal Article
<a href="http://doi.org/10.1207/s15326888chc1803_2" target="_blank" rel="noreferrer">10.1207/s15326888chc1803_2</a>
The Response of Children to the Dying and Death of a Sibling
sibling bereavement
1989-01
Birenbaum LK; Robinson MA; Phillips DS; Stewart BJ; McCown DE
Omega
1989
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Journal Article
<a href="http://doi.org/10.2190/DHGK-NMG8-FFR4-UFW9" target="_blank" rel="noreferrer">10.2190/DHGK-NMG8-FFR4-UFW9</a>
Pediatric uses of opioids
Child; infant; Drug Interactions; Opioid-Related Disorders; Preschool; infant; Newborn; Receptors; Human; Pediatrics; Meperidine/pharmacology; Methadone/pharmacology; Morphine/pharmacology; Codeine/pharmacology; Fentanyl/pharmacology; Narcotics/adverse effects/pharmacokinetics/pharmacology/therapeutic use; Opioid
It is evident that opioids are underused in infants and children, mainly owing to the erroneous belief that long-term adverse effects may result from effective use, coupled with the difficulties infants and children have in verbalizing their feelings of pain. Sufficient data exist to date on the safe use of opioids in the pediatric age group to allow pediatricians to incorporate them in a variety of protocols. Moreover, unlike most drugs in clinical use, opioids have a specific, safe antidote that can reverse their toxic effects promptly and effectively.
1989
Koren G; Maurice L
Pediatric Clinics Of North America
1989
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Journal Article