Brief Report: HIV-Exposed Newborns Show Inferior Orienting and Abnormal Reflexes on the Brazelton Scale

Assessed 48 infants of HIV-positive and HIV-negative motherson the Brazelton Neonatal Behavioral Assessment Scale. Infantsexposed to HIV-positive mothers were disadvantaged from birthdue to their mothers having obstetric complications and to theinfants having orienting problems and abnormal reflexes on theBrazelton Newborn Scale. These problems may be early precursorsof the later visual-spatial delays and typertonicity noted inthese infants.     

Infant Scales in the Pediatric Setting: The Brazelton Neonatal Behavioral Assessment Scale and the Carey Infant Temperament Questionnaire

The Brazelton Neonatal Assessment Scale items and scoring techniquesare described. Research comparing populations has shown cross-culturaldifferences and relationships between newborn behavior and addiction,obstetrical medication, risk status, and mother-infant interaction.Clinical and social applications and prediction to later infancyare reviewed. The Carey Questionnaire assesses infant temperamentbetween 4 and 8 months. The items and scoring procedures aresummarized and compared with the New York Longitudinal StudyInterview. Carey temperament scores are relatively stable andhave been related to behavior problems, infant development,risk status, and mother-infant interaction patterns. The useof both scales for investigating direction of effects in parent-infantrelationships is discussed. Critical comments are offered.     

Brief report: health beliefs among survivors of childhood cancer

OBJECTIVE: To describe interest in cancer screening and tobacco-control procedures (nicotine-addiction susceptibility testing) among survivors of childhood cancer and to identify psychosocial modifying and readiness factors associated with survivors' interest, based on the children's health belief model. METHODS: Twenty-eight survivor-mother dyads were interviewed as part of a preliminary study (mean age of survivors = 15.4 years at time of interview, 10.1 years at time of diagnosis, and 12.0 years at end of treatment); interviews consisted of well-validated self-report items and measures of health beliefs. RESULTS: In sum, 57% and 61% of survivors were interested in screening and susceptibility testing, respectively. Survivors who rated themselves as more competent, more concerned about cancer, and more vulnerable to cancer were more interested in participating in screening. Regarding interest in nicotine-addiction susceptibility testing, survivors were more interested when they perceived greater vulnerability to the harm of smoking and when they had mothers who perceived themselves to be in better health. CONCLUSIONS: Preliminary data suggest that psychosocial modifying and readiness factors are associated with survivors' interest in cancer screening and tobacco-control procedures and that additional research in this area is warranted.     

Brief report: newborn behavior differs with decosahexaenoic acid levels in breast milk

OBJECTIVE: To assess whether natural variations in decosahexaenoic acid (DHA) levels in breast milk would relate to infant neurobehavioral outcomes at the newborn stage following equivocal findings on infant and toddler outcomes of exposure to DHA in formula and breast milk. METHODS: Breast milk samples from N = 20 mothers were collected 9 days after delivery, while the Brazelton Neonatal Behavioral Assessment Scale (NBAS) was administered on the infant. Milk samples were later analyzed for fatty acids, including DHA. RESULTS: Pearson correlations revealed a positive association between DHA concentrations in breast milk and infants' scores on the NBAS Range of State cluster score, suggesting that DHA is related to the infant's superior ability to maintain optimal arousal. CONCLUSIONS: These results suggest that breast milk DHA is beneficial to the neonate's neurobehavioral functioning and call for investigative attention to DHA's role in potentiating optimized intellectual functioning at later stages of development. The findings may also be interpreted as supporting formula supplementation with DHA.     

Brief report: birth status, medical complications, and social environment: individual differences in development of preterm, very low birth weight infants

OBJECTIVE: To assess whether medical complications mediate the relationship between birth status (i.e., birth weight and gestational age) and developmental outcome of preterm, very low birth weight (VLBW) infants, as well as the role of the early social environment (maternal distress and social support) in infant development. METHOD: Birth status and medical complication information was collected during the child's NICU stay. Maternal distress was assessed with the Beck Depression Inventory and the Parenting Stress Index at 4 months corrected infant age. Social support was measured with the Dunst Scales at 4 months corrected age. Child development measures were collected at 4 and 13 months corrected age (Bayley MDI and PDI), and at 36 months chronological age (PPVT-R and Achenbach CBCL). RESULTS: Medical complications mediated the birth status-outcome relationship at 4 and 13 months, but not at 36 months. The 36-month outcomes were predicted by 4-month maternal distress and social support. CONCLUSIONS: Prematurity and VLBW are indirectly related to early developmental outcome through their association with medical complications. However, by 36 months, developmental outcomes are more closely related to aspects of the early social environment than to early physiological factors.     

Brief report: factor structure of the Childhood Illness Attitude Scales (CIAS)

OBJECTIVE: To examine the factor structure of the Childhood Illness Attitude Scales (CIAS). The CIAS is a 35-item self-report measure based on the Illness Attitudes Scales, designed for use with school-age children. The CIAS measures fears, beliefs, and attitudes associated with health anxiety and abnormal illness behavior in childhood. METHODS: CIAS item responses for 201 school-age children were subjected to principal-components analysis with oblique rotation. RESULTS: The CIAS was best conceptualized as comprising four factors: fears, help seeking, treatment experience, and symptom effects. Further factor analysis supported the notion that the CIAS can also be conceptualized as having a hierarchical structure, with four lower-order factors loading onto a single higher-order factor of health anxiety. CONCLUSIONS: Results suggest that the CIAS possesses good psychometric properties, including factorial validity and internal consistency, and appears to be a psychometrically sound instrument for measuring children's health anxiety.     

Brief report: Assessment of children's gastrointestinal symptoms for clinical trials

OBJECTIVE: To conduct a pilot study evaluating a procedure for assessment of daily symptoms and functioning in pediatric patients. METHOD: Participants included 11 parent-child dyads referred to a tertiary care center for evaluation of constipation and abdominal pain. Each family was provided a hand-held computer and modem. For 7 consecutive days, parents and children (ages 6-10 years) responded as a team to questions regarding the level of children's gastrointestinal symptoms and the extent to which symptoms interfered with the day's activities. Parents responded to a telephone interview evaluating the procedure. RESULTS: Parents reported that children understood most questions and that responses entered into the computer were accurate. Parents and children were enthusiastic about the data collection method. Some technical problems arose in use of the computers. CONCLUSIONS: Within the limitations of a small sample, this data collection procedure appears to have promise for evaluating pediatric symptom outcomes.     

Brief report: psychometric evaluation of the severity of illness scale in a pediatric oncology sample

OBJECTIVE: To examine the psychometric properties of the Severity of Illness Scale (SOIS), a measure that focuses on the medical severity of illness of children with cancer, from the point of view of medical personnel. METHODS: Following pretesting, the SOIS was administered to nurses and physicians of 55 pediatric cancer patients at three time periods: entry into study, 2-week follow-up, and 3-month follow-up. Validity determination included analyses of relapse status and bone marrow transplant. Test utility was determined via a respondent questionnaire. RESULTS: Test-retest reliability coefficients were .96 and .92 for 2-week and 3-month time periods. Interrater reliability, assessed by comparing physician ratings to nurse ratings, was .89. Evidence for criterion-related validity revealed that the SOIS discriminates both bone marrow transplant and relapse status. Physicians and nurses rated the SOIS positively for brevity, ease of completion, and usefulness in depicting medical severity of disease. CONCLUSIONS: There is preliminary evidence for the psychometric utility of the Severity of Illness Scale for a pediatric cancer population. The inclusion of illness parameters in current models of risk and resiliency dictate the need for such a measure.     

Brief report: cautions against using the Stanford-Binet-IV to classify high-risk preschoolers

OBJECTIVE: To explore concurrent and predictive validity of the Stanford-Binet: Fourth Edition (SB-IV) by comparing scores on the SB-IV with scores from the Battelle Developmental Inventory (BDI) and later achievement scores in preschoolers at risk due to very low birthweight, and/or intraventricular hemorrhage (IVH) and other medical complications. METHODS: At ages 3,4, and 5, 92 preschoolers were tested with the SB-IV and BDI as part of an 8-year early intervention follow-up. RESULTS: The SB-IV and BDI concurrent correlations at ages 3, 4, and 5 were statistically significant (r = .73-.78, p < .0001), as were predictive correlations (r = .58-.85, p < .0001). However, the BDI and SB-IV failed to place the children in the same categories for intervention services. With the BDI as the comparison measure, SB-IV failed to detect 87% of the children who were "delayed" (by BDI) at age 3 and 50% of the "delayed" children at age 5. CONCLUSIONS: Caution is recommended when using the SB-IV to assess high risk for early intervention eligibility.     

情绪性量表在公务员中的信效度评价

目的评价中国成年人情绪性量表在我国公务员中的信效度。方法用情绪性量表在我国公务员群体中进行施测,通过项目分析、探索性因子分析和验证性因子分析对量表的信效度进行检验。结果经项目分析和探索性因子分析,情绪性量表表达性因子的7个项目被删除,量表保留了愉悦性和乐观性2个因子20个项目。20个项目的题总相关系数均大于0.4,因子载荷大于0.4,共同性大于0.16。2个因子可累积解释量表总变异量的57.821%。20项量表的建构效度、收敛效度、区别效度和效标效度也都符合心理测量学的要求。量表的内部一致性信度Cronbach'sα系数为0.902,愉悦性和镇定性2个因子的Cronbach'sα系数分别为0.918、0.919;愉悦性和镇定性2个因子的组合信度分别为0.919、0.848。结论情绪性量表(20项)具有良好的信效度,可以作为测量和评估我国公务员情绪性的工具。     

Brief report: speed of information processing in children with insulin-dependent diabetes mellitus

OBJECTIVE: To determine whether children with insulin-dependent diabetes mellitus (IDDM) process information more slowly than children who do not have diabetes. METHODS: We tested 31 children with early onset and longer duration of IDDM, 35 with later onset and briefer duration of IDDM, and 36 comparison children without diabetes. They were administered five tasks requiring rapid responding that assessed a range of cognitive processes. RESULTS: On most tasks, children in the three groups were quite similar in the accuracy and speed of performance. Furthermore, for children in the diabetic groups, disease-related variables were unrelated to accuracy and speed of performance. CONCLUSIONS: The results suggest that children with IDDM do not have a pervasive deficit in speed of information processing, although more circumscribed deficits in processing speed are possible.     

北京居民心理健康量表的内容效度检验

目的:初步编制北京居民心理健康量表,并对其内容效度进行检验。方法:采用专家评定法,在2016年2月-2016年12月邀请21位专家对北京居民心理健康量表的条目进行评定,运用问卷的回收率和专家提出建议的百分率来表示专家的积极性,权威系数表示专家的权威程度,使用均值、变异系数、协调系数表示专家评定意见的集中程度和一致性。结果:问卷有效回收率为80.95%,专家的权威系数为0.864,所有条目均值得分为1.82~3.81,各条目变异系数的得分在0.11~0.59之间,专家的协调系数为0.22(P0.05)。删除专家评分均值较低或专家意见相差较大的条目共32项,并根据专家意见对22个条目进行了进一步的修改。结论:经过专家评定的北京居民心理健康量表具有良好的内容效度,可以用于进一步验证信效度的研究。     

Brief report: sluggish cognitive tempo among pediatric survivors of acute lymphoblastic leukemia

OBJECTIVE: The purpose of the present study was to assess sluggish cognitive tempo (SCT) behavioral symptoms among pediatric survivors of acute lymphoblastic leukemia (ALL) and to determine the relationship of these behaviors with cognitive late effects. METHODS: ALL survivors (n = 80) and a sibling control group (n = 19) were administered intelligence (IQ) testing, achievement testing and SCT behavioral items. Group differences (patients vs. siblings) were examined on the SCT behaviors and partial correlations were conducted to explore the relationship of the SCT behaviors with IQ and achievement, while controlling for age at treatment and time since treatment. RESULTS: ALL survivors exhibited significantly more SCT symptoms than the sibling control group and increased SCT symptoms were associated with lower IQ and achievement scores. CONCLUSIONS: ALL survivors are vulnerable to SCT symptoms and these behaviors are associated with cognitive late effects. SCT symptoms may represent a behavioral component of cognitive late effects.     

Brief report: effects of pediatric HIV infection on mental and psychomotor development

OBJECTIVE: To examine the effect of HIV status on infants' mental and psychomotor functioning, controlling for confounding factors such as prenatal drug exposure and birth conditions. METHODS: Twenty HIV-infected and 25 seroreverted infants (ages 3-30 months old) were administered the Bayley Scales of Infant Development (BSID) and a neurological examination at two time points, 4 to 12 months apart. The majority were from ethnic minority, socioeconomically disadvantaged families; 67% of the infants were prenatally drug-exposed. RESULTS: HIV-infected infants had significantly lower scores on the BSID at baseline (mental development) and follow-up (motor development) compared to seroreverters. When HIV and neurological deficits were considered together, HIV+ children with neurological deficits scored significantly lower than HIV+ children without neurological deficits and seroreverters, with and without neurological diagnoses. Prenatal drug exposure was not associated with performance on the BSID. CONCLUSIONS: These data suggest that CNS involvement is a critical pathway by which HIV affects infants' neurodevelopment.     

Brief report: Adolescents' attitudes toward epilepsy: further validation of the Child Attitude Toward Illness Scale (CATIS)

OBJECTIVE: To examine adolescents' attitudes toward having epilepsy using the Child Attitude Toward Illness Scale (CATIS) and to provide further psychometric validation of the scale in this population. METHODS: Participants were 197 adolescents aged 11 to 17 years who completed the CATIS at two points and two external validation scales. Test-retest and internal consistency reliability and construct validity were computed. Analysis of variance was used to examine differences in attitudes according to gender, age, and epilepsy severity. RESULTS: Girls, older adolescents, and those with more severe epilepsy had more negative attitudes toward having epilepsy than boys, younger adolescents, and those with moderate or mild epilepsy, respectively. Psychometric analyses yielded excellent internal consistency reliability and good test-retest reliability. The CATIS was moderately correlated with self-esteem and mastery, supporting its construct validity. CONCLUSIONS: The CATIS is a useful and psychometrically sound tool to assess adolescents' attitudes toward having chronic illness.     

Brief report: Predictors of parenting stress among parents of children with biochemical genetic disorders

OBJECTIVE: To examine predictors of parenting stress in parents whose children were diagnosed with a biochemical genetic disorder clinically or through newborn screening. METHODS: Parents of 263 children with biochemical genetic disorders (139 identified by newborn screening, 124 identified clinically) completed interviews focused on child health, medical service use, satisfaction with services, parenting stress, and family functioning. RESULTS: Multiple regression analyses suggested that child adaptive functioning, parental satisfaction with support, and difficulties parents experienced meeting their child's health care needs were associated with scores on the Parenting Stress Index (R2 =.51). CONCLUSIONS: Initiatives to improve child adaptive functioning and parental support as well as practical assistance to help parents meet their child's health needs may reduce parental stress and family disruption in this population.     

Brief report: the relationship between chronic illness and identification and management of psychosocial problems in pediatric primary care

OBJECTIVE: To compare identification, management, and barriers to treatment for psychosocial concerns in children with and without a chronic illness. METHODS: Using data from the Child Behavior Study (CBS), provider rates of identification, treatment, and reports of barriers to treatment were compared in children with and without a chronic illness. Of the 21,065 children ranging in age from 4 to 15 years, 808 children were identified with a chronic illness and were matched on eight demographic variables with 763 healthy children. RESULTS: Providers identified psychosocial concerns in significantly more children with a chronic illness (36.8%) than healthy children (20.2%). Among children with psychosocial concerns, rates of identification, treatment, and barriers to treatment did not differ across the two groups. CONCLUSIONS: Chronic illness did not present more barriers to the management of psychosocial concerns. Increased rates of identification and treatment of psychosocial concerns require attention to general barriers to treatment and screening.     

Delivering sensitive health care information: challenging the taboo of women's sexual health after pelvic radiotherapy

OBJECTIVE: The aim of this study was to elicit current practice with regard to the content and delivery of patient education for women undergoing pelvic radiotherapy. METHODS: A 38-item questionnaire was sent to all radiotherapy departments (n=65) and a convenience sample of specialist gynaecological oncology nurses (n=166), with response rates of 62% (n=40) and 42% (n=52), respectively. Data analysis of 32 different patient education leaflets from individual cancer units, cancer networks and vaginal dilator manufacturers was conducted. Content was evaluated on the inclusion and accuracy of the key knowledge women should receive before completing pelvic radiotherapy. RESULTS: Patient education focused on the technical aspects of vaginal dilation with minimal content on psychosocial 6% (n=2) or sexual health components 44% (n=14). It was evident from the information leaflets reviewed and questionnaire responses that there was duplication of verbal and written information provision in the clinical setting as opposed to using different information strategies to provide more comprehensive coverage of knowledge gaps in post-treatment sexual rehabilitation. CONCLUSION: Results suggest the provision of vaginal dilation advice and sexual health information may benefit from being placed in the wider context of assessing treatment impact on women's health. PRACTICE IMPLICATIONS: It is important to analyse the management of sensitive content, within both written information materials and verbal consultations, to determine the most effective information provision strategies that support sexual health interventions in cancer practice.     

Brief report: the adaptation of Project Northland for urban youth

OBJECTIVE: Summarizes the research and intervention design of a new trial to evaluate an adaptation of Project Northland, a multicomponent, community-wide alcohol prevention program for culturally diverse youth living in a large city. The original Project Northland was successful in reducing alcohol use among a sample of mostly White, rural adolescents. METHODS: We highlight the steps taken to adapt the intervention strategies for culturally diverse inner-city youth, families, and neighborhoods. The research design is a randomized controlled trial to evaluate the effectiveness of the adapted Project Northland for reducing the early onset and prevalence of alcohol use among young urban adolescents. CONCLUSION: The information gained from this trial, including the process of adaptation of prevention strategies, will be beneficial for alcohol-use prevention efforts within diverse urban communities across the country.