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1.
After the introduction of measles vaccine in the United States in 1963 the reported incidence of measles (rubeola) decreased substantially. The disease, however, has not been eliminated. Since 1983, when the lowest number of cases was reported, slight increases in incidence have been observed. Outbreaks are occurring among previously immunized school- and college-age children and unimmunized preschool children and infants. This article describes measles occurrence, transmission, diagnosis, development of measles immunity, the 1989 Centers for Disease Control recommendations for immunization, and implications for health care providers for preventing measles outbreaks. 相似文献
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Yifat Cohen Anthony Spirito Cheryl Sterling Deidre Donaldson Ronald Seifer Barry Plummer Ruscinda Avila Kathy Ferrer 《Journal of child psychology and psychiatry, and allied disciplines》1996,37(8):989-993
Adolescents who were psychiatrically hospitalized ( N = 105) were classified as sexually abused, physically abused, both sexually and physically abused, or not abused, and studied to determine the prevalence of suicidal behavior and psychiatric disorders. Self-reports of hopelessness, depression, coping, and self-concept were also examined. No difference in suicidal behavior or psychiatric disorder, based on abuse history, was found, with one exception. Adolescents who were sexually abused, particularly those who experienced the most severe sexual abuse, used negative coping strategies more often than those not sexually abused. Findings suggest that symptomatology of adolescents who are psychiatrically hospitalized does not differ markedly based on history of abuse. 相似文献
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The purpose of this study was to describe the characteristics associated with different levels of substance use in a national probability sample of maltreated 11- to 15-year-olds (n = 1,179). Bivariate (chi-square tests) and multivariate (logistic regression) analyses were used to examine the association of adolescent substance use with demographics, placement type, and youth and family characteristics. Seventy-one percent of youth reported no use, 20% reported low levels of substance use, and approximately 9% reported moderate to high levels of use. Youth substance use was similar across placement types. Conduct problems and low caregiver relatedness were more prevalent for youth reporting higher levels of substance use. High levels of conduct problems increased the odds of substance use, whereas high caregiver monitoring decreased the odds of substance use. Caregiver monitoring may be a key tactic in attempts to reduce the likelihood of substance use in maltreated youth, regardless of placement type. 相似文献
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Aims: (1) To identify factors at 1 week of age which put infants at risk of failing to sleep through the night at 12 weeks of age. (2) To assess whether a behavioural programme increases the likelihood that these infants will sleep through the night at 12 weeks of age. Methods: A community sample of 316 newborn infants was employed to identify the risk factors at 1 week of age which increased the likelihood of failing to sleep through the night at 12 weeks of age. Infants who met these risk criteria and were randomly assigned to a behavioural programme were compared with at risk infants in the control group on measures of sleeping, crying, and feeding at 12 weeks of age. Results: Infants who had a high number (>11) of feeds in 24 hours at 1 week were 2.7 times (95% CI 1.5 to 4.8) more likely than other control group infants to fail to sleep through the night at 12 weeks of age. At 12 weeks, 82% of these at risk infants assigned to the behavioural programme, compared to 61% in the control group, slept through the night. The findings were similar in breast and bottle feeders. Conclusions: Preventing infant sleeping problems should be more cost effective than treating them after they have arisen. This study provides evidence that it is possible to identify infants who are at risk of failing to sleep through the night at an early age, and that a simple, three step, preventive behavioural programme increases the number who sleep through the night by 21%. 相似文献
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Can developmental screening tests identify children who are developmentally at risk? 总被引:3,自引:0,他引:3
S J Meisels 《Pediatrics》1989,83(4):578-585
Developmental screening tests are in widespread use, but few reliable and valid tests are available. The most frequently used screening instrument for detecting young children who are at risk for developmental delays is the Denver Developmental Screening Test (DDST). Although the DDST has excellent test specificity, overreferring few children, results from more than a dozen studies of the DDST's concurrent and predictive validity fail to replicate the original validation and demonstrate a uniformly poor sensitivity, ie, a high proportion of underreferrals. Whether samples are stratified by age, risk, duration of time between predictor and outcome, or type of outcome measure used, these studies demonstrate that the DDST underrefers children at nearly a 2:1 ratio. Several other screening tests with more optimal psychometric properties are presented. It is urged that caution be exercised in using tests for predicting the risk of developmental problems in young children unless the tests have acceptable levels of sensitivity and specificity. 相似文献
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To determine whether clinicians correctly identify newborn infants who are at high risk of child maltreatment, we examined the outcomes of high-risk and non-high-risk children. Infants who were born at Yale-New Haven Hospital from 1979 to 1981 and who were referred by clinicians during the postpartum period to the hospital's child abuse registry because they were considered at high risk of child abuse or neglect became the high-risk group. For each high-risk infant, a comparison infant was selected and matched according to date of birth, gender, race, and method of payment for the hospitalization. For both groups, the occurrence of maltreatment was ascertained by reviewing the medical records until the child's fourth birthday. Each injury for which medical care was sought was classified into one of seven categories (from definite child abuse to accident) by a pediatrician who was unaware of the child's risk status. Information also was recorded about nonorganic failure to thrive and changes in the child's caretaker. Maltreatment (defined as abuse or neglect) occurred more frequently in the high-risk group than the comparison group (adjusted matched odds ratio = 4.3; 95% confidence interval = 1.41, 6.93; p less than 0.001), as did poor weight gain from a nonorganic cause (matched odds ratio = 7.0; 95% confidence interval = 1.59, 30.79; p less than 0.01) and changes in the child's caretaker (matched odds ratio = 9.0; 95% confidence interval = 3.80; 20.55; p less than 0.001). We conclude that as early as the postpartum period, clinicians can identify some families who are at high risk of maltreatment and other major adverse outcomes resulting from poor parenting. 相似文献
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One thousand and ten Non-Hispanic White, African American, Hispanic, and Asian Pacific Islander youth who were high risk and receiving public sector services were interviewed regarding history of child emotional and physical abuse and current internalizing symptoms. The study examined whether race moderated the association between adolescents' reports of specific parent behaviors and their self-labeling as victims of abuse. The study also examined whether reports of parental behaviors or self-labeled abuse better predicted internalizing symptoms, and whether these associations differed by race. When reporting punitive parent behavior, Non-Hispanic White youth were more likely to describe themselves as abused compared to Asian Pacific Islanders. Reported punitive parental behaviors accounted for more variance in internalizing symptoms than did self-labeled abuse. Reports of parent behaviors were more strongly related to concurrent internalizing symptoms among ethnic minority youth than among Non-Hispanic White youth. Results are discussed in the context of cultural competence in identification of child abuse. 相似文献
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This study examined the cross-ethnic equivalence of measures and the relationships between psychosocial variables and risk behaviors in an ethnically diverse sample of maltreated adolescents 6 years after their placement in foster care. Overall, there was cross-ethnic measurement equivalence, except for the self-destructive behavior and perceived opportunities constructs, which did not demonstrate internal consistency for African American youth. The authors found few differences between White (non-Latino), Hispanic, and African American youth on levels of engagement in risk behaviors and across domains of psychosocial functioning. The relationships between the psychosocial variables and risk behaviors were then examined across ethnic groups. The pattern of results was different as a function of ethnicity, as fewer of the psychosocial variables were significantly related to the risk behavior variables for African American youth. Possible explanations for these differences are presented and implications for intervention discussed. 相似文献
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David V. Milford 《Paediatrics & Child Health》2009,19(12):565-569
Microalbuminuria is the first marker of renal damage in T1DM but does not invariably progress to diabetic nephropathy and may be reversed in some patients. An annual measurement of albumin to creatinine ratio in an early morning urine sample is recommended, with serial daily samples used to confirm increased excretion and early institution of ACEi and/or AIIrb to treat persistent microalbuminuria. Good glycaemic control from diagnosis is essential for good long term renal function. Aggressive treatment of hypertension reduces the rate of renal decline once diabetic nephropathy is established. 相似文献
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OBJECTIVE: The aim of this study was to further evaluate the 'Motor Performance Checklist for 5-year-olds', an instrument which had been piloted with some success and reported via this journal in 1996. METHOD: Both validity and reliability in identifying children in most need of paediatric occupational therapy services was assessed. The Motor Performance Checklist was compared against a chosen 'gold standard' test, The Bruininks-Oseretsky test of Motor Proficiency, in a group of 141 5-year-old children. RESULTS: Correlations of 0.72 and 0.85 were found between the tests. The checklist was found to have a sensitivity of 83% and a specificity of 98%. Positive predictive validity was found to be 72% and negative predictive validity 99%. Interrater reliability ranged between 0.79 and 0.99 and intrarater reliability was 0.77. CONCLUSIONS: These results indicate that the Motor Performance Checklist has the potential to assist in identifying children in most need of referral to community occupational therapy services. 相似文献
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Sebastian Lundström Claire M.A. Haworth Eva Carlström Christopher Gillberg Jonathan Mill Maria Råstam Christina M. Hultman Angelica Ronald Henrik Anckarsäter Robert Plomin Paul Lichtenstein Abraham Reichenberg 《Journal of child psychology and psychiatry, and allied disciplines》2010,51(7):850-856
Background: Despite extensive efforts, the causes of autism remain unknown. Advancing paternal age has been associated with various neurodevelopmental disorders. We aim to investigate three unresolved questions: (a) What is the association between paternal age and autism spectrum disorders (ASD)?; (b) Does paternal age moderate the genetic and environmental etiological factors for ASD? (c) Does paternal age affect normal variation in autistic‐like traits? Methods: Two nationally representative twin studies from Sweden (n = 11, 122, assessed at age 9 or 12) and the UK (n = 13, 524, assessed at age 9) were used. Categorical and continuous measures of ASD, autistic‐like traits and autistic similarity were calculated and compared over paternal age categories. Results: Both cohorts showed a strong association between paternal age and the risk for ASD. A U‐shaped risk association could be discerned since the offspring of both the youngest and oldest fathers showed an elevation in the risk for ASD. Autistic similarity increased with advancing paternal age in both monozygotic and dizygotic twins. Both cohorts showed significantly higher autistic‐like traits in the offspring of the youngest and oldest fathers. Conclusions: Phenomena associated with paternal age are clearly involved in the trajectories leading to autistic‐like traits and ASD. Mechanisms influencing the trajectories might differ between older and younger fathers. Molecular genetic studies are now needed in order to further understand the association between paternal age and ASD, as well as normal variation in social, language, and repetitive behaviors in the general population. 相似文献
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Angold A Erkanli A Silberg J Eaves L Costello EJ 《Journal of child psychology and psychiatry, and allied disciplines》2002,43(8):1052-1063
BACKGROUND: The excess of unipolar depression in females emerges in adolescence. However, studies of age effects on depression scale scores have produced divergent estimates of changes from childhood to adolescence. METHOD: We explored possible reasons for this discrepancy in two large, longitudinal samples of twins and singletons aged 8-17. RESULTS: There were no differences between twins and singletons in their scores on the Short Mood and Feelings Questionnaire (SMFQ), a 13-item self-report depression scale. SMFQ scores for boys fell over this age-range, while those for girls fell from age 9 to age 11 and then increased from age 12 to age 17. The mean scores of girls under 12 and those 12 and over differed by only around one-fifth of a standard deviation. However, given the non-normal distribution of the scores, a cut point that selected the upper 6% of scores created the expected female:male ratio of 2:1. CONCLUSIONS: Implications for future research on adolescent depression are discussed. 相似文献
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This article presents the findings of a study exploring current levels of consensus among practitioners in the United Kingdom (UK) and the Republic of Ireland (ROI) about good practice in relation to youth who are sexually abusive. A three-stage Delphi procedure was used to survey the views of 78 practitioners, experienced in this field, on a range of matters relating to preferred responses to this population. The exercise indicated high levels of agreement that youth who are sexually abusive should be seen as a group clinically distinct from adult sex offenders and that all of their developmental needs, and their problematic behavior, should be targeted in intervention. A strong level of consensus was found among respondents about the goals and content of ideal practice with this user group, although there was less consensus about the theoretical models that should underpin practice. 相似文献