Assessing motivation for physicians to prevent antimicrobial resistance in hospitalized children using the Health Belief Model as a framework

BACKGROUND: Antimicrobial resistance (AR) is a threat to hospitalized children, and more information is needed to motivate physicians to adopt evidence-based practices such as those in the Centers for Disease Control and Prevention's (CDC) Campaign to Prevent Antimicrobial Resistance. METHODS: The framework of the Health Belief Model (HBM) was used to assess personal perceptions and cues to action related to the prevention of AR in 3 national focus groups in August 2003. RESULTS: Twenty-five physicians who treat hospitalized children participated; all reported that they had cared for a patient with an antimicrobial-resistant organism. Physicians perceived that AR was more of a problem nationally (92%) than in their institution (76%) or practice (60%) and reported that issues such as nursing shortage, cost of health care, and lack of specialty services presented more of a challenge to the care of hospitalized children than AR. Reported preferences of cues to action included journal articles (80%), infectious disease experts (76%), and colleagues (52%). CONCLUSIONS: The HBM provides insight into physicians' perceptions about AR and preferred cues to action, which yield valuable information concerning the modes, methods, and messengers to intervene on problems such as antimicrobial resistance in hospitalized children.     

What you see is what you get: contextual modulation of face scanning in typical and atypical development

Infants’ visual scanning of social scenes is influenced by both exogenously and endogenously driven shifts of attention. We manipulate these factors by contrasting individual infants’ distribution of visual attention to the eyes relative to the mouth when viewing complex dynamic scenes with multiple communicative signals (e.g. peek-a-boo), relative to the same infant viewing simpler scenes where only single features move (moving eyes, mouth and hands). We explore the relationship between context-dependent scanning patterns and later social and communication outcomes in two groups of infants, with and without familial risk for autism. Our findings suggest that in complex scenes requiring more endogenous control of attention, increased scanning of the mouth region relative to the eyes at 7 months is associated with superior expressive language (EL) at 36 months. This relationship holds even after controlling for outcome group. In contrast, in simple scenes where only the mouth is moving, those infants, irrespective of their group membership, who direct their attention to the repetitive moving feature, i.e. the mouth, have poorer EL at 36 months. Taken together, our findings suggest that scanning of complex social scenes does not begin as strikingly different in those infants later diagnosed with autism.     

Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting

A recent study documented the efficacy of the Early Start Denver Model (ESDM) delivered in a 1:1 fashion. In the current study we investigated the effectiveness and feasibility of the ESDM in the context of a long-day care community service, with a child-staff ratio of 1:3. Outcomes of 27 preschoolers with ASD undergoing 15–25 h per week of ESDM over 12 months were compared to those of 30 peers with ASD undergoing a different intervention program delivered in a similar community long-day care service. Children in both groups made gains in cognitive, adaptive and social skills. Participants in the ESDM group showed significantly higher gains in developmental rate and receptive language.