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Biomedical subjects

A Butler

Publications and source records attributed to A Butler.

140 records · Page 8Linked to original sources

The outcome of adolescent school phobia.

A hundred-and-twenty-five school phobic youngsters had been treated in a psychiatric in-patient unit for young adolescents of secondary school age over a seven-year period; a hundred of them were reviewed on average three years after discharge. About a third of cases were found to have improved little; they had persistent severe symptoms of emotional disturbance and continuing social impairment. Another third had improved appreciably and were affected by neurotic symptoms rather than social impairment. The remaining third had improved substantially or completely. School attendance difficulties had remained in about half of all cases. Subsequent difficulties in going to work were less pronounced. The best predictor of outcome was clinical state on discharge. High intelligence also emerged as a significant predictor of poor outcome. Five girls and a boy had already developed severe and persistent agoraphobic difficulties when reviewed. It was found that severe school phobia in early adolescence resembled adult affective disorders in some clinical features and in outcome.

Absenteeism↗

Breast cancer.

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Adaptation, Psychological↗

Child's play is therapy.

Play can be a simple, effective way of helping the preschool child to deal with the strange and sometimes painful hospital world and to master situations that might otherwise be overwhelming. This type of play can be incorporated easily into the nursing care plan and can become an essential aspect of the care of the hospitalized preschool child. The results are rewarding in terms of happier, less anxious children, parents, and nursing staff.

Adaptation, Psychological↗

Predictors of glycemic control in children with type 1 diabetes: the importance of race.

Diabetes is a common cause of kidney failure and blindness among young adults, particularly of African-American descent. Since glycemic control is a predictor of diabetes complications, we evaluated the impact of multiple factors including a special multidisciplinary management program on glycosylated hemoglobin in children with Type 1 diabetes. Data was collected from pediatric diabetes clinics in New Orleans, LA and Baltimore, MD. In New Orleans, hemoglobin A(1c) was higher in African-American patients 12. 5+/-3.3% (n=71) vs. 10.7+/-2.1% (n=80) in Caucasian children, p<0. 0001. Longer duration of diabetes was also associated with higher hemoglobin A(1c) in both races. The effect of race on hemoglobin A(1c) was independent of the influence of sex, insurance status, body mass index (BMI) z-score, and number of clinic visits. Covariate analysis with mean blood glucose levels indicated that higher hemoglobin A(1c) was attributable to higher mean blood glucose levels in African-American children. From the Baltimore data, a multidisciplinary intervention program led to improved total glycosylated hemoglobin for Caucasian patients but not for African-American children. Poorer glycemic control of African-American children is likely to predispose them to a higher likelihood of developing microvascular complications as they mature. Standard hospital-based multidisciplinary programming for diabetes management may have limited effectiveness in improving glycemic control of African-American children with diabetes. Innovative intervention programs are needed for these high-risk patients.

Adolescent↗