Biomedical subjects

Anne Gadomski

Publications and source records attributed to Anne Gadomski.

4 recordsLinked to original sources

PubMed2006

Efficacy of the North American guidelines for children's agricultural tasks in reducing childhood agricultural injuries.

OBJECTIVES: We assessed whether active dissemination of the North American Guidelines for Children's Agricultural Tasks (NAGCAT) reduced childhood agricultural injuries. METHODS: In this randomized controlled trial, lay educators visited intervention farms to review NAGCAT. New York State farms with resident or working children were randomized. Control farms were visited only to collect baseline data. Data on childhood injuries, tasks, and hours worked were obtained quarterly for 21 months. Injury rates per farm were compared between the treatment and control groups, along with time span to occurrence of an injury and to violation of NAGCAT age guidelines. RESULTS: Intervention farms were less likely than control farms to violate NAGCAT age guidelines in the areas of all-terrain-vehicle use and tractor and haying operations. Cox proportional hazards regression models showed a significant protective effect of the intervention on preventable injuries after adjustment for important covariates. CONCLUSIONS: Our results showed that dissemination of NAGCAT reduced rates of work-related childhood agricultural injuries. A comprehensive public health approach is needed to reduce non-work-related childhood injuries.

Adolescent↗

PubMed2005

Do economic stresses influence child work hours on family farms?

BACKGROUND: Economic stresses are a frequently cited reason for children doing farm work. OBJECTIVE: To explore the relationship between economic indicators and child agricultural work hours between January 2001 and October 2003. METHODS: This ecologic study design compares trends in aggregate child work hours with national and regional economic indicators. Child work hours were obtained from quarterly surveillance data from a randomized field trial of agricultural task guidelines for children. 2,360 children living or working on 845 farms in central New York participated in the original study. The relationship between child work hours and three economic indicators: national all farm index (AFI) ratio, national fuel index, and regional milk prices was analyzed using times series plots, correlation, and multiple linear regression. RESULTS: The AFI ratio was positively correlated with child work hours (r = 0.49, p = 0.008) but there was no significant correlation between child work hours and fuel or milk prices. Multiple linear regression demonstrated that the relationship between AFI and child work hours is independent of a seasonal effect. CONCLUSIONS: Increased child work hours may be associated with periods of higher farm sector productivity, rather than economic stress per se. Findings are limited by the ecologic study design, use of national economic indicators, and the limited number of cycles of child work hours available for time series analysis. Economic conditions may influence decisions about children's farm work.

Accidents, Occupational↗

PubMed2003

Guidelines for Adolescent Preventive Services: the GAPS in practice.

DESIGN: Pre- and post-Guidelines for Adolescent Preventive Services (GAPS) comparison of outcomes gathered via chart audit. SETTING: A rural hospital-based general pediatric clinic. PARTICIPANTS: Adolescents who underwent annual examinations between April 1, 1998, and March 31, 2001. A random sample of 441 medical records was reviewed. INTERVENTION: Training in the GAPS model and use of the questionnaire began in April 1998. MAIN OUTCOME MEASURES: Detection of, discussion of, and referrals for GAPS-related risk behavior. RESULTS: The medical records of 162 younger adolescents (aged 11-15 years) and 279 older adolescents (aged 16-19 years) were audited. Detection of risk behaviors increased from 19% at baseline to 95% with the initial GAPS and 87% with the periodic GAPS. The most prevalent risk factor was having a rifle or gun in the home (younger adolescents, 47% and older adolescents, 39%). The mean number of risk behaviors and health concerns documented was higher in the initial GAPS (4.8 and 1.3, respectively) than in the periodic GAPS (3.8 and 0.7) (P =.01 and.006). The GAPS questionnaires detected lower levels of risk behavior compared with a local Youth Risk Behavior Survey. Controlling for sex, age, and clinician, discussion of psychosocial topics increased during the study period; however, there was considerable variation among clinicians regarding the topics addressed. The GAPS-related referral rate did not change significantly. CONCLUSION: The GAPS model increases clinicians' detection and discussion of risk behaviors.

Adolescent↗

PubMedDate not supplied

Parent and teacher mental health ratings of children using primary-care services: interrater agreement and implications for mental health screening.

OBJECTIVE: To examine interrater agreement when screening for child mental health problems during primary-care visits. METHODS: Children aged 5 to 10 (n = 227) and one of their parents were systematically recruited from the waiting rooms of 15 primary-care sites located in Baltimore, Md; Washington, DC; and rural New York from 2002 to 2005. The parent and teacher of the child completed the Strengths and Difficulties Questionnaire to measure the child's emotions, behaviors, and functional impairment. RESULTS: Parents and teachers identified a similar proportion of children as having high symptoms (25% vs 23%) and high impairment (27% vs 32%) but rarely agreed in their assessments of specific children. Parent ratings alone missed 52% of children rated by teachers as having both high symptoms and high impairment (kappa = 0.15). Only 6% of these discrepant visits were for mental health problems, making it unlikely that teacher reports would have been solicited. CONCLUSIONS: Parent reports failed to detect half of school-aged children considered to be seriously disturbed by their teachers. Efforts to improve detection of mental health problems by using screening tools in primary care may require algorithms that help providers judge when to solicit teacher reports and how to interpret conflicting information from parents and teachers.

Baltimore↗