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Biomedical subjects

E Chesterman

Publications and source records attributed to E Chesterman.

5 recordsLinked to original sources

After-school child care and self-esteem in school-age children.

Although more than 2 million US children are in self-care after school, little is known of the extent to which self-care may adversely affect developmental processes, such as the development of self-esteem. To test the hypothesis that lower self-esteem is associated with being in self-care, 297 subjects in fourth and sixth grades from three ethnically diverse schools in northern California were enrolled in a cross-sectional study during November 1987. Sixty percent of subjects were in adult in-home care, 13% in adult out-of-home care, 19% in self-care, and 8.0% in older sibling care. No significant differences in self-competence scores, as measured by the Harter Self-perception Profile for Children, were observed for children in self-care compared with the three other care groups. However, children who were cared for by older siblings unexpectedly exhibited lower self-competence scores for five of the six self-competence domains, with three domains showing significance at P less than .05. Children in self-care were significantly more isolated socially than children in adult care, reporting fewer opportunities to play outside or have friends visit at their homes. The results indicate that children in sibling care may be at potentially greater risk for negative effects on self-esteem and social development. Children in self-care may also experience more social isolation after school than children in other forms of afterschool care.

Age Factors↗

Home care for ventilator-dependent children. Psychosocial impact on the family.

The impact of providing home care for ventilator-dependent children was studied in a cross-sectional survey of 18 northern California families. Through the use of a confidential structured interview and the impact on Family Scale, we obtained information on family demographics; the childrens' medical conditions; financial, social, and personal impact on the family; and parental coping-mastery of the care of a ventilator-dependent child at home. Analysis of scores from the impact on Family Scale showed no differences in the perceived family impact between primary caretakers and their spouses. Primary caretakers in the sample, however, showed significantly reduced Coping subscale scores with a longer duration of home ventilatory care. This finding, if confirmed in future studies, has policy implications for physicians and other health professionals working with ventilator-dependent children and their families, especially those who care for children over long periods.

Adaptation, Psychological↗

Life events, social support, and cardiovascular reactivity in adolescence.

Physiologic responses to environmental stress show striking interindividual differences, beginning early in life. Whereas cardiovascular reactivity (CVR) to stress has been linked to short- and long-term changes in health, little previous work has addressed reactivity in children, and no past studies have investigated the relationship of reactivity to psychosocial factors, such as stressful life events (LE) and social support (SS). We therefore studied cardiovascular response to psychologically and physically stressful laboratory tasks in 25 adolescent boys. The degree of individual CVR was examined cross-sectionally in relationship to LE, SS, and "sense of permanence" (SP), a construct reflecting the stability or continuity in the child's life experience. Heart rate reactivity (HRR) and mean arterial pressure reactivity (BPR) were bimodally distributed, with a subpopulation of approximately 20% of subjects demonstrating an exaggerated cardiovascular response. SP was related to BPR at a borderline level of significance (R = 0.33, p less than 0.10), whereas SS was unrelated to either reactivity variable. Unexpectedly, LE was strongly and inversely related to both HRR and BPR (R = -0.40 and -0.47, respectively, p less than 0.05). Subjects reporting low numbers of previous stressful life events had the highest level of cardiovascular reactivity. Possible explanations for this finding included (1) the development of a hyperdynamic response as a consequence of avoiding or denying stressful experience, (2) an effect of exaggerated CVR on cognition and the reporting of stressful events, or, most plausibly, (3) an 'inoculation effect,' in which previous LE facilitate the development of effective coping strategies, thereby diminishing responses to stressful laboratory tasks.

Adolescent↗