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Biomedical subjects

G E Fryer

Publications and source records attributed to G E Fryer.

At least 19 recordsLinked to original sources
PubMed1994

A survival analysis of the revictimization of children: the case of Colorado.

This paper reports the results of a survival analysis of patterns of revictimization of children with records of confirmed cases of maltreatment in Colorado during the 4-year period 1986-1989. The study examined the cases of 24,507 children in that state's Child Abuse and Neglect Registry for evidence of their revictimization. Hazard rates for repeat offenses were highest immediately after the initial incident of abuse or neglect. Risk of revictimization was greater for younger children and for females, but those relationships were strongly mediated by the form of maltreatment. The rate of revictimization of physically neglected children exceeded that for other major types of maltreatment. Although abused and neglected children were most at risk immediately after their incident of abuse or neglect, they remained at greater risk of mistreatment for years thereafter.

Adolescent↗
PubMed1994

Neonatal group B streptococcal sepsis during 2 years of a universal screening program.

OBJECTIVE: To assess the feasibility and efficacy of a protocol for universal screening for group B streptococci combined with selective intrapartum prophylaxis at a teaching hospital. METHODS: This is a descriptive study of experience with a standardized protocol in which patients were screened at 26-28 weeks with a rectal and genital culture placed directly in selective media. As risk factors, we used clinical chorioamnionitis, preterm birth, and rupture of the membranes greater than 12 hours. Participants were all women receiving prenatal care at our hospital. Major outcomes were compliance and neonatal sepsis due to group B streptococci. RESULTS: The prevalence of rectal and genital group B streptococci was 18.5% of 3721 screened women. Of culture-positive women, 35% developed risk factors (9% chorioamnionitis, 13% preterm birth, and 13% membrane rupture greater than 12 hours at term). With strict application of criteria, the compliance rate in administering indicated prophylaxis was 80.3%. Of women receiving prophylaxis, 42% had the first dose for 4 hours or less before delivery. There were five cases of group B streptococcal neonatal sepsis, resulting from either protocol violations, protocol failures, or both. Compared to the historic rate of group B streptococcal sepsis of 1.5 per 1000 births at our hospital, the rate in these 2 years was 1.0 per 1000 (1.6 per 1000 in the first year and 0.5 per 1000 in the second). CONCLUSIONS: It is feasible to conduct such a protocol, but compliance is only moderately good because the algorithm is complex. The protocol is not foolproof in preventing neonatal group B streptococcal sepsis, as there are protocol failures and violations.

Adult↗
PubMed1991

Physician assistants as members of social service child protection units.

A nationwide survey of county departments of social services revealed a need for medical services and consultation to child protection units. Over 92% of the 84 counties surveyed stated they had a problem meeting their medical needs and would be willing to hire a physician assistant as medical consultant to their county's child protection team. No county refused to consider a physician assistant, but 7% felt their medical requirements were being met. Needs the counties most commonly identified were providing parent education/anticipatory guidance (69%), interviewing (65.5%), interpreting medical information to a multidisciplinary child protection team (58.3%), review of medical records (45.8%), and physical examinations (42.9%). Over 17% of the counties had money to fund a full-time physician assistant, and over 60% of the counties could provide a partial salary, with 70.5% willing to share a salary with adjacent counties and 76.9% with the county's public health department.

Child↗
PubMed1990

Prison mental health services: results of a national survey of standards, resources, administrative structure, and litigation.

The formation of adequate mental health systems within prisons has accelerated as a result of successful class action lawsuits. Our recent national survey questioned all state correctional departments about the existence of standards in each system, compliance with such standards, prevalence of class action lawsuits involving the issue of providing adequate mental health services for inmates, issues related to consent decrees, available mental health resources within the correctional system, and the administrative structure of the mental health system. Our purpose was to identify those factors correlated with certified class action lawsuits involving issues related to mental health services. Twenty-one states were involved in such litigation. Only the presence of psychiatric hospitals operated by the department of corrections correlated with the presence of certified class action lawsuits involving mental health services. Prison systems larger than 15,000 inmates were at higher risk for such litigation. Smaller systems having psychiatric hospitals run by the state mental health agency appeared to be at less risk for such litigation.

Jurisprudence↗
PubMed1989

The relationship of child protection worker attitudes to attrition from the field.

Child protection workers in 33 states and the District of Columbia participated in a survey conducted by the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect to determine the attitudes and attributes of workers who terminate their careers in child protection. A year after the survey, telephone follow-up was done to identify respondents to the survey who had left the child protection field. Attributes and attitudes were then linked directly to whether workers had terminated or continued child protective service. Just 8.0% (15 of 187) of the workers had left the field. There were few differences between workers that departed and those whose services were retained. Both were generally dissatisfied with their profession at the time of the survey. The shrinking social service labor market and worker investment in the field are discussed as factors impeding turnover among child protection workers.

Attitude↗
PubMed1988

Patient satisfaction with current dental condition related to self-concept and dental status.

Structured interviews were administered to 168 male veterans from five locations to examine the relationship between attitudes toward dental esthetics, age, self-concept, and dental status. Results indicate the following. 1. Subjects who had a more positive self-concept rated their current dental condition higher. 2. Veterans who use dentures do not have a lower self-concept than those who have remaining natural teeth and feel more positively about their dental appearance. 3. Among the sample studied, dental appearance was considered less important than function or comfort. 4. Diminished self-concept is not associated with greater concern for dental esthetics.

Adult↗
PubMed1988

The efficacy of hospitalization of nonorganic failure-to-thrive children: a meta-analysis.

This study ascertained the efficacy of hospitalization of children with nonorganic failure to thrive (NOFTT). A meta-analysis was performed on previously published research findings which met certain criteria for inclusion in the analysis. Two categories of outcome measures, physical growth pattern and psychosocial development, were quantitatively synthesized separately using standard meta-analytic techniques. Hospitalization was found to significantly enhance the probability of sustained catch-up physical growth among NOFTT children, but only a comparatively small effect size for hospitalization on their psychosocial development was documented. There remains need for prospective longitudinal study of effectiveness in treating NOFTT children. But meta-analysis is a powerful technique which introduces scientific rigor to the review of study results, none of which is singularly conclusive.

Child Development↗
PubMed1988

The child protective service worker: a profile of needs, attitudes, and utilization of professional resources.

County child protection units throughout the United States were surveyed to (1) profile the attributes of child protection workers, (2) determine their prevailing attitudes and needs, and (3) assess their access to and utilization of professional literature and consultation resources. Responses were received from 301 child protection workers employed in 33 different states. Respondents were generally depressed about their working conditions, the burden of huge caseloads, and unrealistic expectations of them. Job dissatisfaction was especially prevalent among workers who had been in the field for longer periods of time. Many workers had developed attitudes of resignation to their inability to help clients and had a tendency to avoid client contact. Workers reported doing very little professional reading due to the service requirements of their large caseloads and inaccessibility to journals and other meaningful literature pertinent to the field of child abuse and neglect. The availability of consultation in major specialty areas related to the performance of their child protective duties was frequently inadequate to meet their needs. Participation in formal training prior to first case involvement promoted professional reading and worker confidence in the quality of service provided. Worker job satisfaction and self-perceived professional skills were enhanced by membership in professional associations or societies and membership in or use of multidisciplinary teams. These results suggest the need to further develop national and regional resource centers in support of the practice of child protective service (CPS) workers.

Adult↗
PubMed1987

Measuring actual reduction of risk to child abuse: a new approach.

Previous efforts to measure the effectiveness of child abuse prevention programs have relied on proximate measures presumed to be predictive of actual skills. This paper presents documentation that brings those assumptions into question, describes actual observation and measurement of behavioral change in children before and after prevention education, and correlates that behavioral response with more traditional measures of effectiveness. Unique to the evaluation was the staging of an actual situation in which each of the children had an opportunity to leave the school building with a stranger. Each simulation was videotaped and conducted in such a way that the children remained unaware of the fact that they had been tested. In addition, tests of language development, self-esteem and knowledge of prevention and safety concepts were administered before and after participating in the Children Need to Know Personal Safety Training Program [1]. Several findings have significant value for future examinations and programming. The effectiveness of a primary prevention program based on age-appropriate, experiential and interactive instruction was empirically documented. Traditional instrumentation which elicits written or verbal responses to cognitive questions about safety may be misleading in assessing children's vulnerability. Higher self-esteem before instruction and higher knowledge/attitude scores after instruction were found to be predictive of a reduction in vulnerability. While this is a significant series of findings, some children did not achieve the objectives of the prevention program. These results suggest further possibilities for evaluation and some direction for improving prevention education.

Child↗
PubMed1987

Measuring children's retention of skills to resist stranger abduction: use of the simulation technique.

This paper describes an evaluation which builds upon an earlier project to measure actual behavioral change in the form of reduction of vulnerability to abduction and abuse by strangers; change attributable to participation in a primary prevention program. Simulations, life-like scenarios previously described, were used to address three key questions: Did children who had demonstrated mastery of prevention skills acquired six months earlier retain those skills? Would reteaching the prevention program result in mastery for those children who failed to demonstrate required skills after the first presentation of the prevention program? Could the experimental group results of the first project be repeated with the previous control group? Several findings validated the earlier work and enhanced the understanding of what can be accomplished through prevention programing. Thirty of the original 44 children who participated six months earlier were again available to take part in the final simulation. Of those, all of the previous experimental group children who had performed successfully when participating in the simulation upon completion of the first project were again successful six months later in resisting the invitation of a stranger to leave their school. Each of the previous control group children were successful in the final simulation after participation in the program. But reteaching of the prevention program was successful for just two of the four children who had earlier failed following participation in the program. These findings document the immediate and continued benefits which may accrue from experientially based prevention programing and suggest an important research agenda to facilitate the further evolution of prevention programing and evaluation.

Child↗