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Biomedical subjects

K M Butler

Publications and source records attributed to K M Butler.

42 records · Page 3Linked to original sources

Improving classroom behavior in mentally retarded children through correspondence training.

Except for a few studies, most research investigating correspondence training procedures has been more analogue in nature. The purpose of the present set of studies was to examine whether a "say-do" correspondence training technique could be used with children in special education classes to improve classroom behavior. The specific behaviors targeted for change included: out-of-seat behavior (Experiment 1), sitting posture (Experiment 2), and on-task behavior (Experiment 3). The say-do procedure used in Experiment 1 resembled that of previous studies, whereas that in Experiment 2 was more elaborate in the specificity of verbal statements required from the children and the feedback given them. The training procedure in Experiment 3 used a format similar to the say-do approach, but stressed visual rather than verbal cuing because it was used with nonverbal children. All three studies used single-subject designs and examined maintenance and/or generalization questions. Experiments 2 and 3 also evaluated whether concomitant changes in performance on academic tasks occurred. The results of the three studies provide strong evidence that correspondence training can be effectively used with educationally handicapped children. Moreover, the successful modification of the "say-do" to a "show-do" procedure in Experiment 3 points out the flexibility of the correspondence training approach.

Achievement↗

Perinatal transmission of HIV and diagnosis of HIV infection in infants: a review.

Paediatric HIV infection has become a major burden on families, communities and health services worldwide. The vast majority of children now acquire HIV as a result of mother to infant (vertical) transmission. Recent major advances have occurred following the greater understanding of the risk factors for perinatal transmission and the role of antiretroviral therapy in preventing transmission. Now that interruption of vertical transmission is possible, early identification of HIV-infected pregnant women is critical. As of June 1997, HIV infection has been diagnosed in 37 children under 15 yrs of age in the Republic of Ireland; 32 as a result of maternal to infant transmission. The exact timing of HIV transmission during pregnancy is unclear but it is estimated that 60-70 per cent of infants may be infected at the time of delivery with approximately 30 per cent infected earlier in gestation. Vertical transmission rates vary from 15-40 per cent in different global areas. Antenatal and perinatal zidovudine treatment can reduce this rate by 60-70 per cent. Risk factors for the vertical transmission of HIV-1 are multifactorial. These factors include maternal disease status, in particular maternal viral load, route of delivery, duration of membrane rupture, presence of obstetric complications and infant feeding practices. Definitive diagnosis of HIV infection in infancy has been difficult in the past. Direct viral detection methods now allow the reliable diagnosis of HIV infection in the first few months of life. The most effective intervention to reduce perinatal HIV infection will be the better identification of HIV positive pregnant women with the subsequent introduction of measures to interrupt vertical transmission of HIV.

Anti-HIV Agents↗

Mother-to-child transmission of human immunodeficiency virus (HIV) in Ireland: a prospective study.

Symptomatic HIV infection was first diagnosed in an Irish child in 1985. A prospective study was initiated to determine the vertical transmission rate (VTR) of HIV and the average age of infant seroreversion and to monitor clinical, immunologic and virologic evidence for HIV infection in seroreverters. Ninety three HIV positive infants have been prospectively identified since 1985. The predominant underlying maternal risk factor for HIV infection is intravenous drug use (IVDU) (96 per cent). Of 93 infants, median gestational age was 40 weeks and median birth weight 3125 grams. Ninety-four per cent of infants were bottle fed. Currently 72 (77 per cent) infants are uninfected, 12 (13 per cent) are infected, 4 (4.5 per cent) are indeterminate and 5 (5.5 per cent) have been lost to follow up. The intermediate estimate of vertical transmission rate (VTR) is 14.3 per cent. The median age at documented seroreversion was 12 months. There are no significant differences between infected and non-infected children in male/female ratio, gestational age, mode of delivery or birth weight. Strategies to reduce the transmission of HIV among drug users in combination with routine antenatal screening and antiretroviral prophylaxis of vertical transmission are all measures which can reduce HIV infection in our children.

AIDS Serodiagnosis↗

Hepatitis C infection in an Irish antenatal population.

BACKGROUND: Hepatitis C infection (HCV) has an estimated seroprevalence of 1-2% in women of child-bearing age and vertical transmission rate of 5-15%. AIMS: To characterise the current trends of HCV in an Irish antenatal population. METHODS: Infants of HCV seropositive women, born 1994 to 1999, were referred to the Paediatric Infectious Diseases service. Maternal details were collected retrospectively. RESULTS: 296 HCV seropositive women were studied. 244 (82%) were infected through intravenous drug use (IVDU), 25 (8%) through heterosexual contact and 13 (7%) via blood products. Nine women had no identifiable risk factors. Coinfection with other blood borne viruses was uncommon (4.7% HIV, 3.4% hepatitis B). Of 84 women tested for HCV-RNA, 46 (55%) were positive. Eighty three (26%) delivered prematurely; the caesarean section rate was 11%. CONCLUSIONS: HCV is increasingly detected in antenatal clinics. Heterosexual contact is a mode of spread. Maternal HCV viraemia can be variable in pregnancy. Further study of HCV in pregnancy is needed to define the impact of pregnancy on HCV, accurately predict infant outcome and selectively target interventions to women at greatest risk of transmission.

Adolescent↗

Outcome of infants born to hepatitis C infected women.

BACKGROUND: Hepatitis C virus (HCV) can be transmitted vertically from mother to infant, either late in pregnancy or at delivery. AIMS: To determine the outcome of infants born to HCV infected women, to characterise epidemiology and to design an appropriate infant monitoring schedule. METHODS: Three hundred and fourteen infants, born to 296 HCV positive women between 1994 and 1999 were monitored for a median of 18 months (range 1-52). RESULTS: Forty per cent of infants were small for age and 46% had neonatal abstinence syndrome (NAS). Of 173 infants of defined status, 11 were infected (vertical transmission rate [VTR] 6.4%, 95% CI 2.8-10). Infected infants were diagnosed at a median of three months (range 0.5-10). Liver transaminases elevation was documented in 8% of uninfected infants. A negative HCV PCR test before one month of age did not exclude infection but all infected patients had detectable HCV RNA when next tested (range 2-10 months). CONCLUSIONS: 94% of infants born to HCV antibody positive women are not HIV infected. Liver transaminase elevation in exposed infants is not always indicative of infection. A minimum monitoring schedule of testing (PCR and antibody) at six to eight weeks, six and 18 months allows early diagnosis while detecting late seroconversions.

Adolescent↗