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Biomedical subjects

N W Boris

Publications and source records attributed to N W Boris.

10 recordsLinked to original sources

Occupational working conditions as risk factors for preterm birth in Benin, West Africa.

BACKGROUND: Although many studies from developed countries have established a relationship between various occupational working conditions during pregnancy and preterm birth, there is little data available in developing countries where both maternal physical labor during pregnancy and preterm birth are common. The aim of this study was to examine the association between difficult occupational working conditions of pregnant women and premature births in the Republic of Benin in West Africa. METHOD: The case-control study included 99 women with preterm babies and 104 women with full-term babies. The participants were residents of the Republic of Benin who delivered between May 1, 2000 and April 30, 2002. Preterm delivery was defined as delivery prior to 37 completed weeks of gestation. The study sample was selected randomly from birth records. Data were collected both reviewing birth records and conducting semi-structured personal interviews with mothers. Logistic regression models were adjusted for mother's age, mother's education, health problems during pregnancy, and twin birth. RESULTS: Although working state of mother during pregnancy did not increase the risk for preterm delivery, carrying heavy loads more than 5 days per week was significantly associated with having a preterm baby (adjusted OR: 5.0; 95% CI: 1.38-18.8; P=0.018). Carrying heavy loads and having worked a lot more than 5 days per week was also significantly associated with preterm birth (adjusted OR: 6.88; 95% CI: 1.45-32.2; P=0.015). CONCLUSION: Reducing heavy loads carrying during pregnancy may also prevent preterm delivery in developing countries. Though replication of these data using a prospective design is needed, our results suggest that educating women about the risks associated with heavy labor during pregnancy is indicated.

Adult↗

Attachment and developmental psychopathology.

This article describes the case of an 8-year-old boy who was first brought to clinical attention at age 2 1/2. He was followed by several clinicians over a 6-year period and was assigned a wide variety of diagnoses. From the first assessment to hospitalization at age 8, a pattern of mother-child relationship disturbance is evident. The use of principles and recent research derived from attachment theory provides a useful basis for formulation in this complex case. This report focuses on the relationship between the patient's mother's internal working models of attachment and his behavior in infancy and early childhood.

Child↗

Research on resilience to child maltreatment: empirical considerations.

OBJECTIVE: To review the current research literature on resilience to maltreatment in childhood and adolescence. METHOD: First, this paper addresses the methodological issues applicable to this area of research. Second, it reviews the empirical literature on the protective factors believed to contribute to resilience to maltreatment and offers commentary on specific issues raised in each study. RESULTS: The current findings are summarized and an integrated descriptive picture, based on the extant literature of the processes and factors contributing to the development of resilience to childhood maltreatment is outlined. CONCLUSION: Based on this extensive review and critique of the current empirical literature on resilience to maltreatment, suggestions for future investigations in this area are recommended.

Adaptation, Psychological↗

Clinical disturbances of attachment in infancy and early childhood.

The development of the attachment behavioral system in infancy has been the focus of a wide range of research in the past 30 years. The clinical significance of disturbances in this area of development is currently a major focus for this research. Research on patterns of attachment in infancy has informed understanding of the development of psychopathology in later childhood; insecure-disorganized attachment is recognized as an important risk factor in this regard. The clinical features of reactive attachment disorder in early childhood are also becoming more clear. Finally, knowledge about the intersection between attachment and various risk conditions is growing and should inform clinical judgement about infants and young children requiring intervention. Primary care physicians can use these findings to identify children in need of intervention.

Child, Preschool↗

Attachment disorders in infancy and early childhood: a preliminary investigation of diagnostic criteria.

OBJECTIVE: The primary purpose of this study was to compare the reliability of differing sets of criteria for attachment disorders by using a retrospective case review. METHOD: Forty-eight consecutive clinical case summaries from an infant behavior clinic were reviewed by four experienced clinicians. Attachment disorders were coded as present or absent by using competing criteria and were scored by using a continuous scale of relationship functioning. RESULTS: The reliability of alternative criteria was acceptable, but the reliability of DSM-IV criteria in diagnosing attachment disorders was marginal. Preliminary validity for the criteria was demonstrated by the fact that more severe relationship disturbances were seen in infants diagnosed with attachment disorders than in infants diagnosed with other disorders. CONCLUSIONS: Standardized assessments of at-risk populations should be used to replicate these preliminary results; revision of DSM-IV criteria may be necessary to obtain adequate reliability for diagnosing attachment disorders.

Adult↗

Infant development and developmental risk: a review of the past 10 years.

OBJECTIVE: To review critically the research on infant developmental risk published in the past 10 years. METHOD: A brief framework on development in the first 3 years is provided. This is followed by a review of pertinent studies of developmental risk, chosen to illustrate major risk conditions and the protective factors known to affect infant development. Illustrative risk conditions include prematurity and serious medical illness and infant temperament, infant-caregiver attachment, parental psychopathology, marital quality and interactions, poverty and social class, adolescent parenthood, and family violence. RESULTS: Risk and protective factors interact complexly. There are few examples of specific or linear links between risk conditions and outcomes during or beyond the first 3 years of life. Infant development is best appreciated within the context of caregiving relationships, which mediate the effects of both intrinsic and extrinsic risk conditions. CONCLUSIONS: Complex and evolving interrelationships among risk factors are beginning to be elucidated. Linear models of cause and effect are of little use in understanding the development of psychopathology. Refining our markers of risk and demonstrating effective preventive interventions are the next important challenges.

Child Development↗

Psychopathology in infancy.

The first three years of life present unique challenges to the study of psychopathology. We highlight four of the issues in a selective review of the developmental psychopathology of early childhood, including lack of specificity of risk and outcome variables, measurement difficulties, rapid developmental changes and the centrality of the relationship context in early childhood. We also highlight issues relevant to conceptualizations of disorders of infancy, emphasizing especially the need for efforts to validate clinical disorders. We consider two major domains of infant development that we believe are especially relevant to a discussion of psychopathology, namely, regulation of emotion and infant-caregiver attachment. Discussions of these two domains of infant development and their psychopathological extremes allow us to consider conceptualizations of psychopathology from the dual perspectives of developmental psychopathology and clinical disorders. We conclude by suggesting a number of strategies to build upon previous research.

Affective Symptoms↗

Case study: hypersomnolence and precocious puberty in a child with pica and chronic lead intoxication.

The limited literature on hypersomnolence suggests that it is a poorly defined symptom associated with a spectrum of disorders from monosymptomatic hypersomnolence to the Kleine-Levin syndrome. These disorders often herald an organic central nervous system syndrome. Recent evidence suggests a frequent association between these disorders and hypothalamic dysfunction, which itself may be caused by a variety of factors. This case study of a patient with persistent hypersomnolence, hypothalamic dysfunction (in the form of precocious puberty), pica, and chronic lead intoxication strengthens the association between hypersomnolence and hypothalamic dysfunction and suggests a heretofore unreported cause of hypothalamic dysfunction in humans.

Age of Onset↗