PubMed Health⌕ Search

Biomedical subjects

P Baghurst

Publications and source records attributed to P Baghurst.

30 records · Page 2Linked to original sources
PubMed1994

Environmental lead and children's intelligence: a systematic review of the epidemiological evidence.

OBJECTIVE: To quantify the magnitude of the relation between full scale IQ in children aged 5 or more and their body burden of lead. DESIGN: A systematic review of 26 epidemiological studies since 1979: prospective studies of birth cohorts, cross sectional studies of blood lead, and cross sectional studies of tooth lead. SETTING: General populations of children > or = 5 years. MAIN OUTCOME MEASURES: For each study, the regression coefficient of IQ on lead, after adjustment for confounders when possible, was used to derive the estimated change in IQ for a specific doubling of either blood or tooth lead. RESULTS: The five prospective studies with over 1100 children showed no association of cord blood lead or antenatal maternal blood lead with subsequent IQ. Blood lead at around age 2 had a small and significant inverse association with IQ, somewhat greater than that for mean blood lead over the preschool years. The 14 cross sectional studies of blood lead with 3499 children showed a significant inverse association overall, but showed more variation in their results and their ability to allow for confounders. The seven cross sectional studies of tooth lead with 2095 children were more consistent in finding an inverse association, although the estimated magnitude was somewhat smaller. Overall synthesis of this evidence, including a meta-analysis, indicates that a typical doubling of body lead burden (from 10 to 20 micrograms/dl (0.48 to 0.97 mumol/l) blood lead or from 5 to 10 micrograms/g tooth lead) is associated with a mean deficit in full scale IQ of around 1-2 IQ points. CONCLUSION: While low level lead exposure may cause a small IQ deficit, other explanations need considering: are the published studies representative; is there inadequate allowance for confounders; are there selection biases in recruiting and following children; and do children of lower IQ adopt behaviour which makes them more prone to lead uptake (reverse causality)? Even if moderate increases in body lead burden adversely affect IQ, a threshold below which there is negligible influence cannot currently be determined. Because of these uncertainties, the degree of public health priority that should be devoted to detecting and reducing moderate increases in children's blood lead, compared with other important social detriments that impede children's development, needs careful consideration.

Age Factors↗
PubMed1992

Differences between informants' reports describing emotional and behavioural problems in community and clinic-referred children: a research note.

This study compared the pattern of reports describing childhood emotional and behavioural problems amongst children in the community with the pattern of reports describing children referred to mental health clinics. Whereas children in the community reported more externalizing and internalizing problems than were reported by their parents, clinic-referred children reported fewer externalizing but more internalizing problems than their parents. The results highlight potential limitations which may arise when reports describing the problems of clinic-referred children are used as the criterion for assessing the clinical significance of reports describing problems amongst children in the community.

Adolescent↗
PubMed1992

Differences between reports from children, parents and teachers: implications for epidemiological studies.

This study describes the different prevalences obtained when varying combinations of informants were used to identify emotional and behavioural disorders in a representative sample of 336 children living in two-parent families in the community of Adelaide, South Australia. When different informants were used to identify children with disorders, the estimated prevalences ranged from 3.3 +/- 1.6% to 17.9 +/- 4.1% for younger children, and 6.0 +/- 2.9% to 19.9 +/- 4.9% for older children. Results from the study highlight potential methodological problems which arise in epidemiological studies due to differences between reports from children, parents, and teachers describing childhood emotional and behavioural problems.

Adolescent↗
PubMed1992

The effect of computer-assisted interviewing on the clinical assessment of children.

This study investigated the effect of providing clinicians with a report from a computer-assisted interview conducted prior to the clinical assessment of children referred to a mental health service. The results suggest that the availability of reports from computer-assisted interviews influenced the type of problems identified by clinicians and the services that they recommended to manage the children's problems. It is suggested that reports from computer-assisted interviews could assist clinicians by collecting a broad range of clinical information describing the problems of clinic-referred children. It is also suggested that considerably more research is needed into the possible benefits of computer technology in child and adolescent mental health services.

Achievement↗
PubMed1991

The use of a computer-assisted interview to administer the Child Behavior Checklist in a child psychiatry service.

This study describes the use of a computer-assisted interview to administer the Child Behavior Checklist to the parents of children referred to a child psychiatry service. The scores from the computer-assisted interview varied little from the scores obtained using the standard written checklist. Information collected by means of computer-assisted interviews with parents and children has the potential to facilitate the diagnostic assessment of individual children with emotional and behavioral problems, to provide a more comprehensive description of the work of child psychiatry services, and to encourage new clinical research by mental health professionals working in child psychiatry services.

Adolescent↗
PubMed1990

The attitude of parents to the use of computer-assisted interviewing in a child psychiatry service.

Before undergoing interview, parents reported that a computer-assisted interview would lack the friendly and personal approach of one conducted by a clinician but, after completing the interview, parents showed more acceptance of the procedure. Computer-assisted interviewing has the potential to play an important role in the collection of clinically relevant information from both parents and children referred to child psychiatry services.

Attitude to Computers↗
PubMed1989

School performance and psychological adjustment of children treated for leukemia. A long-term follow-up.

This paper describes a long-term follow-up study in which the prevalence of emotional/behavioral problems in a group of 32 children and adolescents treated for leukemia is compared with both their siblings and a matched control group drawn from the general population. The performance of the groups at school and in social activities is also compared. Separate reports on the children were obtained from parents, teachers, and the children themselves using Child Behavior Checklist Lists (CBCLs). In general, there are now fewer differences between the leukemic group and the sibling and control groups than in a previous assessment; however, all of the informants consistently report that children treated for leukemia are still performing significantly worse at school than the matched control group. Possible causes for the continuing poor school performance of the children treated for leukemia are discussed.

Achievement↗
PubMedDate not supplied

Health-service use by children with asthma over a 6-month period.

OBJECTIVES: The present study aims to describe the use of health services by children with asthma, and examine disease-specific, parental and sociodemographic variables associated with different levels of health-service utilization. METHODS: Parents of 135 children attending an emergency room (ER) completed questionnaires measuring the children's asthma symptoms, and sociodemographic and psychological variables. Parents were contacted monthly for 6 months to document the number of planned and unplanned visits to hospital and community health-care services for asthma. RESULTS: At least one further unplanned visit to the ER was made by 37% of children, while 62% made at least one unplanned visit to a general practitioner (GP). Fifty-five per cent made planned review visits to a GP, 30% to paediatricians and 5% to hospital clinics. After controlling for the level of asthma symptoms, parental anxiety and parental perceptions of children's vulnerability were associated with unplanned GP visits (P = 0.05 and P = 0.01, respectively); a planned review visit and the child being admitted to hospital for the index attack were associated with unplanned ER visits (P = 0.05 and P = 0.004, respectively). CONCLUSIONS: Children with asthma more frequently attend GP services than hospital services for both planned and unplanned asthma management. Different variables predict the unplanned use of GP and ER services. Understanding these differences is imperative if children and families are to make the most effective use of health services.

Asthma↗
PubMedDate not supplied

Childhood cancer: a 4-year prospective study of the psychological adjustment of children and parents.

PURPOSE: The objective of this 4-year prospective study was to assess the psychological adjustment of children treated for cancer and their parents. PATIENTS AND METHODS: Children aged 2 to 12 years with cancer diagnosed and their parents and families (n = 39) were assessed immediately after their diagnosis and then annually for the next 4 years. At each assessment, the psychological adjustment of the children and their families was compared with the adjustment of a cohort of children and families in the general community (n = 49). RESULTS: Immediately after the diagnosis of cancer in the children, the children and their parents had significantly more psychological problems than children and parents in the community. However, at subsequent assessments, there was no difference in the number of psychological problems experienced by children and parents in the two groups. CONCLUSIONS: In the longer term, the prevalence of psychological problems experienced by children treated for cancer and their parents does not differ from that found in children and parents in the general community. Future research should give greater attention to other aspects of the lives of children treated for cancer and their parents, including their broader health-related quality of life.

Adaptation, Psychological↗