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Biomedical subjects

R Meadow

Publications and source records attributed to R Meadow.

At least 19 recordsLinked to original sources

Difficult and unlikeable parents.

Children of parents who are perceived as difficult or unlikeable are at risk of receiving less good medical care. Therefore a postal questionnaire was sent to 100 hospital doctors dealing with children asking which features made them consider a parent to be difficult or unlikeable. Seventy eight responded. Most problems arose from parents who displayed aggression, disparagement of their child, unacknowledged anxiety, or fixed ideas about the medical condition and its management. Other unpopular parental features were poor compliance, failure to listen, and the attendance of more than one accompanying adult. Respondents graded 16 features in order of their detrimental effect on the child's care. A major factor was if the child had a condition for which the doctor could offer no treatment; less important was the fact that the child might have a condition not understood by the doctor. Parents originating from the Indian subcontinent posed additional problems, in particular the common unavailability of interpreters. Doctors of all grades understood why parents behaved in awkward ways, but lacked strategies for dealing with them. A similar survey of nurses and therapists produced a poor response (51% returns). Only the most senior acknowledged that some parents were difficult or unlikeable and that, as a consequence, the child's care might be affected. Nurses acknowledged difficulty with parents who were violent or who abused their children physically.

Allied Health Personnel

Suffocation, recurrent apnea, and sudden infant death.

We reviewed the cases of 27 young children from 27 different families who were suffocated by their mothers. The certainty, or near certainty, of suffocation was based on reliable observation or recording of the suffocation, maternal confession, or successful prosecution in a criminal court. Eighteen of the children are alive, although one has severe brain damage; nine are dead. Twenty-four were reported to have had previous episodes of apnea, cyanosis, or seizure, and 11 had had 10 or more such episodes that were either invented or caused by the mother. Repetitive suffocation usually began between the ages of 1 and 3 months and continued until it was discovered, or the child died, 6 to 12 months later. The 27 children had 15 live elder siblings and 18 who had died suddenly and unexpectedly in early life; 13 of the dead siblings had had recurrent apnea, cyanosis, or seizures, and, although most of them at the time of death were certified as having sudden infant death syndrome, it is probable that some were suffocated. Repetitive suffocation has a characteristic clinical presentation that should allow identification before brain damage or death occurs. The characteristics should also allow the cause of death of some cases of sudden infant death to be established more accurately.

Adult