Biomedical subjects

Robert E Larzelere

Publications and source records attributed to Robert E Larzelere.

6 recordsLinked to original sources

PubMed2005

Comparing child outcomes of physical punishment and alternative disciplinary tactics: a meta-analysis.

This meta-analysis investigates differences between the effect sizes of physical punishment and alternative disciplinary tactics for child outcomes in 26 qualifying studies. Analyzing differences in effect sizes reduces systematic biases and emphasizes direct comparisons between the disciplinary tactics that parents have to select among. The results indicated that effect sizes significantly favored conditional spanking over 10 of 13 alternative disciplinary tactics for reducing child noncompliance or antisocial behavior. Customary physical punishment yielded effect sizes equal to alternative tactics, except for one large study favoring physical punishment. Only overly severe or predominant use of physical punishment compared unfavorably with alternative disciplinary tactics. The discussion highlights the need for better discriminations between effective and counterproductive use of disciplinary punishment in general.

Child↗

PubMed2004

The intervention selection bias: an underrecognized confound in intervention research.

Selection bias can be the most important threat to internal validity in intervention research, but is often insufficiently recognized and controlled. The bias is illustrated in research on parental interventions (punishment, homework assistance); medical interventions (hospitalization); and psychological interventions for suicide risk, sex offending, and juvenile delinquency. The intervention selection bias is most adequately controlled in randomized studies or strong quasi-experimental designs, although recent statistical innovations can enhance weaker designs. The most important points are to increase awareness of the intervention selection bias and to systematically evaluate plausible alternative explanations of data before making causal conclusions.

Child↗

PubMed2004

The child suicide risk assessment: a screening measure of suicide risk in pre-adolescents.

This study documents the initial reliability and validity of the Child Suicide Risk Assessment (CSRA) for children under the age of 13. The revised CSRA retained 18 of 20 original items based on item-specific psychometric data from 140 pre-adolescents in out-of-home treatment programs. The CSRA demonstrated adequate internal consistency (alpha=.69) for a multi-dimensional scale (3 factors: Worsening Depression, Lack of Support, and Death as Escape). CSRA scores correlated significantly with criterion measures of prior suicide attempts and ideations. A receiver operating characteristic (ROC) curve discriminated significantly between prior attempters and non-attempters and was used to select preliminary CSRA cut-off scores for identifying substantial suicide risk. The CSRA is the first screening measure of suicide risk in pre-adolescents validated by associations with suicide attempts as well as ideations.

Adolescent↗

PubMed2002

Ordinary physical punishment: is it harmful? Comment on Gershoff (2002).

E. T. Gershoff (2002) reviewed processes that might mediate and contexts that might moderate the associations between corporal punishment (CP) and child behaviors and provided an account of the methodological weaknesses of the research reviewed in her meta-analyses. In this examination of Gershoff, the authors argue that the biases and confounds in the meta-analyses further limit any causal inferences that can be drawn concerning the detrimental "effects" of CP on associated child behaviors. The authors suggest that undesirable child outcomes are associated with CP because the construct marks inept harsh parenting and conclude that although the harmful effects of physical abuse and other extreme punishments are clear, a blanket injunction against spanking is not justified by the evidence presented by Gershoff.

Adolescent↗

PubMedDate not supplied

A comparison of clinical pediatric patient encounters in university medical center and community private practice settings.

BACKGROUND: Growing numbers of medical students complete clerkships in community private practice (CPP) settings instead of the more traditional university-based clinics, yet few empirical studies have evaluated how setting type impacts clinical experiences, skill development, and student satisfaction. OBJECTIVE: This study compared the pediatric patient encounters seen by third-year medical students in university medical center (UMC) and CPP settings. METHODS: Third-year medical students were required to keep a log of all patients seen during their 8-week pediatric clerkship. Logbook entries were coded and then analyzed for differences in the number and distribution of the primary diagnostic categories between settings. RESULTS: CPP students reported, on the average, seeing over 3 times more patients than UMC students. The case mix distribution also differed significantly by setting. In general, CPP students reported seeing proportionately more routine illnesses, whereas UMC students reported seeing proportionately more uncommon disorders. Because CPP students saw more patients overall, they averaged more cases in almost all diagnostic categories. CONCLUSION: CPP students received more clinical patient exposure than UMC students, except for patients in a few diagnostic categories.

Academic Medical Centers↗

PubMedDate not supplied

Comparison of a computerized anesthesia device with a traditional syringe in preschool children.

PURPOSE: The purpose of this investigation was to evaluate the efficacy of a computerized injection device (Wand) on reducing pain behavior during injections with preschool-aged children. METHODS: Subjects consisted of 40 patients between the ages of 2 and 5 requiring local anesthesia for dental restorations in the maxilla. Patients were randomly assigned to either the Wand or the traditional anesthetic delivery system. A palatal approach to the anterior and middle superior alveolar nerves and the anterior superior alveolar nerve was used with the Wand injections. Buccal infiltration and palatal injections were used for the traditional method. Pain behavior was observed and coded. RESULTS: Results of Fisher Exact tests found that using the Wand to deliver anesthetic lead to significantly fewer (P < .01) disruptive behaviors in preschool-aged children when compared with a traditional injection regimen. In addition, none of the preschool-aged children exposed to the Wand required restraint during the initial interval, while nearly half of the children receiving a traditional injection required some type of immediate restraint. CONCLUSIONS: These results demonstrate that the Wand can significantly reduce disruptive behaviors in a population of young children who are traditionally more difficult to manage and may be one method of creating a more positive experience for the young child and the practitioner.

Anesthesia, Dental↗