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Biomedical subjects

S Longstaffe

Publications and source records attributed to S Longstaffe.

8 recordsLinked to original sources

The prenatal visit.

In their role as advocates for children and families, pediatricians are in an excellent position to support and guide parents during the prenatal period. Prenatal visits allow the pediatrician to gather basic information from parents, provide information and advice to them, and identify high-risk situations in which parents may need to be referred to appropriate resources for help. In addition, prenatal visits are the first step in establishing a relationship between the pediatrician and parents and help parents develop parenting skills. The prenatal visit may take several possible forms depending on the experience and preferences of the parents, competence and availability of the pediatrician, and provisions of the health care plan.

Adult↗

Behavioral and self-concept changes after six months of enuresis treatment: a randomized, controlled trial.

BACKGROUND: Previous studies have suggested changes in self-concept with successful treatment of primary nocturnal enuresis (PNE), but behavioral changes have not been reported as a consistent associated finding. OBJECTIVE: To determine if self-concept and behavior change after 6 months of treatment of monosymptomatic PNE by conditioning alarm or desmopressin acetate (DDAVP). DESIGN: Randomized, controlled trial in an inner-city hospital clinic. Subjects were 182 children referred or recruited through media publicity, randomly assigned both to 1 of 8 pediatricians and 1 of 3 treatment groups (alarm, DDAVP, or placebo). Included were children >7 years old with PNE, no daytime symptoms, bladder capacity >50% expected, and wetting >3 times a week. Excluded were children with central nervous system disorders or developmental delays, and those currently on DDAVP or alarm. Subjects completed the Piers-Harris Children's Self-Concept Scale and Harter's Perceived Competence Scale for Children (PCSC) at initial visit and after 6 months of treatment. Parents completed the Achenbach Child Behavior Checklist (CBCL) at the same times. RESULTS: After 6 months of treatment the Piers-Harris total score showed a highly significant treatment by period interaction effect for DDAVP, a significant effect for alarm, and no effect for placebo. For children who achieved 75% dryness the CBCL showed a treatment by improvement interaction effect that was highly significant for DDAVP and placebo with no effect for alarm. For the PCSC there were no treatment or outcome interaction effects. After 6 months of treatment there were significant changes over time unrelated to outcome or treatment in the Piers-Harris Subscales and in the CBCL Internalizing and Externalizing Scores, and the Social Thought and Attention Problems Subscales. The PCSC was more stable with no changes in total score, and positive changes over time in only 2 Subscales, Scholastic and Social. CONCLUSION: Children's self-concept improved with the type of treatment and amount of success. Parents' perceptions of behavior improve with type of treatment and amount of success. Children rate their self-concept and some physical attributes better after treatment with any of DDAVP, alarm, or placebo regardless of outcome. Frequent follow-up with emotional support and encouragement appear to be important components of an efficacious intervention for children with nocturnal enuresis.

Child↗

Inhalant abuse and the abuse of other drugs.

AIMS: To examine the relationship between inhalant abuse and other substances of abuse. DESIGN: Survey using a structured interview administered by a single trained interviewer. SETTING: A juvenile detention facility. PARTICIPANTS: 209 children incarcerated at the facility over a 3-month period. SELECTION PROCEDURE: Consecutive sample. INTERVENTIONS: None. MEASUREMENTS/FINDINGS: The structured interview was adapted from the American Drug and Alcohol Survey, which has been extensively used to obtain substance abuse epidemiologic data. We collected information on inhalants, alcohol, marijuana, downers, pep pills, lysergic acid diethylamide (LSD), cocaine, designer drugs, phencyclidine (PCP), Talwin and Ritalin, speed, and narcotics. The chi-square or Fisher exact test were used when appropriate. Mean ages of initial experimentation were as follows: inhalants, 9.7 years; marijuana, 11.9 years; alcohol (inebriated), 12.0 years; cigarettes, 11.2 years; for the remaining substances of abuse, the mean age was 13.2-14.7 years. Thirty subjects had used inhalants. Significant relationships were found between inhalants and cocaine (p = .004), Talwin and Ritalin (p = .001), downers (p = .01), and narcotics (p = .003). CONCLUSIONS: For children incarcerated in a juvenile detention facility in our community, inhalant abuse is associated with the later use of other substances of abuse. If this finding is replicated in other populations, it underscores the need for effective preventive strategies.

Administration, Inhalation↗

Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: a randomized clinical trial.

OBJECTIVE: To determine the efficacy of iron-fortified infant formula in preventing developmental delays and abnormal behavior. DESIGN: Double-blind, randomized, controlled trial. SETTING: Urban hospital clinic. PARTICIPANTS: A total of 283 healthy, bottle-fed infants from very low income families. Children with prematurity, low birth weight, and major anomalies and those who had received more than 2 weeks of evaporated-milk feedings were excluded. The groups were similar for sociodemographic background variables. Fifty-eight infants (20.5%) dropped out before any outcome data were gathered; 225, 204, 186, and 154 remained at 6-, 9-, 12-, and 15-month assessments, respectively. INTERVENTION: Iron-fortified formula (12.8 mg iron per liter) versus regular formula (1.1 mg iron per liter). MAIN OUTCOME MEASURES: Iron status was measured on venous blood by determination of hemoglobin, serum iron and iron-binding capacity, serum ferritin, and free erythrocyte protoporphyrin values. The Bayley Scales of Infant Development (mental and psychomotor indexes) and two factors of the Infant Behavior Record (test affect and task orientation) were the outcomes of interest. RESULTS: All measures of iron status were significantly different between groups (p < 0.001). Psychomotor development patterns differed between groups (F3,520, 3.4; p = 0.02) with time. Mean values were similar at 6 months but differed at 9 and 12 months of age (p < 0.001), with a decline of 6.4 points in the regular-formula group. By 15 months of age the differences were no longer significant (p = 0.23). Mental development and behavior were not affected. CONCLUSIONS: Iron-fortified formula significantly reduced iron deficiency in a high-risk group of infants and prevented a decline in psychomotor development quotients. This effect may be transient, and its long-term significance needs further study.

Developmental Disabilities↗

The Winnipeg Children's Hospital child protection centre: a provincial medical initiative.

The Winnipeg Children's Hospital child protection centre is a hospital-based provincial protection program that focuses on the diagnosis, treatment and prevention of child abuse and neglect in Manitoba. The multidisciplinary group of professionals working in the centre differs from most hospital-based teams in that it has a strong government liaison both functionally and financially, has strong ties to the welfare system and has legal counsel relating to the court system. The centre represents the philosophy that medical participation in welfare matters relating to children need not be relegated to the sidelines. This paper describes the centre's history and structure, and it outlines some of its research projects.

Child↗

The forensic pediatrician as a child advocate.

This paper focuses on the medicolegal activities of a group of six pediatricians from the Winnipeg Children's Hospital. Increasing legal demands resulted in 93 court appearances for the group, during a 12-month period ending in December 1982. The educational processes and the individual court room issues confronted by both the courts and the six pediatricians, dealing with problems of child protection, are described. Major pediatric roles and principles of advocacy resulting from these experiences are delineated. Society's accountability is discussed with specific reference to the pediatrician's role.

Adult↗

Rheumatic fever in native children in Manitoba.

From data reported to a central computer file, cases of rheumatic fever in persons under 17 years of age in Manitoba were reviewed. Although the overall incidence of the disease declined throughout the study period, Jan. 1, 1970 to July 1, 1979, the rates per 100 000 population were higher overall (36) and for non-natives (29) and much higher for natives (126) than average rates in urban centres around the world. Rates of death and readmission showed that the disease was also more severe in the native Manitoba children.

Adolescent↗