Perceptions of physician shortages.
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Administrative Personnel↗
Biomedical subjects
Theodore A Petti
Publications and source records attributed to Theodore A Petti.
Intramuscular ziprasidone for acute agitation in adolescents.
Several neuropsychiatric disorders in children and adolescents often present with aggressive behavior. In fact, aggression is one of the most common reasons for psychiatric admission for inpatient hospitalization. Psychotropic medication can be helpful in reducing the need for more restrictive interventions, such as seclusion or restraint. The use of "as needed " (PRN) medications has been reported to decrease seclusion and restraint in a university-affiliated hospital setting. In our study, we report the cases of 3 youngsters whose escalating aggression responded to intramuscular ziprasidone with an immediate calming effect and good clinical outcome.
Acute Disease↗
Urinary incontinence with donepezil treatment in hospitalized children and adolescents with attention deficit hyperactivity disorder.
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Adolescent↗
Developing strategies for psychopharmacological studies in preschool children.
OBJECTIVE: To identify the obstacles and special challenges-ethical, practical, scientific, and regulatory-faced by investigators who attempt to conduct psychopharmacological studies in preschoolers. METHOD: In a workshop held at the 47th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, featuring interactive sessions designed to elicit discussion of the theory and feasibility of research in this young population, several key domains were identified: diagnosis and assessment, ethics, research design, special considerations for preschoolers, regulatory/industry issues, and education/training. RESULTS: A Pediatric Psychopharmacology Initiative is needed to consolidate recommendations from this and other workshops and current federal, research, and regulatory committees. A scholarly review and a guide for institutional review boards and investigators should be prepared on issues related to preschoolers. Developmental specialists provide valuable expertise that can strengthen studies of pediatric psychopharmacology. "N of 1" case studies can provide valuable information to clinicians. Only preschoolers with severe symptoms that occur in several interpersonal contexts should be entered into trials. Indications for the study of symptom complexes (e.g., aggression) rather than specific diagnoses should be examined and considered for regulatory activities. Psychopharmacology practice parameters for preschoolers are needed. CONCLUSIONS: With preschoolers being increasingly treated with psychopharmacological agents, the need for investigations to address the safety and efficacy of these medications is becoming a central issue for researchers from many disciplines.
Adolescent↗
Perceptions of P.R.N. psychotropic medications by hospitalized child and adolescent recipients.
OBJECTIVE: To understand patient perceptions of p.r.n. medication for agitation used in institutional settings. METHOD: A questionnaire was administered to child and adolescent psychiatric inpatients within 12 hours of their receiving p.r.n. medication for agitation and repeated 4 hours later. Research staff completed a form to rate each patient's comprehension and behavior in completing the questionnaire. RESULTS: Forty-two patients completed the survey: 38 males and 4 females, aged 7 to 17 years (mean age 12.19 years, median age 12 years). Patients requested the p.r.n. medication in 30% of episodes and assisted with the decision in an additional 10%. The p.r.n. was perceived for loss of control in more than half the cases. About 50% of the youngsters felt that the p.r.n. they received was the "best" for them. Only 30% answered that "something" could have been done by themselves or by staff to avoid requiring a p.r.n. medication. About 65% felt that "something good" happened from receiving the medication. The test-retest reliability of all but one question by kappa statistic was p <or=.001. CONCLUSIONS: Hospitalized children and adolescents perceive p.r.n. medication as useful. The instrument used allows them to share their views in a reliable manner.
Adolescent↗
Adverse effects associated with physical restraint.
OBJECTIVE: Restraint use is not monitored in the US, and only institutions that choose to do so collect statistics. In 1999, investigative journalists reported lethal consequences proximal to restraint use, making it a life-and-death matter that demands attention from professionals. This paper reviews the literature concerning actual and potential causes of deaths proximal to the use of physical restraint. METHOD: Searching the electronic databases Medline, Cinahl, and PsycINFO, we reviewed the areas of forensics and pathology, nursing, cardiology, immunology, psychology, neurosciences, psychiatry, emergency medicine, and sports medicine. CONCLUSIONS: Research is needed to provide clinicians with data on the risk factors and adverse effects associated with restraint use, as well as data on procedures that will lead to reduced use. Research is needed to determine what individual risk factors and combinations thereof contribute to injury and death.
Asphyxia↗