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Biomedical subjects

W T Boyce

Publications and source records attributed to W T Boyce.

At least 19 recordsLinked to original sources
PubMed1992

Sexual abuse of children. The detection of semen on skin.

OBJECTIVE: The detection of semen on the skin of children who present within 72 hours of an episode of sexual assault is critical to medical, forensic, and legal personnel. The Wood's Lamp, a UV light that causes semen to fluoresce, and four forensic laboratory techniques were compared to determine their sensitivity and decline in sensitivity over time. DESIGN: A descriptive study. PARTICIPANTS: Eleven adult female volunteers. MEASUREMENTS/MAIN RESULTS: Semen was placed on the skin of the volunteers. Samples of the dried semen were assessed during a 28-hour period with the Wood's Lamp, microscopy, the acid phosphatase assay, and two assays for the prostatic protein p30 (counterimmunoelectrophoresis and enzyme-linked immunosorbent assay). The intensity of the Wood's Lamp fluorescence of semen diminished dramatically by 28 hours; in contrast, the fluorescence of urine persisted up to 80 hours. Over time, the p30-enzyme-linked immunosorbent assay technique was more sensitive than microscopy, the acid phosphatase assay, and p30-counterimmunoelectrophoresis in detecting semen on skin. CONCLUSIONS: The Wood's Lamp is not a sensitive screening tool and should be used with caution. To improve the detection of sexual abuse in children, we recommend that the p30-enzyme-linked immunosorbent assay be used because of its potential as a more sensitive assay than those in current clinical use.

Acid Phosphatase↗
PubMed1992

Depressive symptoms and adaptive style in children with cancer.

OBJECTIVE: This article explores the relationship between a repressive style of adaptation and depressive symptomatology. METHODS: Thirty-one adolescent cancer patients were compared with 83 healthy high school students. Subjects with repressive adaptation were identified as those reporting low anxiety and high defensiveness. Depressive symptomatology was measured by self-report. RESULTS: Patients with cancer reported significantly lower levels of depression, and a significantly higher proportion were identified as repressors. Repressor status accounted for significant variance in depression over that explained by illness. CONCLUSIONS: Adaptive style may be common in medically ill children and may directly and indirectly influence psychological and medical outcome.

Adaptation, Psychological↗
PubMed1992

Mental disorders in chronically ill children: parent-child discrepancy and physician identification.

Mental disorders affect 18% to 20% of children and adolescents. The rate in children with chronic illness is probably higher. This study of chronically ill children addresses the discrepancy between parent and child reports of child psychiatric disorders and the extent to which pediatricians agree with reports by children and parents regarding such problems. Eighty-three subjects, aged 9 to 18 (mean = 12.6), were recruited; they had the following diagnoses: cystic fibrosis, diabetes, inflammatory bowel disease, and cancer. Subjects and one parent were interviewed separately, using the Diagnostic Interview Schedule for Children (DISC-2.1). The subject's physician completed a questionnaire asking about the presence of a range of mental disorders. Forty-one (49%) subjects reached threshold criteria for a psychiatric diagnosis, using both parent and child as informants. Psychiatric disorders were identified in only 22 subjects (54%) by the child and in 28 (68%) by parent alone. Thus, reliance on one informant resulted in failure to identify one third to one half of psychiatric disorders. Physicians' ratings agreed significantly with children's reports but not with parental reports, suggesting that physicians are sensitive to children's concerns but may underestimate the value and importance of parents' reports. Clinical and research evaluations of chronically ill children, as well as clinician identification of mental health problems, will be influenced by the choice of informant.

Adolescent↗
PubMed1992

Pediatric residency training: ten years after the Task Force report.

A sample of 3000 pediatricians who had completed their residency training in 1978 or later were surveyed regarding the perception of the adequacy of their residency training in specific aspects of pediatric practice and in a number of subspecialty areas. The survey was almost identical with the one that formed the basis for the American Academy of Pediatrics Task Force on Pediatric Education report in 1978. The results revealed relatively little change in the high rates of perceived "insufficient training" in all the areas of pediatrics described as "underemphasized" in the Task Force report. However, those residents who received their training during the second half of the 10 years since the Task Force survey reported significant improvement in the previously underemphasized areas of developmental and behavioral pediatrics and adolescent medicine. Results also revealed a significant increase in the number of pediatricians who identify either a subspecialty interest or subspecialty practice in developmental or behavioral pediatrics. The increase in pediatric subspecialists and the improved training experience since 1984 indicate that the Task Force report may have had a positive impact on residency training in developmental and behavioral pediatrics.

Data Collection↗
PubMed1992

Temperament and the psychobiology of childhood stress.

This paper provides a conceptual overview of recent research on the developmental psychobiology of childhood stress. We propose that the construct of temperament can be regarded as an organizing principle in children's responses to environmental adversity, and we review three physiologic "windows" through which such responses can be usefully examined. It is concluded that individual differences between children in their psychobiologic reactivity to stressors may constitute an important and novel point of departure for future studies of stress and childhood morbidity.

Cardiovascular Physiological Phenomena↗
PubMed1992

After-school child care and self-esteem in school-age children.

Although more than 2 million US children are in self-care after school, little is known of the extent to which self-care may adversely affect developmental processes, such as the development of self-esteem. To test the hypothesis that lower self-esteem is associated with being in self-care, 297 subjects in fourth and sixth grades from three ethnically diverse schools in northern California were enrolled in a cross-sectional study during November 1987. Sixty percent of subjects were in adult in-home care, 13% in adult out-of-home care, 19% in self-care, and 8.0% in older sibling care. No significant differences in self-competence scores, as measured by the Harter Self-perception Profile for Children, were observed for children in self-care compared with the three other care groups. However, children who were cared for by older siblings unexpectedly exhibited lower self-competence scores for five of the six self-competence domains, with three domains showing significance at P less than .05. Children in self-care were significantly more isolated socially than children in adult care, reporting fewer opportunities to play outside or have friends visit at their homes. The results indicate that children in sibling care may be at potentially greater risk for negative effects on self-esteem and social development. Children in self-care may also experience more social isolation after school than children in other forms of afterschool care.

Age Factors↗
PubMed1992

The association between hemoglobin and behavior problems in a sample of low-income Hispanic preschool children.

This cross-sectional study, conducted in 1988, examines the association between hemoglobin level and behavior problems in 236 Hispanic children, ages 2 to 5 years, residing in low-income census tracts in the Los Angeles area. Venous blood samples were analyzed for hemoglobin, mean corpuscular volume, free erythrocyte protoporphyrin, and lead. Family and child data were obtained through a home interview with the child's mother or guardian. Behavior problems were assessed using questionnaires modeled after Child Behavior Checklists for children ages 2 to 3 and 4 to 5 years. A significant correlation between decreasing hemoglobin values and increasing total behavior problems scores was found for girls, 2 to 3 and 4 to 5 years old. These associations remained significant in both age groups after adjusting for maternal education and marital status. Statistically significant inverse correlations also were found between hemoglobin and social withdrawal, sleep problems, and depression (internalizing subscale behaviors) in 2- to 3-year-old girls, and between hemoglobin and aggression and hyperactivity (externalizing subscale behaviors) in 4- to 5-year-old girls. The potentially negative consequences of these anemia-related behavior problems on children's development, learning ability, and parent-child relationships warrant further investigation.

California↗
PubMed1991

Psychosocial predictors of maternal and infant health among adolescent mothers.

Past work suggests that stressful life events and social support are significantly associated with a broad range of child health outcomes. Such associations have remained, however, generally modest in magnitude, suggesting that stress and support may be only proxy measures for a deeper, more central aspect of childhood psychosocial experience. One aspect of young people's lives that could plausibly mediate the effects of stress and social support on health is the sense of stability and "permanence" in ongoing life experience. We developed a standardized psychometric instrument for measuring a "sense of permanence" and employed the measure in a prospective 1-year study of health outcomes among 89 adolescent mothers and their infants. Psychosocial and demographic factors were significantly predictive of maternal, but not infant, health outcomes, and the sense of permanence appeared to operate as a "final common pathway" in the influence of psychosocial variables on health and illness end points. Results of the study underscore the importance of continuity and stability in childhood and suggest that changes in an individual's sense of permanence may underlie the previously documented health effects of stressful life events and social support.

Adolescent↗
PubMed1990

Home care for ventilator-dependent children. Psychosocial impact on the family.

The impact of providing home care for ventilator-dependent children was studied in a cross-sectional survey of 18 northern California families. Through the use of a confidential structured interview and the impact on Family Scale, we obtained information on family demographics; the childrens' medical conditions; financial, social, and personal impact on the family; and parental coping-mastery of the care of a ventilator-dependent child at home. Analysis of scores from the impact on Family Scale showed no differences in the perceived family impact between primary caretakers and their spouses. Primary caretakers in the sample, however, showed significantly reduced Coping subscale scores with a longer duration of home ventilatory care. This finding, if confirmed in future studies, has policy implications for physicians and other health professionals working with ventilator-dependent children and their families, especially those who care for children over long periods.

Adaptation, Psychological↗
PubMed1990

Psychobiological differences in childhood stress response. I. Patterns of illness and susceptibility.

Review of the literature demonstrates that an association between psychosocial stress and illness has consistently been demonstrated in child as well as adult populations. Consideration of the physiology of the stress response lends biological plausibility to the negative effects of stress on health. Associations between stress and illness are only modest, however, and the stress-illness hypothesis does not adequately account for the uneven distribution of morbidity in childhood. Attention to individual differences in children's behavioral, emotional, and biological responsiveness to the environment may provide a more useful perspective for understanding the effects of stress on childhood health. From this vantage point, stressful events are seen as the interactive product of environmental and organismic processes.

Adolescent↗
PubMed1990

Psychobiological differences in childhood stress response. II. Cardiovascular markers of vulnerability.

A fuller understanding of the distribution of morbidity in childhood may be achieved through the study of individual differences in stress susceptibility. The importance of person-environment transactions has been appreciated in the psychological domain, but only recently have individual differences in children's psychobiological responsivity to the environment become the focus of systematic study. Current work on individual differences in children's biobehavioral stress response is illustrated by reviewing current research on two aspects of cardiovascular regulation: cardiovascular reactivity and cardiac vagal tone. Both show promise of being stable individual traits emerging early in childhood, and both have correlates with children's patterns of health, behavior, and development. Consideration of individual differences in children's physiological responsivity can enrich our understanding of the meaning and adaptive significance of childhood behavior.

Arousal↗
PubMed1990

Life events, social support, and cardiovascular reactivity in adolescence.

Physiologic responses to environmental stress show striking interindividual differences, beginning early in life. Whereas cardiovascular reactivity (CVR) to stress has been linked to short- and long-term changes in health, little previous work has addressed reactivity in children, and no past studies have investigated the relationship of reactivity to psychosocial factors, such as stressful life events (LE) and social support (SS). We therefore studied cardiovascular response to psychologically and physically stressful laboratory tasks in 25 adolescent boys. The degree of individual CVR was examined cross-sectionally in relationship to LE, SS, and "sense of permanence" (SP), a construct reflecting the stability or continuity in the child's life experience. Heart rate reactivity (HRR) and mean arterial pressure reactivity (BPR) were bimodally distributed, with a subpopulation of approximately 20% of subjects demonstrating an exaggerated cardiovascular response. SP was related to BPR at a borderline level of significance (R = 0.33, p less than 0.10), whereas SS was unrelated to either reactivity variable. Unexpectedly, LE was strongly and inversely related to both HRR and BPR (R = -0.40 and -0.47, respectively, p less than 0.05). Subjects reporting low numbers of previous stressful life events had the highest level of cardiovascular reactivity. Possible explanations for this finding included (1) the development of a hyperdynamic response as a consequence of avoiding or denying stressful experience, (2) an effect of exaggerated CVR on cognition and the reporting of stressful events, or, most plausibly, (3) an 'inoculation effect,' in which previous LE facilitate the development of effective coping strategies, thereby diminishing responses to stressful laboratory tasks.

Adolescent↗
PubMed1989

Health status of children in self-care.

Are children in self-care more obese, do they miss more school days, and do they make more visits to the school health office than children not in self-care? We undertook a cross-sectional survey of students in ten public elementary schools in Tucson over a two-year period in an attempt to answer these questions. The sample included 503 fifth-grade students, 137 in self-care and 366 not in self-care. Demographic information and data on school absences were obtained from school records. Physical examinations were performed at school. Obesity was assessed using the body mass index calculation, in which body mass index = (body weight in kilograms)/(height in meters). Every visit to the school health office during the 1985-1986 and 1986-1987 school years was recorded for each child. There were no differences in age between those in the self-care and adult-care groups. Boys were more likely to be in self-care, as were non-Hispanic children. There were no differences in weight, body mass index, school days missed, or visits to the school health office between children in self-care and those in adult care. Our findings suggest that, by the criteria used in this study, 11-year-old children in self-care do not suffer more ill health than their counterparts in adult care.

Absenteeism↗
PubMed1989

Recurrent injuries in schoolchildren.

Past work identifying "accident-prone" children with disproportionate rates of injury has been based on clinical data gathered in office, clinic, or emergency department settings. To avoid the biases inherent in such designs, we studied recurrent injuries in a school district population, utilizing a prospective surveillance system to identify injuries meeting standardized criteria. During three school years we observed 54,874 students, ranging in age from 6 to 18 years, for recurrent injuries, which were defined as those occurring in a year in which two or more injuries were reported for the child. Five hundred seventy-three recurrently injured children (1% of the school district population) sustained 1405 injuries (17% of the overall injury experience), a proportion significantly but only slightly greater than that expected on the basis of chance alone (14%). Most recurrently injured children were injured in only a single year, with only 15 children sustaining injuries in all three study years. Age, sex, and type of school were significant correlates of recurrent injury rates, with junior high school students, boys, and students attending schools with alternative educational programs having the highest rates of injury recurrence. The findings indicate that (1) a small group of schoolchildren sustain a disproportionate share of the overall injury experience, (2) the majority of recurrently injured children experience only transient periods of enhanced injury risk, and (3) preventive strategies may benefit from investigation of developmental and social environmental factors that alter such risk.

Adolescent↗