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Description Of The Methodology Used In An Ongoing Pediatric Care Interventional Study Of Children Born With Cleft Lip And Palate In South America [Nct00097149, G. L. Wehby, E. E. Castilla, N. Goco, M. Rittler, V. Cosentino, L. Javois, Ann Marie Mccarthy, G. Bobashev, S. Litavecz, A. Mariona, G. Dutra, J. S. Lopez-Camelo, I. M. Orioli, J. C. Murray

Ann Marie McCarthy

BACKGROUND: The contribution of birth defects, including cleft lip and palate, to neonatal and infant mortality and morbidity is substantial. As other mortality and morbidity causes including infections, hygiene, prematurity, and nutrition are eradicated in less developed countries, the burden of birth defects will increase proportionally. METHODS/DESIGN: We are using cleft lip and palate as a sentinel birth defect to evaluate its burden on neonatal and infant health and to assess the effectiveness of systematic pediatric care during the first month and first two years of life in decreasing this burden. The neonatal intervention, consisting of weekly pediatric evaluation and …

Factors Explaining Children's Responses To Intravenous Needle Insertions, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen

Ann Marie McCarthy

BACKGROUND: Previous research shows that numerous child, parent, and procedural variables affect children's distress responses to procedures. Cognitive-behavioral interventions such as distraction are effective in reducing pain and distress for many children undergoing these procedures. OBJECTIVES: The purpose of this report was to examine child, parent, and procedural variables that explain child distress during a scheduled intravenous insertion when parents are distraction coaches for their children. METHODS: A total of 542 children, between 4 and 10 years of age, and their parents participated. Child age, gender, diagnosis, and ethnicity were measured by questions developed for this study. Standardized instruments were …

Predictors Of Topical Anesthetic Effectiveness In Children, Charmaine Kleiber, D. Schutte, Ann Mccarthy, M. Floria-Santos, J. Murray, Kirsten Hanrahan

Ann Marie McCarthy

Some children report significant pain with peripheral intravenous catheter (IV) insertion, despite the appropriate use of topical lidocaine anesthetics. This analysis of data from an existing study identified factors related to variation in topical anesthetic effectiveness used for IV insertion. The children (n = 218) in this investigation were 4 to 10 years old and undergoing a scheduled IV insertion. Inclusion criteria were (1) topical anesthetic was used according to manufacturer's recommendations, (2) DNA material was available, and (3) child completed a self-report measure of pain intensity (Oucher scale). Low pain phenotype was defined as a pain intensity score of …

Agricultural Health In The Gambia I: Agricultural Practices And Developments, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith R. Culp

Kennith R. Culp

This manuscript reports results of our study to characterize the historical developments of agricultural practices in The Gambia and related health risks of farm workers. It surveys the various factors that shape production agriculture in the country and examines the degrees to which hand tools, animal traction, motorized traction and manual labour all contribute to the inherent hazards of farm work. The principal objective of this study is to lay the ground work for detailed research of occupational health hazards in Gambian agriculture; and development of policies and programmes to promote the health of Gambian farmers. The authors of this …

Agricultural Health In The Gambia Ii: A Systematic Survey Of Safety And Injuries In Production Agriculture, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith R. Culp

Kennith R. Culp

This study was undertaken to provide baseline information on the injuries and health and safety conditions in Gambian agriculture. The objective was to produce information to guide the formulation of an agricultural health and safety policy for the country, future investigations, prevention and surveillance of the adverse health effects in agriculture. A cross-sectional survey of 20 farmers, 20 nurses, and 20 agricultural extension workers was conducted in the Central and Upper River Divisions of The Gambia. The survey was implemented by the means of questionnaires, walk-through survey and hazard checklist. Seventy percent of farms reported an injury during the past …

X-Chromosome Inactivation Patterns In Monozygotic Twins And Sib Pairs Discordant For Nonsyndromic Cleft Lip And/Or Palate, J. Kimani, M. Shi, Sandra Daack-Hirsch, K. Christensen, D. Moretti-Ferreira, M. Marazita, L. Field, J. Canady, J. Murray

Sandra Daack-Hirsch

Nonsyndromic clefts of the lip and/or palate are common birth defects with a strong genetic component. Based on unequal gender ratios for clefting phenotypes, evidence for linkage to the X chromosome and the occurrence of several X-linked clefting syndromes, we investigated the role of skewed X chromosome inactivation (XCI) in orofacial clefts. Our samples consisted of female monozygotic (MZ) twins (n = 8) and sister pairs (n = 152) discordant for nonsyndromic clefting. We measured the XCI pattern in peripheral blood lymphocyte DNA using a methylation based androgen receptor gene assay. Skewing of XCI was defined as the deviation in …

Analysis Of The P63 Gene In Classical Eec Syndrome, Related Syndromes, And Non-Syndromic Orofacial Clefts, L. L. Barrow, H. Van Bokhoven, Sandra Daack-Hirsch, T. Andersen, S. E. Van Beersum, R. Gorlin, J. C. Murray

Sandra Daack-Hirsch

EEC syndrome is an autosomal dominant disorder with the cardinal signs of ectrodactyly, ectodermal dysplasia, and orofacial clefts. EEC syndrome has been linked to chromosome 3q27 and heterozygous p63 mutations were detected in unrelated EEC families. In addition, homozygous p63 null mice exhibit craniofacial abnormalities, limb truncations, and absence of epidermal appendages, such as hair follicles and tooth primordia. In this study, we screened 39 syndromic patients, including four with EEC syndrome, five with syndromes closely related to EEC syndrome, and 30 with other syndromic orofacial clefts and/or limb anomalies. We identified heterozygous p63 mutations in three unrelated cases of …

Thematic Analysis Of The Experience Of Making A Decision To Place A Family Member With Alzheimer's Disease In A Special Care Unit, Howard Butcher, P. Holkup, M. Park, Meridean Maas

Howard K. Butcher

The purpose of this study was to provide an in-depth description of the experience of making the decision to place a family member in a special care unit among a diverse sample of family caregivers. To achieve purposive maximum variation of the sample, the sample of 30 family caregivers was chosen from an original study of 256 family caregivers. The sample was randomly stratified according to ethnicity, gender, and relationship to the care receiver. Three independent researchers used Luborsky's method of thematic analysis to analyze the interviews. After mutual consensus, 1565 themes (descriptive statements) were identified and synthesized into 21 …

The Meaning Of Breast Cancer Risk For African American Women., Janice Phillips, Marlene Z. Cohen

Journal Articles: College of Nursing

PURPOSE: To describe African American women's experience of being at high risk for breast cancer.

DESIGN: A hermeneutic phenomenological approach was used to guide in-depth interviews and analysis. Methods to ensure trustworthiness and rigor were included.

METHODS: Open interviews were conducted with 20 African American women who were at high risk for breast cancer (family history, personal history, genetic mutation). They were recruited from a cancer risk clinic and community-based settings. Data were transcribed verbatim, and themes were labeled among and between all interviews.

FINDINGS: Five themes were identified: (a) life-changing experience; (b) relationships: fears, support, and concerns; (c) the …