Medicine and Health Sciences Commons^™

Development Of An Evidence-Based Clinical Practice Guideline On Linear Growth Measurement Of Children, Jan Foote, L. Brady, A. Burke, J. Cook, M. Dutcher, K. Gradoville, J. Groos, K. Kinkade, R. Meeks, P. Mohr, D. Schultheis, B. S. Walker, K. Phillips

Jan M. Foote

Growth is an important indicator of child health; however, measurements are frequently inaccurate and unreliable. This article reviews the literature on linear growth measurement error and describes methods used to develop and evaluate an evidence-based clinical practice guideline on the measurement of recumbent length and stature of infants, children, and adolescents. Systematic methods were used to identify evidence to answer clinical questions about growth measurement. A multidisciplinary team critically appraised and synthesized the evidence to develop clinical practice recommendations using an evidence-based practice rating scheme. The guideline was prospectively evaluated through internal and external reviews and a pilot study to …

Pyloric Channel Stricture Secondary To High-Dose Ibuprofen Therapy In A Patient With Cystic Fibrosis, E. Bell, R. Grothe, V. Zivkovich, Jan Foote, J. Wellendorf

Jan M. Foote

OBJECTIVE: To describe a case of pyloric channel stricture secondary to high-dose ibuprofen therapy in a pediatric patient with cystic fibrosis. CASE SUMMARY: A 12-year-old white girl started taking high-dose ibuprofen to treat the pulmonary manifestations of cystic fibrosis. The peak plasma concentration at dose initiation was within the accepted therapeutic range. Approximately one month later, the patient developed emesis and intolerance of solid foods, which persisted for several months and resulted in a weight loss of seven kilograms. The patient was referred to a pediatric gastroenterologist, who performed an upper endoscopy and subsequently diagnosed a pyloric channel stricture. The …

Child Birth: Don't Forget The Fathers, Moira Williamson

Moira Williamson

Fathers are often forgotten when a new baby comes into a family. But men face many challenges in the early months of fatherhood as they come to terms with their new or expanded role. And they need more support. UOW Senior Lecturer and Master of Science (Midwifery) Co-ordinator Moira Williamson and colleagues Professor Carol McVeigh from Massey University (NZ) and Mercy Baafi, Midwifery Manager (Education) at Wollongong Hospital, researched the impact of parenthood with 128 new fathers. MOIRA WILLIAMSON prepared this Opinion column, based on their research.

The Burden Of Moderate-To-Heavy Soil-Transmitted Helminth Infections Among Rural Malaysian Aborigines: An Urgent Need For An Integrated Control Programme, Init Ithoi

Init Ithoi

Background: Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. Methods: A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Results: Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. …

A Brief Overview Of Adolescent Developmental Problems In Hong Kong, Daniel T. L. Shek, Hing Keung Ma, Rachel C. F. Sun

Pediatrics Faculty Publications

Several adolescent developmental problems in Hong Kong are briefly reviewed in this paper. First, rising adolescent substance abuse trends are described. Second, Internet use problems and Internet addiction among young people are examined. Third, worrying trends in adolescent sexuality are identified. Fourth, phenomena on bullying among young people are reviewed. Finally, phenomena related to adolescent materialistic orientation are focused upon. With reference to these adolescent developmental problems, possible solutions are briefly discussed particularly with reference to the ecological perspective. It is argued that the related scientific literature provides useful pointers for designing the curriculum in the extension phase of the …

Proposed Perioperative Nurse Translation Of The Federal Clinical Practice Guidelines. Association Of Operating Room Nurses, S. Moorhead, M. Golas, S. Kleinbeck, L. Reehling, Victoria Steelman, D. Wahoff-Stice, M. Weisbrich, D. Fogg

Victoria J. Steelman

No abstract provided.

Non-Geometric Echocardiographic Indices Of Ventricular Function In Patients With A Fontan Circulation., Jonathan Rhodes, Renee Margossian, Lynn A. Sleeper, Piers Barker, Timothy J. Bradley, Minmin Lu, Mark Fogel, Matthew A. Harris, Wyman W. Lai, Andrew J. Powell, Michael D. Puchalski, Girish S. Shirali, Steven D. Colan, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Complex anatomy and limited windows complicate echocardiographic assessments of ventricular function in Fontan patients. For the Pediatric Heart Network Fontan Cross-Sectional Study, data were acquired from which mean ventricular pressure change during isovolumetric contraction (dP/dt(ic)), Tei index, and maximal systolic annular velocity (S') could be measured. The purpose of this study was to compare these nongeometric indices of ventricular function to cardiac magnetic resonance (CMR) measurements of ventricular ejection fraction (EF).

METHODS: Echocardiographic and CMR studies were performed prospectively using standardized protocols; measurements were completed by core laboratories. Data from both modalities were available from 137 patients.

RESULTS: A …

Postenucleation Adjuvant Chemotherapy With Vincristine, Etoposide, And Carboplatin For The Treatment Of High-Risk Retinoblastoma., Swathi Kaliki, Carol L Shields, Sanket U Shah, Ralph C Eagle, Jerry A Shields, Ann Leahey

Wills Eye Hospital Papers

BACKGROUND: Analysis of 52 eyes with high-risk retinoblastoma managed with postenucleation adjuvant chemotherapy using vincristine sulfate, etoposide phosphate, and carboplatin showed no evidence of systemic metastasis in any case during a mean (range) follow-up of 66 (12-202) months.

PURPOSE: To determine the efficacy of postenucleation adjuvant chemotherapy with vincristine, etoposide, and carboplatin in the prevention of metastasis for patients with high-risk retinoblastoma.

METHODS: Retrospective, nonrandomized, interventional case series of 52 eyes in 51 patients with high-risk retinoblastoma consisting of tumor invasion into the anterior segment, posterior uvea 3 mm or greater, postlaminar optic nerve, or any combination of posterior uvea …

Parent-Led Activity And Nutrition (Plan) For Healthy Living: Design And Methods, William T. Dalton, Karen E. Schetzina, Nicole Holt, Hazel Fulton-Robinson, Ai-Leng Ho, Fred Tudiver, Mathew T. Mcbee, Tiejian Wu

ETSU Faculty Works

Child obesity has become an important public health concern, especially in rural areas. Primary care providers are well positioned to intervene with children and their parents, but encounter many barriers to addressing child overweight and obesity. This paper describes the design and methods of a cluster-randomized controlled trial to evaluate a parent-mediated approach utilizing physician's brief motivational interviewing and parent group sessions to treat child (ages 5–11 years) overweight and obesity in the primary care setting in Southern Appalachia. Specific aims of this pilot project will be 1) to establish a primary care based and parent-mediated childhood overweight intervention program …

Factors Associated With Academic Achievement In Children With Type 1 Diabetes, Ann Mccarthy, S. Lindgren, M. Mengeling, E. Tsalikian, J. Engvall

Ann Marie McCarthy

OBJECTIVE: To examine academic achievement in children with diabetes and to identify predictors of achievement. RESEARCH DESIGN AND METHODS: Participants were 244 children, ages 8-18 years, with type 1 diabetes. Measures included school-administered standardized achievement tests (Iowa Tests of Basic Skills and Iowa Tests of Educational Development [ITBS/ITED]), grade point averages (GPAs), school absences, behavioral assessment, age at disease onset, hospitalizations, and HbA(1c). Statistical differences between subgroups of children were evaluated using t test and ANOVA, statistically controlling for socioeconomic status. Regression analyses were carried out to examine predictors of academic performance. RESULTS: Reading scores and GPA were lower for …

Evaluation Of A School Re-Entry Nursing Intervention For Children With Cancer, Ann Mccarthy, Janet Williams, C. Plumer

Ann Marie McCarthy

A retrospective qualitative design was used to identify and compare the concerns, parents, teachers, and children have regarding school re-entry after a cancer diagnosis and to describe the impact of a school re-entry program on parents', teachers', and children's concerns. Audiotaped, semistructured interviews were obtained from a convenience sample of 10 children with cancer (ages 5 to 13 years), 10 mothers, and nine teachers. All participants were positive about the school re-entry nursing intervention, which is described. Results of content analyses indicate that before the intervention, mothers were concerned about their child's safety and peer teasing; teachers were concerned about …

Nurse Practitioner-Patient Interactional Analyses During Well-Child Visits, C. Webster-Stratton, J. Glascock, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

Integrating Molecular Genetics Analyses Into Clinical Research, D. Schutte, Ann Mccarthy, M. Floria-Santos, Kirsten Hanrahan, J. Murray, Charmaine Kleiber

Ann Marie McCarthy

The integration of molecular genetics approaches into the study of complex health phenomena is an increasingly important and available strategy for researchers across the health science disciplines. Pain sensation and response to painful stimuli are examples of complex health phenomena that are particularly amenable to molecular genetics approaches. Both human and animal model research suggests that differences in these responses may be related, in part, to variation in the genes that modulate sensation and behavior. The authors are currently managing a large cross-disciplinary research effort to identify child characteristics, including genotypes, that predict the degree of distress displayed by children …

The Child With Leukemia: The Disease And Its Treatment, G. Foley, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

A Descriptive Study Of Individuals With Membranoproliferative Glomerulonephritis, Der-Fa Lu, Anne Mccarthy, L. Lanning, C. Delaney, C. Porter

Ann Marie McCarthy

OBJECTIVE: Membranoproliferative Glomerulonephritis (MPGN) is one of a group of glomerulonephritides that often begins in childhood and progresses to renal failure. The purpose of this paper is to describe the initial results of a patient-driven database on individuals with MPGN. SAMPLE/SETTING: Patients with MPGN Types I, II, and III and their family members were recruited to this survey study. DESIGN: A population survey design was used. METHODS: A survey was developed for this study that obtained information from the individual with MPGN or a guardian on: patient information, family/patient health history, history of PGN, medications, course of MPGN, history of …

Changes In Medications Administered In Schools, Ann Mccarthy, M. Kelly, S. Johnson, J. Roman, M. Zimmerman

Ann Marie McCarthy

The purpose of this descriptive, cross-sectional study was to determine if there have been changes in the type and number of attention deficit/hyperactivity disorder (AD/HD) medications administered in schools since the introduction of long-acting stimulants. A survey was sent to 1,000 school nurses randomly selected from the National Association of School Nurses membership, with 339 returned (34%). Between 2000 and 2003 the proportion of students receiving any prescription medication (2.9/100 vs. 1.0/100), methylphenidate (1.2 vs. 0.2), or amphetamine/dextroamphetamine (0.3/100 vs. 0.1/100) was significantly reduced ( p < .0001). High school students took fewer prescription ( p < .0001) and AD/HD medications ( p < .0001), but more nonprescription medications than other students. A total of 163 different prescription medications and 28 nonprescription medications were administered during the typical school day. This study suggests that the use of long-acting stimulants has significantly reduced the number of prescription medications administered in schools. This reduction has been accompanied by a dramatic increase in the range of medications administered, making the medication administration process in schools more complex, not less.

Family Perceptions Of Medication Administration At School: Errors, Risk Factors, And Consequences, D. Clay, K. Farris, Ann Mccarthy, M. Kelly, R. Howarth

Ann Marie McCarthy

Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses' and educators' experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems children experience with medicines at school, (b) clarify risk factors for medication errors, and (c) examine the perceived impact of medication errors on school performance and social relationships. Participants included children ages 8 to 18 years (n=157) being treated at a large Midwestern Children's Hospital in diabetes, asthma, and Attention Deficit Hyperactivity Disorder …

Infant And Preschool Well-Child Care: Master's- And Nonmaster's-Prepared Pediatric Nurse Practitioners, J. Glascock, C. Webster-Stratton, Ann Mccarthy

Ann Marie McCarthy

The nursing and medical literature reveals considerable debate over whether graduate or continuing education is the appropriate level for nurse practitioner preparation. These arguments have been rhetorical since the research literature lacks data on the scope of practice of master's- and nonmaster's-prepared nurse practitioners. The purpose of this study was to examine possible differences between the two types of practitioners in one area--well-child care provided by pediatric nurse practitioners (PNPs). A total of 236 master's- and nonmaster's-prepared PNPs completed a background questionnaire and checklists of nursing activities involving infant and preschool well-child care. Analysis of study results showed that master's …

Innovative Approaches For Teaching Children With Chronic Conditions, J. Engvall, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

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 …

Issues Of Medication Administration And Control In Iowa Schools, K. Farris, Ann Mccarthy, M. Kelly, D. Clay, J. Gross

Ann Marie McCarthy

Who is responsible for medication administration at school? To answer this question, a descriptive, self-administered survey was mailed to a random sample of 850 school principals in Iowa. The eight-page, 57-item, anonymous survey was mailed first class, and a follow-up reminder post card was mailed two weeks later. Descriptive analyses were conducted, with type of respondent (principal versus school nurse), grade level, and size of school examined to explore differences. A 46.6% response rate was obtained; 97% of respondents indicated their schools had written guidelines for medication administration. Principals (41%) and school nurses (34%) reported that they have the ultimate …

Psychological Screening Of Children For Participation In Nontherapeutic Invasive Research, Ann Mccarthy, L. Richman, R. Hoffman, L. Rubenstein

Ann Marie McCarthy

BACKGROUND: The need for children to participate in research has raised concerns about ethical issues surrounding their participation. OBJECTIVES: To describe a protocol of preresearch psychological screening and postresearch outcomes and to present the results of the screening process for a nontherapeutic, invasive research study. DESIGN AND SETTING: Descriptive study carried out at The University of Iowa Hospitals and Clinics, Iowa City. PARTICIPANTS: Twenty-eight children (mean age, 10.6 years) were screened, with 4 not completing the research study and another 4 unavailable for psychological follow-up. MAIN OUTCOME MEASURES: Prescreening interviews with parent and child and screening measures of appropriate child …

Development Of The Distraction Coaching Index, Charmaine Kleiber, Ann Mccarthy, Kirsten Hanrahan, L. Myers, N. Weathers

Ann Marie McCarthy

Children's distress during medical procedures can be decreased when professionals or parents provide distraction coaching, but the quality of distraction may contribute to the variation in the results. This article describes the development of the Distraction Coaching Index (DCI), a tool for measuring the quality and frequency of distraction coaching. Nominal group technique and consensus agreement were used for concept clarification and development of behavioral indicators and descriptors. Videotapes of untrained parents, trained parents, and expert professional coaches, who provided distraction to children (4-10 years old) undergoing peripheral intravenous catheter insertion, were used to assess interrater reliability and construct validity. …

Chronic Headaches In Children, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

Normative Salivary Cortisol Values And Responsivity In Children, Ann Mccarthy, Kirsten Hanrahan, Charmaine Kleiber, M. Zimmerman, S. Lutgendorf, E. Tsalikian

Ann Marie McCarthy

This was a descriptive study on normative salivary cortisol values and responsivity to a hospital clinic visit and an intravenous (IV) procedure in children. The study presented was a subproject of a primary research study that examined parents coaching their children requiring an IV placement in the use of distraction. One measure of child response in the primary study, salivary cortisol, was included to further our understanding of children's physiologic response to stressful and painful stimuli. Salivary cortisol samples were obtained from 384 children aged between 4 and 10 years upon arrival to the clinic and 20 minutes after their …

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 …

Migraine Headaches In Children: Treatment, Ann Mccarthy, J. Mehegan

Ann Marie McCarthy

No abstract provided.

The Child With Leukemia: In A Special Hematology Clinic, G. Foley, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

A Conceptual Model Of Factors Influencing Children's Responses To A Painful Procedure When Parents Are Distraction Coaches, Ann Mccarthy, Charmaine Kleiber

Ann Marie McCarthy

The purpose of this article is to present a model of factors that may influence a child's response to a painful procedure when parents are distraction coaches during the procedure. Nonpharmacological interventions, in particular, distraction, and parents as coaches for their children during procedures are discussed. A conceptual model is presented that illustrates the multiple factors and their possible relationships. A selected review of studies is provided that supports the inclusion of these factors in the model. The model and literature review focus on three major areas: characteristics of the child, characteristics of the parent, and procedural variables. The model …

Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen

Ann Marie McCarthy

This study evaluates the impact of parent-provided distraction on children's responses (behavioral, physiological, parent, and self-report) during an IV insertion. Participants were 542 children, 4 to 10 years old, randomized to an experimental group that received a parent distraction coaching intervention or to routine care. Experimental group children had significantly less cortisol responsivity (p = .026). Children that received the highest level of distraction coaching had the lowest distress on behavioral, parent report, and cortisol measures. When parents provide a higher frequency and quality of distraction, children have lower distress responses on most measures.