Medicine and Health Sciences Commons^™

Rice Consumption Contributes To Arsenic Exposure In Us Women, Diane Gilbert-Diamond, Kathryn L. Cottingham, Joann F. Gruber, Tracy Punshon, Vicki Sayarath, A. Jay Gandolfi, Emily R. Baker, Brian P. Jackson, Carol L. Folt, Margaret R. Karagas

Dartmouth Scholarship

Emerging data indicate that rice consumption may lead to potentially harmful arsenic exposure. However, few human data are available, and virtually none exist for vulnerable periods such as pregnancy. Here we document a positive association between rice consumption and urinary arsenic excretion, a biomarker of recent arsenic exposure, in 229 pregnant women. At a 6-mo prenatal visit, we collected a urine sample and 3-d dietary record for water, fish/seafood, and rice. We also tested women's home tap water for arsenic, which we combined with tap water consumption to estimate arsenic exposure through water. Women who reported rice intake (n …

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 …

Project P.A.T.H.S. In Hong Kong: New Curriculum In Response To Adolescent Developmental Issues, Hing Keung Ma, Daniel T. L. Shek, Joav Merrick

Pediatrics Faculty Publications

No abstract.

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. …

Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman

Virginia M. Conley

Home care of a terminally ill family member is stressful, especially in rural areas. This qualitative study sought to determine informational needs of rural caregivers and how that information is obtained. Although most caregivers stated satisfaction with available information, mostly obtained from physicians and nurses, their behavior belied their satisfaction. Assertive and self-reliant, they used informal communications rather than written information to meet most of their needs. Approaches home care nurses can use to help caregivers obtain important information are presented.

Patient And Parent/Guardian Perspectives On The Health Care Of Adults With Mental Retardation, Sarah Voss Horrell, William Maclean, Virginia Conley

Virginia M. Conley

Individuals with mental retardation and their parents/guardians have long been neglected in health care research. In this study we used a qualitative methodology to describe the experiences adults with mental retardation and their parents/guardians have with the delivery of primary care services. Semi-structured in-depth interviews were conducted with 12 adults who had mental retardation and 9 parents/guardians. The grounded theory approach was utilized to guide data collection and analysis. Findings suggest an overall positive experience with primary care services. Unique themes were identified that distinguished parent/guardian experiences from those of adults with mental retardation, who focused on immediate, concrete issues …

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 …

Development Of A New Curriculum In A Positive Youth Development Program: The Project P.A.T.H.S. In Hong Kong, Daniel T. L. Shek, Hing Keung Ma, Rachel C. F. Sun

Pediatrics Faculty Publications

The design of a new curriculum in a positive youth development program (Project P.A.T.H.S.) in Hong Kong is outlined. The Tier 1 Program of the original phase of the Project P.A.T.H.S. is a universal positive youth development program for students in Secondary 1 to Secondary 3 with the curricula developed by a research team comprising scholars in different disciplines (e.g., social work, psychology, and education). The 120 teaching units are designed with reference to 15 positive youth development constructs identified in the successful positive youth development programs. In the extension phase of the project, a new curriculum with 60 teaching …

Case Study In Academic And Industry Collaboration: The Development Of An Adolescent Targeted Sun Protection Intervention In Nsw, Melinda Williams, Sandra Jones, Donald Iverson, Peter Caputi, Sofia Potente

Sandra Jones

Academic and industry collaboration is increasingly identified as a critical element in the future health of Australians through linking theory and practice, with the major priority for academic institutions being the identification of new knowledge and the transfer of this knowledge into changes in policy and health services. Collaborations between academia and industry are increasingly encouraged in Australia by research funding schemes such as ARCLinkage and, more recently, NHMRC Partnerships. While a recent US study suggests that such schemes have a moderate effect on academics’ propensity to work with industry (Bozeman and Gaughan, 2007), industry groups have recognised the value …

The Prevalence Of Postpartum Depression: The Relative Significance Of Three Social Status Indices, Lisa Segre, Michael O'Hara, Stephan Arndt, Scott Stuart

Lisa S. Segre

BACKGROUND: Little is known about the prevalence of clinically significant postpartum depression in women of varying social status. The purpose of the present study was to examine the prevalence of postpartum depression as a function of three indices of social status: income, education and occupational prestige. METHOD: A sample of 4,332 postpartum women completed a demographic interview and the Inventory to Diagnose Depression, a self-report scale developed to identify a major depressive episode in accordance with DSM diagnostic criteria. Logistic regression was used to assess the relative significance of the three social status variables as risk factors for postpartum depression …

Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree

Jill Scott-Cawiezell

OBJECTIVE: To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff. DATA SOURCES/STUDY SETTING: Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices. DESIGN: A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent …

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 …

The Beginning Breastfeeding Survey: Measuring Mothers' Perceptions Of Breastfeeding Effectiveness During The Postpartum Hospitalization, Pamela Mulder, T. Johnson

Pamela J. Mulder

No current breastfeeding assessment tool assesses the mother's perception of breastfeeding effectiveness during the early postpartum. Psychometric analysis of a new tool, the Beginning Breastfeeding Survey (BBS), in a multi-racial sample of 131 women revealed a coefficient alpha of .90. Factor analysis yielded three factors, (a) Maternal Breastfeeding Competence and Emotional Satisfaction, (b) Maternal Discomfort and Anxiety, and (c) Infant Breastfeeding Skill and Emotional Satisfaction. The BBS demonstrated discriminant validity in known group analyses and convergent validity with breastfeeding self-efficacy and postpartum fatigue. Future research will focus on improving the internal consistency reliability of the BBS and examining its ability …

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 …

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 …

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

Ann Marie McCarthy

No abstract provided.

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 …

The Early Bird Does Not Get The Worm: Time-Of-Day Effects On College Students' Basic Cognitive Processing, P. Allen, J. Grabbe, Ann Mccarthy, A. Bush, B. Wallace

Ann Marie McCarthy

We conducted a neuropsychological and cognitive assessment study to determine whether time of day affects cognitive performance. We measured executive control (fluency), processing speed, semantic memory, and episodic memory performance. We followed 56 students across 3 different times of day, testing performance on vocabulary, fluency, processing speed, and episodic memory. Results showed an advantage for fluency and digit symbol task performance in the afternoon and evening testing times relative to morning testing (regardless of testing order), but that time of day did not affect semantic or episodic memory performance. These results suggest that optimal executive functioning and processing speed may …

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 …

Chronic Headaches In Children, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

Cognitive Behavioral Pain And Anxiety Interventions In Pediatric Oncology Centers And Bone Marrow Transplant Units, Ann Mccarthy, V. Cool, M. Petersen, D. Bruene

Ann Marie McCarthy

Although research conducted on the treatment of pain and anxiety in children has found a number of cognitive behavioral interventions to be effective, it is not known to what extent this research has been put into practice. The purpose of this project was to obtain information on the use of cognitive behavioral interventions to help children and families cope with the pain and anxiety experienced during lumbar punctures and bone marrow aspirations. In this descriptive study, 15 Pediatric Bone Marrow Transplant Units and 32 Pediatric Hematology/Oncology Centers from across the country were surveyed using a questionnaire developed to obtain information …

Effects Of Diabetes On Learning In Children, Ann Mccarthy, S. Lindgren, M. Mengeling, E. Tsalikian, J. Engvall

Ann Marie McCarthy

OBJECTIVE: Subtle neuropsychological deficits have been found in some children with type 1 diabetes. However, these data have been inconsistent, and it is not clear what the impact of these deficits might be on the learning of children with diabetes over time. The purpose of this study was to determine whether type 1 diabetes significantly interferes with the development of functional academic skills. It was hypothesized that 1) children with type 1 diabetes would demonstrate deficits in academic performance and behavior when compared with sibling or classmate control subjects and 2) that academic performance in children with type 1 diabetes …

Medication Administration Practices Of School Nurses, Ann Mccarthy, M. Kelly, D. Reed

Ann Marie McCarthy

This study assessed the medication administration practices of school nurses. From a random sample of 1,000 members of the National Association of School Nurses, 649 (64.9%) completed the survey developed for the study. These school nurses report that during a typical day, 5.6% of children receive medication in school, with 3.3% receiving medications for ADHD. Almost all the school nurses follow written guidelines for administering medication. Potential problems were identified in documenting side effects of medications, storage of medications, student self-administration practices, and appropriate authorization of nonprescription drug use. Most nurses (75.6%) delegate medication administration to unlicensed assistive personnel (UAP), …

School Nurses' Experiences With Children With Chronic Conditions, Janet Williams, Ann Mccarthy

Ann Marie McCarthy

No abstract provided.

Cognitive Behavioral Interventions For Children During Painful Procedures: Research Challenges And Program Development, Ann Mccarthy, V. Cool, Kirsten Hanrahan

Ann Marie McCarthy

The purpose of this report is to describe a pilot program designed to introduce the use of cognitive behavioral interventions for painful pediatric procedures at a university hospital, and to discuss the challenges that occurred during this process. Participants in the program included ten parents and their children who were newly diagnosed with leukemia, and staff who provided treatment for these children. Measures included direct videotaped observations of the children, perceptions of pain and anxiety completed by children, parents, and staff, and parent and staff ratings of satisfaction with the program. Results indicated strong acceptance of the interventions. This report …

Where Are All The Pnps? Pediatric Nurse Practitioner Practice Opportunities And Challenges, D. Loman, Patricia Clinton

Patricia K. Clinton

No abstract provided.

Pain-Sensitive Temperament And Postoperative Pain, Charmaine Kleiber, M. Suwanraj, L. Dolan, Mary Berg, A. Kleese

Mary Berg

PURPOSE: To describe the relationship between pain-sensitive temperament and self-report of pain intensity following surgery. DESIGN AND METHODS: Fifty-nine adolescents and young adults (average age 14 years) undergoing spinal fusion for adolescent idiopathic scoliosis completed the Sensitivity Temperament Inventory for Pain-Child version (STIP-C). The Pearson correlation between STIP-C scores and the highest pain intensity for each of the first three postoperative days was investigated. RESULTS: There was a small but significant correlation between the Perceptual Sensitivity and Symptom Reporting subscales of the STIP-C and pain intensity measured on the third postoperative day. PRACTICE IMPLICATIONS: Aspects of the pain-sensitive temperament may …