A survey about management of febrile children without source by primary care physicians

BACKGROUND: The management of young children with fever without source is controversial, and differences between physician specialties have been noted previously. The emergence of penicillin-resistant Streptococcus pneumoniae, the sharp decline in invasive Haemophilus influenzae infections in immunized populations and publication of practice guidelines have potentially altered physician practices. OBJECTIVE: To determine the present practice preferences of pediatricians, family medicine physicians (FP) and emergency medicine physicians (EP). METHODS: We mailed a checklist survey to 1600 randomly selected pediatricians, family medicine practitioners (FP) and emergency medicine physicians (EP) in the United States and replicated the methodology of a 1991/1992 survey. Physicians were asked about their evaluation and management of children of various ages (3 weeks, 7 weeks, 4 months and 16 months) with fever without source. RESULTS: Most primary care physicians would admit the 3- and 7-week-old infants. For the 4-month-old infant 59% of EP, 45% of pediatricians and 28% of FP would give empiric antibiotic(s) as an outpatient (P=0.005 for FP compared with pediatricians and P=0.02 for EP compared with pediatricians). The majority of physicians would manage the 16-month-old child as an outpatient without antibiotic therapy. Ceftriaxone was the preferred antibiotic for outpatient empiric therapy. There was a 3-fold increase (28% vs. 9%) for pediatricians in the use of empiric outpatient antibiotics for the 7-week-old infant in the present survey compared with the 1991/1992 survey. CONCLUSIONS: Physicians in the United States generally agree in their management of the young febrile infant, but with increasing patient age there is considerable variation. FP were the least aggressive in their evaluation and EP were the most aggressive.     

Parenting in context: Systemic thinking about parental conflict and its influence on children.

R. L. Fauber and N. Long's (see record 1992-43921-001) overview of research on family therapy with children is a valuable integration of the literatures on the family correlates of and treatments for childhood disorders. Several concerns apply to some of the influence Fauber and Long draw from risk research, however. Their assertion that various sources of family distress have effects that are mediated primarily through parenting is questionable, as is their suggestion that parenting therefore is the appropriate focus of family treatment. The conceptual issues of reductionism, linearity, holism, and change in defining causality are discussed in questioning these conclusions about etiology and treatment. Other empirical and methodological issues are raised briefly, particularly as they relate to statistical models of direct and indirect influences and to the body of correlational and analog research on how parental conflict influences children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parents' attitudes about children: Associations with parental life histories and child-rearing quality.

This study examined relations among parents' perceptions of their childhood, attitudes about life, expectations for child behavior, attitudes about their child's behavior, and the child-rearing environment parents provide. Eighty mothers of 1–5 yr olds were interviewed about perceptions of receiving harsh parenting as children, current attitudes about life, developmental expectations, and views of intentionality and severity of their child's misbehavior. The home environment was measured using the Home Observation for Measurement of the Environment (R. H. Bradley & B. Caldwell, 1979) scale. Mothers who reported harsh parenting as children, negative attitudes about life, and unrealistic developmental expectations had negative attitudes about their own child. These attitudes were related to provision of lower quality home environments. Results support a constructivist approach to understanding parental social cognitions and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Jordanian view about cancer knowledge and attitudes

Inherited polycystic kidney disease (PKD) in children is a disorder characterized by diffuse cystic involvement of both kidneys, without evidence of dysplasia. Both forms, autosomal recessive (ARPKD) and autosomal dominant (ADPKD) have considerable overlap in clinical presentation and radiographic features in the pediatric population. At present, a prenatal diagnosis is possible with ultrasound examination. A brief review of the literature is here reported. The knowledge of pathophysiological and clinical data is requested, since PKD represents a major cause of renal failure in pediatrics.     

A survey of common misconceptions about epilepsy.

Administered a survey questionnaire to 202 Ss of varying age, educational, occupational, racial, and gender background to determine the most common misconceptions about epilepsy relative to causes, initiators of seizures, first aid, personal characteristics, everyday activities, and treatment. Responses were dichotimized into categories of true and false, and the Ss' source of information was reported. ANOVAs indicated that public knowledge about the causes of epilepsy was limited. Educational information regarding first aid for seizures and treatment was needed. Specific knowledge deficiencies and some stigmatizing still persisted, and younger members of the general populations were the least informed. College graduates, white collar workers, and postgraduate students are the most informed. The data obtained can be used to design enlightening educational programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticipating parental death in families with young children

Voltage-activated currents from adult honey bee antennal motor neurons were characterized with in vitro studies in parallel with recordings taken from cells in situ. Two methods were used to ensure unequivocal identification of cells as antennal motor neurons: 1) selective backfilling of the neurons with fluorescent markers before dissociation for cell culture or before recording from cells in intact brains, semiintact brains, or in brain slices or 2) staining with a fluorescent marker via the patch pipette during recordings and identifying antennal motor neurons in situ on the basis of their characteristic morphology. Four voltage-activated currents were isolated in these antennal motor neurons with pharmacological, voltage, and ion substitution protocols. The neurons expressed at least two distinct K+ currents, a transient current (IA) that was blocked by 4-aminopyridine (4-5 x 10(-3) M), and a sustained current (IK(V)) that was partially blocked by tetraethylammonium (2-3 x 10(-2) M) and quinidine (5 x 10(-5) M). IA activated above -40 to -30 mV and the half-maximal voltages for steady-state activation and inactivation were -8.8 and -43.2 mV, respectively. IK(V) activated above -50 to -40 mV and the midpoint of the steady-state activation curve was +11.2 mV. IK(V) did not show steady-state inactivation. Additionally, two inward currents were isolated: a tetrodotoxin (10(-7) M)-sensitive, transient Na+ current (INa) that activated above -35 mV, with a maximum around -5 mV and a half-maximal voltage for inactivation of -72.6 mV, and a CdCl2 (5 x 10(-5) M)-sensitive Ca2+ current that activated above -45 to -40 mV, with a maximum around -15 mV. This study represents the first step in our effort to analyze the cellular and ionic mechanisms underlying the intrinsic properties and plasticity of antennal motor neurons.     

What do Norwegians know about sexually transmitted diseases? Results from a survey on Norwegians' knowledge about sexually transmitted diseases

This paper reports on knowledge about sexually transmitted diseases in Norwegian adults. The sample (572 males and 601 females) was representative of Norwegians aged 15 and above. Data were collected by means of personal interviews and self-completed questionnaires. Out of ten respondents, seven did not know that sexually diseases are not transmitted via toilet seats; six that syphilis is not the most prevalent of the sexually transmitted diseases in Norway; five that both males and females can be infected by chlamydia; four that contraceptive pills do not protect against chlamydia infection; three that condoms protect against all sexually transmitted diseases; and two that condoms protect against gonorrhoea and that females infected by sexually transmitted diseases run higher risk of infertility. Knowledge about sexually transmitted diseases was lowest in the youngest and oldest age groups, and increased monotonously with increased education.     

A review and integration of knowledge about faculty research productivity

The nursing literature is replete with commentary and opinions about the research and scholarly productivity of nursing faculty. There are also a number of research studies on several aspects of faculty productivity. However, a scholarly critique and integration of research on this topic is lacking. This article reviews the literature on faculty research productivity and synthesizes the findings to present recommendations for promoting nursing faculty research and scholarship.     

Innocent heart murmurs in children. A survey of 119 patients

The clinical findings in 119 children with innocent heart murmurs have been reviewed. The majority were aged between 1 and 5 years, and it was in this age-group also that a maximum incidence of venous hum was recorded. There were no particular ECG or chest X-ray findings.     

Reciprocal influences between parental knowledge and adolescent self-control: A cross-sequential nationwide study of Korean youth.

The main purpose of this study was to examine the bidirectional relation between parental knowledge and self-control among South Korean youth using a nationwide cross-sequential data. Data included early adolescents (N = 2,844, mean age at Wave 1 = 9.86 years) and middle adolescents (N = 3,449, mean age at Wave 1 = 13.79 years) over the 3 and 4 yearly assessments, respectively. Latent growth curve models revealed that the relation between parental knowledge and adolescent self-control was not a unidirectional phenomenon, but rather bidirectional dynamic set of interactive processes. Evidence of reciprocal influences indicated that higher initial levels of adolescents' perceptions of parental knowledge of their whereabouts and activities predicted slower rates of increase in their self-control and that higher initial levels of self-control predicted slower rates of increase in parental knowledge over time. The results point to the importance of a bidirectional, transactional view for understanding parent-adolescent interactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing parental instructions to schizophrenic and normal children: A pilot study.

Hypothesized that parents communicate to their schizophrenic children in conflicting ways. An experiment was designed where parents instructed their children in a task. Instructions were given from a separate room and were tape recorded so they could be played to matched samples of children. Parents of schizophrenics, of nonschizophrenic abnormal children, and of normal children were contrasted. The achievement of the children in the task was measured, and matched samples of children listened to the instructions of a group of parents of schizophrenics and a group of parents of normal children. Indications were that parents of schizophrenics do not communicate in more conflicting ways than parents of normal children when the measurement is the success of a child in following their instructions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors for stress in children after parental stroke.

Objectives: To assess risk factors for stress in children 3 years after parental stroke. Participants: Questionnaires were filled in by 44 children aged 7–18 years, parents who suffered a stroke and healthy spouses from 29 families recruited in 9 participating rehabilitation centers across the Netherlands. Method: We measured patient functioning (cognitive disorders, communicative disorders and ADL dependency), parental depression and perceived quality of marital relationship at 4 assessments, from the start of rehabilitation until 3 years post-stroke. Children assessed their stress level 3 years after parental stroke. Results: Girls experienced more stress than boys. Spouses' depressive symptoms during the first year after stroke were positively correlated with stress in children. Patients' depressive symptoms 2 months post-rehabilitation (2 months after discharge from the rehabilitation center), 1 year and 3 years post-stroke were also positively correlated with stress in children. The perceived quality of marital relationship decreased over time and at 2 months postrehabilitation, it was related to stress in children. Stress was not related to patient gender and functioning. Conclusions: Early prediction of long-term stress in children after parental stroke may be most accurate on the basis of children's female gender and depressive symptoms of the patient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some psychodynamic aspects of felt parental alliance in young children.

"No attempt is made to generalize this projective alliance beyond the possibility that it reflects some form of felt alliance on the part of the child. It is the relationship of this felt alliance to other factors that is presented here, as a research finding needing further, more direct, study for any real generalization." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wuchereria bancrofti microfilaraemia in children in relation to parental infection status

OBJECTIVE: To determine prevalence and severity of carboplatin-induced dose-limiting toxicoses in the cat. ANIMALS: 9 healthy, 6- to 7-month-old cats weighing 4.7 (range, 3.0 to 6.5) kg. PROCEDURE: Cats were given a single i.v. bolus of carboplatin at a dosage of 150 (n = 3), 200 (n = 3), or 250 (n = 3) mg/m2 of body surface area. RESULTS: Dose-limiting neutropenia and thrombocytopenia were significant in all cats given carboplatin at 200 or 250 mg/m2. Weight loss, changes in appetite, and evidence of respiratory difficulty, as well as vomiting, diarrhea, or lethargy were not observed at any time during the 28-day period. At a highest dosage (250 mg/m2), the neutrophil nadir (560 +/- 303 neutrophils/microliters) was observed on day 17 and the platelet count nadir (96,500 +/- 11,815 platelets/microliters) was observed on day 14 after carboplatin administration. CONCLUSIONS: Carboplatin appears to be safe and clinically well-tolerated when given i.v. as a single bolus at a dosage of 200 mg/m2 to clinically normal cats. The dose-limiting toxicity of a single i.v. administered bolus is neutropenia. The nadir of a 200 mg/m2 i.v. administered dose occurs on day 17 (1,110 +/- 165 neutrophils/microliters) and neutropenia (< 2,000 neutrophils/microliters) lasts from day 14 through day 25 after carboplatin administration. CLINICAL RELEVANCE: The fatal dose-related pulmonary toxicosis observed in cisplatin-treated cats was inapparent in carboplatin-treated cats. To adequately determine the therapeutic role of carboplatin in tumor-bearing cats, a moderately tolerated dose of carboplatin of 200 mg/m2 given i.v. once every 4 weeks should be considered.     

Women's knowledge about breast cancer. Dimensions of knowledge and scale development

Evidence suggests that knowledge about breast cancer may influence secondary prevention, care-seeking behavior, and participation in treatment decision-making. Yet few standardized measures of breast cancer knowledge are in existence. Using factor analysis, this paper describes the structure of women's knowledge about breast cancer and uses that structure to develop a measurement scale. Principal axis factoring and varimax rotation yielded a nine factor solution, which accounted for 59.3% of the common variance. Interpretation of the conceptual structure of these factors suggests that knowledge is organized around breast cancer treatment, misconceptions, risk factors, symptoms, menstruation, and prevalence. Considering only those items with factor loadings of .35 and greater, and including only those factors containing three or more items, a 16-item scale, which included four factor-based subscales covering knowledge about breast cancer treatment, misconceptions, risks, and symptoms was developed. Internal consistency reliability of the total scale and of the four subscales was high (alphas = .76-.95). Using chi square analysis, it was found that levels of knowledge on the total scale and on the treatment and symptom subscales are associated with age, education, income, and history of breast cancer. Knowledge on the misconceptions subscale was associated with age, education, and income. Knowledge on the risks subscale was associated with age and education. Issues of reliability and validity of the scale as well as directions for future research in this area are discussed.