Pub Date : 1989-09-01DOI: 10.1001/ARCHPEDI.1989.02150210031012
E. Marcuse
{"title":"Why wait for DTP-E-IPV?","authors":"E. Marcuse","doi":"10.1001/ARCHPEDI.1989.02150210031012","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150210031012","url":null,"abstract":"","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"68 1","pages":"1006-7"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88120862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-09-01DOI: 10.1001/archpedi.1989.02150210017009
R. D. Mauro
In Reply .—Dr Mauro's remarks would be very pertinent if we had suggested in our reply that platelet antibodies should be detected as part of a screening program of ITP in the general population . This is not so, however. Such a screening test would be unjustifiable, not only because of its immense costs, but mainly because it would offer no therapeutic or preventive advantage to the patients detected in this manner, as compared with those whose thrombocytopenia has been discovered, as is usually the case, on clinical grounds. Thus, the controversy regarding the utility of platelet antibody testing is limited to the population of patients with thrombocytopenia and cannot be extrapolated to the general population. In this setting, our statement on "coin flipping" remains correct. Platelet antibody testing has a positive predictive value for ITP of 50%. In other words, the probability for a patient with thrombocytopenia of having ITP if the
{"title":"Clear heads and bayesian tales: predictive value and the coin toss?","authors":"R. D. Mauro","doi":"10.1001/archpedi.1989.02150210017009","DOIUrl":"https://doi.org/10.1001/archpedi.1989.02150210017009","url":null,"abstract":"In Reply .—Dr Mauro's remarks would be very pertinent if we had suggested in our reply that platelet antibodies should be detected as part of a screening program of ITP in the general population . This is not so, however. Such a screening test would be unjustifiable, not only because of its immense costs, but mainly because it would offer no therapeutic or preventive advantage to the patients detected in this manner, as compared with those whose thrombocytopenia has been discovered, as is usually the case, on clinical grounds. Thus, the controversy regarding the utility of platelet antibody testing is limited to the population of patients with thrombocytopenia and cannot be extrapolated to the general population. In this setting, our statement on \"coin flipping\" remains correct. Platelet antibody testing has a positive predictive value for ITP of 50%. In other words, the probability for a patient with thrombocytopenia of having ITP if the","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"3 1","pages":"1000-1"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87389966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-09-01DOI: 10.1001/ARCHPEDI.1989.02150210047016
E. Handler
The use of computers to aid care for chronically ill pediatric patients is a relatively new concept. We are currently using Filemaker II software and a Macintosh Plus computer to augment overall patient care in children with chronic diseases, such as spina bifida, cerebral palsy, neuromuscular diseases, head injury, and spinal cord injury. This is a computerized medical record with a clinical database for dissemination of information to multidisciplinary team members, generating letters to private health care providers, displaying telephone messages, and assisting inpatient care. Advances in computer technology will provide future applications to aid health care providers in caring for patients with chronic illnesses.
{"title":"Computers in medicine. Augmenting medical care in pediatric patients with chronic illnesses.","authors":"E. Handler","doi":"10.1001/ARCHPEDI.1989.02150210047016","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150210047016","url":null,"abstract":"The use of computers to aid care for chronically ill pediatric patients is a relatively new concept. We are currently using Filemaker II software and a Macintosh Plus computer to augment overall patient care in children with chronic diseases, such as spina bifida, cerebral palsy, neuromuscular diseases, head injury, and spinal cord injury. This is a computerized medical record with a clinical database for dissemination of information to multidisciplinary team members, generating letters to private health care providers, displaying telephone messages, and assisting inpatient care. Advances in computer technology will provide future applications to aid health care providers in caring for patients with chronic illnesses.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"39 1","pages":"1021-3"},"PeriodicalIF":0.0,"publicationDate":"1989-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88392804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-08-01DOI: 10.1001/ARCHPEDI.1989.02150200111028
Cynthia C. See, L. Newman, S. Berezin, M. Glassman, M. Medow, A. Dozor, S. Schwarz
To evaluate relationships between gastroesophageal reflux (GER) and the development and onset of apparent life-threatening event(s) (ALTE), 16 infants presenting with ALTE and 6 control subjects manifesting clinical GER alone were studied using prolonged, esophageal pH monitoring in conjunction with simultaneous pulse oximetry and transthoracic impedance pneumocardiography. Despite the absence of a clinical vomiting history in 14 of 16 patients with ALTE, the incidence of GER was similar in both groups (patients with ALTE vs control subjects, 95% vs 100%). Significant arterial oxygen desaturation (less than 90% for greater than 3 minutes) was monitored during 60 episodes in 14 of 16 infants with ALTE, compared with no episodes of reduced arterial oxygen saturation in control subjects. Fifty-four of 60 of these desaturation events commenced within 3.9 +/- 0.4 minutes (mean +/- SD) of onset of a drop in esophageal pH to less than 4.0. Linear regression analysis indicates a significant correlation between duration of esophageal acidification and length of individual hypoxemic episodes (r = .39). Pneumocardiograms were normal in all patients. These data suggest that unsuspected GER is common in infants presenting with ALTE and, in these patients, GER may be directly associated with reflex hypoxemic episodes. Prolonged intraesophageal pH monitoring, performed simultaneously with evaluation for apnea, should be considered in all infants presenting with ALTE.
为了评估胃食管反流(GER)与明显危及生命事件(ALTE)的发生和发展之间的关系，我们对16名表现为ALTE的婴儿和6名单纯表现为临床GER的对照组进行了研究，采用长时间食管pH监测，同时进行脉搏血氧测定和经胸阻抗肺心动图。尽管16例ALTE患者中有14例没有临床呕吐史，但两组患者的GER发生率相似(ALTE患者与对照组，95% vs 100%)。16例ALTE患儿中有14例在60次发作中监测到明显的动脉血氧饱和度降低(低于90%，持续时间大于3分钟)，而对照组没有出现动脉血氧饱和度降低。60例去饱和事件中有54例发生在食道pH降至4.0以下的3.9 +/- 0.4分钟内(平均+/- SD)。线性回归分析显示，食管酸化持续时间与个体低氧血症发作时间之间存在显著相关性(r = 0.39)。所有患者的肺心动图均正常。这些数据表明，未预料到的GER在ALTE患儿中很常见，在这些患者中，GER可能与反射性低氧血症发作直接相关。所有ALTE患儿均应考虑延长食管内pH监测时间，并与呼吸暂停评估同时进行。
{"title":"Gastroesophageal reflux-induced hypoxemia in infants with apparent life-threatening event(s).","authors":"Cynthia C. See, L. Newman, S. Berezin, M. Glassman, M. Medow, A. Dozor, S. Schwarz","doi":"10.1001/ARCHPEDI.1989.02150200111028","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150200111028","url":null,"abstract":"To evaluate relationships between gastroesophageal reflux (GER) and the development and onset of apparent life-threatening event(s) (ALTE), 16 infants presenting with ALTE and 6 control subjects manifesting clinical GER alone were studied using prolonged, esophageal pH monitoring in conjunction with simultaneous pulse oximetry and transthoracic impedance pneumocardiography. Despite the absence of a clinical vomiting history in 14 of 16 patients with ALTE, the incidence of GER was similar in both groups (patients with ALTE vs control subjects, 95% vs 100%). Significant arterial oxygen desaturation (less than 90% for greater than 3 minutes) was monitored during 60 episodes in 14 of 16 infants with ALTE, compared with no episodes of reduced arterial oxygen saturation in control subjects. Fifty-four of 60 of these desaturation events commenced within 3.9 +/- 0.4 minutes (mean +/- SD) of onset of a drop in esophageal pH to less than 4.0. Linear regression analysis indicates a significant correlation between duration of esophageal acidification and length of individual hypoxemic episodes (r = .39). Pneumocardiograms were normal in all patients. These data suggest that unsuspected GER is common in infants presenting with ALTE and, in these patients, GER may be directly associated with reflex hypoxemic episodes. Prolonged intraesophageal pH monitoring, performed simultaneously with evaluation for apnea, should be considered in all infants presenting with ALTE.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"124 1","pages":"951-4"},"PeriodicalIF":0.0,"publicationDate":"1989-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87974927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-08-01DOI: 10.1001/ARCHPEDI.1989.02150200030013
G. Rachelefsky
Sinusitis is one of the most frequently overlooked and poorly understood diseases of childhood. There is a lack of information regarding criteria for diagnosis and the most effective method of management of sinusiSee also p 938. tis in children. Controversy exists regarding whether a sinus cavity is infected, how to diagnose sinusitis, and what the best treatment choice and duration is. The article by Tinkelman and Silk 1 in this issue of AJDC has prompted this editorial to bring the pediatrician up to date regarding these issues. I will limit my remarks to chronic sinusitis, that is, compatible symptoms that have been present for at least 3 weeks. (Some experts in the field would shorten this time to 10 days. 2,3 ) The nasal sinuses are four paired structures: the maxillary, ethmoidal, sphenoidal, and frontal sinuses that develop as evaginations of the mucous membranes of the nasal meatuses. The origin of
{"title":"Chronic sinusitis. The disease of all ages.","authors":"G. Rachelefsky","doi":"10.1001/ARCHPEDI.1989.02150200030013","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150200030013","url":null,"abstract":"Sinusitis is one of the most frequently overlooked and poorly understood diseases of childhood. There is a lack of information regarding criteria for diagnosis and the most effective method of management of sinusiSee also p 938. tis in children. Controversy exists regarding whether a sinus cavity is infected, how to diagnose sinusitis, and what the best treatment choice and duration is. The article by Tinkelman and Silk 1 in this issue of AJDC has prompted this editorial to bring the pediatrician up to date regarding these issues. I will limit my remarks to chronic sinusitis, that is, compatible symptoms that have been present for at least 3 weeks. (Some experts in the field would shorten this time to 10 days. 2,3 ) The nasal sinuses are four paired structures: the maxillary, ethmoidal, sphenoidal, and frontal sinuses that develop as evaginations of the mucous membranes of the nasal meatuses. The origin of","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"14 1","pages":"886-8"},"PeriodicalIF":0.0,"publicationDate":"1989-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81662685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-08-01DOI: 10.1001/ARCHPEDI.1989.02150200063019
Susan M. Kegeles, Nancy E. Adler, Charles E. Irwin
Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.
{"title":"Adolescents and condoms. Associations of beliefs with intentions to use.","authors":"Susan M. Kegeles, Nancy E. Adler, Charles E. Irwin","doi":"10.1001/ARCHPEDI.1989.02150200063019","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150200063019","url":null,"abstract":"Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"1 1","pages":"911-5"},"PeriodicalIF":0.0,"publicationDate":"1989-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80154834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-08-01DOI: 10.1001/ARCHPEDI.1989.02150200014004
B. Dahms, S. Czinn, P. Kilbridge
In Reply. —Chiesa et al and Oderda et al agree with us regarding the high prevalence of CP infection and its relationship to antral gastritis and duodenal ulcer. The highly effective results of antimicrobial therapy reported by Chiesa et al are interesting. To date, we have en unsuccessful in eradicating CP with amoxicillin monotherapy. Our results are in agreement with recently reported adult studies by Rauws et al, 1 as well as pediatric studies by De Giacomo et al. 2 The latter group had no success in eradicating CP or improving the underlying gastritis in their pediatric patients. The experience cited above by Oderda et al also indicates failure to achieve permanent eradication of the organism with ampicillin. We look forward to the publication of the study done by Chiesa et al. Perhaps we may be able to determine why we and others have not been successful in our efforts to eradicate
在回答。-Chiesa et al和Oderda et al同意我们关于CP感染高发及其与胃窦性胃炎和十二指肠溃疡的关系的观点。Chiesa等人报道的抗菌治疗的高效结果是有趣的。到目前为止，我们用阿莫西林单药治疗已经成功根除了CP。我们的研究结果与最近报道的Rauws等人的成人研究1以及De Giacomo等人的儿科研究一致。后一组在根除CP或改善其儿科患者的潜在胃炎方面没有成功。Oderda等人引用的上述经验也表明氨苄西林无法永久根除该菌。我们期待Chiesa等人的研究成果发表。也许我们可以确定为什么我们和其他人在根除疟疾的努力中没有成功
{"title":"Campylobacter pylori gastritis and peptic ulcer in children.","authors":"B. Dahms, S. Czinn, P. Kilbridge","doi":"10.1001/ARCHPEDI.1989.02150200014004","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150200014004","url":null,"abstract":"In Reply. —Chiesa et al and Oderda et al agree with us regarding the high prevalence of CP infection and its relationship to antral gastritis and duodenal ulcer. The highly effective results of antimicrobial therapy reported by Chiesa et al are interesting. To date, we have en unsuccessful in eradicating CP with amoxicillin monotherapy. Our results are in agreement with recently reported adult studies by Rauws et al, 1 as well as pediatric studies by De Giacomo et al. 2 The latter group had no success in eradicating CP or improving the underlying gastritis in their pediatric patients. The experience cited above by Oderda et al also indicates failure to achieve permanent eradication of the organism with ampicillin. We look forward to the publication of the study done by Chiesa et al. Perhaps we may be able to determine why we and others have not been successful in our efforts to eradicate","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"11 1","pages":"877-8"},"PeriodicalIF":0.0,"publicationDate":"1989-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84484875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-07-01DOI: 10.1001/ARCHPEDI.1989.02150190083027
R. Eldridge, Martha Bridge Denckla, Ellen Bien, Susan E. Myers, Muriel I. Kaiser-Kupfer, A. Pikus, Sandra Schlesinger, D. M. Parry, James M. Dambrosia, Michael Zasloff, John J. Mulvihill
Neurologic and cognitive function in neurofibromatosis type 1 (NF1) were assessed in a controlled pilot study of 13 pairs of siblings aged 6 to 27 years. One subject in each pair was affected with NF1, and the other, the control subject, was unaffected. Subjects with evidence of focal central nervous system disease were excluded. The 13 subjects with NF1 had no excess of mental retardation, attention-deficit disorder, or specific learning disorders (using Wilcoxon's Signed Rank Test and McNemar's Test for Symmetry). These subjects, however, had significantly higher scores for subtle neurologic abnormalities (21 vs 6) and significantly lower full-scale IQ scores (94 vs 105) than their unaffected siblings. The IQ scores of the affected subjects were not clustered at the lower end of the scale but showed a slight downward shift in distribution compared with those of their siblings. In addition, a visual-spatial orientation deficit was present in eight of nine affected subjects so evaluated. The findings suggest that subjects with NF1 have a widespread alteration of the brain during development that manifests as one or more specific types of neuropsychologic deficits.
1型神经纤维瘤病(NF1)的神经和认知功能在一项对照试验中进行了评估，研究对象是13对6至27岁的兄弟姐妹。每对中有一名受试者受到NF1的影响，而另一名对照受试者则未受影响。排除有局灶性中枢神经系统疾病证据的受试者。13名患有NF1的受试者没有过度的智力迟钝、注意力缺陷障碍或特殊学习障碍(使用Wilcoxon's Signed Rank检验和McNemar's Test for Symmetry)。然而，与未受影响的兄弟姐妹相比，这些受试者在细微神经异常方面的得分明显较高(21比6)，而全面智商得分明显较低(94比105)。受影响的受试者的智商分数并没有集中在量表的低端，但与他们的兄弟姐妹相比，在分布上有轻微的下降。此外，在接受评估的9名受影响的受试者中，有8人存在视觉空间定向缺陷。研究结果表明，患有NF1的受试者在发育过程中大脑有广泛的改变，表现为一种或多种特定类型的神经心理缺陷。
{"title":"Neurofibromatosis type 1 (Recklinghausen's disease). Neurologic and cognitive assessment with sibling controls.","authors":"R. Eldridge, Martha Bridge Denckla, Ellen Bien, Susan E. Myers, Muriel I. Kaiser-Kupfer, A. Pikus, Sandra Schlesinger, D. M. Parry, James M. Dambrosia, Michael Zasloff, John J. Mulvihill","doi":"10.1001/ARCHPEDI.1989.02150190083027","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150190083027","url":null,"abstract":"Neurologic and cognitive function in neurofibromatosis type 1 (NF1) were assessed in a controlled pilot study of 13 pairs of siblings aged 6 to 27 years. One subject in each pair was affected with NF1, and the other, the control subject, was unaffected. Subjects with evidence of focal central nervous system disease were excluded. The 13 subjects with NF1 had no excess of mental retardation, attention-deficit disorder, or specific learning disorders (using Wilcoxon's Signed Rank Test and McNemar's Test for Symmetry). These subjects, however, had significantly higher scores for subtle neurologic abnormalities (21 vs 6) and significantly lower full-scale IQ scores (94 vs 105) than their unaffected siblings. The IQ scores of the affected subjects were not clustered at the lower end of the scale but showed a slight downward shift in distribution compared with those of their siblings. In addition, a visual-spatial orientation deficit was present in eight of nine affected subjects so evaluated. The findings suggest that subjects with NF1 have a widespread alteration of the brain during development that manifests as one or more specific types of neuropsychologic deficits.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"24 1","pages":"833-7"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87358275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-07-01DOI: 10.1001/ARCHPEDI.1989.02150190059021
M. E. Wilson, J. Weiner, J. Bender, S. Bergstrom, B. Starfield
Pediatric residents are required to care for a group of children over a period of time. For many, this "continuity" experience is in a hospital outpatient department that may or may not provide primary care. We applied a measure of primary care to the Primary Care Clinic, the continuity clinic at The Johns Hopkins Hospital, Baltimore, Md, and found that it compared favorably with private pediatric practices in the Baltimore area, providing significantly more "principal care" (93% vs. 84.5% of encounters), and to the Harris Lane Home walk-in clinic, where only 51% of encounters were "principal care". The Primary Care Clinic scored higher on a primary care index, a measure of the extent to which the facility serves as a primary care source for patients, suggesting that hospital-based training can provide residents with an opportunity to provide primary care.
{"title":"Does a residents' continuity clinic provide primary care?","authors":"M. E. Wilson, J. Weiner, J. Bender, S. Bergstrom, B. Starfield","doi":"10.1001/ARCHPEDI.1989.02150190059021","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150190059021","url":null,"abstract":"Pediatric residents are required to care for a group of children over a period of time. For many, this \"continuity\" experience is in a hospital outpatient department that may or may not provide primary care. We applied a measure of primary care to the Primary Care Clinic, the continuity clinic at The Johns Hopkins Hospital, Baltimore, Md, and found that it compared favorably with private pediatric practices in the Baltimore area, providing significantly more \"principal care\" (93% vs. 84.5% of encounters), and to the Harris Lane Home walk-in clinic, where only 51% of encounters were \"principal care\". The Primary Care Clinic scored higher on a primary care index, a measure of the extent to which the facility serves as a primary care source for patients, suggesting that hospital-based training can provide residents with an opportunity to provide primary care.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"66 1","pages":"809-12"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81115880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-06-01DOI: 10.1001/ARCHPEDI.1989.02150180113031
D. Offer, E. Ostrov, K. I. Howard
We present in some detail what constitutes normal behavior, or mental health, among teenagers. Our data are based on the results of a specially devised psychological questionnaire by one of us (D.O.). This questionnaire has been shown to reliably distinguish mentally healthy from psychiatrically disturbed populations. Results are presented across three decades (1960s, 1970s, and 1980s), across genders, and across the high school years. A conceptual framework is presented to help the clinician working with adolescents to understand the fluctuation in psychopathology among youth. Adolescent density in the total population is shown to be a significant factor in determining the rate of disturbance among teenagers. Our research findings demonstrate that the rate of behavioral disturbance among adolescents is the same as in other parts of the life cycle. The clinician working with adolescents tends to underestimate the severity of adolescent problems because of the near-universal belief that all adolescents undergo "adolescent turmoil." We have found that adolescents who are experiencing turmoil need professional help.
{"title":"Adolescence. What is normal?","authors":"D. Offer, E. Ostrov, K. I. Howard","doi":"10.1001/ARCHPEDI.1989.02150180113031","DOIUrl":"https://doi.org/10.1001/ARCHPEDI.1989.02150180113031","url":null,"abstract":"We present in some detail what constitutes normal behavior, or mental health, among teenagers. Our data are based on the results of a specially devised psychological questionnaire by one of us (D.O.). This questionnaire has been shown to reliably distinguish mentally healthy from psychiatrically disturbed populations. Results are presented across three decades (1960s, 1970s, and 1980s), across genders, and across the high school years. A conceptual framework is presented to help the clinician working with adolescents to understand the fluctuation in psychopathology among youth. Adolescent density in the total population is shown to be a significant factor in determining the rate of disturbance among teenagers. Our research findings demonstrate that the rate of behavioral disturbance among adolescents is the same as in other parts of the life cycle. The clinician working with adolescents tends to underestimate the severity of adolescent problems because of the near-universal belief that all adolescents undergo \"adolescent turmoil.\" We have found that adolescents who are experiencing turmoil need professional help.","PeriodicalId":7654,"journal":{"name":"American journal of diseases of children","volume":"75 1","pages":"731-6"},"PeriodicalIF":0.0,"publicationDate":"1989-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85299476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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