Developmental changes in cardiacsomatic relations and infants\u27 orientation to complex sounds as a function of frequency.

The present study investigated how the frequency composition of a complex sound differentially influences newborns\u27 and five month-olds\u27 auditory localization. The stimuli were tape recordings of a rattle, filtered to produce 4 stimulus conditions: low frequency band-pass rattle ( less than 1600 Hz ) , mid-frequency band-pass rattle ( 1000-3000 Hz ), high frequency band-pass rattle ( greater than 1800 Hz ), and an unfiltered broad-band rattle. Sound pressure level was varied across trials to eliminate the possibility of any confounding effects as a result of the frequency manipulation. Direction, latency and duration of head turning, alerting and quieting were scored from videotapes of the infant\u27s behavior. Cardiac measures of responding were also taken in order to assess developmental ly the nature of cardiac-somatic relations in infants. In general, five month-olds head turned towards sounds more than newborns, and in contrast to the newborns, they turned their heads exclusively in the direction of the sound source. Significant differences in quantitative aspects of head turning towards a sound emerged, the head turning of newborns being longer in latency and duration. Differences in head turning towards the different frequency sounds occurred in newborns and five month-olds. The pattern of results for newborn head turning towards the sounds revealed an order of correct \u27 localizability \u27 proceeding from low ^ medium -4 high/broad frequencies* with no iv significant differences in head turning to the high vs broad-band frequency stimuli. Five month-olds showed an order of localizability proceeding from low/medium high/broad-band frequencies. Crossage comparisons revealed a developmental increase in head turning towards the low frequency stimulus. Five month-olds showed more alerting and quieting to sounds than newborns, and were as likely to alert as to quiet to a sound. In contrast, newborns showed significantly more alerting than quieting. Cardiac measures of responding revealed that heart rate change varied, at each age, as a function of head turning towards a sound. Newborns responded with cardiac decelerations only on those trials in which they did not head turn. On \u27head turn\u27 trials they showed no reliable cardiac response. Five month-olds responded with cardiac deceleration on both \u27head turn\u27 and \u27no head turn\u27 trials. The magnitude of the deceleration, however, was greater on trials in which they did not head turn. Results are discussed with regard to the development of the auditory system, recent findings on developmental changes in sensitivity to frequency information and literature on cardiacsomatic relations

Children’s perspectives on outpatient physician visits: Capturing a missing voice in patient-centered care

Actively involving children in their healthcare is a core value of patient-centered care. This is the first study to directly obtain children’s detailed perspectives on positive and negative aspects of outpatient physician visits in a primary care setting (e.g., checkups) and their preferred level of participation. Individual interviews were conducted with 167 children (female n = 82, male n = 85; ages 7–10, Mage = 8.07 years, SD = 0.82). Open-ended questions were used so that children’s responses were not confined to researchers’ assumptions, followed by close-ended questions to meet specific objectives. Quantitative content analysis, correlations, logistic regression, and Cochran’s Q were used to explore the data. Children were highly fearful of needle procedures (61%), blood draws (73%), pain (45%), and the unknown (21%). Children indicated that they liked receiving rewards (32%) and improving their health (16%). Children who were more fearful during physician visits wanted more preparatory information (ExpB = 1.05, Waldx2 (1) = 9.11, p = 0.003, McFadden’s R22 = 0.07) and more participation during the visit (ExpB = 1.04, Waldx2 (1) = 5.88, p = 0.015, McFadden’s R22 = 0.03). Our results can inform efforts to promote positive physician visit experiences for children, reduce procedural distress, and foster children’s ability to take an active role in managing their health

Motivational Interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: Methodology and design

<p>Abstract</p> <p>Background</p> <p>Childhood obesity is associated with serious physiological and psychological consequences including type 2 diabetes, higher rates of depression and low self-esteem. With the population of overweight and obese youth increasing, appropriate interventions are needed that speak to the issue of readiness to change and motivation to maintain adherence to healthy behavior changes. Motivational Interviewing (MI) is a method of therapy found to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behavior changes. While MI has shown promise in the adult obesity literature as effecting positive lifestyle change, little is known about the effectiveness of MI with overweight and obese youth. This study aims to: 1) demonstrate that MI is an effective intervention for increasing a person's self-efficacy; 2) demonstrate that exposure to MI will facilitate healthy behavior changes; 3) explore psychological changes related to participation in MI and 4) compare physiological and anthropometric outcomes before and after intervention.</p> <p>Methods/Design</p> <p>The current investigation is a prospective study conducted with ongoing participants who regularly attend an outpatient pediatric care center for weight-loss. Overweight youth (BMI > 85^th%ile) between the ages of 10 and 18 who meet eligibility criteria will be recruited. Participants will be randomly assigned to a control group (social skills training) or a treatment group (MI). Participants will meet with the therapist for approximately 30 minutes prior to seeing the dietician, over the course of 6 months. Participants will also undergo a full day assessment at the beginning and end of psychology intervention to evaluate body fat, and metabolic risk (screening for diabetes, high cholesterol, high blood pressure and fitness level). The paper and pencil portions of the assessments as well as the clinical testing will occur at baseline and at the conclusion of the intervention (6 months) with a repeat assessment 6 months following the completion of the intervention.</p> <p>Discussion</p> <p>Results from this study are expected to enhance our understanding of the efficacy of MI with children and adolescents who are overweight or obese.</p> <p>Trial registration</p> <p>Current Controlled Trials #<a href="http://www.clinicaltrials.gov/ct2/show/NCT00326404">NCT00326404</a>.</p

Older siblings as supervisors: Does this influence young children's risk of unintentional injury?

Unintentional injury is a leading cause of death and hospitalization of young children. Many of these injuries occur in the home when children presumably are being supervised. This study focused on the under-explored issue of sibling supervision in the home, drawing on data collected from a sample of Canadian mothers. Mothers in this sample completed a structured telephone interview and mailed back questionnaires to provide information about the nature and extent of sibling supervision that occurs in the home, as well as the younger child's injury history. Results indicated that older siblings supervise younger ones about 11% of their mutual wake time, with children typically playing and parents usually doing other chores during this time. Time spent with siblings as supervisors was positively related to the supervisee's history of injuries suggesting that sibling supervision may elevate younger children's risk of injury. However, the behavior of the supervisee contributed to risk more so than that of the supervisor. Specifically, sibling supervisors were reported to utilize the same types of strategies as their mother and father in their efforts to supervise and persuade younger children to stop things that could lead to injury. However, poor compliance by the younger child when the older sibling was supervising predicted injury. Implications for childhood injury and directions for future research are discussed.Canada Children Unintentional injury Supervision Siblings

A new approach to understanding pediatric farm injuries

The objective of this study was to apply a new conceptual approach to the study of pediatric farm injuries. A large case series of pediatric farm injuries in North America was evaluated to assess interactions between risk factors for injury. Information about pediatric farm injuries to children in three age groups (Canada US Children Farm injuries Risk factors Interactions

Deve[opmenta[ changes in masked thresholds

Masked thresholds for octave-band noises with center frequencies of 0.4, 1, 2, 4, and 10 kHz and for a «-octave-band noise centered at 10 kHz were obtained from listeners 6.5 months to 20.5 years of age at two levels of a broadband masker (0 and 10 dB/cycle). Thresholds declined exponentially as a function of age for all stimuli tested. The rate and extent of this decline, but not its asymptote, were independent of the frequency or bandwidth employed. The time course for this change parallels that found for electrophysiological matural;ion of more central auditory processes