Search

Social and economic conditions in the world today are leading to alterations in the family structure. Many mothers are required to work outside the home to provide for family needs. Consequently, more facilities of all kinds are being established to provide care for the children of working parents. The quality of services provided has increased from that of a simple child-minding service to an environment that can provide for the developmental needs of the child. The World Health Organization (WHO) has emphasized the introduction of physical and mental health care into child care facilities, while other United Nations agencies emphasize early childhood education. The necessity for some means of comparing facilities, assessing performance, and most importantly, evaluating the quality of child care is apparent. A series of test and inquiry items were submitted for review and analysis, from which a protocol for the WHO Child Care Facility Schedule (CCFS) was developed. The schedule consists of 80 items, covering matters concerning the physical environment, health and safety, nutrition and food services, staff-children interaction, observable child behavior, staff-family interaction, curriculum, and administration. The evaluation teams examined these schedules in Greece, Nigeria and the Philippines. Suggestions were made to rate the value of each item to develop a scale of performance. (Consumer Summary produced by Reliance Medical Information, Inc.), This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of [...]

The relationship between spouses' levels of expressed emotion (EE) and relapse was examined in a sample of 39 depressed psychiatric hospital patients. Over a nine-month follow-up, 59% of patients with high-EE spouses relapsed, although no patients living with low-EE spouses did so. The results replicate the association found by Vaughn & Leff between EE and depression, and suggest that the EE construct has predictive validity in both schizophrenic and depressed populations. [ABSTRACT FROM AUTHOR]

The article presents a study on the changes in attitude to illness amongst educated the Ganda tribe in Uganda. A Semantic Differential was prepared using 11 diseases as elements and eight constructs. A Semantic Differential was made in an attempt to measure changes in attitude to illness amongst educated Ugandans. A group of 19 qualified nurses with a group of 17 nurses at the very beginning of their training and with a group of 17 secondary school pupils of about the same educational standard as the student nurses were compared in order to investigate the effects of psychiatric nursing training.

We describe the detection and management of a retroperitoneal dermoid cyst in a young girl. Transabdominal ultrasound revealed in the pelvis a complex mass with anechogenic and echogenic components characteristic of a dermoid cyst. Initially, it was presumed to be of ovarian origin, because extragonadal dermoid cysts are very rare in adolescence; however, the findings on physical examination were normal. Laparoscopy was performed but failed to identify a cyst. Ultrasound examination was repeated intraoperatively and confirmed the presence of the cyst, which was then removed by laparotomy from the retroperitoneum. This case illustrates the significance of ultrasonography in the diagnosis of a rare condition in adolescent gynecology and demonstrates the possibility of performing ultrasound scanning intraoperatively to confirm the presence of a mass which was not identified by laparoscopy.

Study Objective: To evaluate the characteristics and symptoms of ovarian cysts, their connection with the methods of treatment, and the effectiveness of the therapy., Methods: A retrospective analysis of data on girls with ovarian cysts was performed at a university clinic. Participants included 119 girls in whom 144 ovarian cysts were found by ultrasound examination performed either routinely or for a specific purpose. One group of patients received gestogen to facilitate resolution of the cyst and as treatment of menstrual disorder. Others received clomiphene citrate exclusively as therapy for menstrual irregularity. Aside from this, patients were treated by surgical intervention, or only follow-up sonography was performed. The site, number, size, and type of the cysts were examined. The indications for ultrasonography and the effectiveness of the treatment were analyzed., Results: The ovarian cysts were mostly unilateral, unilocular, and simple, with the size varying between 3 cm and 5 cm in diameter in 90 cases, more than 5 cm in 41 cases, and less than 3 cm in 13 cases. A number of cysts were found incidentally on ultrasound. Girls were scanned most often because of irregular bleeding (80 cases). Hormonal treatment was given in 105 cases, whereas in 35 cases only follow-up sonography was performed. Cysts resolved spontaneously in 4.5 weeks on average, or in 3 weeks after hormonal treatment. Surgical therapy was necessary for nine patients. The indication for surgery was the detection of complex cysts indicative of dermoid type, size of the cysts, severe pelvic pain, or failure of the cyst to resolve or decrease in size spontaneously or in response to treatment as determined by follow-up sonography. All of the cysts were benign on pathological evaluation., Conclusion: Most ovarian cysts in girls could be managed conservatively, even the larger ones greater than 5 cm in diameter. Only exceptional cases required surgical therapy. Hormonal treatment shortened the duration of the cysts somewhat, but not significantly, and thus was useful mainly in the treatment of concomitant menstrual disorders.

WHO's work on child mental health began with John Bowlby's classic on the subject, written for WHO in the early 1950s. In the mid-1970s the Division of Mental Health was created, and this led to major advances in establishing a sound epidemiological and scientific basis for child mental health services. Significant contributions were made to the establishment of "biobehavioural" interventions to tackle the major causes of childhood mortality and morbidity throughout the world, and to provide better care for children with mental disorders at primary level.

Culturally appropriate techniques for monitoring child psychosocial development were prepared and tested in China, India and Thailand on a total of 28,139 children. This is the largest study of its kind ever undertaken. Representative groups aged between birth and 6 years were examined and the results were used to produce national development standards-separately for rural and urban children in China and India, and for all children combined in Thailand-which are considered to be more satisfactory than foreign-based standards. In each country, between 13 and 19 key milestones of psychosocial development were selected for a simplified developmental screening operation and these have been incorporated on a home-based record of a child's growth and development. Between 35 and 67 tests have been devised in each country to test the children at first-referral level.

Study Objective: To diagnose premature or prepubertal breast development or breast diseases., Design: Harmless, non-invasive examinations were conducted on young girls by the use of ultrasound and liquid crystal thermography with discs of various sensitivity., Setting: The study was conducted at the Radiological Department of the Postgraduate Medical University in Budapest, Hungary., Participants: The study entailed examination of 283 patients, all under age 14, of the paediatric gynaecological ward and the outpatient service who had breast problems., Interventions: Aspiration cytology or surgical intervention were used only in rare cases., Main Outcome Measure(s): The outcome was measured based on the accuracy and expediency of the diagnostic procedures., Results: The most frequent problems observed were precocious breast development, precocious pubertal development and asymmetric breasts. Precocious thelarche was observed in 117 patients, four patients were found to have cysts, and there were 59 cases of inflammation or abscess., Conclusions: Liquid crystal thermography and ultrasound proved to be sufficient and accurate means of diagnosis breast problems.

A WHO working group undertook a radical revision of the psychosocial axis for the classification of abnormal psychosocial situations. The rationale for the revision and the approach taken is described, together with the overall structure of the coding scheme and the subcodings within each category.

In 27 prepubertal-pubertal girls the chloride ion concentration in vaginal discharge and urine was estimated four times during the menstrual cycle by means of a direct new micromethod using a Cl-selective electrode. In pubertal girls the chloride content showed changes both in vaginal discharge and in urine; the latter changed practically parallel with the vaginal value. A sharp rise in chloride content characteristic of normal ovulation was observed in 5 patients free from hormonal disturbances, while there were significant differences during ovulation 5 times and in the premenstrual phase 6 times in the girls with hormonal disturbances.

The potential of several classes of antihypertensive drugs to cause orthostatic hypotension in man was evaluated in a conscious cynomolgus monkey model. Supine and erect blood pressure and heart rate were continuously monitored before and after administration of chlorisondamine (a ganglionic blocking agent); phentolamine and prazosin (alpha-adrenergic blocking agents); propranolol (a beta-adrenergic blocking agent); and minoxidil (a vasodilator). Substantial validation of the model was accomplished when it was observed that these drugs evoked cardiovascular responses in the animal model which were similar to those which had been described in the clinical literature.

A novel series of 1-(alkylamino)-1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepins shows hypotensive activity. A typical example is 1-[2-(1,3,4,5-tetrahydro-7,8-dimethoxy-2-benzoxepin-1-yl)ethyl]-4-(4-fluorophenyl)piperazine. This compound is an alpha blocker with peripheral and central activities.

Adults in two small Ugandan villages were interviewed, using a standard psychiatric examination and standard methods of case identification and diagnosis. Twenty percent had disorders just above threshold level, and a further 5% had more definite disorders. Most of these conditions were depressive, but hypomanic and anxiety states were also represented. A survey of women in southeast London found only half this frequency of disorders. Further studies are required to confirm these results.

We investigated the value of serum levels of adrenal steroids (dehydroepiandrosterone sulphate, testosterone, 17-hydroxyprogesterone, cortisol) in the identification in peripubertal females with late-onset congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Among 68 females (age 3-18 years) with virilization in childhood, peripubertally or postpubertally, we selected 21 girls for an ACTH test by measurement of basal blood-spot or serum 17-hydroxyprogesterone (17-OHP) levels. Eight of 21 patients had supranormal post-ACTH serum 17-OHP concentration (57-153 nmol/l) with low normal cortisol concentration. All of them had supranormal basal and post-ACTH 17-OHP to cortisol ratios. These data show a relatively high incidence (about 12%) of mild 21-hydroxylase deficiency among prepubertal and adolescent girls with virilization. It is concluded that the first step in the investigation of peripubertally virilized girls should be the determination of serum 17-OHP and cortisol. Patients with basal morning 17-OHP concentration and 17-OHP to cortisol ratio above reference range should be given an ACTH test.