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In 1988, Franklin County (Ohio) Children Services (FCCS) initiated the development of a bi-level, community-based, multi-disciplinary process to review all deaths of children in its open caseload, as well as child deaths in families with which FCCS had contact in the previous 12 months. This report examines the work of the Deceased Child Review Team during 1992, when 207 child deaths were investigated, 58 of which were of children with prior or continuing contact with FCCS. The report notes that cause of death was determined in 200 cases, with the largest number, 85, being cases of perinatal death due to extreme prematurity. The second leading cause of death was Sudden Infant Death Syndrome (SIDS), which accounted for 31 deaths. Child deaths tended to be clustered in Columbus, the largest city in the county, and black children had a higher death rate than white children. Of 31 FCCS cases subjected to further investigation, maltreatment was confirmed as the cause of death in 3 cases, while maltreatment was suspected in 5 others. The report includes various tables and charts presenting demographic data about the child deaths in the county. Seven appendixes provide tabular data about child deaths in Franklin County from 1989 through 1992 and information about the FCCS Deceased Child Review System. (MDM)

This report summarizes research and training activities between 1984 and 1987 of the Pregnancy and Perinatology Branch of the National Institute of Child Health and Human Development. Activities are reported for the following six maternal-infant emphasis areas: (1) high risk pregnancies; (2) fetal pathophysiology; (3) premature birth and labor; (4) disorders of the newborn; (5) Sudden Infant Death Syndrome; and (6) Acquired Immune Deficiency Syndrome. The Branch supported research in these areas including awarding approximately 32.4 million dollars in 236 grants and contracts during Fiscal Year 1986. Highlights of research supported is summarized for each of these areas. Also reported is research training, provided through Individual Postdoctoral Fellowships and Institutional Research Training Grants. Recent research supported by the Branch through the Perinatal Emphasis Research Centers is noted. Briefly reviewed are the Branch's Cooperative Agreements, the Contract Program, and the Small Business Innovative Research Program. Finally, planned future research emphases in the six areas are reported. Various figures detail funding distribution and several tables present specific funding data by category. (DB)

This material was developed to be used by instructors in the health related fields who have contact with nurses, doctors, ambulance crews, emergency medical technicians, and paramedics. The essay is a summary from various portions of an educational unit. The objective of the essay is to provide the reader with current up-to-date factual information involving Sudden Infant Death Syndrome (SIDS). The article is divided into the following four categories: (1) general facts concerning SIDS, (2) medical research involving SIDS, (3) professional involvement with SIDS, and (4) parental reaction to SIDS. A review of the literature was made and is presented in summary form. An extensive list of references is included. (Author/EB)

Crisis intervention programs for persons experiencing the sudden death of family members or surviving natural disasters have been advocated as methods of primary prevention, although few have actually been implemented. A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) was examined as an illustration of such preventive programing. This project covered the state of North Carolina and involved a sample of 154 subject families, after the infants' deaths, three home visits were conducted. Psychological goals of the visits were: (1) to reduce parents' guilt by countering inaccurate explanations for the death; (2) to encourage expression and acceptance of grief and to reassure them that this normal grieving process would end; and (3) to provide support in coping with problems. Demographic data on the families was similar to that reported elsewhere in that younger, unmarried, and nonwhite mothers were overrepresented. Because parents of SIDS victims experience profound feelings of guilt and especially severe crisis reactions, programs relieving guilt and providing additional support to them are felt to have significant preventive potential. Data tentatively supporting the conclusion that the SIDS grief intervention program had a beneficial impact on the participants. (Author/JLL)

The first five-year research plans developed by the National Institute of Child Health and Human Development (NICHD), covering fiscal years 1983-1987 and 10 program areas, are published in this volume. Present knowledge is reviewed and research opportunities are indicated in the areas of reproduction, fetal development, the birth process, the newborn, infancy and childhood, adolescents, and family and populations. Subsequently, priorities for future research are specified for the 10 program areas of (1) fertility and infertility, (2) pregnancy, birth and the infant, (3) nutrition, (4) sudden infant death syndrome, (5) congenital defects, (6) mental retardation, (7) child and adolescent development, (8) contraceptive development, (9) contraceptive evaluation, and (10) population dynamics. The volume also contains a description of a strategy for annual program evaluation and further planning. Appendices provide a description of the method of study used by the NICHD Steering Committee, a description of the task with which the study groups were charged, an outline of the review process and a listing of reviewers, and the procedure used to arrive at the research plan. (Author/RH)

This report addresses implementation of the maternal and child health (MCH) services block grant. Information concerning implementation was gathered from 13 states. At least one state was selected in every standard federal region, and, in total, the 13 states accounted for approximately 45 percent of all block grant funds and an equivalent portion of the nation's population. In addition, these states accounted for about 40 percent of MCH block grant funds. At the federal level, information concerning MCH fund allocations for fiscal years 1981, 1982, and 1983 and certain program information was obtained. At state and local levels, a wide variety of data collection instruments and approaches was used to obtain information from individuals or organizations responsible for or having an interest in a single block grant or multiple block grants. Fieldwork was carried out primarily between January and August of 1983. Chapters of the report focus on the following: funding patterns emerging under the MCH block grant and the ways they differed from patterns existing in prior categorical programs; changes made at the state and service-provider levels in the types of MCH services offered and the methods of delivery; state organization and management changes; and the involvement of citizens, state elected officials, and interest groups in processes leading to decisions on the use of block grant funds. Appendices describe data collection methodology, indicate expenditures for various health conditions, and disclose interest group responses to questions about block grant implementation for MCH programs. (RH)

This report describes research programs focusing on the sudden infant death syndrome (SIDS) and indicates some presently available results. Specific attention is given to research on sleep apnea, respiratory control, and hypoxia, as well as to infectious disease processes and immunology. Findings of a large-scale multidisciplinary SIDS project are discussed. In addition, various related research studies conducted by different agencies are described. Funds allocated to and estimated for public health service agencies are specified for the years 1980 through 1984. (RH)

Reviews three areas of literature on home apnea monitoring for infants: (1) identification of infants at risk, (2)technical aspects of monitoring, and (3) families' responses to monitoring. Outlines areas of controversy, including effect of use of home monitors on parent anxiety. Calls for ongoing education for parents who undertake home monitoring. (AJH)

Examined differences within 34 pairs of parents bereaved by Sudden Infant Death Syndrome (SIDS), 3-40 months after their loss. Findings revealed that bereaved parents sought support from within family most frequently and from outside resources the least. Bereaved mothers used these coping patterns significantly more often than did fathers. Found gender differences in frequencies for expressing feelings. (Author/NB)

The responses of friends and acquaintances of parents whose child has died as the result of Sudden Infant Death Syndrome can be helpful and supportive or they can be guilt-producing, painful, and destructive. Some destructive responses experienced by parents in those circumstances include questioning such as, "Did you...?" which implies that somehow the parents were neglectful and responsible for the death; silence, which may be eloquently accusing or isolating if it is the silence of avoidance; suggestions that the baby be forgotten, which encourage the parents to deny the existence of a baby; "Well, you're young," which assumes that another baby can simply replace the dead one; and "at least" statements "at least the baby didn't suffer,""at least you have other children" which deny the validity of the parents' feelings. The most helpful responses, whether verbal or nonverbal, are those responses that allow the parents to cry, express anger, talk about guilt, and vent hostility. (TJ)

There is a growing body of evidence that Sudden Infant Death Syndrome (SIDS) victims are not completely normal and healthy, as was once believed. A variety of new information from several disciplines strongly suggests that the infant who dies suddenly and unexpectedly may do so because of subtle developmental, neurologic, cardiorespiratory, and metabolic defects that converge at a particularly vulnerable time. Associated factors may include the anatomic structure of the upper airway, upper respiratory infection, and stress-producing environmental conditions. This report on SIDS first presents the historical perspective, the epidemiology, and the etiology of the phenomenon and describes the research efforts of the National Institute of Child Health and Human Development. The second section outlines the current stage of knowledge about SIDS including recent pathologic findings and findings on the role of sleep. In the final section, recommendations are made for research in the areas of epidemiology, infection and immunology, metabolic factors, upper and lower airways, behavioral considerations, sleep, biochemical factors, and the central nervous system. A bibliography of 77 references is included. (JD)