A Follow-up Study of Traumatized Children

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Elizabeth Elmer

This study compared 17 abused children with 17 children who had been in accidents, matched for age, race, sex, and socioeconomic status, eight years after all had been studied as infants. Each traumatized group was also compared with a matched untraumatized group with no known history of abuse or infantile accident. The majority of all children were lower-class. Hypotheses were that the abused children would fall below the nonabused in health history and physical development, intellectual functioning, language, and self-concept; and that the abused children would score higher in impulsivity and aggression. Clinical assessments revealed few group differences. The surprising finding was the extent of various problems across the entire sample Seventy percent of the children had speech problems; over 50% showed some degree of disturbance; and 39% were achieving poorly in school. However, these disabilities were distributed randomly among abuse, accident, and comparison children. Most of the children appeared sad and fearful of personal attack by adults or other children. Many mothers' reports indicated that the families, whether abuse, accident, or comparison, experienced constant violence, both environmental and personal. It was concluded that the effects on child development of lower-class membership may be as powerful as abuse.

2021 ◽  
Vol 12 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson

The objective of this study was to examine the incidence of concussion and risk factors for sustaining concussion among children from the United States general population. This prospective cohort study used data from the Adolescent Brain Cognitive Development (ABCD) Study®. Children were recruited from schools across the US, sampled to reflect the sociodemographic variation of the US population. The current sample includes 11,013 children aged 9 to 10 years old (47.6% girls; 65.5% White) who were prospectively followed for an average of 1 year (mean = 367.9 days, SD = 40.8, range 249–601). The primary outcome was caregiver-reported concussion during a 1 year follow-up period. Logistic regression was used to determine which potential clinical, health history, and behavioral characteristics (assessed at baseline) were prospectively associated with concussion. In the 1 year follow-up period between ages 10 and 11, 1 in 100 children (n = 123, 1.1%) sustained a concussion. In univariate models, three baseline predictors (ADHD, prior concussion, and accident proneness) were significantly associated with sustaining a concussion. In a multivariate model, controlling for all other predictors, only prior concussion remained significantly associated with the occurrence of a concussion during the observation period (Odds Ratio = 5.49, 95% CI: 3.40–8.87). The most robust and only independent prospective predictor of sustaining a concussion was history of a prior concussion. History of concussion is associated with 5.5 times greater odds of sustaining concussion between ages 10 and 11 among children from the general US population.


2020 ◽  
Vol 36 (5) ◽  
pp. 313-318
Author(s):  
Jason M. Avedesian ◽  
Tracey Covassin ◽  
Janet S. Dufek

Recent evidence suggests previously concussed athletes are at greater risk for lower-extremity (LE) injuries than are controls. However, little is known regarding the influence of sports-related concussion (SRC) on landing biomechanics that may provide a mechanistic rationale for LE injury risk. The purpose of this investigation was to examine LE drop-landing biomechanics in adolescent athletes with and without a previous SRC history. Participants included 10 adolescent athletes with an SRC history and 11 controls from multiple sports. Three-dimensional kinematic and kinetic data associated with LE injury risk were analyzed across 5 trials for 30- and 60-cm landing heights. Multivariate analyses indicated group differences in landing patterns from the 30- (P = .041) and 60-cm (P = .015) landing heights. Follow-up analyses indicated that concussed adolescent athletes demonstrated significantly less ankle dorsiflexion and knee flexion versus controls when performing drop landings. Our findings suggest that previously concussed adolescent athletes complete drop-landing maneuvers with ankle and knee joint kinematic patterns that suggest greater risk for LE injury. While limitations such as sport variety and explicit LE injury history are present, the results of this study provide a possible biomechanical rationale for the association between SRC and LE injury risk.


2004 ◽  
Vol 9 (2) ◽  
pp. 1-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Douglas Van Zet ◽  
Debra J. Northrup ◽  
Edward B. Whitney ◽  
...  

Abstract [Continued from the January/February 2004 issue of The Guides Newsletter.] To understand discrepancies in reviewers’ ratings of impairments based on different editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), users can usefully study the history of the revisions as successive editions attempted to provide a comprehensive, valid, reliable, unbiased, and evidence-based system. Some shortcomings of earlier editions have been addressed in the AMA Guides, Fifth Edition, but problems remain with each edition, largely because of the limited scientific evidence available. In the context of the history of the different editions of the AMA Guides and their development, the authors discuss and contextualize a number of key terms and principles including the following: definitions of impairment and normal; activities of daily living; maximum medical improvement; impairment percentages; conversion of regional impairments; combining impairments; pain and other subjective complaints; physician judgment; and causation analysis; finally, the authors note that impairment is not synonymous with disability or work interference. The AMA Guides, Fifth Edition, contrasts impairment evaluations and independent medical evaluations (this was not done in previous editions) and discusses impairment evaluations, rules for evaluations, and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome).


2001 ◽  
Vol 120 (5) ◽  
pp. A128-A128 ◽  
Author(s):  
H MALATY ◽  
D GRAHAM ◽  
A ELKASABANY ◽  
S REDDY ◽  
S SRINIVASAN ◽  
...  

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.


Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.


1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)


Author(s):  
ROY PORTER

The physician George Hoggart Toulmin (1754–1817) propounded his theory of the Earth in a number of works beginning with The antiquity and duration of the world (1780) and ending with his The eternity of the universe (1789). It bore many resemblances to James Hutton's "Theory of the Earth" (1788) in stressing the uniformity of Nature, the gradual destruction and recreation of the continents and the unfathomable age of the Earth. In Toulmin's view, the progress of the proper theory of the Earth and of political advancement were inseparable from each other. For he analysed the commonly accepted geological ideas of his day (which postulated that the Earth had been created at no great distance of time by God; that God had intervened in Earth history on occasions like the Deluge to punish man; and that all Nature had been fabricated by God to serve man) and argued they were symptomatic of a society trapped in ignorance and superstition, and held down by priestcraft and political tyranny. In this respect he shared the outlook of the more radical figures of the French Enlightenment such as Helvétius and the Baron d'Holbach. He believed that the advance of freedom and knowledge would bring about improved understanding of the history and nature of the Earth, as a consequence of which Man would better understand the terms of his own existence, and learn to live in peace, harmony and civilization. Yet Toulmin's hopes were tempered by his naturalistic view of the history of the Earth and of Man. For Time destroyed everything — continents and civilizations. The fundamental law of things was cyclicality not progress. This latent political conservatism and pessimism became explicit in Toulmin's volume of verse, Illustration of affection, published posthumously in 1819. In those poems he signalled his disapproval of the French Revolution and of Napoleonic imperialism. He now argued that all was for the best in the social order, and he abandoned his own earlier atheistic religious radicalism, now subscribing to a more Christian view of God. Toulmin's earlier geological views had run into considerable opposition from orthodox religious elements. They were largely ignored by the geological community in late eighteenth and early nineteenth century Britain, but were revived and reprinted by lower class radicals such as Richard Carlile. This paper is to be published in the American journal, The Journal for the History of Ideas in 1978 (in press).


2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  

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