Evaluating emergency preparedness and impact of a hurricane sandy in pediatric patients with diabetes.

BACKGROUND: Natural disasters have always been associated with significant adverse events including medical and mental health problems. Children with chronic disease such has diabetes have also been believed to be affected to a greater extent by any natural disaster. The purpose of this study was to assess and compare emergency preparedness post-disaster and post-traumatic stress effects of Hurricane Sandy in affected and relatively unaffected populations. METHODS: The study was conducted between February and July 2013. A total of 142 families caring for children with Type 1 Diabetes Mellitus (T1DM) who attended clinics were recruited from hospitals in Bronx, NY (control) and in NJ (affected) by Hurricane Sandy. Subjects were recruited to participate in a survey 3-6 months after the hurricane. Data on demographics, glycemic control and insulin regimens were collected. Families were surveyed for socio-economic status (SES), using Hollingshead questionnaire, general and diabetes preparedness and the Hurricane Related Traumatic Experiences (HURTE) questionnaire was used to evaluate for symptoms of post-traumatic stress. RESULTS: Ninety-five percent of families reported to be generally well to moderately prepared for the hurricane and 83 % reported to be very well prepared with regards to their child's diabetes during the disaster. There was no difference between the sites for preparedness for the disaster, age or gender. There was a trend toward significance (p < 0.06) in New Jersey subjects as to a greater psychological impact from the hurricane. Poor glycemic control was significantly associated with lower SES (p < 0.008). Most importantly, SES was unrelated to preparedness for diabetes management during the hurricane. CONCLUSIONS: Despite low SES, families were generally well to moderately prepared for hurricane. In children with diabetes, interventional studies should be designed and implemented so that glycemic control remains unaffected, following any major disaster.

The role of ethnicity in observers' ratings of mother-child behavior.

This study examined the role of ethnicity in untrained observers' ratings of videotaped mother-child interactions. Participants were Black, White, and Latino undergraduates (N = 109), who rated videotapes of 4 Black, 4 White, and 4 Latino mother-child dyads. Overall, participants of different ethnicities showed more similarities than differences in their ratings of parent-child behavior. There was, however, evidence that participant ethnicity and parent-child ethnicity interacted for ratings of child defiance/negative emotion. Black and White participants differed in their ratings of Black and White children's defiance/negative emotion, with members of each ethnic group favoring children of their own ethnic group. Intergroup contact appeared to play a role in ratings of parent behavior among Black observers. Black observers who reported low intergroup contact tended to rate Black mothers high on strictness and low on permissiveness. More research is needed to better understand the role of ethnicity in observers' ratings of parent and child behavior.

Neuropsychological abilities of preschool-aged children who display hyperactivity and/or oppositional-defiant behavior problems.

This study focused on gaining a better understanding of the neuropsychological abilities of preschool-aged children who show elevated levels of hyperactivity and oppositional-defiance. It examined the performance of children aged 48 to 67 months on tests of attention/executive function, language, memory, and sensorimotor abilities, as measured by the NEPSY and Conners' K-CPT. Two hundred thirty-seven children were divided into four subgroups based on mothers' report of behavior using rating scales and a diagnostic interview: hyperactive only (HYP), oppositional-defiant only (OD), hyperactive and oppositional-defiant (HYP/OD), and nonproblem. Children in the HYP/OD group scored significantly worse than nonproblem children on four of nine subtests on the NEPSY, including one test of executive function, one test of language comprehension, and both tests of short-term verbal memory. However, only the test of executive function (Statue) showed significant predictive power, and, while specificity of this subtest was good, sensitivity was poor. On the K-CPT, a continuous performance test, children in both the HYP and HYP/OD groups performed worse than children in the OD and nonproblem groups. When the NEPSY Statue subtest and the K-CPT were used together, overall predictive power was .74. Results suggest that neuropsychological deficits can be observed among preschool children with hyperactivity, particularly when comorbid oppositional-defiance is present; however, moderate predictive power suggests that these tests should be used in conjunction with other methods of assessment.