ABSTRACT
The relations of fear to anxiety sensitivity, control beliefs, and maternal overprotection were examined in 126 7- to 13-year-old clinically referred children with specific phobias. Results indicated that anxiety sensitivity and control beliefs were significant predictors of children's fear levels, accounting for approximately 48% of the total variance. Unexpectedly, age, gender, and maternal overprotection did not emerge as significant predictors of fear in the overall sample. In subsequent analyses, anxiety sensitivity was found to be a consistent, significant predictor for both girls and boys, for both younger and older children, and for children with and without an additional anxiety disorder diagnosis. Control beliefs were only a significant predictor for girls, younger children, and children with an additional anxiety diagnosis. Maternal overprotection was not a significant predictor for any group. Children with an additional anxiety disorder diagnosis had higher levels of fear, anxiety sensitivity, and maternal overprotection, as well as lower levels of control beliefs than the non-additional anxiety disorder subgroup. Future directions and clinical implications are explored.
ABSTRACT
BACKGROUND: Methicillin-resistant Staphylococcus aureues (MRSA) has been increasingly reported as the cause of community acquired skin infections in individuals without established risk factors. MRSA infections have been reported in multiple settings, but not yet in the commercial maritime industry. OBJECTIVE: To evaluate the incidence of skin and soft tissue infections at sea over the past 5 years, and to see if there are trends in reported clinical features that suggest MRSA as the pathogen. METHOD: A retrospective chart review was undertaken of all cases reported from 2002 until 2006 to a single tele-medical advice service for ships at sea. Since microbiologic diagnosis is not feasible at sea, cases were evaluated for the following features which may suggest MRSA: the presence of pus, small abscess or furuncle, or suspected spider bite. RESULTS: From 2002 to 2006 the percentage of cases that were skin infections rose from 5.5 to 8.8%. In 2002, 36% had features consistent with MRSA infection and 74 % had them in 2006 ( p <.05). Across all years approximately 25% of cases required an I&D procedure at sea or upon arrival in port. CONCLUSIONS: The number of skin infections reported to a single tele-medical advice service has increased in the past five years. Furthermore, the proportion of cases with features common to MRSA infections doubled. Planners for health care at sea should consider stocking appropriate antibiotics for suspected MRSA and ensure medical officers are trained to perform I&D (incision and drainage) in order to treat this increasingly common skin infection.
