Association between corticosteroids and psychologic change in hospitalized asthmatic children.

Thirty-two children (mean age 14 years) with chronic, severe asthma were evaluated through the course of short-term prednisone "burst" treatment. At high steroid day (mean dose = 61.4 mg), the children reported more symptoms of anxiety and depression and demonstrated diminished verbal memory relative to low steroid day (mean dose = 6.97 mg). Order effects (evaluation at high steroid day first versus low steroid day first) were not significant for these steroid-sensitive variables. No dose-related changes emerged on measures of hyperactivity, attention, impulsivity, or fine motor control. Five subject variables were examined as potential risk factors. No association emerged between psychologic change scores and age, socioeconomic status, IQ, or asthma severity. Significant findings indicated that, as children increasingly demonstrated emotional difficulty or were from dysfunctional families, they were more likely to experience negative psychologic changes associated with high-dose steroids.

The child protective service worker: a profile of needs, attitudes, and utilization of professional resources.

County child protection units throughout the United States were surveyed to (1) profile the attributes of child protection workers, (2) determine their prevailing attitudes and needs, and (3) assess their access to and utilization of professional literature and consultation resources. Responses were received from 301 child protection workers employed in 33 different states. Respondents were generally depressed about their working conditions, the burden of huge caseloads, and unrealistic expectations of them. Job dissatisfaction was especially prevalent among workers who had been in the field for longer periods of time. Many workers had developed attitudes of resignation to their inability to help clients and had a tendency to avoid client contact. Workers reported doing very little professional reading due to the service requirements of their large caseloads and inaccessibility to journals and other meaningful literature pertinent to the field of child abuse and neglect. The availability of consultation in major specialty areas related to the performance of their child protective duties was frequently inadequate to meet their needs. Participation in formal training prior to first case involvement promoted professional reading and worker confidence in the quality of service provided. Worker job satisfaction and self-perceived professional skills were enhanced by membership in professional associations or societies and membership in or use of multidisciplinary teams. These results suggest the need to further develop national and regional resource centers in support of the practice of child protective service (CPS) workers.