ABSTRACT
OBJECTIVE: To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care (PC) and delivered using interactive voice technology (IVR) to families from underserved populations. DESIGN AND METHODS: Fifty parent-child dyads (child 9-12 yrs, BMI > 95th percentile) were recruited from a pediatric PC clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidence-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3-month follow-up. RESULTS: Forty-three dyads completed the study. IVR parents ate one cup more fruit than WLC (P < 0.05). No other group differences were found. Children classified as high users of the IVR decreased weight, BMI, and BMI z-score compared to low users ( P < 0.05). Mean number of calls for parents and children were 9.1 (5.2 SD) and 9.0 (5.7 SD), respectively. Of those who made calls, >75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. CONCLUSION: An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations.
Subject(s)
Family , Health Promotion/methods , Pediatric Obesity/therapy , Program Evaluation , Telephone , Vulnerable Populations , Weight Reduction Programs , Adult , Black or African American , Behavior Therapy , Body Mass Index , Child , Communication , Counseling , Diet , Female , Humans , Male , Middle Aged , Patient Education as Topic , Patient Satisfaction , Pediatric Obesity/ethnology , Poverty , Primary Health Care , Technology , Weight LossABSTRACT
Methacholine chloride bronchoprovocation challenges are performed for the diagnosis and investigation of hyperreactive airways. Over the last 20 yrs various formulations and pH values for the preparation of solutions of methacholine have been described. To determine the stability of methacholine chloride solutions prepared in a variety of buffers with differing pH values and under varying storage temperatures, we measured methacholine concentrations at intervals from 1 to 5 weeks. It was found that methacholine chloride solutions rapidly decompose if the pH is greater than 6 and that decomposition is more rapid as the pH is raised; solutions at pH 9, i.e. bicarbonate buffer, and stored at 27 degrees C have degradation up to 36% after only one week. Solutions of the same pH but prepared in different buffers can have both varied rates of deterioration and different absolute amounts of methacholine hydrolysed, e.g. solutions prepared in pH 9 borate buffer and stored at 27 degrees C have up to 60% degradation after 1 week. Solutions prepared in saline are stable probably because methacholine solutions are weakly acidic. The results emphasise the importance of preparing methacholine chloride in the proper buffers for use in the accurate assessment of airway responsiveness.
Subject(s)
Bronchoconstrictor Agents/chemistry , Methacholine Chloride/chemistry , Drug Stability , Hydrogen-Ion ConcentrationABSTRACT
Learning difficulties have been considered to be a symptom of childhood depression by some authors, whereas others have examined depression as a cause of cognitive difficulties, including learning disabilities (LD). This study examined the prevalence of depressive symptoms in a sample of public school elementary children aged 8 through 11, 37 boys and 16 girls, identified as LD by state standards. Of the sample of 53 children, 35.85% scored in the depressed range on the Children's Depression Inventory. Comparison of the children's self-reports and parents' reports of depressive symptoms in their children was not significant. Implications of the results are discussed relative to the role of school personnel and the assessment process in recognizing depressive symptoms in students with LD.
Subject(s)
Depression/psychology , Education, Special , Learning Disabilities/psychology , Child , Depression/diagnosis , Female , Humans , Learning Disabilities/diagnosis , Male , Personality Assessment , Risk FactorsABSTRACT
This Article explores the constitutional, statutory and common law privacy rights of physicians given the inescapable role of delivery data under supply side competition. The Article begins with a general review of the federal constitutional right of privacy. It then discusses the statutory protection given to physician-specific data under current federal law, and considers the insights gained from the controversy over physician data and the federal Freedom of Information Act. The remainder of the Article analyzes the usefulness of several common law causes of action to remedy the misuse of physician data, and concludes with recommendations which may obviate the need for litigation to protect against misuse of physician-specific data.
