Atropine sulfate--a current review of a useful agent for controlling salivation during dental procedures.

After reading this article, the reader should be able to describe techniques for the control of saliva during dental procedures; discuss the problems associated with saliva contamination of an operative field; explain the clinical benefits, dosing guidelines, and contraindications for using atropine sulfate to temporarily reduce saliva flow during dental procedures.

Role-modeling healthy behavior: peer counseling for pregnant and postpartum women in recovery.

The utilization of paraprofessional peer counselors for pregnant and postpartum women in recovery represents a nonthreatening and innovative departure from conventional medical and social service models. However, it must be acknowledged that these are women in recovery confronting the same daily stresses as their clients. In essence, they require the same social support services as their clients. Therefore, program planners must be reminded to build in the necessary social support systems for them at the outset. The rewards in terms of the peer counselors' capacity to engage and retain women with whom they can identify and help is well worth the investment. As a consequence of extensive community outreach and supportive activities undertaken by peer counselors, barriers to client receptivity may be removed, greater compliance and service utilization will be achieved, and the potential for successful recovery will be enhanced.

Impact of home-based respite care on families of children with chronic illnesses.

The recent dramatic medical and technological advances have meant that many children, who would have died previously of their chronic illnesses, now survive and live longer with their families. The purpose of this undertaking was to evaluate whether the implementation of home-based pediatric respite care reduced stress and improved the quality of life for families caring for children with chronic illnesses. Utilization of respite services was associated with a statistically significant (p < .05) reduction in somatic complaints by primary caregivers. There was also a trend in the data suggestive of an association between respite utilization and a subsequent decrease in the number of hospitalization days required by children (p < .07). Public health policy implications of the intervention are discussed.

Project CONNECT: an interagency partnership to confront new challenges facing at-risk women and children in New York City.

Project CONNECT is a New York State--New York City collaborative venture to facilitate access to, coordinate and expand the delivery of health and human services, during the perinatal period to women and children in the three areas of New York City with the highest rates of morbidity and mortality. Based on the concept of comprehensive case management, CONNECT coordinates diverse providers around existing resources. Services implemented by community-based case managers for families in need include: medical care, substance/alcohol abuse treatment, foster care preventive services, parent education, developmental assessment, screening and child care. The initial points of entry to CONNECT are specific hospitals within the three targeted neighborhoods. Additional points of entry, including other hospitals and prenatal care sites, are being added on an incremental basis. Enrollment in CONNECT is also enrollment in Medicaid and participants are eligible for Medicaid services. It is expected that the CONNECT program will result in improved birth and health outcomes for women and their children, reduction in chemical dependency and improved family preservation. The state and city agencies that created CONNECT hope that by working together, through a very specific interagency agreement monitored by the offices of the Governor and the Mayor, they will be able to reach those families who have many needs, but traditionally have been difficult to engage and keep involved in the service delivery system. The ultimate benefit will go to the family as a whole, particularly the children, both the newborns and their siblings.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship of perceived maternal acceptance-rejection in childhood and social support networks of pregnant adolescents.

In a sample of 53 at-risk pregnant adolescents, the relationship between their perceptions of maternal acceptance-rejection in childhood and the nature of their social supports was examined. Perception of acceptance-rejection was significantly correlated with both frequency of interaction with social network members and expectations of their future support. Implications for public health strategies are discussed.

PIP: The purpose of this study was to examine the relationship between the perception of maternal acceptance/rejection in childhood and the nature of supportive relationships perceived by at risk pregnant adolescents in the US. The sample was selected from pregnant adolescents who were determined to be at risk for child abuse and neglect or low birth weight or prematurity; the respondents were outpatients of the obstetrics and gynecology department of a large Rochester, New York hospital. The 53 respondents were residents of inner city neighborhoods, and had a mean age of 16 years. 78% were black, 20% white, and 1 Hispanic. 60% lived at home with parents. 40% received public assistance, and 56% reported at least 1 parent employed. About 50% had a history of difficulties such as truancy, suspension, or expulsion. By the 3rd trimester, 46% were not in school. Antecedent social problems revealed 15% child abuse or neglect, 13% suicide, 27% running away from home, 13% psychiatric counseling, 16% criminal probation, and 24% residential placement. The Parental 24 Item Acceptance/Rejection Questionnaire (PARQ) was administered in the 3rd trimester and requested information about mother's or caretaker's treatment when they were 7-12 years of age. 4 scales measured warmth and affection, aggression and hostility, indifference and neglect, and undifferentiated rejection. 10 items measured acceptance and 14 measured rejection; in the discussion, statistical reliability of measures is reported. A social support network measure was developed from a University of Rochester questionnaire. The research findings were that receiving warmth and acceptance in the early relationship with one's mother encourages similar behavior in relationship with others. Feeling rejected by one's caregiver tends to inhibit the formation of effective relationships with others in the social network. Perceived maternal acceptance during childhood was related to more social interaction with and higher expectations from social network members, particularly the baby's father and his family. It was not related to social interaction with mothers during pregnancy. The findings corroborate prior research and theory on the social isolation of pregnant teenagers from close supportive relationships. Public policy implications are that intervention strategies must help teenagers develop supportive relationships within their social networks.

Predictors of the decision to place developmentally disabled family members in residential care.

Critical circumstances that predict parents' requests for residential placements for developmentally disabled persons were described. The survey sample included 154 families who placed their disabled family member and 377 families who provided care at home. Empirical findings suggest that among families who place, the disabled persons are more impaired and have more severe behavior problems than do disabled persons being cared for at home. Families who place are more likely to be larger, headed by a single parent, suffer greater disruption of family life, and receive fewer direct client services. The policy implications of these findings were discussed.