Parental Complaints Research Articles

Worldwide safety experience with ceftibuten pediatric suspension.

Ceftibuten suspension was administered to 1312 pediatric patients in clinical trials at a dosage of 9 mg/kg once daily, with a maximal daily dose of 400 mg. Adverse experiences were collected by voluntary reports by physicians from direct observations, parental and/or patient complaints in 1152 patients. In 160 patients gastrointestinal adverse experiences were elicited at each visit in addition to voluntary reports. Patients had a mean age of 4.9 years, the male: female ratio was 1:1 and 72% were white. Fifty-five percent (719 of 1312) of patients were treated in otitis media studies, 33% (438 of 1312) were treated in a pharyngitis study and 12% (155 of 1312) were treated in other studies. Adverse experiences occurred in 10% (138 of 1312) of all patients receiving ceftibuten suspension. The most common voluntarily reported treatment-related adverse events were diarrhea 3% (34 of 1152) and vomiting 2% (22 of 1152). For elicited adverse events related to treatment, the most common were also diarrhea 9% (14 of 160) and vomiting 3% (5 of 160). There were no deaths and only 0.9% (12 of 1312) patients discontinued treatment because of adverse events. Abnormal laboratory values related to therapy were uncommon and no patient discontinued treatment because of abnormal laboratory values. No cases of Stevens-Johnson syndrome, toxic epidermal necrolysis, serum sickness-like reactions or pseudomembranous colitis have been observed with ceftibuten suspension in research studies to date.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilateral massive adrenal hemorrhage

A systematic review of the etiopathogenesis of adrenal hemorrhage reveals that the factors that determine the occurrence of this complication in a patient can be identified prospectively. Such prospective diagnostic suspicion allows the significance of the otherwise nonspecific clinical features heralding this catastrophe to be appreciated in the precrisis interval. Confirmation of the diagnosis is achieved by visual demonstration of bilaterally enlarged and hyperdense adrenal glands on a CT scan and by demonstration of adrenocortical failure on hormonal evaluation. Preemptive steroid therapy and diagnostic evaluation during the precrisis period prevent the occurrence of a potentially disastrous adrenal crisis in a patient who is seriously ill from other problems and who cannot afford a setback of this severity. Because steroid therapy delayed until the stage of crisis may be unsuccessful in salvaging such a patient, prospective recognition must be based on identifying the patient at risk for BMAH and recognizing the significance of the nonspecific clinical features that accompany it in the appropriate clinical context.

Parent Behavioral Training for Child Noncompliance: Rationale, Concepts, and Effectiveness

No! Is there a word more famil iar to parents of toddlers? Indeed, not only do all children learn to say no to their parents, doing so is considered a normal characteristic of the developing 2to 3-year-old. Moreover, saying no may even be an expression of a toddler's emerg ing sense of identity, self-regulation, and independence.1 However, for some families, what begins as appar ently age-appropriate behavior de velops into a severe and unmanage able problem. In such cases, parents feel frustrated, helpless, and ineffec tive as their children become more and more defiant and oppositional. Such children refuse to follow direc tions and rules set by parents, by teachers, and by other adults. In short, these children are continually noncompliant, consistently refusing to initiate or complete actions re quested by other people.2 Noncompliance is perhaps the most common complaint of parents in general and is the most frequent presenting complaint among chil dren referred to clinics for treatment

Infant sleep problems: Origins, assessment, interventions

Infant sleep problems have become prevalent as complaints of parents to clinicians during the first 2 years of the child's life. This paper reviews (1) identification of multiple etiological sources for infant sleep problems from a systems perspective, (2) the assessment of sleep disturbances, and (3) the applica tion of intervention methods to the appropriate component of system dysfunction. These areas are reviewed by integrating research findings with clinical vignettes from our practice as pediatric sleep clinicians.

Pediatric emergency department complaints: A three-year analysis of sources and trends

To identify the incidence and major causes of patient and parental complaints in a pediatric emergency department. Retrospective analysis of complaints received regarding patients seen between January 1987 and December 1989. ED of Children's Hospital of Pittsburgh. All complaints received during the three-year period. Complaints were reviewed for reason, validity, and location at which patient was seen. One hundred seventy-six complaints from a total of 154,648 ED visits yielded a frequency of 1.1 complaints per 1,000 patient visits. Main reasons for dissatisfaction were misdiagnosis, billing, and inadequate treatment; 49% of complaints were judged valid. There were 0.69 complaints per 1,000 patient visits in the nonurgent medical portion of the ED. Patients seen emergently (critical care and trauma) had a significantly lower complaint frequency of 0.08 per 1,000 patient visits (P less than .001 by chi 2 analysis). Assessment of ED complaints is useful to highlight areas of patient dissatisfaction and develop plans for improving patient care.

PEDIATRIC EMERGENCY DEPARTMENT COMPLAINTS

Study objective: To identify the incidence and major causes of patient and parental complaints in a pediatric emergency department. Design: Retrospective analysis of complaints received regarding patients seen between January 1987 and December 1989. Setting: ED of Children's Hospital of Pittsburgh. Participants: All complaints received during the three-year period. Interventions: Complaints were reviewed for reason, validity, and location at which patient was seen. Measurements and results: One hundred seventy-six complaints from a total of 154,648 ED visits yielded a frequency of 1.1 complaints per 1,000 patient visits. Main reasons for dissatisfaction were misdiagnosis, billing, and inadequate treatment; 49% of complaints were judged valid. There were 0.69 complaints per 1,000 patient visits in the nonurgent medical portion of the ED. Patients seen emergently (critical care and trauma) had a significantly lower complaint frequency of 0.08 per 1,000 patient visits ( P χ 2 analysis). Conclusion: Assessment of ED complaints is useful to highlight areas of patient dissatisfaction and develop plans for improving patient care.

Auriculotemporal Syndrome Seen Clinically as Food Allergy

Adverse food reactions are common complaints to the general pediatrician. True hypersensitivity reactions are only a small part of the overall incidence of reactions. Other conditions that are initially thought to be food allergies include enzyme deficiencies, food poisoning, and pharmacologic agents in foods. We describe four children with parental complaints of "food allergies." For each child, auriculotemporal or Frey syndrome was later diagnosed. Because of its benign nature, Frey syndrome is important to recognize to avoid unnecessary laboratory testing and extensive referrals. CASE REPORTS Patient 1 A 4-year-old white girl had a history of food allergy that caused flushing of the left cheek. According to the mother, this flushing seemed most apparent after the child ingested red foods such as tomatoes, strawberries, and red candy.

Distinguished Children's Books in Spanish

Despite the ubiquitous complaints of many teachers, librarians, and parents regarding the selection and acquisition of children's books in Spanish, it is indeed reassuring to note the ever-increasing number of distinguished books for Spanish-speaking children recently being published in many countries around the world. This doesn't deny the fact that there is still an incredible number of vacuous stories/novels published in Spanish that, in the name of fantasy, insist on moralizing to young readers about what their authors consider good or desirable behavior. As has been always true, these absurd fantasies bore young readers with their inane plots, saccharine characters and/or tedious writing styles. The following, however, are exciting and/or informative fiction and non-fiction books recently published in Mexico, Spain, Argentina, Sweden and the United States which will delight Spanish-speakers. For the convenience of the reader I have assigned a tentative grade level to each book discussed.

The search for excellence: an encore.

The search for excellence: an encore.

A One-Year Follow-up Study of Parent-refer red Hyperactive Preschool Children

Thirty-five problem children and 19 controls were followed up 1 year after an initial assessment. Parent complaints at intake focused on active, inattentive, impulsive, and noncompliant behavior. Children were seen initially at a mean age of 35 months and were reassessed 11 months later. Mothers continued to rate problem children as more hyperactive and aggressive than controls. Independent laboratory assessments confirmed that problem behaviors persisted. These data suggest that symptoms of attention deficit disorder can be identified in young children, but they must be differentiated from difficult, but typical toddler behaviors which are more evanescent in nature.

Unusual Presentation of Nasal Foreign Bodies in Children

NASAL foreign bodies have been of interest to otolaryngologists, dentists, and pediatricians for many years. There is little doubt about the diagnosis when the classic clinical picture of a unilateral, purulent, fetid rhinorrhea is present; however, the diagnosis is still being missed by physicians.1In the atypical case, however, the literature does not mention, to our knowledge, the extremes to which the malodorous component of the symptom complex can serve to confound the clinician and plague the patient by overpowering other complaints. We have recently seen three such cases in which the chief parental complaint was of their child's bad body odor. Since, to our knowledge, this symptom has not been heretofore associated with nasal foreign bodies, it is our purpose to call attention to this potentially helpful diagnostic clue. Report of Cases Case 1.— At age 4 1/2 years, a boy had a one-year history of strong and

Delivery Systems in the Management of Hearing Impaired Children

The management of a hearing impaired child involves the family as well as the child himself, especially when the child is very young. Delivery systems therefore must include the parents as an integral part of the delivery chain and be sensitive to the parents' need to understand the treatment or therapy and, when appropriate, to sustain it in the home. Health care services that have educational implications have been termed eduhealth, which in the case of the hearing impaired child, refers to such services as the early detection of hearing loss, the proper fitting of hearing aids, the prompt treatment of upper respiratory infections that might lead to further hearing loss, and vision screening. The otolaryngologist, audiologist, and parent all have eduhealth responsibilities. Professionals in medicine and allied fields, although well trained and experienced in their specialities, are rarely prepared to meet all the needs of the young hearing impaired child and his parents with appropriate services and in the manner most appropriate for them. Some agencies, however, have demonstrated comprehensive capabilities in this area. In referring a family to a delivery system, the otolaryngologist should establish to his own satisfaction that the requisite skills are present. Common complaints of parents of hearing impaired children are the lack of communication with the physician and clinician, which is frequently the result of the vocabulary used by the specialist and the limited time spent with the parents during visits. The result can be parental failure to follow instructions and possibly irreversible damage to the child's development of listening, language, and speech skills. The eduhealth delivery service index is a new attempt to measure the effectiveness of systems for the delivery of education and health care services to young hearing impaired children and their parents. It has been demonstrated in a limited population and may prove useful in the comparison of delivery systems. The otolaryngologist is urged to become better acquainted with the various elements of delivery systems and to be cautious in accepting claims of comprehensive quality services until verified by his own experience or the reports of actual consumers of the services offered.

AN EVALUATION OF PARENTAL COMPLAINTS.

Back to table of contents Previous article Next article ArticleNo AccessAN EVALUATION OF PARENTAL COMPLAINTSJOHN C. ADAM, LEE D. RACHIELE, and MARY A. YOUNGJOHN C. ADAMSearch for more papers by this author, LEE D. RACHIELESearch for more papers by this author, and MARY A. YOUNGSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.121.12.1209AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "AN EVALUATION OF PARENTAL COMPLAINTS." American Journal of Psychiatry, 121(12), pp. 1209–1210 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByNone Volume 121Issue 12 June 1965Pages 1209-1210 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1965

Mathematics in the Junior High School: Junior High School and The Stock Market

In answer to the complaint of many parents today that their children are not learning arithmetic that will be of practical use, here is an arithmetic unit that the junior high teacher can use to enliven the classroom and at the same time develop many meaningful implications.

CRITERIA FOR RECOGNITION OF NEUROSES IN CHILDREN

RECOGNITION of the value of psychiatric treatment of children is spreading rapidly, but the selection of cases for psychiatric care is still determined more often by the complaints of parents than by objective criteria. This paper presents a developmental approach to the recognition of neurotic disorders in childhood. Thanks to the contributions of the psychometric and developmental branches of psychology, the well read pediatrician, equipped with books by Buhler,1Gesell,2Kulmann3and others, can detect a child who is subnormal in mental development. But what appears like mental subnormality may be a symptom of disturbed instinctual development. To recognize this symptom for what it is and to recognize other neurotic symptoms that may be present, it is necessary to know the normal progression of instinctual life. The recognized sequence of instinctual development is from the oral level to the anal level, the phallic level, the latency period