Nonorganic failure to thrive: an outpatient approach

This article reviews our experience, as well as the medical literature, regarding the treatment of failure to thrive (FTT) on an outpatient basis. Nonorganic FTT can be accidental, neglectful, or deliberate. Accidental FTT occurs with errors in formula preparation, diet selection, or feeding technique. These errors can usually be corrected by education and demonstration. Deliberate underfeeding is rare, and these children usually require placement in foster care. Neglectful FTT usually occurs because the mother is overwhelmed or psychologically disturbed. Children with neglectful FTT do not automatically require hospitalization. If the degree of FTT is mild to moderate, the mother-child interaction is positive, the mother is not severely disturbed, and the baby has no inflicted injuries or deprivational behavior, the baby can be safely and more economically managed as an outpatient. Management includes new feeding instructions, a stimulation program, social work intervention, home visits by a public health nurse, and weekly weight checks. Most infants respond to this one-month therapeutic trial with an appropriate weight gain. Even after normal weight is attained, many of these families require long-term follow-up to help them deal with multiple psychosocial issues.     

Applying systems analysis to program failure in organizations

Certain systems analysis techniques can be applied to examinations of program failure in continuing education to locate weaknesses in planning and implementing stages. Since failures can be the result of human errors and environmental conditions (and frequently a combination of both), a systems design to determine causes must include techniques that can detect both individual and nonhuman factors. Questions to guide an analysis and various procedures are recommended. Unexamined failures may lead to tossing the baby out with the bathwater, when analysis, in fact, could be the initial step toward successful future implementation.     

A quantitative cost effectiveness model for Web-supported academic instruction

This paper describes a quantitative cost effectiveness model for Web-supported academic instruction. The model was designed for Web-supported instruction (rather than distance learning only) characterizing most of the traditional higher education institutions. It is based on empirical data (Web logs) of students' and instructors' usage implementing Web-mining techniques. This will enable to quantify the costs and benefits of Web-supported instruction on both the single-course and the campus-wide levels. This paper describes the model's characteristics; the costs and benefits components in six dimensions; the computational mechanism that translates the cost and benefit components into quantitative values referring to university policymakers, instructors, and students; and its development process consists of the model design, creation of the computational mechanism and validation by instructors and students.     

Similarities and differences between nonorganic failure to thrive and deprivation dwarfism

Although the terms, nonorganic failure to thrive and deprivation dwarfism, are sometimes used interchangeably, and while the family pathology is similar in both conditions, the clinical features differ. The majority of children with nonorganic failure to thrive are under 2 years and often 18 months of age. Weight loss is the most marked feature and they are often withdrawn and apathetic. In contrast, the documented ages of children with deprivation dwarfism range from 2 to 15 years although the history may reveal earlier feeding and behavior problems. Short stature is the most striking feature, their weight often being in proportion to their height. They may steal and hoard food and have bizarre eating habits. In some cases reversible hypopituitarism has been documented. It is suggested that deprivation dwarfism constitutes a subgroup within the nonorganic failure to thrive syndrome. Management in both conditions is similar. It should emphasize a practical, supportive approach and be on a long-term basis.     

Variables related to the effectiveness of response cost

Students in four second-grade classes exhibiting disruptive behavior were exposed to response cost programs with varying initial reinforcement and fine levels. Results indicated that all treatments were highly effective, as all groups underwent maximum behavioral change, with the target behaviors approaching a near-zero level. Thus, the degree of aversiveness of the procedure did not appear to be strongly related to effectiveness. Results are explained in terms of the discriminative properties of response cost.     

The cost effectiveness of vocational training: A survey of British studies

Over thirty published and unpublished analyses of the cost-effectiveness of vocational training in the United Kingdom from 1965 to 1980 are surveyed. The emphasis is not on situation-specific conclusions but on methodological developments in costing, in assessing effectiveness, and in procedures for relating, interpreting, and presenting evidence on the costs and effectiveness of training. The state of the art suggests that these analyses should be treated as conditional information summaries rather than categorical guides to investment.     

Prediction of weight for height following intervention in three-year-old children with early histories of nonorganic failure to thrive

The present study assessed the weight for height outcomes of 59 3-year-old children who had been hospitalized for nonorganic failure to thrive (NOFT) as infants (average age of 5 months) and received time-limited outreach intervention. Although the majority of children attained normal weight for height, nearly one-third demonstrated at least mild wasting. Type of outreach intervention did not affect weight for height at outcome. The predictive efficacy of a variable set which included characteristics of NOFT (age of onset and duration), velocity of weight gain subsequent to diagnosis and environmental characteristics (income and home stimulation) was tested. Shorter duration of NOFT prior to diagnosis and greater initial rate of weight gain following hospitalization predicted weight for height at 36 months. The findings underscore the need for close monitoring of physical growth and nutritional status of NOFT children following hospitalization as well as comprehensive assessment and treatment for children who continue to demonstrate nutritional deficits. Additional studies of factors which affect the prognosis of NOFT children are needed.     

德国企业在职业教育中的作用及成本效益分析

德国企业在职业教育中发挥着教学主体、经费主体和法律主体三大作用.从微观教育经济学的观点看,企业对职业教育的高投入,确实增加了企业成本.但实际情况表明,企业的投入不仅创造了直接经济效益,而且也取得了间接经济效益,这主要体现在获得高素质的职业人才方面.特别是从宏观教育经济学的观点分析,企业对职业教育的投资是对人力资源开发的投资,是企业未来发展的需要.     

Hospitalized cases of nonorganic failure to thrive: the scope of the problem and short-term lay health visitor intervention

This paper describes the characteristics of thriving and failure to thrive (FTT) children and their mothers and examines the effect of short-term lay health visitor intervention in cases of nonorganic failure to thrive (NO FTT). Twenty-five FTT children and mothers received lay health visitor (LHV) intervention in addition to other community and medical treatment; 25 other FTT children and mothers did not receive the LHV intervention but did receive all other medical and community treatment. Twenty-five thriving children and mothers were matched with the FTT children and mothers in the LHV group on the child's age at intake, sex, birth weight, and the mother's age, ethnicity, and number of living children. At initial assessment, the FTT and thriving groups were found to be comparable on demographic factors, infant birth weight percentiles, apgar scores, complications of pregnancy or delivery, and separations in the newborn period. There were more premature births in the LHV group although the proportion of premature births for the FTT and thriving groups overall were similar. A majority of mothers in the FTT groups had negative memories of childhood in contrast to more positive memories in the thriving group. At initial assessment, the majority of thriving children were developmentally normal and had increased from their birth weight percentiles whereas all of the FTT children had decreased from their birthweight percentiles and over half were developmentally delayed. There were clear differences in mother-child interaction patterns in the thriving and FTT groups. Three patterns of interaction were identified in the FTT group: benign neglect, incoordination, and overt hostility. Intervention had no measurable effect on the child's weight, development, or interaction patterns. Only 8 of 37 FTT children reevaluated 6 months later showed "catch up" growth and only 7 had improved in developmental score category. Patterns of interaction were found to persist over the 6 months in all cases. One to three year follow-up of 44 families emphasized the severity of the condition and the need for differentiation of the severity of the disturbance in the mother-child relationship and for more intensive intervention than was available in this study. Of these 44 cases, 2 children had died, 5 had been physically abused or further neglected, and 10 were in alternative care arrangements.     

An urban school renewal program: A case analysis

Conclusion One of the most gratifying returns was a chance comment offered by a teacher as we walked across the lawn toward a local fast food restaurant. We were chatting about what he had experienced during the preceding two years. You know, he said, when we began this, I didn't see many hopeful signs, but I think that most of us (teachers) feel now that we work in the best high school in the city. The source may have been biased, and rigorous controls were obviously lacking, but that is the way one teacher perceived the changes. Many gained planning, leadership, problem solving, and other important behavioral and coping skills that contributed in interactively subtle, but nevertheless real ways.Can good things be made to happen in urban schools? The quantified data are equivocal, but we believe that the associations among interventions and perceived changes support cautious optimism.     

Child sex abuse treatment: Some barriers to program operation

A treatment program for sexually abusing families is described, which illustrates the complexities in the families, in the treatment required to assist them, and in the interrelations of agencies with whom they come into contact. The program used a multi-therapist, multi-modality treatment model in conjunction with expert consultants in medicine, psychology, art therapy, law, criminology, and research. The article discusses the formidable barriers to creating a treatment program that stem from the necessity of establishing linkages with other agencies and systems in the society. These barriers include the difficulty other service providers may have in recognizing the problem; the trouble doctors, lawyers, and policemen have in interviewing the young victims; the problems in the criminal justice system with obtaining justice for the victim by arresting and prosecuting the offender while protecting his rights; and the conflict of the schools caught between their responsibility as mandated reporters of abuse and the legal rights of the parent-offender. Questions are raised which may assist others embarked on developing similar programs.     

Some effects of the iscs program: A meta analysis

Many studies have been conducted to assess the effects of the ISCS program on student performance. On the basis of the conflicting findings, the task of arriving at a general conclusion about the effects of ISCS has been difficult indeed. This study was designed to integrate quantitatively the collective research dealing with the effects of ISCS on student performance and attitude. The weighted mean effect size was found to be 0.09, indicating that the performance of the ISCS students was 0.09 standard deviations above the performance of students in traditional science courses. The design of the study accounted for a significant proportion of variation in the effect size, whereas the type of instrumentation and reliability of the instrument did not.