Treatment practices for childhood posttraumatic stress disorder

OBJECTIVE: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. METHOD: An anonymous survey was mailed to 207 child psychiatrists ("medical") and 460 nonphysician ("non-medical") therapists inquiring about current interventions used to treat children with PTSD. RESULTS: Two hundred and forty-seven responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. Ninety-five percent of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. CONCLUSIONS: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR.     

Job satisfaction: perceptions of a national sample of teachers of students who are deaf or hard of hearing

The study examined the perceptions of a national sample of teachers of students who are deaf or hard or hearing to assess their level of job satisfaction. A questionnaire was developed and distributed; 610 completed surveys were analyzed. Overall, respondents appeared satisfied with their jobs. Of the 59 items in the survey, 51 were scored as positive for the group as a whole. Participants reported that their relationships with colleagues were the most enjoyable aspect of the job. Paperwork, state assessment tests, and lack of family involvement were identified as the least satisfying aspects. Data were also analyzed by comparing the responses of teachers across groups--itinerant, elementary, secondary, and resource room. Generally, this group-by-group analysis produced findings similar to those for the overall sample. Recommendations on addressing the specific factors that teachers responded to negatively are provided.     

Why natural childbirth?

A reader asks for help in answering the question "Why natural childbirth?" Understanding the simple story of normal, natural birth, what helps and what sabotages nature's plan for birth, and the appropriate use of interventions are discussed and form the foundation for coming to the conclusion that nature's plan makes sense. Women are inherently capable of giving birth, have a deep, intuitive instinct about birth, and, when supported and free to find comfort, are able to give birth without interventions and without suffering.     

The effects of sotalol on ventricular repolarization during exercise

Objective: Although after pacing animal and human studies have demonstrated a rate-dependent effect of sotalol on ventricular repolarization, there is little information on the effects of sotalol on ventricular repolarization during exercise. This study attempted to show the effects of sotalol on ventricular repolarization during physiological exercise. Methods: Thirty-one healthy volunteers (18 males, 13 females) were enrolled in the study. Each performed a maximal treadmill exercise test according to the Bruce protocol after random treatment with sotalol, propranolol and placebo. Results: Sotalol significantly prolonged QTc(corrected QT) and JTc (corrected JT) intervals at rest compared with propranolol (QTc 324.86 ms vs 305.21 ms, P＜0.001; JTc245.04 ms vs 224.17 ms, P＜0.001) and placebo (QTc 324.86 ms vs 314.06 ms, P＜0.01; JTc 245.04 ms vs. 232.69 ms, P＜0.001).The JTc percent reduction increased progressively with each stage of exercise and correlated positively with exercise heart rate(r=0.148, P＜0.01). The JTc percent reduction correlation with exercise heart rate did not exist with either propranolol or placebo.Conclusions: These results imply that with sotalol ventricular repolarization is progressively shortened after exercise. Thus the specific class Ⅲ antiarrhythmic activity of sotalol, present as delay of ventricular repolarization, may be attenuated during exercise.Such findings may imply the need to consider other antiarrythmic therapy during periods of stress-induced tachycardia.     

Questions from our readers: commentary on "lamaze in the 21st century"

In response to Lamaze International's latest position paper, "Lamaze in the 21st Century," the author discusses the concept of normal birth and identifies the need for an advocacy effort in support of normal birth as the standard procedure.     

Do rice water weevils and rice stem borers compete when sharing a host plant?

The rice water weevil (RWW) Lissorhoptrus oryzophilus Knsehel (Coleoptera: Curculionidae) is an invasive insect pest office Oryza sativa L. in China. Little is known about the interactions of this weevil with indigenous herbivores. In the present study, adult feeding and population density of the weevil, injury level of striped stem borer Chilo suppressalis (Walker) (Lepi-doptera: Pyralidae) and pink stem borer Sesamia inferens (Walker) (Lepidoptera: Noctuidae) to rice, as well as growth status of their host plants were surveyed in a rice field located in Southeastern Zhejiang, China, in 2004 with the objective to discover interspecific interactions on the rice. At tillering stage, both adult feeding of the weevil and injury of the stem borers tended to occur on larger tillers (bearing 5 leaves) compared with small tillers (bearing 24 leaves), but the insects showed no evident competition with each other. At booting stage, the stem borers caused more withering/dead hearts and the weevil reached a higher density on the plants which had more productive tillers and larger root system; the number of weevils per tiller correlated nega-tively with the percentage of withering/dead hearts of plants in a hill. These observations indicate that interspecific interactions exist between the rice water weevil and the rice stem borers with negative relations occurring at booting or earlier developmental stages of rice.     

Home visiting intervention for vulnerable families with newborns: follow-up results of a randomized controlled trial

OBJECTIVE: This study aimed to: (1) Assess the community utility of a screening tool to identify families with child abuse or neglect risk factors in the immediate postnatal period (2) Determine the social validity and effectiveness of a home visiting program using community child health nurses and offering social work services for identified families, and (3) Identify factors in the immediate postnatal period associated with the child's environment that predict poor adjustment to the parenting role. METHOD: A randomized controlled trial using a cohort of 181 families was undertaken to evaluate the impact of a home visiting program. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting program or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. A repeated measures design was used to test parenting stress and maternal depression from the immediate postnatal period to 12-month follow-up and physical child abuse potential to 18-month follow-up. To test whether measures taken in the immediate postnatal period were predictive for poor adjustment to the parenting role, a linear regression model was used. RESULTS: The screening procedure was shown to have utility in the context of recruitment to a research trial and mothers were willing to accept the home visiting program examined by this study from the immediate postnatal period. From as early as 6 weeks the program demonstrated ability to impact positively on maternal, infant, family, and home environment variables (testing 90 randomly allocated intervention vs. 91 comparison families). At follow-up, parental adjustment variables were not significantly different between groups (testing the remaining 68 (75.5%) intervention vs. 70 (76.9%) comparison families) and home environment assessment scores had converged. Predictive analysis of factors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. CONCLUSIONS: Follow-up evaluation did not demonstrate a positive impact on parenting stress, parenting competence, or quality of the home environment confirming the need to test early program success on longer term outcomes. Further, thestudy not only demonstrated that there was a relationship between maternal, family and environmental factors identified in the immediate postnatal period. and adjustment to the parenting role, but also challenged demographic targeting for child abuse and neglect risk. At the same time, the immediate postnatal period presented an exciting window of opportunity to access high-risk families who may otherwise have become marginalized from traditional services.     

Relative effectiveness of reading practice or word-level instruction in supplemental tutoring: how text matters

In this quasi-experimental study, which is part of a series of investigations on supplemental reading tutoring variations, the relative effectiveness of more intense decoding instruction or text reading practice was examined. Fifty-seven first-grade students scoring in the lowest quartile for reading skills received either classroom reading instruction or one of two treatments: tutoring in word study with text reading practice, or word study tutoring alone. Individual instruction was provided by trained paraprofessional tutors. At the end of first grade, treatment students significantly outperformed their nontutored peers on measures of reading accuracy, reading comprehension, reading efficiency, passage reading fluency, and spelling. Differential treatment effects on passage reading fluency are examined, taking into consideration pretest skill levels and text reading practice characteristics.     

Tea saponins affect in vitro fermentation and methanogenesis in faunated and defaunated rumen fluid

INTRODUCTION Livestock is one of the largest sources of meth-ane emission with 80~115 million tons produced peryear, equivalent to 15%~20% of total anthropogenicmethane (IPCC, 2001). The global cattle population isresponsible for 73% of methane emissions of alllivestock, and methane produced during ruminalfermentation represents a loss of 2%~15% of grossenergy intake and may contribute to global warming(Johnson and Johnson, 1995). Many researches hadbeen carried out to find ways to low…