RESUMO
OBJECTIVE: The aim of this study was to investigate the relationship between mental illness identity, shame, secrecy, public stigma, and disclosure amongst college students. Participants included 1393 college students from five postsecondary institutions. METHODS: Structural equation modeling was used to examine two path models predicting disclosure and desire to join a program aiding with disclosure. RESULTS: Variables found to be significant in predicting disclosure included mental illness identity and public stigma. In turn, desire for disclosure predicted desire to join a program aiding in disclosure. Gender and race/ethnic differences were observed, with men and Whites more likely to want to disclose a mental illness or join a program aiding with disclosure compared with women and non-Whites, respectively. CONCLUSIONS: These findings suggest that some college students may find programs aiding in disclosure useful in assisting them to achieve their desire to be "out" with their mental illness.
Assuntos
Revelação , Transtornos Mentais/psicologia , Estigma Social , Estudantes/psicologia , Adulto , Feminino , Humanos , Masculino , Vergonha , Universidades , Adulto JovemRESUMO
OBJECTIVE: To describe parents' experience with their child's allergic rhinitis (AR) to inform management by the primary care provider (PCP). STUDY DESIGN: Two hundred parents with a child 7 to 15 years old with AR symptoms within the past 12 months completed a paper survey. RESULTS: The child's AR was identified as a significant problem in spring (89.3%), fall (63.4%), summer (50.3%), and winter (21.4%); 51.3% had persistent disease. AR symptoms most commonly interfered with the child's outdoor activities and sleeping, and frequently bothered the parent and other family members. Most parents (88.3%) wanted to know what their child was allergic to and had many concerns about treatment options. A total of 62.9% had sought AR care from the PCP in the past 12 months. CONCLUSIONS: Many families experience significant morbidity from their child's AR and turn to their PCP for help. We identified opportunities for the PCP to reduce AR morbidity.
Assuntos
Comportamento de Busca de Ajuda , Relações Pais-Filho , Pais , Atenção Primária à Saúde/estatística & dados numéricos , Rinite Alérgica/fisiopatologia , Adolescente , Corticosteroides/uso terapêutico , Criança , Estudos Transversais , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Avaliação de Resultados da Assistência ao Paciente , Percepção , Relações Profissional-Família , Rinite Alérgica/tratamento farmacológico , Índice de Gravidade de Doença , Inquéritos e Questionários , Estados UnidosRESUMO
Background. Although common practice, evidence to support treatment of croup with prednisolone is scant. Methods. We conducted a community-based randomized trial to compare the effectiveness of prednisolone (2 mg/kg/d for 3 days, n = 41) versus 1 dose of dexamethasone (0.6 mg/kg) and 2 doses of placebo (n = 46). Participants were children 1 to 8 years old with croup symptoms ≤48 hours, categorized as mild (42%) or moderate (58%). Results. There were no differences for those treated with dexamethasone or prednisolone for additional health care for croup (2% vs 7%, P = .34), duration of croup symptoms (2.8 vs 2.2 days, P = .63), nonbarky cough (6.1 vs 5.9 days, P = .81), nights with disturbed sleep for the parent (0.68 vs 1.21 nights, P = .55), and days with stress (1.39 vs 1.56 days, P = .51). Conclusion. There were no detected differences in outcomes between the 2 croup treatments for either child or parent.
Assuntos
Anti-Inflamatórios/administração & dosagem , Crupe/tratamento farmacológico , Dexametasona/administração & dosagem , Prednisolona/administração & dosagem , Pré-Escolar , Pesquisa Comparativa da Efetividade , Humanos , Lactente , Resultado do TratamentoRESUMO
OBJECTIVE: Bacteria have been identified in different regions of the placenta. Here, we tested the hypothesis that the maternal basal plate of the placenta harbors microbes that may be associated with adverse pregnancy outcomes. STUDY DESIGN: We performed a cross-sectional study of pregnancies from a single tertiary care hospital. Maternal medical and obstetric characteristics were obtained and pregnancies followed up prospectively for outcomes and placental collection. After delivery, systematic random sampling of the placental basal plate was performed. Paraffin sections of basal plates were stained with 4 histologic stains and scored for morphological evidence of bacteria. RESULTS: Of 195 total patients in the study, Gram-positive and -negative intracellular bacteria of diverse morphologies were documented in the basal plates of 27% of all placentas. Of the patients, 35% delivered preterm. No difference was noted between placental basal plates from preterm or term gestations. Intracellular bacteria were found in the placental basal plates of 54% spontaneous preterm deliveries <28 weeks, and in 26% of term spontaneous deliveries (P = .02). Intracellular bacteria were also documented in placentas without clinical or pathologic chorioamnionitis. CONCLUSION: A total of 27% of placentas demonstrated intracellular bacteria in the placental basal plate using morphological techniques. Thus, the maternal basal plate is a possible source of intrauterine colonization and placental pathological examination could include examination for bacteria in this important maternal-fetal interface.