The ACT Against Violence Parents Raising Safe Kids program (ACT-PRSK) is an interactive violence prevention program developed by the American Psychological Association for parents of young children. The program teaches and supports parents in the areas of child development, roots and consequences of violence, anger management for adults and children, social problem solving, positive discipline, and the impact of media violence on children. Ninety-two parents/caregivers of young children participated in a study of the effects of the program on parenting behaviors. The first 50 participants were assigned to the intervention group and completed the ACT-PRSK program, and the remaining 42 parents/caregivers served as comparisons. Results indicated reduced spanking and reduced rate of hitting children with objects for the ACT-PRSK participants. Furthermore, the ACT-PRSK group evidenced improved knowledge, behaviors, and beliefs regarding violence prevention and parenting. Results provide support for the efficacy of this brief intervention for preventing child maltreatment.
Obstructive sleep apnea (OSA) is associated with major morbidity and daytime somnolence. 1 Location of the obstruction cannot be determined by polysomnography, thereby contributing to variance in cure rates for surgical procedures such as uvulopalatopharyngoplasty (UPPP). 2,3 There is no clinically accepted, comfortable, and noninvasive method for visualizing the airway during sleep. Ultrasonic imaging of the airway is an established method used in the evaluation of swallowing. 4,5 It is a dynamic, safe method, permitting the noninvasive visualization of soft-tissue structures of the pharynx. 5 Ultrasound has never been used in the evaluation of OSA.Methods. Five male subjects age 35 to 57 years with OSA underwent this procedure. All subjects had apnea indices greater than 35. One subject had undergone unsuccessful UPPP in the past, and all subjects were using continuous positive airway pressure (CPAP) at home.Video output from the real-time mechanical sector ultrasonic machine (ATL HDI 5000, Advanced Technology Laboratories, Bothell, WA) was combined with the polysomnography signal from a Telefactor digital EEG machine (Telefactor, West Conshohocken, PA) equipped with sleep software that produces a splitscreen image containing polysomnography and ultrasound recorded simultaneously. The ultrasonic transducer (P5-3 phased array or L12-5 linear array) was fastened around the head and positioned submentally, resting just above the sternum in a slinglike cotton pocket fastened around the neck with Velcro bands for position stabilization during sleep (figure). Time on both was synchronized. Recordings were made on an outpatient basis, when subjects had been deprived of 2 to 3 hours of sleep the night before, and lasted for approximately 1.5 to 2 hours.The polysomnogram was scored according to the methods of Rechtshaffen and Kales. 6 Obstructive events were scored only if they lasted 10 seconds or more. The first 20 apneic events were identified for each subject on the polysomnogram, and simultaneous ultrasonic images were observed. Each event identified by polysomnography was graded as containing or lacking a simultaneous ultrasonic event, and was described in terms of the locations and movements of the structures involved.Results. A total of 93 events were identified. One subject had difficulty with sleep maintenance due, in part, to OSA, and had only 13 events during the entire testing session. All apneas identified by polysomnography were accompanied by an ultrasonic event. No ultrasonic obstructive events were noted without polysomnographic events. The nature of the event seen on ultrasound was consistent for each subject and was seen on all samples. Five to 10 seconds before the onset of apnea, the geniohyoid and mylohyoid muscles composing the floor of the mouth relaxed. At the beginning of and during each subsequent apnea, the tongue base moved posterior or inferior toward the hypopharynx and cased airway obstruction, which was reflected in the polysomnograph. At the end of the apneic event, a slight contractio...
Twenty-two pediatric residents and 31 medical students viewed the Play Nicely program. The Play Nicely program is a multimedia program that teaches health care professionals how to counsel parents to use positive parenting and disciplining strategies in response to early childhood aggression. Health care professionals completed pre- and posttraining questionnaires to assess changes in comfort with counseling, parenting knowledge, and attitudes toward spanking. Results indicated at posttraining that health care professionals were significantly more comfortable with counseling parents, had increased parenting knowledge, and decreased positive attitudes toward spanking. Findings suggest that this program holds promise for educating health care professionals on how to counsel parents on positive parenting strategies and positively change attitudes toward spanking.
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