667 the Effect of Triple Dye on Shedding of the Umbilical Cord

Abstract

(Sponsored by Loretta P. Finnegan.) A manual and scoring s h e e t f o r n u t r i t i o n a l assessment of the p e d i a t r i c p a t i e n t has been developed. The manual includes a l i s t of appropriate d i e t a r y and medical h i s t o r i c a l questions t o aid in identifying the p e d i a t r i c p a t i e n t a t r i s k f o r n u t r i t i o n a l d e f i c i e n c i e s; a system oriented n u t r i t i o n a l physical examination t o i d e n t i f y physical findings of n u t r i t i o n a l d e f i c i t s ; and a l i s t of s p e c i f i c n u t r i t i o n a l d e f i c i t s associated with p e d i a t r i c d i s e a s e processes. Guide1 ines a r e included f o r obtaining, 1 ) additional blood s t u d i e s such a s serun vitamin and mineral l e v e l s , 2) x-ray s t u d i e s , such a s chest x-ray, bone age, and CT scan of t h e brain, 3 ) EKG, 4 ) and c o l l e c t i o n s of urine and feces.The scoring s h e e t includes consideration of percent ideal body weight, percent weight change, weight f o r height, t r i c e p s and subscapular skin fold thickness, arm muscle circumference, albumin, t r a n s f e r r i n , skin t e s t i n g , and absolute lymphocyte counts t h a t have been adapted f o r use i n the various age groups within p e d i a t r i c s . A numerical score i s assigned t o each item indicating degree of d e f i c i t and a t o t a l n u t r i t i o n score i s c a lculated. A score of 0 t o 5 i n d i c a t e s normal n u t r i t i o n a l s t a t u s , 6 t o 10 mild, 11 t o 15 moderate, a n d > l 5 , severe n u t r i t i o n a l d e f i c i t s . This type of manual and scoring sheet provides a means t o teach concepts of p e d i a t r i c n u t r i t i o n a l assessment. There is an increasing awareness of t h e need f o r formal t r a i ni n g i n behavioral and s o c i a l aspects of p e d i a t r i c s . Housestaff response t o a new t r a i n i n g program i n p e r i n a t a l behavior was studied. The program, run by a p s y c h i a t r i s t and psychologist, was d i r e c t e d a t the 7 house o f f i c e r s each month on the neonatal s e r v i c e . I n s t r u c t i o n a l methods included i n t e g r a t i o n of discuss i o n s of psychosocial i s s u e s on medical rounds i n both the well and i n t e n s i v e c a r e n u r s e r i e s , weekly psychosocial rounds, didact i c seminars, interviews with parents and house o f f i c e r s , neurobehavioral assessment exams, and guest speakers. GENERAL PEDIATRICS, EDUCATION AND TRAININGAttitude questionnaires concerning t h e importance of the behavioral sciences and mental h e a l t h professionals i n medical care were obtained from housestaff (n=29) a t the beginning and end of each month's r o t a t i o n . Items were scored on a 5-point agreement s c a l e (strongly agree-strongly disagree). Mean values were compared between beginning and end of t h e month and revealed a s i g n i f i c a n t (pC0.025) improvement i n a t t i t u d e s toward the importance of t h e behavioral sciences and menta...