RESUMO
Sydenham's chorea (SC) is a disorder of the central nervous system (CNS) characterized by sudden, involuntary, arrhythmic, clonic, and purposeless movements. SC appears to provide a model for understanding various neuropsychiatric dysfunctions. Its relationship with attentional deficits, obsessive-compulsive symptoms (OCS) as well as movement disorders provides support for the hypothesis of the involvement of the corticostriatal loops in the pathophysiology of the disorder.
Assuntos
Coreia , Doenças Autoimunes/etiologia , Gânglios da Base/fisiopatologia , Sintomas Comportamentais , Coreia/tratamento farmacológico , Coreia/epidemiologia , Coreia/etiologia , Coreia/imunologia , Coreia/fisiopatologia , Humanos , Comportamento Impulsivo/fisiopatologia , Febre Reumática/complicações , Febre Reumática/epidemiologia , Febre Reumática/genéticaRESUMO
This study sought (1) to retest an approach to the prediction of risk of child maltreatment and (2) to test the effect of a comprehensive prenatal and pediatric health services program on the rate of maltreatment. Of 2585 women screened at their first prenatal visit, 1154 qualified for the study. Risk assignment was determined by a structured interview. High-risk women (n = 314) were assigned to receive standard (high-risk control group; n = 154) or intervention (high-risk intervention group; n = 160) services throughout the prenatal period and during the first 2 years of their infants' life. A third group (low-risk control group; n = 295) was selected among low-risk women and received standard care without intervention services. State records were searched for substantive reports of child maltreatment up to 36 months after birth. Physical abuse was found for 5.1% of the study population; neglect was substantiated for 5.9%. Prediction efforts were effective in identifying risk of physical abuse but not of neglect. Comprehensive health services did not alter the reported abuse rate for high-risk parents and was associated with an increased number of neglect reports. Intervention reduced subject attrition and appeared to serve as a bias for detection of maltreatment. Thus this long-term, prospective approach was ineffective for child abuse prevention, perhaps because of detection biases and societal changes.
Assuntos
Maus-Tratos Infantis/prevenção & controle , Serviços de Saúde da Criança , Serviços de Saúde Materna , Cuidado Pré-Natal , Adulto , Maus-Tratos Infantis/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Entrevista Psicológica , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Viés de Seleção , Fatores de TempoRESUMO
To determine the prenatal antecedents of child neglect by low-income women, data from a prospective study of child maltreatment were reviewed. Mothers determined to be at high risk prenatally for maltreatment were more likely to be identified as neglectful within 24 months of the interview. Neglectful mothers were less likely to have completed high school, had more children younger than 6 years of age, and had more aberrant responses on parenting skills and support systems scales. Neglected children were lower in birth weight, were rated more difficult temperamentally, and had poorer mental and motor developmental scores.