Ambika Mathur

The Use of Folk Remedies Among Children in an Urban Black Community: Remedies for Fever, Colic, and Teething

Background. Folk remedy use is universal, occurring in all cultures. Folk remedies have been and still are relied on in the black community. In this study, folk remedies refer to herbs, over-the-counter medications, and items traditionally used for cooking that are used to treat a variety of ailments. Objective. To identify folk remedies used to treat fever, colic, and teething among black children in Detroit, Michigan. Methods. Structured interviews were conducted with caregivers of healthy black children <2 years of age who were patients of the general pediatric clinic at Childrens Hospital of Michigan. Descriptive analysis of the frequency distribution of the responses was performed. Results. One hundred seven caregivers agreed to participate. All participants were familiar with the use of folk remedies. Most caregivers learned of these remedies from their mothers or grandmothers. Older parents were more likely to use folk remedies, but there was no difference in remedy use among different levels of maternal education. Conclusions. The knowledge and use of folk remedies were active in this black community. Their use seems to be cultural, rather than attributable to decreased access to health care. Physicians should be aware of these remedies, to educate families about remedies that may be harmful. Most remedies used pose no threat to health. In some cases, remedies may be blended with traditional medical treatments to ensure better patient compliance.

A Randomized Placebo-Controlled Trial of Massage Therapy on the Immune System of Preterm Infants

OBJECTIVES: The aim of this study was to investigate the effects of massage therapy (MT) on the immune system of preterm infants. The primary hypothesis was that MT compared with sham therapy (control) will enhance the immune system of stable premature infants by increasing the proportion of their natural killer (NK) cell numbers. METHODS: A randomized placebo-controlled trial of MT versus sham therapy (control) was conducted among stable premature infants in the NICU. Study intervention was provided 5 days per week until hospital discharge for a maximum of 4 weeks. Immunologic evaluations (absolute NK cells, T and B cells, T cell subsets, and NK cytotoxicity), weight, number of infections, and length of hospital stay were also evaluated. RESULTS: The study enrolled 120 infants (58 massage; 62 control). At the end of the study, absolute NK cells were not different between the 2 groups; however, NK cytotoxicity was higher in the massage group, particularly among those who received ≥5 consecutive days of study intervention compared with control (13.79 vs 10 lytic units, respectively; P = .04). Infants in the massage group were heavier at end of study and had greater daily weight gain compared with those in the control group; other immunologic parameters, number of infections, and length of stay were not different between the 2 groups. CONCLUSIONS: In this study, MT administered to stable preterm infants was associated with higher NK cytotoxicity and more daily weight gain. MT may improve the overall outcome of these infants. Larger studies are needed.

Evaluation of a child guidance model for visits for mental disorders to an inner-city pediatric emergency department.

Background: To address a rising trend of emergency department (ED) visits for mental disorders (VMD), our ED implemented a child guidance model for their efficient evaluation and disposition. Objectives: The main objective of our study was to evaluate the impact of the child guidance model on the ED length of stay (LOS) and ED costs on children with VMD. Methods: We conducted a retrospective chart analysis on 1031 VMD visits made to an inner-city tertiary care pediatric ED in 2002 (1.4% of the total 2002 ED visits). We collected demographic and LOS information on all VMD visits. The child guidance model was implemented June 2002, after which we divided the VMD cases into 2 groups based on the presence or absence of the model. We performed a cost analysis to assess the impact of the model on LOS and determined the opportunity costs of prolonged LOS of the VMD visits as compared with 500 non-VMD visits. Results: The average LOS of VMD visits was longer than that of the 500 non-VMD visits (236.04 minutes ± 162.82 vs. 134.69 minutes ± 95.19; mean difference, 101.34 minutes; P = 0.001). The LOS was significantly reduced after the model was implemented (259.49 minutes ± 171.12 vs. 216.39 ± 152.95 minutes, P = 0.00). The lost revenue due to extended VMD LOS was calculated as opportunity costs of

Living environment and schooling of children with HIV-infected parents in southwest China

201,173.30, whereas the cost savings during the study period due to reduced LOS after the model was implemented was

Schooling of migrant children in China: Perspectives of school teachers

10,651. Conclusions: This study suggests that children with VMD visits contribute a substantial resource burden in the ED, and focused interventions such as the child guidance model in the ED can significantly decrease LOS and reduce ED costs.

Music Therapy in Pediatrics

Abstract A cross-sectional household survey was conducted in Longchuan County, China, to study the lives of children with HIV-infected parents. Registered HIV-infected drug users and their households were approached and information about the living environment of children ≤15 years of age was collected. Of the 266 households interviewed, there were 213 children ≤15 years old. Forty percent of the children had lost at least one parent. Most of the children resided in a household with low economic status and a high dependency ratio. One-half of the children experienced discordant family relations, family anxiety and shame. Compared to orphans, non-orphans and their families were less likely to receive social support from the community. Orphans and older children were less likely to attend school and more likely to be truant if enrolled in school. Findings in the current study suggest that many children whose parents are infected with HIV or have died from HIV are living in stressful environments with minimal support from the community. Efforts should be taken to provide support and supervision to these children.

Stigmatizing attitudes towards people living with HIV/AIDS among college students in China: Implications for HIV/AIDS education and prevention

The impact of family migration on childrens schooling has been the focus of much investigation in western countries. However, there are limited data on such impact in China, despite a large number of rural-to-urban migrants. In-depth interviews were conducted among 20 school teachers in Beijing. Findings reveal that barriers for migrant children to attend public schools include extra financial charge and stigmatization resulting from their migratory status. The schools serving solely migrant children were perceived as having poor teaching facilities and lacking adequately trained teachers. Migrant parents were generally perceived as having limited involvement in their childrens schooling. Findings suggest that national policy related to the schooling of migrant children should be improved and support from family and society should be emphasized.

Transforming training to reflect the workforce

The soothing effects of music have been well described over the centuries and across cultures. In more recent times, studies have shown the beneficial effects of music in alleviating symptoms in a wide variety of clinical and psychologic conditions. Music therapy has been primarily used as an intervention to control emotional states, in pain management, cognitive processing, and stress management. Stress is associated with increased production of the stress hormone cortisol, which is known to suppress immune responses. Several studies in the past few decades have demonstrated a positive effect of music therapy on reducing stress or increasing immune responses, or both. Music therapy should therefore be considered as a valuable addition to standard pharmacologic therapeutic modalities in enhancing the immune response and lowering stress levels in such conditions. This article reviews the role of music as a therapeutic modality and the future for music therapy, particularly in pediatrics.

Traveler's diarrhea: updates for pediatricians.

Purpose – The purpose of this paper is to show that HIV/AIDS‐related stigma has persisted world‐wide for decades. However, studies on the linkage between stigmatizing attitudes towards people living with HIV/AIDS (PLWHA) and misconceptions about HIV transmission routes in the general population, especially among youth in China, are sparse – a gap this study is intended to fill.Design/methodology/approach – Cross‐sectional data from 1,839 students from 19 colleges were collected by trained interviewers using a structured questionnaire in Jiangsu province of China.Findings – This study reveals that there is a high proportion of college students having both stigmatizing attitudes toward PLWHA and misconceptions about HIV/AIDS transmission routes. Multilevel logistic regression analysis results show that having stigmatizing attitudes towards PLWHA is positively associated with having misconceptions about HIV transmission routes. Participants with high misconception scores were more likely to possess stigmatiz...

Knowledge and Use of Music Therapy Among Pediatric Practitioners in Michigan

Twenty-first century training programs seek to provide the “BEST” graduate education for our future biomedical workforce.