Quality of Life of HIV-Infected People Across Different Stages of Infection

Quality of life is an important component in the evaluation of the well-being of HIV-infected patients. In the present study, an attempt has been made to compare HIV-infected patients across the three stages namely, asymptomatic, symptomatic, and AIDS-related conditions. This is a cross-sectional study. For this study, a total number of 90 subjects, 30 each in asymptomatic, symptomatic, and AIDS-related conditions, were taken. The study population consisted of HIV positive individual already enrolled in Voluntary Counseling and Testing Center, Institute of Medical Science, Banaras Hindu University, Varanasi, India. The WHOQOL-HIV BREF was used to assess quality of life across the group of patients. One-way analysis of variance was performed to find out significant difference between the clinical categories. On average AIDS patients experienced significantly poorer quality of life in all the six domains, namely physical (M = 7.87, SD = 1.83), psychological (M = 8.50, SD = 1.54), level of independence (M = 8.57, SD = 1.59), social relation (M = 9.17, SD = 2.59), environment (M = 8.78, SD = 1.50), and spirituality/religion/personal belief (M = 6.93, SD = 1.26) to symptomatic and asymptomatic HIV-infected people (p = .000). Result suggested that there is an inverse relationship between quality of life and different stages of HIV infection.     

Engagement in Behavioral Parent Training: Review of the Literature and Implications for Practice

Engagement in behavioral parent training (BPT), including enrollment, attrition, attendance, within-session engagement, and homework completion, has long been a critical issue in the literature. Several estimates of various aspects of engagement have been suggested in the literature, but a systematic review of the available literature has never been accomplished. This review examines engagement data across 262 studies of BPT. Recruitment attrition, program attrition, attendance, and within-session engagement are examined across studies, with particular emphasis on the impact that SES, study purpose (efficacy vs. effectiveness), treatment format (individual vs. group), and age of child may have on those rates. Results of this review suggest that the significant amount of attrition occurs prior to enrollment in BPT, with at least 25 % of those identified as appropriate for BPT not enrolling in such programs. An additional 26 % begin, but drop out before completing treatment. Still the combined dropout rate of at least 51 % leaves at best half of identified parents completing treatment. While SES status had a small effect on attrition, other variables were not found to meaningfully impact engagement. Information on within-session engagement (homework and ratings of participation) was not often reported in studies. Key issues in this literature (e.g., varying definitions of engagement, limited attention to reporting key aspects of engagement) are discussed, and recommendations are made to further improve this important area of research and clinical practice.     

A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD

Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5–12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children’s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose–response curve for medication in NBM, the dose–response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195–216, 2007). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment.