Current Status of Psychosocial Intervention Research for Pediatric Outpatient Surgery

We reviewed 20 published studies of psychosocial interventions (i.e., preoperative preparation, parental presence) for children undergoing outpatient surgical procedures. The effectiveness of different intervention strategies on child and parent outcomes is summarized. Few positive effects were found for any of the psychosocial interventions. However, only a small number of randomized controlled trials were conducted and many of the studies using quasi-experimental designs had significant methodological problems that limited the interpretation of their findings. Research recommendations are described such as strengthening methodological rigor, making intervention strategies relevant to outpatient surgery, and using developmentally appropriate intervention strategies.     

Transgenic Brain-Derived Neurotrophic Factor Modulates a Developing Cerebellar Inhibitory Synapse

Brain-derived neurotrophic factor (BDNF) has been shown to promote synapse formation and maturation in neurons of many brain regions, including inhibitory synapses. In the cerebellum, the Golgi cell-granule cell GABAergic synaptic responses undergo developmental transition from slow-decaying to fast-decaying kinetics, which parallels a developmental increase of GABA_A receptor α6 subunit expression in the cerebellar granule cells. In culture, BDNF accelerates the expression of GABA_A receptor α6 subunit expression in granule cells. Here we examined synaptic GABA_A response kinetics in BDNF transgenic mice. The mutant mouse, which carries a BDNF transgene driven by a β-actin promoter, overexpresses BDNF (two- to fivefold increase compared with wild types) in all brain regions. Recordings of the spontaneous GABA_A responses indicate that the decay time constant of the GABAergic responses decreases during early postnatal development; this transition is accelerated in the BDNF transgenic mouse. The amplitude of the spontaneous GABA_A responses was also larger in the transgenic mouse than in the wild-type mouse. However, the frequency of the spontaneous GABA_A responses were not different between the two groups. Our results suggest that BDNF may modulate GABAergic synapse maturation in the cerebellum.     

Interaction of depression and bereavement on mental health in the elderly

Three hundred ninety-three elderly adults aged 55 and older were divided into 1 of 9 subgroups in a 3 (bereavement group: survivors of spouses who died by natural death or by suicide and nonbereaved control Ss) x 3 (depression group: none, mild, and moderate-severe) design over 4 times of measurement--1 month, 6 months, 1 year, and 2.5 years after death of spouse. Significant Bereavement x Depression Group effects were obtained on Brief Symptom Inventory scores. The moderate-severe depression/suicide subgroup had the greatest psychiatric complications with bereavement. Results indicated that elderly persons with significant clinical depression at the time of a spouse's death were at significant risk for psychological complications during the bereavement process, and survivors of spouses who had committed suicide were even more at risk within the greatest depression group.     

Analysis of public verbal feedback as a staff management procedure

We evaluated public verbal feedback as a potentially effective and efficient means of improving institutional staff performance. Following baseline observations of the self-help training conducted by three groups of direct care staff with clients who had profound mental retardation, verbal feedback was presented publicly to individual staff during routine staff meetings. The feedback addressed the (in)frequency of the staffs training endeavors and required only a few minutes to present. Results indicated that each group of staff increased their client training when the public verbal feedback was provided. Probes of client self-help skills indicated that as the frequency of staff-conducted training increased, client skill acquisition improved. Generalization measures indicated that staff increased only those work behaviors for which they received feedback. Results are discussed regarding the efficiency of public verbal feedback as a means of improving staff performance, as well as the need for research to continue expanding and refining a technology of staff management.     

Social Change and Change in Intentions of Iranian Youth Regarding Education,Marriage, and Careers

Effects of large-scale socio-political movements and policy changes on individual attitudes and behaviours have been the focus of attention of social scientists and policy-makers in different countries. For example, concerns have been expressed regarding the effects of the so-called “fundamentalist” Islamic movements on attitudes and behaviours in relation to marriage, family structure, and the roles/rights of women. The Islamic Revolution of 1978 in Iran is usually assumed to have affected such beliefs and behaviours. To test the accuracy of such an assumption, three data sets collected in the same geographical location in 1982, 1984, and 1986 were compared within sex and SES groups. The intentions and aspirations of high school seniors regarding education, marriage, and careers were closer to conservative/traditional expectations in the 1982 sample than in the 1984 and 1986 samples. It is concluded that, even if there was an increase in traditionalism shortly after the Revolution, traditional tendencies have not returned to extreme levels within the few years surveyed, at least among the urban educated youth under study. Alarm regarding a ‘return to fundamentalism” in relation to marriage, family, and women's roles/rights might be less warranted than is commonly assumed.     

EVALUATION OF COMPONENTS OF RESIDENTIAL TREATMENT BY MEDICAID ICF-MR SURVEYS: A VALIDITY ASSESSMENT

We evaluated the proficiency of the federal Medicaid program's survey process for evaluating intermediate care facilities for the mentally retarded. In Study 1, an observational analysis of active treatment during leisure times in living units suggested that these surveys did not discriminate between certified and noncertified units. In Study 2, a reactivity analysis of a survey indicated that direct-care staff performed differently during the survey by increasing interactions with clients and decreasing nonwork behavior. Similarly, results of Study 3 showed increases in client access to leisure materials during a survey. In Study 4, questionnaire results indicated considerable variability among service providers' opinions on the consistency, accuracy, and objectivity with which survey teams determine agency standard compliance. Results are discussed regarding effects of the questionable proficiency of survey processes and the potential utility of behavioral assessment methodologies to improve such processes.     

Development and validation of the Physical Appearance Related Teasing Scale

The development and preliminary validation of the Physical Appearance Related Testing Scale (PARTS) is reported. The 18-item scale has good psychometric qualities (high internal consistency and test-retest reliabilities) and consists of two factors: Weight/Size Testing (W/ST) and General Appearance Teasing (GAT). The W/ST converges well with measures of eating disturbance, body image dissatisfaction, social comparison, depression, and self-esteem, whereas the GAT scale shows little relationship to these variables. The role of teasing history as an etiological component of body image and eating disturbance is discussed; the need for further validation work on the PARTS is addressed.     

INCREASING HABILITATIVE SERVICES FOR PERSONS WITH PROFOUND HANDICAPS: AN APPLICATION OF STRUCTURAL ANALYSIS TO STAFF MANAGEMENT

We evaluated a structural analysis methodology for enhancing the utility of a staff management program. In Experiment 1, a structural analysis of direct-care staff behavior in a mental retardation facility revealed differences in work patterns over time. Specific times were identified when few basic care duties were necessary and staff engaged in nonwork activity. In Experiment 2, a management program was implemented to increase staff members' training activities during periods identified through the structural analysis. The program was accompanied by increases in training activities and decreases in nonwork behavior. The improvements were maintained during a 43-week period while the most labor-intensive component of the program was withdrawn. Staff acceptability measures indicated a positive response to the management intervention, although responses varied across components within the multifaceted program. The increased training was accompanied by beneficial changes among clients with profound handicaps. Results are discussed regarding practical considerations for improving staff performance and for adopting innovations resulting from applied research.     

The role of language familiarity in voice identification

Four experiments examined the effects of language characteristics on voice identification. In Experiment 1, monolingual English listeners identified bilinguals' voices much better when they spoke English than when they spoke German. The opposite outcome was found in Experiment 2, in which the listeners were monolingual in German. In Experiment 3, monolingual English listeners also showed better voice identification when bilinguals spoke a familiar language (English) than when they spoke an unfamiliar one (Spanish). However, English-Spanish bilinguals hearing the same voices showed a different pattern, with the English-Spanish difference being statistically eliminated. Finally, Experiment 4 demonstrated that, for English-dominant listeners, voice recognition deteriorates systematically as the passage being spoken is made less similar to English by rearranging words, rearranging syllables, and reversing normal text. Taken together, the four experiments confirm that language familiarity plays an important role in voice identification.