Pediatric Sub-specialist Controversies in the Treatment of Congenital Heart Disease in Trisomy 13 or 18

Trisomy 13 and 18 are associated with congenital heart disease. Cardiac palliation has been reported in the literature, but is not usually done in this population. Thus, a multi-disciplinary team may experience controversy in formulating a care plan that includes cardiac intervention. Our objective was to determine differences in recommendations for cardiac intervention in this population between physicians specializing in pediatric cardiac critical care, neonatology, and genetics. A web-based survey was performed between April 2007 and August 2008. This survey evaluated surgical and transcatheter cardiac palliations that had been performed for individuals with trisomy 13 or 18 at the respondent’s institution, the respondent’s recommendations for cardiac intervention in hypothetical symptomatic patients with trisomy 13 or trisomy 18 and the influence of parental preference on these recommendations. Eight hundred fifty-nine responses were obtained from a primarily academic practice setting (59%). Cardiologists were most likely to recommend intervention; low risk interventions were recommended by 32% of cardiologists, 7% of neonatologists and 20% of geneticists. Parental request to intervene resulted in a 3 fold increased in the likelihood of all specialist recommending intervention. Counseling of families frequently occurred by multiple sub specialists (50%) and there was frequently (71%) a difference in opinion. Individuals with trisomy 13 or 18 are receiving cardiac intervention at many institutions. Cardiologists were more likely than geneticists or neonatologists to recommend intervention on all heart lesions other than single ventricle palliation which no specialists recommended. Parental wishes that “everything be done” significantly influenced all specialists’ recommendations.     

Master resilience training in the U.S. Army

The U.S. Army Master Resilience Trainer (MRT) course, which provides face-to-face resilience training, is one of the foundational pillars of the Comprehensive Soldier Fitness program. The 10-day MRT course is the foundation for training resilience skills to sergeants and for teaching sergeants how to teach these skills to their soldiers. The curriculum is based on materials developed by the University of Pennsylvania, the Penn Resilience Program (PRP), and other empirically validated work in the field of positive psychology. This "train the trainer model" is the main vehicle for the dissemination of MRT concepts to the entire force.     

Effects of delay of prospective memory cues in an ongoing task on prospective memory task performance

To address the mixed results reported in previous studies, the present experiments examined forgetting in prospective memory (PM) by manipulating the delay between the PM instructions and cue presentation in event-based PM tasks. PM performance was measured for delays of 2–20 min in Experiment 1 and for delays of approximately 1–10 min in Experiment 2. Experiment 2 included both focal and nonfocal PM tasks, and speed on the ongoing task was measured to examine evidence for monitoring processes across the delays tested. The results suggest that nonfocal PM performance follows a nonlinear forgetting function (i.e., rapid decline for shorter delays and slower decline for longer delays) when tested over delays from 1 to 20 min. No effect of delay was seen for the focal task tested in Experiment 2 from 1 to 10 min. In Experiment 2, ongoing-task costs were also found for the first delay but not for longer delays, suggesting that monitoring was significantly reduced between 1 and 2.5 min of the ongoing-task trials.     

The Effects of Locus of Control on Coalition Formation Among College Females

Past research in coalition formation reveals differing strategies between sexes, and that females tend to follow the Anti-Competitive Theory. The present study tries to show that a theory of coalition formation based solely on sex is inadequate and suggests that personality variables be included in explaining this phenomenon. The personality variable chosen for this study was the locus of control.
Based on their scores on the locus of control scale, 45 college coeds were placed into three categories of triads: externals, mixed and internals. Each subject was in turn assigned weights of 4, 3, and 2 in playing a dice game where they could form alliances or play individually. Results indicated that both the frequency and the pattern of coalitions formed were significantly influenced by locus of control, thus the findings lend support to the basic reasoning of the researchers.     

Bereavement Group for Parents Who Suffered a Suicidal Loss of a Child

ABSTRACT: This paper describes a supportive group therapy experience for parents who sought relief from the painful grief experienced after the suicide of their child. Parents who felt overwhelmed by feelings of shame, guilt, self-doubt, confusion and isolation found some relief in the universality of their grief and felt accepted and understood. Within three months, they were able to take this experience into their larger social network and felt more integrated.