Use of Multisystemic Therapy to Improve Regimen Adherence Among Adolescents with Type 1 Diabetes in Poor Metabolic Control: A Pilot Investigation

The purpose of the current study was to conduct a pilot investigation to determine the effectiveness of Multisystemic Therapy (MST) for improving regimen adherence and metabolic control among adolescents with poorly controlled Type 1 diabetes. Thirty-one adolescents were randomly assigned to either MST or a control condition. MST treatment lasted approximately six months. Data were collected at study entry and at a six-month posttest. Twenty-five adolescents completed the study. Adolescents who received MST had significantly improved adherence to blood glucose testing and metabolic control from study entry to the six-month posttest, whereas controls did not. Adolescents receiving MST also had a decreased number of inpatient admissions at the six-month posttest. Improvements in metabolic control were related to improvements in parent report of adolescent adherence. Results suggest that MST holds promise as an intervention for improving adherence behavior and health outcomes among adolescents in poor metabolic control.     

Anxiety and the blues after breast cancer: how common are they?

A number of myths exist concerning the psychological impact of breast cancer. Primary among these is the belief that women with breast cancer have greater emotional disability than individuals with other diseases or the population at large. While research has shown that women cope remarkably well with a diagnosis of breast cancer, an understanding of the key periods of anxiety and primary stressors is crucial to the overall psychological and medical management plan. While psychopharmacologic therapy may be indicated for women with breast cancer, it is rarely sufficient and should be combined with effective psychosocial interventions such as group therapy.     

VISUAL SCREENING: AN ALTERNATIVE METHOD FOR REDUCING STEREOTYPIC BEHAVIORS

Visual screening, a mildly aversive response suppression procedure, was evaluated across two studies for its effectiveness in reducing topographically similar and dissimilar stereotypic behaviors of four developmentally disabled children. In the first study, a multiple baseline design across subjects and behaviors was used to assess the effectiveness of the procedure as a treatment for reducing the visual and auditory self-stimulatory responses of two 9-yr-old mentally retarded and behaviorally disturbed children. A multiple baseline design across subjects was used in the second study to evaluate the effectiveness of visual screening as a treatment for reducing stereotypic fabric pulling and self-mutilative ear bending, respectively, of two 13-yr-old mentally retarded, autisticlike adolescents. Long-term follow-up data for both studies were reported. The results suggested that visual screening was an easily administered, effective, and exceptionally durable treatment procedure for controlling a variety of stereotypic behaviors commonly associated with the developmentally disabled.     

Hepatic versus cerebral origin of stimulus for feeding induced by 2-deoxy-d-glucose in rats

Intravenous administration of 2-deoxy-D-glucose (2-DG), a competitive inhibitor of glucose utilization, increased the food intake of rats. Infusions of glucose or mannose abolished this effect, whereas equimolar fructose solutions did not affect 2-DG-induced feeding. Similar results were obtained when 2-DG and the hexoses were administered into the hepatic portal vein. These findings suggest that 2-DG elicits feeding due to glucoprivation at a site that is inaccessible to fructose. This site is likely to be in the brain, not the liver, because all three sugars can nourish peripheral tissue but only fructose cannot penetrate the blood-brain barrier. Moreover, 2-DG-induced feeding was abolished by intravenous infusion of beta-hydroxybutyrate, a substrate that can be oxidized by brain and other tissues but not by the liver.     

Organizational factors in picture recognition memory

Since humans have been shown to have a large capacity for dealing with pictures but not for more abstract forms of visual information, it follows that humans must rely on existing mental structures in picture recognition tasks. A series of experiments were designed to examine some characteristics of that structure. The results indicate that something analogous to categories exists for pictures and that when subjects view pictures they tag these categories. The decision in a recognition task that they have or have not seen a picture appears to be based on whether or not an existing category has been tagged. For example, the results indicate subjects can detect a new picture as new with a high degree of certainty. Further, the results show that subjects use information contained in or associated with the new member of the pair in a forced-choice procedure for deciding which member of the pair is old. Since other research has shown that figure-ground ratings made by one group of subjects is a reliable predictor of errors for subjects ranging in age from five to adult, there is evidence that whatever the exact nature of these categories they are not only common between individuals but are established at a very early age.     

Counselling in primary care: a systematic review of the research evidence

Counselling in primary care in the UK is expanding rapidly, and its evidence base needs to be established. We present the rationale for conducting controlled trials of counselling in primary care, and suggest that a systematic review of controlled trials of counselling in primary care is timely. We describe the process of conducting the review in accordance with Cochrane Collaboration guidelines. The review aimed to assess the effectiveness and cost-effectiveness of counselling in primary care, by systematically reviewing cost and outcome data from randomised controlled trials and controlled patient preference trials of counselling interventions, for patients with psychological and psychosocial problems considered suitable for counselling. The search strategy, inclusion and exclusion criteria, data collection and data analysis are described. The results of the review are presented. The review included only controlled trials of counselling in which counsellors accredited by the British Association for Counselling (or equivalent) provided non-directive counselling in primary care. Four trials met the inclusion criteria. Results indicated that patients who receive counselling show a modest but significant improvement in symptom levels compared with those who receive GP care. Levels of satisfaction with counselling are high. There is very tentative evidence to suggest that counselled patients are more likely to be considered recovered than usual GP care patients. There is limited information about the cost-effectiveness of counselling. We conclude by reflecting upon the results of the review and their implications for counselling research.