Treatment Adherence in Children with Sickle Cell Disease: Disease-Related Risk and Psychosocial Resistance Factors

To identify disease-related risk factors and psychosocial resistance factors that impact adherence to prescribed treatment in the context of admission to a Hematology Acute Care Unit (HACU) designed to provide acute care for children with sickle cell disease (SCD) presenting with pain or fever. A total of 73 primary caregivers and 24 children (if age 8 or older) completed standardized forms during the HACU admission. Treatment adherence variables (medical staff rating, SCD-related care activities, percentage of agreement between treatment recommendations made and care activities, and attendance at hematology clinic) indicated moderate-to-high adherence. Based on regression analyses, the risk variable of disease-related stress and the resistance variables of family flexibility and less reliance on passive coping accounted for significant portions of the variance in treatment adherence. Empirical evaluation of interventions designed to improve communication regarding expectations for the care of children with SCD and to support active family problem solving during times of SCD-related stress must be ongoing.     

A Self-Management Program for Adolescents and Children with Renal Transplantation

This paper describes the development and implementation of a self-management program designed to address noncompliance in adolescents with renal transplants. Transplantation provides the best treatment alternative for End-Stage Renal Disease (ESRD), but is a procedure that subsequently demands recipients follow a life-long medication regimen. Nonadherance to medical therapy is a serious problem for adolescents; it is one of the most common causes of chronic graft rejection in this population. To improve compliance rates for this population, a self-management program was designed: (1) to provide social support; (2) to review information about medications and transplant management; and (3) to both teach and provide transplantation patients the opportunity to practice self-management skills. Details about the program, including recruitment issues and session content, are provided. Evaluations by participants indicated that the program was effective in creating a supportive environment for both patients and their parents, and in addressing health-related concerns.     

Presurgical Coping, Depression, and Quality of Life in Persons with Parkinson's Disease

This study describes utilization of coping strategies and evaluates the interaction between coping strategies, depression, and quality of life (QOL) in patients with Parkinson's disease (PD) who are being considered for neurosurgical intervention. Eighty patients (mean age 61.7 years) with PD being evaluated for possible deep brain stimulation completed self-report instruments of coping strategies (Coping Responses Inventory), depression (Beck Depression Inventory), and disease-specific QOL (Parkinson's Disease Questionnaire-39). Analyses showed that patients with PD cope with the acute stressor of approaching neurosurgery through a variety of strategies, but particularly avoidant and behavioral strategies. When the correlated but apparently opposing effects of cognitive and behavioral strategies were teased apart, greater use of cognitive strategies was associated with more severe depressive symptomatology (and poorer QOL), while greater use of behavioral strategies appeared to be associated with less depression. Depressive symptomatology, in turn, was associated with poorer QOL. However, coping had minimal direct association with QOL. From this it was concluded that patients with advanced PD generate a variety of coping responses to an acute stressor such as surgery, and the use of behavioral strategies, in particular seeking of alternative enjoyable activities, may be associated with better mood if salutary effects are not overwhelmed by less helpful cognitive coping techniques. The minimization of depressive symptomatology, in turn, is associated with better QOL.     

关于儿童自闭症行为矫治法的几个理论问题

了解儿童自闭症行为矫治法有助于提高自闭症治疗的质量和效果。本文讨论了有关儿童自闭症行为矫治法的几个理论问题。作者还介绍分析了中外自闭症文献中记载的儿童自闭症行为矫治法的临床实验及其治疗效果。     

Fostering young children's representation, planning, and reflection: A focus in three current early childhood models

Many educators and developmental psychologists have pointed to the development of symbolic thought and representational abilities as a set of fundamental capacities that underlie the development of self-regulation, problem solving, planning, and higher level thought processes. While many early childhood programs value children's development of symbolic capacities, three approaches, High/Scope, Tools of the Mind, and Reggio Emilia, were analyzed in terms of one context from the array of strategies and experiences that characterizes the approach in order to examine the distinctive way that three different preschool programs apply the theoretical construct of representational development to pedagogical strategies.     

Some Hindu Insights on a Global Ethic in the Context of Diseases and Epidemics

As we develop a global ethic in the context of diseases, we need to reconsider the wisdom of the religious traditions, for there is more to ailments than their material causes. In the Hindu framework, aside from the Ayurvedic system, which is based on herbal medicines and a philosophical framework, there is the insight that much of what we experience is a direct consequence of our karma (consequential actions). Therefore, here one emphasizes self–restraint and self–discipline in contexts that are conducive to self–hurting behavior.     

Women's Sexual Aggression Against Men: Prevalence and Predictors

In this study, we investigated the prevalence of women's sexual aggression against men and examined predictors of sexual aggression in a sample of 248 women. Respondents reported their use of aggressive strategies (physical force, exploitation of a man's incapacitated state, and verbal pressure) to make a man engage in sexual touch, sexual intercourse, or oral sex against his will. Childhood abuse, gender role orientation, ambiguous communication of sexual intentions, level of sexual activity, and peer pressure were included as predictors of sexual aggression. Almost 1 in 10 respondents (9.3%) reported having used aggressive strategies to coerce a man into sexual activities. Exploitation of the man's incapacitated state was used most frequently (5.6%), followed by verbal pressure (3.2%) and physical force (2%). An additional 5.4% reported attempted acts of sexual aggression. Sexual abuse in childhood, ambiguous communication of sexual intentions, high levels of sexual activity, and peer pressure toward sexual activity were linked to an increased likelihood of sexual aggression. The findings are discussed in relation to the literature on men's sexual aggression.     

The value of stress-management interventions in life-threatening medical conditions

Emotional stress has been associated with the development and progression of several chronic medical conditions. Recently, researchers have assessed the impact of stress-management interventions on patients' psychological functioning, quality of life, and various disease outcomes, including survival. This review summarizes the value of stress-management techniques in the treatment of two important, life-threatening conditions: coronary heart disease and cancer. Results from randomized clinical trials indicate that psychological interventions can improve patients' psychological functioning and quality of life. However, there is limited evidence to suggest that these interventions significantly reduce morbidity and mortality.     

异体造血干细胞移植问题、发展与思考

异体造血干细胞移植(Allo-HSCT)已成为治疗恶性血液病及其他各种疾病的有效方法之一。在Allo-HSCT中由于供体和受体免疫屏障的存在。从而一开始就是一个供受体矛盾的对立统一的过程。对其中矛盾的研究和解决充满了辩证唯物的哲学思想。也促使Allo-HSCT技术不断发展。新的方法和理念不断出现。使Allo-HSCT治疗白血病的疗效不断提高。     

Longitudinal interplay of young children's negative affectivity and maternal interaction quality in the context of unequal psychosocial resources

Interaction quality and child temperament predict early and later child development. Research hints at transactional interrelations of both aspects but lacks adequate data to examine this assumption. Maternal psychosocial resources are suspected moderators in this context but rarely taken into account. Drawing on data of the German National Educational Panel Study we conducted a cross-lagged panel analysis on the longitudinal interplay of maternal interaction quality and children's negative affectivity at 6–8, 16–18, and 25–27 months and compared mothers with and without accumulated strains. Both variables showed moderate to high structural and rank order stability over time and low but increasing connections. In the case of accumulated stress factors, interaction quality is clearly impaired and high negative affectivity acts as an additional burden while low negative affectivity helps strained mothers to maintain higher interaction quality but only in the first year of life.