Correlates of Regimen Adherence in Cystic Fibrosis

The present investigation studied psychological and familial factors associated with self-care adherence in a sample of 50 children (ages 9 to 17 years) with cystic fibrosis (CF). Children and their parents were recruited through an outpatient pediatric pulmonary medicine clinic at a metropolitan children's hospital. Participants were interviewed and administered measures of family behavior and child psychological variables. Regimen adherence was measured using a telephone interview approach across three occasions per participant. Hierarchical multiple regression with age, perceived family behaviors, health locus of control, and self-competency as predictors, accounted for 53.8% of the variance in regimen adherence. Findings suggest that higher self-esteem and younger age are related to higher rates of regimen adherence among children with CF.     

Rapid Adoption and Implementation of Telehealth Group Psychotherapy During COVID 19: Practical Strategies and Recommendations

Behavioral health services have been tasked with rapidly adopting and implementing teletherapy during the SARS-CoV-2/COVID-19 pandemic to assure patient and staff safety. Existing teletherapy guidelines were developed prior to the pandemic and do not capture the nuances of rapidly transitioning in-person individual and group-based treatments to a teletherapy format. In this paper, we describe our approach to quickly adapting to a teletherapy technology platform for an intensive outpatient program (IOP) guided by cognitive and behavioral modular principles for adults with serious mental illness. A review of existing guidelines was conducted and the staged approach for teletherapy implementation (Muir et al., 2020) was selected as the most appropriate model for our organizational context. We describe the most pertinent implementation strategies and report our preliminary findings detailing the feasibility of IOPs delivered via telehealth. This model of rapid teletherapy implementation offers practical clinical guidelines for administrators and clinicians seeking to transition traditional in-person behavioral health services to a teletherapy format.     

Primary prevention of psychological difficulties in vulnerable mothers: pilot programme evaluation

This pilot study evaluated a primary prevention programme delivered to mothers who were considered to be vulnerable to the development of psychological difficulties (N = 11). Beneficial effects were noted in terms of mood and coping, as well as a reduction in the mothers' attendance at their general practitioners surgery. Copyright © 2001 John Wiley & Sons, Ltd.     

美国与知情同意有关的一些问题

知情同意是医疗保健和医学研究的一个基本的伦理学要求。这两种情况中,当医学研究的知情同意标准比医疗保健要求更加严格时,知情同意包含了3种要素：（1）告知病人或受试者该研究的性质。包括益处,危险和其他有关内容;（2）确保病人受试者理解所提供的信息;（3）得到病人或受试者自愿的同意,没有能力参与知情同意的病人包括患痴呆和危重病等无决断 能力的病人,这些病人属弱势病人。如要获许对他们的疾病进行研究,我们必须制定保护弱势受试者有效的伦理政策,提出了关于对痴呆病人、危重病人,脑死亡病人研究的伦理学政策。     

Resilience and Family Psychosocial Processes Among Children of Parents with Serious Mental Disorders

Resilience involves successful adaptation despite adverse circumstances, and is operationalized in this study as a multidimensional construct which consists of both positive and negative indicators of adaptation. Previous research has emphasized the importance of parental psychopathology in predicting child adaptation among children of parents with serious mental disorders. In contrast, we hypothesized five family psychosocial processes as common sequelae to serious parental mental disorder that are central to child adaptation beyond that predicted by parental psychiatric status. These are diminished family financial resources, social network constriction, impaired performance of parenting tasks, increased familial stress, and disruption of the parent-child bond. We examined the relationship of these processes to child adaptation independently through hierarchical regression analyses after taking into account parental psychiatric symptoms and functioning as well as the child's age and gender. One hundred seventy-seven children of mothers with serious mental disorder, ages 2–17 years old, were assessed on measures of adaptation. Results indicated that family psychosocial processes are a more consistent and powerful predictor of child adaptation than parental psychopathology. Results also indicated that, for these children, adaptation is predicted most consistently by parenting performance, and to lesser extents, by the parent-child bond and familial stress. We discuss our results in terms of their implications for theory and intervention with children of parents with serious mental disorders and for the study of resilience.     

医师知识结构和思维方式与肺血栓栓塞症诊断

肺血栓栓塞症是常见的临床病症,因其临床表现多样,易发生误诊漏诊而导致较高的病死率.但"凡事顸则立,不顸则废",充分掌握肺血栓栓塞症的知识、以正确的思维方式引导临床诊疗可以有效减少和避免误诊漏诊.     

The role of neuropsychology in UK pediatric HIV care: Relevance to clinical practice and research

There has been a dramatic improvement in the survival of children with perinatally-acquired HIV (PHIV) following the introduction of effective treatment in 1990s. The care for children living with PHIV is now focused on more accurately understanding the effects of both HIV and HIV treatment on the developing body and brain. An evaluation of current HIV neuroimaging, and neurocognitive research, when combined with clinical experience in the area of HIV, could help to inform United Kingdom (UK) PHIV service provision. This paper argues that an understanding from a neuropsychological perspective will help these young people to optimize their health, quality of life, and future functioning. The aim of the paper is to bring together research and clinical understanding of HIV and its treatment effects on the developing brain, together with an understanding of other potential neurological risk factors. It is argued here that there is a need for targeted neuropsychology assessment and preventative interventions, supported by clinical and preliminary research on the neurocognitive effects of HIV and its treatments.     

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.     

Family identity and severe mental illness: A thematic synthesis of qualitative studies

There is a growing amount of research showing that a shared social identity and the sense of belonging to a family have a potential effect on health. However, little is known about the effects of severe mental illness on family identity. The authors carried out this thematic synthesis based on a systematic review of literature on family narratives of severe mental illness and family identity. The main findings indicate that in many families (i) their identity—as a shared social identity—undergoes a transformation process by which the identity aspects of being a family are reinforced; (ii) family members often take on a caring role as their main family role; and finally, (iii) a cultural component shapes this transformation process. The authors describe implications for research and application in the mental health field. All in all, family identity is transformed by the experience of severe mental illness.     

Measuring change in psychotherapeutic work with a traumatised child on the autistic spectrum

This paper describes a developmental psychotherapy undertaken with a physically disabled latency boy, with a background of significant developmental deficits and multiple psychological trauma, diagnosed by CAMHS as being on the autistic spectrum. Using an assessment framework following Anna Freud’s conceptualisation of developmental lines, pathology as a deviation from the norm was formulated. Assessments using standard psychological tests were made at the beginning, in the middle, and at the end of his therapy, in order to study the changes in his personality development. Standard assessment findings were also used to portray the fragmentation of the boy’s psyche in a concrete fashion, in order to facilitate his re-integration.