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.     

Self-Determination in Intervention With Battered Arab Women in Community Health Clinics in Israel

Many abused women from patriarchal collectivistic societies that are subjected to social control seek help in community health clinics. The article is based on a qualitative study, which consisted of 24 interviews with 12 abused Israeli Arab women who sought the help of social workers in community health clinics. A central theme that emerged from the interviews was the women’s wish to maintain their self-determination in retaining the power to determine the boundaries of the intervention within the professional relationship. The discussion focuses on the dialectical consequences of maintaining the women’s self-determination—empowering them, on one hand, and limiting them, on the other.     

Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

Posttraumatic Stress Following Acute Medical Trauma in Children: A Proposed Model of Bio-Psycho-Social Processes During the Peri-Trauma Period

Millions of children worldwide experience acute medical events. Children’s responses to these events range from transient distress to significant posttraumatic stress disorder symptoms (PTSS). While many models suggest explanations for the development and maintenance of PTSS in adults, very few have focused on children. Current models of child PTSS are primarily restricted to the post-trauma period, thus neglecting the critical peri-trauma period when screening and preventive interventions may be most easily implemented. Research on PTSS in response to pediatric medical trauma typically examines predictors in isolation, often overlooking potentially important interactions. This paper proposes a new model utilizing the bio-psycho-social framework and focusing on peri-trauma processes of acute medical events. Understanding the relationships among bio-psycho-social factors during peri-trauma can inform early identification of at-risk children, preventive interventions and clinical care. Recommendations for future research, including the need to examine PTSS in the context of multiple influences, are discussed.     

Proposed Strategies for Teaching Ethics of Nanotechnology

Nanotechnology and nanosciences have recently gained tremendous attention and funding, from multiple entities and directions. In the last 10 years the funding for nanotechnology research has increased by orders of magnitude. An important part that has also gained parallel attention is the societal and ethical impact of nanotechnology and the possible consequences of its products and processes on human life and welfare. Multiple thinkers and philosophers wrote about both negative and positive effects of nanotechnology on humans and societies. The literature has a considerable amount of views about nanotechnology that range from calling for the abandonment and blockage of all efforts in that direction to complete support and encouragement in hopes that nanotechnology will be the next big jump in ameliorating human life and welfare. However, amidst all this hype about the ethics of nanotechnology, relatively less efforts and resources can be found in the literature to help engineering professionals and educators, and to provide practical methods and techniques for teaching ethics of nanotechnology and relating the technical side of it to the societal and human aspect. The purpose of this paper is to introduce strategies and ideas for teaching ethics of nanotechnology in engineering in relation to engineering codes of ethics. The paper is neither a new philosophical view about ethics of nanotechnology nor a discussion of the ethical dimensions of nanotechnology. This is an attempt to help educators and professionals by answering the question of how to incorporate ethics of nanotechnology in the educational process and practice of engineering and what is critical for the students and professionals to know in that regard. The contents of the presented strategies and ideas focus on the practical aspects of ethical issues related to nanotechnology and its societal impact. It also builds a relation between these issues and engineering codes of ethics. The pedagogical components of the strategies are based on best-practices to produce independent life-long self-learners and critical thinkers. These strategies and ideas can be incorporated as a whole or in part, in the engineering curriculum, to raise awareness of the ethical issues related to nanotechnology, improve the level of professionalism among engineering graduates, and apply ABET criteria. It can also be used in the way of professional development and continuing education courses to benefit professional engineers. Educators and institutions are welcome to use these strategies, a modified version, or even a further developed version of it, that suits their needs and circumstances.     

The effect of statistical learning on internal stimulus representations: Predictable items are enhanced even when not predicted

Statistical learning is the automatic and unconscious learning of environmental regularities and is a basic mechanism of learning in a variety of human perceptual and cognitive domains. Previous studies have mainly focused on the associative mechanisms of statistical learning. However, an unexplored question is whether the internal representations of individual stimuli are altered as their associations are learned. Using a temporal statistical learning paradigm, we examine this question across three experiments and find clear evidence that the internal representations of individual stimuli are differentially altered according to their degree of temporal predictability. These findings complement previous accounts of statistical learning and reveal an enriched mechanism of human learning, such that learning to associate items also enhances the representations of certain items relative to others.