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Purpose: Grandparents can be profoundly emotionally affected when a grandchild is diagnosed with cancer. They also often provide invaluable support for the family (e.g., caring for the sick child and/or siblings). Multigenerational family functioning may therefore change. Limited research has assessed grandparents' perspectives after their grandchild is diagnosed with cancer. In this study, we aimed to (1) assess differences in perceived family functioning among grandparents of a child with cancer and grandparents of healthy children and (2) assess the cancer-specific and demographic factors related to perceived family functioning in grandparents of a grandchild with cancer.Procedure: Grandparents of a child with cancer (n = 89) and grandparents of healthy children (n = 133) completed the general functioning, communication, and problem-solving scales of the Family Assessment Device. We used multilevel models with a random intercept to detect (1) between-group differences and (2) identify factors related to perceived family functioning among grandparents with a grandchild with cancer.Results: Grandparents with a grandchild with cancer reported poorer family functioning than grandparents with healthy grandchildren. Among the grandparents with a grandchild with cancer, impairments in family functioning were correlated with fewer years since diagnosis, providing care to their sick grandchild and/or siblings and living far away from the sick grandchild.Conclusions: The detrimental impact of childhood cancer likely extends beyond the immediate family members. Including grandparents in interventions-beginning at diagnosis-to reduce distress and increase cohesion for families of a child with cancer is warranted, particularly for grandparents who provide care to their sick grandchild or siblings. [ABSTRACT FROM AUTHOR]

Objective: When a child is diagnosed with cancer, parents are faced with many practical and emotional challenges that can significantly affect their relationship. This study explores how having a child with cancer affects the quality of the parents' relationship, categorizes time points and events during the child's treatment when the relationship becomes most stressed and/or strengthened, identifies factors that help couples remain emotionally engaged throughout their child's cancer treatment, and assesses parental interest in a counseling intervention.Methods: This is a cross-sectional, multicenter study conducted via a semistructured self-administered questionnaire that included the Revised Dyadic Adjustment Scale.Results: One hundred ninety-two parents of children diagnosed between the ages of 1 and 21 participated. Forty percent felt their relationship moved in a negative direction. Diagnosis and relapse of disease were cited as the most individually stressful time points in the disease trajectory, with hospitalizations and relapse being most stressful on the relationship. Participants felt most emotionally connected at diagnosis and least emotionally connected at the start and end of treatment. The majority of couples indicated interest in counseling to address ways to support their relationship. Soon after diagnosis and during treatment was reported as the preferred time to offer these interventions.Conclusion: This study identified specific events and parent behaviors that strain the couples' relationship during the childhood cancer trajectory. This information can inform the development of a couple's intervention. Prospective research is needed to better understand how childhood cancer affects caregivers' partnerships through survivorship and beyond. [ABSTRACT FROM AUTHOR]

Purpose: ShopTalk is a therapeutic game, created to help youth living with cancer talk about their illness in a non-threatening way. The aim of this study is to learn how the game is being used in clinical settings and to gather information regarding the usefulness of ShopTalk in establishing a therapeutic relationship and in assessing key psychosocial issues in the child's life.Methods: ShopTalk was distributed at a social work pediatric oncology conference and to 70 sites. Game holders were asked to complete a survey regarding their clinical experience using ShopTalk.Results: Responses came from 110 professionals. ShopTalk has been found to be as an effective tool in identifying coping skills and psychological adjustment, as well as issues related to family relationships, depression/sadness, stress, prognosis, peer relationships, and self-esteem. Respondents found ShopTalk useful from diagnosis to end of life. Qualitative feedback suggested therapeutic value along with discomfort with specific questions.Conclusion: ShopTalk appears to be a beneficial therapeutic tool in building rapport and identifying and discussing difficult issues with medically ill children. Areas for future versions of the game and research exploring patient/therapist outcomes are discussed. [ABSTRACT FROM AUTHOR]

Following the publication in 2006 of 'Working together to safeguard children' (HM Government 2006), an audit was undertaken to assess the working knowledge of children's services staff about safeguarding. The aims of the audit were to:identify knowledge of key legal issues required when caring for children and young peoplehighlight gaps in knowledgeidentify training needs.Staff in acute children's services in two district general hospitals and in the child and adolescent mental health service were interviewed using a structured questionnaire. The results of the audit showed that professionals' knowledge about the sharing of information was good. This may have been due to a recent introduction of a policy on sharing information and also mandatory training on safeguarding children, which includes issues regarding sharing information. However, the audit identified a lack of understanding about parental responsibility with only 41 per cent of staff able to provide an acceptable response. Other gaps in staff knowledge were identified concerning legal orders, particularly emergency protection orders and police protection powers. [ABSTRACT FROM AUTHOR]

Objective: To examine the chronic illness literature and evaluate the impact on single parenting and children and adolescents with chronic illness.Methods: We conducted literature reviews of relevant research pertaining to single-parent families on PubMed, Medline, and PsychINFO and also surveyed pertinent book chapters and all of the articles from the Journal of Pediatric Psychology since 1987 for articles, specifically examining the potential associations of single (lone) parenting versus two-parent households on children's psychosocial functioning and the impact of the child's illness on caregiver functioning.Results: While the literature has examined and discussed the stressors associated with parenting a child with an illness, including the impact of illness on finances, family roles, and caregiver burden, few studies have examined single parents of children and adolescents with chronic illnesses and related stressors stemming from being a lone caregiver.Conclusions: There is a dearth of studies examining the association between lone parenting and psychosocial functioning among children and adolescents with chronic illnesses. Specific questions necessitating future investigation are summarized and recommendations are made for future research in this important area of inquiry. [ABSTRACT FROM AUTHOR]

Objective: To examine the psychosocial stressors experienced by fathers of children diagnosed with HIV/AIDS.Methods: Thirty-one fathers whose children (ages 6 to 19) were participating in pediatric HIV clinical trials completed self-report measures of parenting stress, psychological distress, and need for psychosocial services.Results: Over half of this sample experienced significantly elevated levels of both parenting stress and psychological distress compared to standardized norms. Ninety-seven percent of these men reported the need for services including gender-specific support groups, assistance with discipline, disease management, and assistance with planning for the future.Conclusions: Elevated levels of parenting stress and psychological distress in fathers of children living with HIV suggest the need for additional psychological intervention in this population. [ABSTRACT FROM AUTHOR]

Despite the growing numbers of HIV-infected school-aged children, we know very little about the mental health status of this group. This longitudinal study examined the frequency of psychological distress symptoms in HIV-infected children between the ages of 6 and 11 years at three time points over a period of two and one-half years. Children were assessed using the Dominic, a pictorial instrument that assesses for 7 psychological distress symptoms of childhood. In addition, family and demographic variables were collected at Time 1. Children were found to be relatively well-adjusted, with low to moderate incidence of psychological distress. While there were no significant changes in frequency of psychological distress symptoms from Time 1 to Time 3, the prevalence of overanxious and depressive symptomatology increased over time. Implications for clinical practice and future research will be discussed. [ABSTRACT FROM AUTHOR]

Coronary artery stenosis diminishes and eventually abolishes the peak reactive hyperaemic response following momentary coronary occlusion. If stenosis is increased beyond this point, it is generally believed that resting coronary blood flow and reactive blood flow will continue to be identical. This assumption was investigated in 14 anaesthetised dogs. Aortic pressure, distal coronary pressure, and coronary flow were measured. Stenotic resistance was calculated as the pressure gradient across the stenosis divided by the coronary blood flow. Before coronary artery constriction, the usual large coronary blood flow increase and distal coronary resistance decrease were observed. With moderate stenosis, distal coronary resistance decreased and coronary blood flow increased, although attenuated. With severe stenosis, coronary blood flow remained unaltered, the distal coronary resistance decrease being nullified by the stenotic resistance increase. With further constriction, coronary blood flow actually decreased following momentary coronary occlusion. The coronary blood flow decrease was associated with a large stenotic resistance increase. We believe the most plausible explanation for the observed stenotic resistance increase was a passive collapse of the vessel due to the distal coronary pressure reduction. This hypothesis is strengthened by our demonstration of similar stenotic resistance increases in an in vitro,constant flow perfused carotid artery, induced by reducing the peripheral resistance. This study demonstrates that stenotic resistance is not fixed, but is dynamic. Conceivably, in the presence of severe coronary artery stenosis, vasodilatation could increase stenotic resistance and thereby reduce coronary blood flow. [ABSTRACT FROM PUBLISHER]

Bark beetle (Col., Scolytidae) colonization and terpene patterns in the bark of Norway spruce (Picea abies Karst.) trap trees Trap trees of the Norway spruce were used to investigate correlations between colonization density of bark beetles and terpene patterns of the trunk phloem. Ips typographus and Pityogenes chalcographus were the dominant species, which demonstrated the usual differentiated patterns of attack concentration along the trunks. There were, however also exceptions made by P. chalcographus, extending its mass colonization down to more basical parts of the trunk. Phloem samples were collected from 7 trap trees, when bark beetle flight was just starting in middle of May 1985. Three samples per trap tree were each taken from the center of the bottom, middle and top third of the trunk, respectively, and analyzed by a GC/MS device. The average density of enterance holes of I. typographus and P. chalcographus as calculated for each third of an individual trunk, was now compared with the varying mono- and sesquiterpene patterns of the respective trunk sections. A strong positive correlation of P. chalcographus attack density was found to exist to myrcene, and to the b̃-pinene: α-pinene relation, and to b̃-phellandrene × limonene as well. Correlation was a little higher, when these three terpene values were combined by addition. With I. typographus it was more difficult to find correlations with terpene contents of the bark. A r = 0.679 (p < 0.01) was calculated for the term (α-pinene × limonene): (myrcene × camphene); neglecting some outliers correlation could be increased to r = 0.912. Considering the total number of values, correlation is improved by addition of b̃-phellandrene: (Δ3-carene + 1) and tricylene × (terpinolene + 1) (r = 0.739, p < 0.001). It is suggested that the differing preference of I. typographus and P. chalcographus for completely different terpene patterns of the spruce phloem may play an important role in host tree selection as well as in selection of the colonization site within a trunk. Further experiments should demonstrate, whether these terpene fractions are involved in the 'primary attraction principle' of Norway spruce to the investigated bark beetle species. Zusammenfassung An einer Serie von Fangbäumen ( Picea abies) wurden die Anflugdynamik und Siedlungsverteilung der Borkenkäfer Ips typographus und Pityogenes chalcographus sowie die Terpenmuster der Fichtenrinde und ihre Verteilung am Stamm untersucht. Die Verteilung der Käferansiedelungen an den Stämmen sowie jene der Terpenmuster variierten in korrespondierender Weise. Bei P. chalcographus korrelierte die Einbohrdichte eng und positiv mit dem relativen Gehalt der Fichtenrinde an Myrcen, aber auch mit dem Verhältnis b̃-Pinen: α-Pinen und mit dem Produkt aus b̃-Phellandren × Limonen. Da die Korrelation durch additive Vereinigung der drei Terpenwerte verbessert werden konnte, wird vermutet, daß jeder einzelne Terpenparameter bereits starken Informationswert für P. chalcographus besitzt, dieser in Kombination der drei Parameter aber vrstärkt wird. Der völlig anderen Verteilung der Einbohrdichten von I. typographus an den Stämmen entspricht auch ein deutlich abweichendes Terpenmuster, mit dem ein Zusammenhang der Käferansiedelung festgestellt werden konnte. Den stärksten positiven Einfluß zeigt die Terpenkombination (α-Pinen × Limonen): (Myrcen × Camphen). Geringfügige Verbesserungen der Korrelation mit den Einbohrdichten konnten durch die Einbindung von b̃-Phellandren: (Δ3-Caren + 1) sowie Tricylen × (Terpinolen + 1) in den Terpenterm erzielt werden. In allen Fällen wurde mit den prozentualen Anteilen der einzelnen Verbindungen am gesamten CLSA-Rindenextrakt gerechnet. Der mögliche Informationswert der beschriebenen Terpenmuster als Lenkungssignale für die Selektion des Ansiedlungsortes der beiden Käferarten sowie ihre eventuelle Rolle bei der Primärattraktion derselben werden diskutiert. [ABSTRACT FROM AUTHOR]

A multi-institutional trials program was initiated to define the effects of interferons in disseminated human breast carcinoma. Interferon alpha, prepared from buffy coats, was administered intramuscularly at 3 x 10(6) U daily for an initial period of 28 days. Of 23 patients who entered the program, five had an objective partial response of 92 days mean duration at diverse sites of involvement. Patients who responded were significantly older (p = 0.05) than nonresponders. Dose escalation in eight patients did not result in any clear evidence of additional responses. Major toxicities were fatigue, anorexia with weight loss, and reversible leukopenia (less than 3.5 x 10(9) leukocytes/L in 16 patients). Natural killer cell and antibody-dependent cell-mediated cytotoxicity were significantly (p less than 0.05) enhanced 48 hours after interferon administration began but subsequently declined despite continued therapy. Serum beta 2-microglobulin concentration increased on day 15 (p less than 0.05) and remained significantly elevated on day 22 (p less than 0.005). Peak interferon titers (mean, 62 U) occurred 6 hours after interferon was started, varied widely between patients, and were higher and more persistent with dose escalation. Once an optimal dose is defined, prospectively randomized trials will define what role interferons may have in systemic therapy of breast carcinoma. [ABSTRACT FROM AUTHOR]

Presents information on a study that examined the clinical and metabolic effects of propranolol and phenoxybenzamine hydrochloride administered in hyperthyroid patients. Methodology of the study; Results and discussion on the study.