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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: Past research has demonstrated that self-disclosure of traumatic or secretive information produces observable health benefits. Self-disclosure has also been linked, albeit less consistently, to improved psychological health. The present study examined the physiological and psychological consequences of children's self-disclosure of their HIV/AIDS status to friends.Methods: Data were collected twice, one year apart, from 64 caregiver-child dyads in which all of the children were infected with HIV. Dependent variables included the child's CD4%, self-concept, and level of behavioral problems.Results: Children who had disclosed their HIV+ diagnosis to friends during the 1-year course of the study had a significantly larger increase in CD4% than children who had told their friends before the study or those children who had not yet disclosed their HIV+ diagnosis to friends. This effect remained significant when the child's age and level of medication (protease inhibitors) were statistically controlled. Self-disclosure to friends did not impact the child's behavior or self-concept.Conclusions: This is the first study to investigate the effect of self-disclosure in children. The results were consistent with previous studies showing the positive health consequences of self-disclosure in adults, and suggest potentially important implications for professional and familial care givers of HIV/AIDS individuals. [ABSTRACT FROM AUTHOR]

For many parents who have lost a child to terminal illness, the loved one will live on in vivid dreams or unusual sensory perceptions. Researchers report what they've learned about these 'evocative experiences' and offer some insights on how to support parents who have them. [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]

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.