Written communication as an important management skill.
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Administrative Personnel↗
Biomedical subjects
M L Peters
Publications and source records attributed to M L Peters.
Immune responses to experimental stress: effects of mental effort and uncontrollability.
OBJECTIVE: Two important determinants of physiological stress responses have been identified, uncontrollability of the stressor and amount of effort involved in coping with the stressor. In the present experiment, we tried to identify the specific contributions of effort and uncontrollability to immune system responses to stress. METHODS: In a 2 x 2 design, effort and uncontrollability were manipulated independently of each other. Subjects participated in one of four experimental conditions, and their endocrine, immune, and sympathetic nervous system responses to the task were assessed. RESULTS: Effort had a stimulating effect on enumerative immunological parameters (CD8 and CD16+ cells) and on natural killer cell activity. The effect occurred immediately after the stressor and was transient. Regression models indicated that this effort effect may have been mediated by activation of the sympathetic nervous system. Uncontrollability influenced in vitro production of the cytokine interleukin-6, leading to decreased production 15 and 30 minutes after the stressor. Uncontrollability also led to an increased level of cortisol, but no evidence was found that the decrease in cytokine production was mediated by cortisol release. CONCLUSION: The results suggest that two major stressor characteristics, effort and uncontrollability, may have differential effects on the immune system.
Adaptation, Psychological↗
Psychosocial challenges for children with insulin-dependent diabetes mellitus.
This article describes the particular relevance of Erik Erikson's psychosocial stages of development for children with insulin-dependent diabetes. The developmental issues for young children centering on trust, autonomy, initiative, and industry have special significance for children with diabetes. Although the issues faced in each of Erikson's psychosocial stages are present in every stage, behaviors are manifested differently at each stage. Practical suggestions are provided for families and healthcare providers living with or working with children of various ages who have diabetes.
Adolescent↗
Iron supplementation of total parenteral nutrition: a prospective study.
A prospective study to evaluate the iron dosage needed to restore serum iron levels was performed on patients receiving prolonged total parenteral nutrition (TPN). Intravenous iron intakes of 0, 25, 87.5, and 175 mg/wk were sequentially studied. No untoward responses were seen in 42 patients studied for 2758 patient days. When compared to pre-TPN levels, serum iron levels increased significantly with increasing iron dosage (p less than 0.002). In every single patient at the two highest dosage levels, serum iron levels at 3 wk rose from the pre-TPN level. Hemoglobin, reticulocyte count, transfusion requirement, total iron binding capacity, and red cell indices were not affected by iron dosage. There was no increased incidence of sepsis in patients who received increasing iron dosage. Both the 87.5 and 175 mg/wk iron doses increased serum iron levels from pre-TPN values, but the highest dose increased serum iron levels above the normal range in 80% of patients after 3 wk of administration allowing us to recommend the 87.5 mg/wk dose.
Adult↗