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PubMed2005

A PERSON-CENTERED AND ECOLOGICAL INVESTIGATION OF ACCULTURATION STRATEGIES IN HISPANIC IMMIGRANT YOUTH.

Understanding the processes of acculturation in ethnic minority populations is one of the central tasks of crosscultural research. Addressing challenges of theory, methods, and application in acculturation research requires ongoing advancements in methods and theoretical and model development. The current study was designed to explain a person-centered approach to investigating acculturation and biculturalism and to illustrate this method with a sample of 315 Hispanic youth. Pattern analyses of the Hispanicism and Americanism scores from the Bicultural Involvement Scale yielded four distinct acculturation types, including one characterized by moderate scores on both scales. Relations between acculturation types and indicators of individual, family, and peer adaptation were tested. Results indicated that bicultural youth tended to show the most adaptive pattern of functioning across multiple sociocultural domains. Assimilated youth did not show as strongly negative a pattern as has been reported elsewhere. Implications and benefits of a person-centered approach are discussed.

Journal Article↗
PubMed2002

Cognitive and neuropsychological outcomes: more than IQ scores.

Improved survival in preterm infants has broadened interest in cognitive and neuropsychological outcomes. The incidence of major disabilities (moderate/severe mental retardation, neurosensory disorders, epilepsy, cerebral palsy) has remained consistent, but high prevalence/low severity dysfunctions (learning disabilities, ADHD, borderline mental retardation, specific neuropsychological deficits, behavioral disorders) have increased. The follow-up literature contains methodologic problems that make generalizations regarding outcome difficult, and these are discussed. Although mean IQs of former VLBW infants generally are in the low average range and are 3-9 points below normal birth weight peers, these scores mask subtle deficits in: visual-motor and visual-perceptual abilities, complex language functions, academics (reading, mathematics, spelling and writing), and attentional skills. There is an increased incidence of non-verbal learning disabilities, need for special educational assistance, and behavioral disorders in children born prematurely. Males have more problems, and there is a trend for worsening outcome over time, due to emergence of more subtle deficits in response to increased performance demands. In addition to IQ and achievement testing in follow-up, there should be evaluation of executive functions and attention, language, sensorimotor functions, visuospatial processes, memory and learning, and behavioral adjustment.

Cognition Disorders↗
PubMed2007

Design and feasibility of a randomized behavioral intervention to reduce distributive injection risk and improve health-care access among hepatitis C virus positive injection drug users: the Study to Reduce Intravenous Exposures (STRIVE).

Hepatitis C virus (HCV) is hyperendemic among injection drug users (IDUs). However, few scientifically proven interventions to prevent secondary transmission of HCV from infected IDUs to others exist. This report describes the design, feasibility, and baseline characteristics of participants enrolled in the Study to Reduce Intravenous Exposure (STRIVE). STRIVE was a multisite, randomized-control trial to test a behavioral intervention developed to reduce distribution of used injection equipment (needles, cookers, cottons, and rinse water) and increase health-care utilization among antibody HCV (anti-HCV) positive IDUs. STRIVE enrolled anti-HCV positive IDU in Baltimore, New York City, and Seattle; participants completed behavioral assessments and venipuncture for HIV, HCV-RNA, and liver function tests (LFTs) and were randomized to attend either a six-session, small-group, peer-mentoring intervention workshop or a time-matched, attention-control condition. Follow-up visits were conducted at 3 and 6 months. At baseline, of the 630 HCV-positive IDUs enrolled (mean age of 26 years, 60% white, 76% male), 55% reported distributive needle sharing, whereas 74, 69, and 69% reported sharing cookers, cottons, and rinse water, respectively. Health-care access was low, with 41% reporting an emergency room as their main source of medical care. Among those enrolled, 66% (418/630) were randomized: 53% (222/418) and 47% (196/418) to the intervention and control conditions, respectively. Follow-up rates were 70 and 73% for the 3- and 6-month visits, respectively. As distributive sharing of used injection equipment was common while reports of receiving HCV care were low, these findings indicate an urgent need for HCV-related interventions with IDUs and demonstrate the acceptability and feasibility to do so.

Adolescent↗
PubMed2006

Behavior, neurocognition and quality-of-life in children with sleep-disordered breathing.

OBJECTIVES: To summarize current evidence that sleep-disordered breathing in children is associated with behavioral, neurocognitive and quality-of-life problems and to suggest new lines of investigation for future research on sleep-disordered breathing and behavior. METHODS: A comprehensive review of the medical literature between January 1990 and December 2004 was performed using the National Library of Medicine's PUBMED database. RESULTS: Analysis revealed 33 articles that satisfied the inclusion and exclusion criteria. The total study population in these articles was 22,255 children. Sample sizes per study ranged from 12 to 5728 children. The age range was 2-18 years (mean 6.8+/-2.8). The majority of studies examined behavior, neurocognition or quality-of-life as a single outcome measure. Behavioral problems included reduced attention, hyperactivity, increased aggression, irritability, emotional and peer problems, and somatic complaints. The following neurocognitive skills were affected: memory; immediate recall; visual-spatial functions; attention and vigilance; mental flexibility; and intelligence. The quality-of-life of children with sleep-disordered breathing was similar that of children with asthma or rheumatoid arthritis. Improvements in behavior, neurocognition and quality-of-life scores for children with sleep-disordered breathing were seen after adenotonsillectomy. CONCLUSIONS: There is compelling evidence that sleep-disordered breathing in children is associated with behavioral and neurocognitive problems and leads to reduced quality-of-life. In addition to improvements in sleep, adenotonsillectomy is associated with improvements in behavior, neurocognition and quality-of-life in these children. However, the lack of uniform criteria for the diagnosis of sleep-disordered breathing in children and variation in methods used to assess the outcome of surgical therapy limit our current knowledge and should be addressed by future research. The high prevalence of sleep-disordered breathing in children should make this research a public health priority.

Brain↗
PubMed2004

Social support in diabetes: a systematic review of controlled intervention studies.

Systematic, computerized search in Medline, the Cochrane Library, Eric, PsychINFO and Embase files, 1980-2003, selecting descriptions of prospective intervention trials with good methodological design, testing effects of social support interventions on health outcomes in primary and outpatient care for type 2 diabetes. Six controlled trials were reviewed. They defined, modified, and measured social support in various ways, and scored outcomes with varying measures. Gender differences and the right amount of support seem important. Promising new forms of social support: group consultations (better HbA1c and lifestyle), Internet or telephone-based peer support (improved perceived support, increased physical activity, respectively), and social support groups (improved knowledge and psychosocial functioning). No improved diabetes control by classic forms of support, e.g. from spouse (but weight loss in women) and family and friends (no differences). It is tentatively concluded that this review supports the hypothesis that specific social support interventions affect patient self-care and diabetes outcomes. New forms of social support may be discussed and incorporated in the work of diabetes teams, and offered to patients as new possibilities to help them adjust to a life with (type 2) diabetes and make information-based decisions. Only in the group consultations study, diabetes control was protected. More well-designed research testing the effects of specific social support interventions on patient self-care, lifestyle adaptations, and outcomes of diabetes care, is warranted.

Counseling↗
PubMed1997

Aggression and environmental risk among low-income African-American youth.

PURPOSE: This study examined the extent to which individual, family, and environmental factors discriminated between aggressive and nonaggressive African-American youth. METHODS: One hundred fifty African-American boys and girls from eight housing communities in a medium sized Alabama central city were surveyed. From this nonrandom sample, information was collected concerning respondents' demographics, family characteristics, exposure(s) to violence, questions pertaining to weapon possession, and a peer-nominated question on aggression. Multivariate analysis was employed to differentiate aggressive from nonaggressive youth. RESULTS: Discriminant function analysis found gender (males) and age (older) to be important discriminators between nonaggressive and aggressive youth. In addition, a significant amount of separation between these groups was accounted for by their varying degrees of exposure to violence, specifically as a witness to and victim of violence, and their possession of a weapon. CONCLUSIONS: Findings provide evidence that victimization and witnessing violence were significantly related to aggressive behavior among this sample of African-American youth. In addition, this study confirms the clinical significance of environment and its potential role in predicting physical health, mental health, and social and behavioral outcomes for youth.

Adolescent↗
PubMed1998

Children's predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew.

This study examined (a) children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and (b) whether children who were exposed to the disaster would display a worsening of prior functioning. Fifteen months before the disaster, 92 4th through 6th graders provided self-reports of anxiety; peers and teachers rated behavior problems (anxiety, inattention, and conduct) and academic skills. Measures were repeated 3 months postdisaster; children also reported PTS symptoms and hurricane-related experiences (i.e., exposure). PTS symptoms were again assessed 7 months postdisaster. At 3 months postdisaster, children's exposure to the disaster, as well as predisaster ratings of anxiety, inattention, and academic skills, predicted PTS symptoms. By 7 months, only exposure, African American ethnicity, and predisaster anxiety predicted PTS. Prior anxiety levels also worsened as a result of exposure to the disaster. The findings have implications for identifying and treating children at risk for stress reactions following a catastrophic disaster.

Adjustment Disorders↗
PubMed2004

The emerging lexicon of children with phonological delays: phonotactic constraints and probability in acquisition.

The effects of phonotactic constraints (i.e., the status of a sound as correctly or incorrectly articulated) and phonotactic probability (i.e., the likelihood of a sound sequence) on lexical acquisition have been investigated independently. This study investigated the interactive influence of phonotactic constraints and phonotactic probability on lexical acquisition in 3 groups of children: children with functional phonological delays (PD), phonology-matched, younger, typically developing children (PM), and age-/vocabulary-matched typically developing peers (AVM). Sixty-eight children participated in a multitrial word-learning task involving nonwords varying in phonotactic constraints (IN vs. OUT) and phonotactic probability (common vs. rare). Correct and error responses were analyzed. Results indicated that OUT sound sequences were learned more rapidly than IN sound sequences. This suggests that OUT sounds may be salient because they represent only a small subset of the child's sound system. The effect of phonotactic probability varied across groups: Children with PD showed a common sound sequence disadvantage, younger PM children showed a common sound sequence advantage, and AVM children showed no effect. Moreover, error analyses indicated that children with PD had particular difficulty creating lexical representations and associations between lexical and semantic representations when learning common sound sequences. Children with PD may rely more heavily on lexical representations to learn new words or may have difficulty learning common sound sequences because of the high degree of similarity between these sequences and other known words. Finally, the effect of phonotactic probability was consistent across IN and OUT sound sequences, suggesting that the lexical representation of both correctly articulated and misarticulated words is based on the adult-target pronunciation.

Articulation Disorders↗
PubMed2005

Quality of life and psychomotor development after surgical treatment of hydrocephalus.

The purpose of this report is to analyse the long-term outcome in hydrocephalic children treated by shunt insertion, in particular their psycho-intellectual development and quality of life. We studied 46 patients aged 3 - 21, who had been operated on in the Department of Paediatric Surgery of the Medical University of Bialystok between 1982 - 2000 and had had ventriculo-peritoneal shunts inserted during their first year of life. Data from anamnesis and medical documentation were analysed. Age-appropriate psychomotor development and IQ tests were carried out: Wechsler Intelligence Scale for Children, Revised (WISC-R) (for children between the ages of 6 and 16), Wechsler Adult Intelligence Scale, Revised (WAIS-R PL) (for adults), Brunet-Lezine psychometric scale (early childhood), and Terman-Merril intelligence scale (children younger than 3). The final IQs were above 90 in 30 % of children, between 70 and 90 in 24 %, between 50 and 70 in 26 %, and lower than 50 in 20 %. 69 % of patients presented with neurological deficits and visual or auditory deficits were found in 22 %. Integration into normal schools was possible for 58.7 % of the children, one of whom is now a second year medical student. A relationship between shunt malfunction and the children's development was observed. An essential aspect of caring for hydrocephalic children is their rehabilitation and integration into society. Early physical rehabilitation, stimulation of psychological development, and continued monitoring by a paediatric surgeon to ensure proper functioning of the shunts will improve the independence of such children in their families and among their peers.

Adolescent↗
PubMed1990

Child functioning predictors of outcome among boys at risk for psychological disorder.

This study examined the success of child functioning measures in predicting child outcome for 97 boys with one parent previously hospitalized for psychiatric illness. The best predictors of adaptive functioning at a 3-year follow-up were IQ and clinician ratings based on parent report. Peer and teacher assessments and clinician ratings from interviews were moderately successful.

Adaptation, Psychological↗
PubMed2005

National survey of cancer educators: salary and budget.

The National Cancer Institute's Cancer Patient Education Network (CPEN) is composed of cancer education leaders from National Cancer Institute (NCI)-designated comprehensive and clinical cancer centers throughout the United States. Despite this commonality, the role and responsibilities of CPEN members vary across institutions. In an effort to further understand the commonalities and variances among the membership, the authors undertook a research project addressing salary and budget issues across NCI-designated cancer centers. The purpose of this study was to benchmark salaries and budgets of cancer educators at NCI-designated cancer centers; provide information to support a competitive salary range based on benchmarking with peers responsible for cancer patient education; and glean information on CPEN membership, roles, education levels, and job functions. This article highlights lessons learned and offers suggestions for using this information in a broader capacity for other cancer patient educators and patient educators in general.

Benchmarking↗
PubMed1984

Medicare program; acquisition, protection and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Proposed rule.

This proposal would govern the acquisition, protection and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organizations (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on the disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations would implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded, and used only for proper purposes.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1985

Medicare program; acquisition, protection, and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Final rule.

These regulations govern the acquisition, protection, and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organization (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded and disclosed only for proper purposes.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1989

Analysis of T-cell receptor delta chain gene in hematological malignancies.

We analyzed the rearrangement of TcR delta chain gene in 179 cases of hematological malignancies. In 17 T-cell lines, RPMI 8402, DND41, Peer, and Molt 13 had delta rearranged band (s). Except for RPMI 8402, these cell lines expressed functional delta gene. All of those gamma delta-T-cell lines had short message (1 kb) of TcR beta gene. These findings suggest differences between alpha beta-T-cells and gamma delta-T-cells. All 9 cases of T-ALL/LBL, of which 4 had neither gamma nor beta gene rearrangement, had a new rearranged band of TcR delta locus. This rearrangement was observed in 63% of B-lineage ALL/LBL. In the other T-lymphoproliferative disorders, only 2 cases of AILD and 1 of T-cell lymphoma had the rearranged band (s), showing derived T-cell neoplasm from gamma delta-T-cell as minority. In B-leukemia/lymphoma and myelocytic leukemia, 15% of the cases had the delta rearrangement. Heterogenous findings of TcR delta locus analysis were observed in ATLL without proviral HTLV-I DNA, T-cell lymphoma, AILD and HD. The J delta 1 region was frequently used and the J delta 2 region was rearranged in one AILD. It is suspected that J delta 3 was used in one T-ALL/LBL. There was no correlation between the phenotypic pattern of CD3, CD4, and CD8 in T cell disorders and the rearrangement of the TcR delta gene. These findings suggest that the newly identified TcR delta chain gene rearranges at a very early stage of T cell ontogeny; prior to the other TcR genes and perhaps at almost the same differentiation level as that of CD7 expression. The TcR delta gene is useful in evaluating clonality for the most immature T cell neoplasms not showing rearrangement of the other TcR genes. This gene is not lineage specific, however, when used in conjunction with IgHC gene, it may be a useful tool for the study of ALL/LBL.

Gene Rearrangement, T-Lymphocyte↗
PubMedDate not supplied

The Norwegian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Norwegian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Norwegian CHAQ and CHQ have already been published and therefore they were fully revalidated in this study. A total of 148 subjects were enrolled: 88 patients with JIA (6% systemic onset, 45% polyarticular onset, 10% extended oligoarticular subtype, and 39% persistent oligoarticular subtype) and 60 healthy children. The CHAQ clinically discriminated between patients with various JIA subtypes, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to those with persistent oligoarticular arthritis. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Norwegian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Adolescent↗
PubMed2005

Cognitive functioning in children with early onset type 1 diabetes and severe hypoglycemia.

OBJECTIVE: To investigate whether severe hypoglycemia in young children with early-onset type 1 diabetes (T1DM) is associated with subsequent abnormalities in cognitive status. STUDY DESIGN: Recruitment was from a large population-based database of children and adolescents with T1DM. Children and adolescents with early-onset T1DM (<6 years) were eligible for the study. Diabetic individuals (n = 41) with a prospectively documented history of seizure or coma were compared with peers with no history of severe hypoglycemic events (n = 43). A comprehensive test battery of learning and memory was used together with intellectual and behavioral measures. RESULTS: No significant group differences were revealed on the intellectual, memory, or behavioral measures. Similarly, those participants with a history of early first seizure did not differ from their peers with no seizures. There were no significant group differences on the memory subtests that were examined given their potential sensitivity to compromised hippocampal function. CONCLUSIONS: There was no clear evidence from this cohort that episodes of seizure or coma, even those occurring in very early childhood, resulted in broad cognitive dysfunction, nor was there evidence of specific memory difficulties at the time of testing in children and adolescents with early-onset T1DM.

Age of Onset↗
PubMed1998

Parental representations and support-seeking behaviors related to dependency and self-criticism.

Cognitive and interpersonal models of depression were integrated by examining the links between parental representations and the interpersonal behaviors of individuals at risk for depression. Study 1 assessed the quantity and type of social support associated with Dependency and Self-Criticism. Study 2 examined the parental representations related to these personality styles, in an effort to document cognitive variables that might contribute to interpersonal behaviors. Self-critics were found to be more dysphoric over a 21-day, self-monitoring period, made fewer requests for social support, and showed lower perceptions of support. Peers did not report providing less support to self-critics, but found them less expressive and did not know them as well. Study 2 found pervasive, negative parental representations associated with Self-Criticism providing a cognitive underpinning to social distancing. Dependent participants reported higher levels of support, which was corroborated by the peer reports. Study 2 found Dependency to be related to favorable representation of parents for friendly and submissive, but not hostile, situations. The impact of cognitive representations for interpersonal functioning is highlighted, and reciprocal processes between the two are discussed.

Adaptation, Psychological↗
PubMed2000

Social, emotional, and behavioral functioning of children with juvenile rheumatoid arthritis.

OBJECTIVE: To investigate the hypothesis that children with juvenile rheumatoid arthritis (JRA) would have more social and emotional problems than case-control classmates. METHODS: Using a case-control design, children with JRA (n = 74), ages 8-14, were compared with case-control classmates (n = 74). Peer relationships, emotional well-being, and behavior, based on peer-, teacher-, parent-, and self-report scores on common measures, were compared using analysis of variance. RESULTS: Relative to case-control classmates, children with JRA were similar on all measures of social functioning and behavior. Mothers reported more internalizing symptoms in the child with JRA, but child self reports and father reports showed no differences. Scores on all standardized measures were in the normal range for both the JRA and the case-control groups. CONCLUSION: Children with JRA were remarkably similar to case-control children on measures of social functioning, emotional well-being, and behavior. These findings are not supportive of disability/stress models of chronic illness in childhood and suggest considerable psychological hardiness among children with JRA.

Adolescent↗