Ferrochelatase activities in patients with erythropoietic protoporphyria and their families

Ferrochelatase, estimated as zinc chelatase, was measured in the lymphocytes of 30 patients with erythropoietic protoporphyria (EPP), in 35 first- or second-degree relatives of patients with EPP, and in 50 healthy controls. In 30 EPP patients the zinc chelatase level (mean +/- standard deviation, SD) was 0.45 +/- 0.10 nmol of zinc protoporphyrin per hour per milligram of protein, in 14 EPP carriers the zinc chelatase level (mean +/- SD) was 0.42 +/- 0.09 and in 50 healthy controls the zinc chelatase level (mean +/- SD) was 0.84 +/- 0.27. All patients with EPP were also demonstrated to have an elevated protoporphyrin level in their red blood cells: the erythrocyte protoporphyrin levels were as follows EPP patients (mean +/- SD) 1300 +/- 758 nmol protoporphyrin/dl, EPP carriers (mean +/- SD) 60 +/- 24, and healthy controls (mean +/- SD) 50 +/- 25 (P < 0.001 for EPP patients compared to controls and EPP carriers). The families of 12 out of 15 EPP patients were examined with respect to the mode of inheritance of the disorder. Of 35 relatives, 14 were carriers of EPP, as characterized by reduced zinc chelatase activity in lymphocytes and by a normal protoporphyrin level in red blood cells. None of the 14 EPP carriers had presented with clinical symptoms of EPP. The mod of inheritance was autosomal dominant in seven of the 12 examined families, and autosomal recessive in two. In two families only one parent could be investigated, but we nevertheless concluded that the inheritance was autosomal dominant. Inheritance in one EPP family could not be elucidated as both parents showed normal zinc chelatase levels and did not demonstrate abnormal erythrocyte protoporphyrin levels.     

Marshalling social support for medical patients and their families.

Discusses the relationship between social support and the outcomes of medical illness and presents tenets of dyadic support (DS) strategies and peer support (PS) groups. DS includes efforts to improve communication between medical caregivers and patients and their family members and the introduction of supportive lay companions (spouses, family, or friends). Partners may be used during childbirth, treatment of juvenile obesity, or during inpatient care. PS groups may be composed of patients with similar afflictions under the sponsorship of a professional and are considered to be most useful when members are matched with respect to disease severity and anxiety. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The use of the Color-Your-Life technique with pediatric cancer patients and their siblings.

Examined the use of the Color-Your-Life (CYL) technique with 18 pediatric cancer patients (CPS), 20 siblings of pediatric patients (SIBS) and 40 controls, all aged 7–13 yrs. Findings show no differences were found between the groups for the percentages of colors. However, there were differences with respect to the way these groups represented negative emotions. SIBS tended to use the color/affect pair red/mad to indicate feelings of depression, while CPS used the absence of color, leaving white space on the paper. The Children's Depression Inventory (A. E. Kazdin, 1990) significantly correlates with the amount of blue (sad) that the Ss drew. However, this was not true for the State-Trait Anxiety Inventory for Children (C. D. Speilberger et al, 1973) and the amount of black (scared/nervous). CPS and SIBS who completed the CYL technique prior to completing the inventories had higher scores on these instruments than the children who completed the written instruments 1st. This finding was the opposite for controls, suggesting that these groups of Ss have different reactions to completing the CYL activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The experiences and health care needs of Asian coronary patients and their partners. Methodological issues and preliminary findings

The incidence of heart disease in the Asian population in the UK is high and mortality from coronary heart disease for both Asian men and women is also higher than for non-Asians. The need to provide more information on cardiac rehabilitation programmes is highlighted. Cultural factors influence how Asian people perceive the heart, health and health care practices. A number of methodological issues are pertinent to conducting research involving ethnic groups, namely inter vs intra group differences, victim blaming, sampling, measurement, language issues and researcher effect. The aim of the study is to design, refine and validate a number of tools for use with Asian people in relation to cardiac rehabilitation. Preliminary and tentative conclusions suggest that cardiac rehabilitation services need a higher profile within the Asian community and that established approaches to data collection may need to be challenged if accurate and relevant feedback is to be achieved.     

Working mothers and their families.

The topic of maternal employment and its effects on the family is receiving considerable attention as more and more mothers enter the work force when their children are very young. This article reviews the effects of mothers' employment on marital relations, on the development of their children, and on mothers themselves. Research shows that maternal employment per se is not the major issue in either marital relations or child development. Rather, the circumstances of the family, the attitudes and expectations of fathers and mothers, and the distribution of time available have important effects. The needs of working mothers for social supports, such as parental leave, spouse support, child care, and better wages are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The educational needs of myocardial infarction patients

Over the last 20 years, the educational needs of myocardial infarction (MI) patients have been addressed from the points of view of health care providers and patients. However, most teaching is based on the health care providers' perceptions of patients' educational needs. Little emphasis has been placed on patients' perception of educational needs. This article identifies the MI patients' perceived learning needs in the coronary care unit, in the post-coronary care unit, and at home, and evaluates the extent of the effectiveness of various types of cardiac rehabilitation programs. Recommendations for educating first-time MI patients during each phase of cardiac recovery and for conducting future research studies are discussed.     

Clinical psychologists' religious and spiritual orientations and their practice of psychotherapy.

Examined the nature of 107 female and 299 male clinical psychologists' (aged 29–88 yrs) religiousness and spirituality, attitudes toward religiousness, use of interventions of a religious nature in psychotherapy, and training regarding religious and spiritual issues. Findings suggest that religious and spiritual orientation affects clinical psychologists' attitudes as well as their therapeutic interventions, which may in turn impact on the process and outcome of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Doctoring" doctors and their families

Being selected to provide medical care to other physicians or their family members represents not only a gratifying professional recognition of competence by one's peers but also a challenge. Many personal and psychological factors may influence the medical care of physicians. III physicians may have difficulty with role reversal and "the VIP syndrome," while treating physicians may have to deal with their own anxiety and issues such as confidentiality, privacy, empathy, and intrusion by a physician-relative into the care of medical family members. Based on experience with more than 200 physician-patients and many adult family members of physicians, suggestions are offered for care of these patient groups.     

How should we talk about acute leukaemia to adult patients and their families?

Problems of communication with patients with acute leukaemia and their families were explored by interviewing the next of kin of 26 patients, six of whom were still alive. In all but two cases the diagnosis had been disclosed to the relatives before the patient, but almost one-third of the relatives were not entirely satisfied with the way in which the diagnosis was presented. Medical prognostications at these initial interviews were, on the whole, regarded as being realistic by the relatives. Nine patients learnt of their diagnosis at an early stage, but relatives were undecided whether patients should be told of the diagnosis in explicit terms. Patients often established complete dependence on the hospital and its staff and had difficulties in relating to their own general practitioners while at home during their illness. Social chats were preferred by the relatives rather than regular progress reports from the doctors.     

Emergency nurses investigate their patients' needs

This article reports on a study in which clinical nurses contributed actively to the scientific investigation of the nursing needs of their patients. The study revealed valuable information relating to both the psycho-social needs caused by the accident and the integration of nurses in clinical nursing research.     

Health promotion for Vietnamese women and their families

Women's health is an important factor in caring for older people and children at home. This article describes similarities and differences in the way Vietnamese and Australian women manage their own health, and how these affect their family's health, and suggests ways of developing health promotion programmes which take account of these.