Meeting the needs of gifted and talented preschoolers

The paper provides the evidence on interaction of the endocrine system hypophysis-gonads with varicocele. Gonadotropic hormones and sexual steroids were measured in the blood of varicocele males (47 cases) and of fertile healthy males (17 cases), testosterone in the tissue of the sexual glands and blood of white noninbred rats (40 test against 20 control animals). It was found that in 18% of varicocele patients high levels of FSH were associated with oligo-, pathospermia and changes in spermatogenic epithelium. Interstitial cell stimulating hormone did not shift above the standard in all varicocele patients, while testosterone was low in 15% of them and combined with hypogonadism manifestations. Progesterone rose high in 38% of the examinees. The discussion covers the problem of hyperprogesteronemia origin. Recommendations are given on gonadotropic hormones and sexual steroids assays which are thought useful in examination of the patients to validate pathogenetic treatment.     

Meeting the educational needs of patients with oral lichen planus

Lichen planus is a chronic oral disorder that is often painful and annoying. The patients have been described as usually over 50 years old, with a high educational level, anxious and high-strung. In previous research studies, these patients have reported unusual and highly stressful life events. Because dentists are in a position to advise their patients about chronic illness, this study was designed to (1) determine what information was given to lichen planus patients by their dentists; (2) determine what questions the patients asked their dentists; and (3) assess what educational materials would be helpful for this group of patients. A survey was sent to 151 biopsy-confirmed lichen planus patients, with a response rate of 55 percent. The results indicated that the patients were concerned about the possibility of malignancy and of contagion, and that they were frustrated by the lack of available patient education.     

Work ability of young adults

This paper reviews the themes related to work ability of young adults. Premature working discapacity causes significant economical and social costs in Finland compared to other Nordic countries and has for that reason been studied most intensively there. Work ability is an interaction of social, environmental and individual factors such as physical fitness, coping skills, social support behaviour and health behaviour. Environmental factors influencing work ability can be concrete, like physical and chemical exposures or more abstract like unemployment. The work ability of ageing people has been studied intensively, while work ability of young adults has not been properly evaluated so far. The worsened economic situation in Finland has meant an excessive work load for those who still have work. At the same time the risk of permanent unemployment is increasing. This polarizationing affects especially the young because they may fail to enter the working life. Also factors related to childhood may affect and even determine work ability in adulthood.     

Older adults prefer less choice than young adults.

Previous research has demonstrated that older adults prefer less autonomy and seek less information when making decisions on their own relative to young adults (for a review, see M. Mather, 2006). Would older adults also prefer fewer options from which to choose? The authors tested this hypothesis in the context of different decision domains. Participants completed a choice preferences survey in which they indicated their desired number of choices across 6 domains of health care and everyday decisions. The hypothesis was confirmed across all decision domains. The authors discuss implications from these results as they relate to theories of aging and health care policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meeting the social service needs of persons with AIDS: hospices' response

A national sample of 148 directors of hospice social service departments (or persons most familiar with the delivery of social services in the hospice) participated in an exploratory study investigating the effects of the acquired immune deficiency syndrome (AIDS) epidemic on the delivery of hospice social services. Findings suggest, as does the literature, that the psychosocial needs of persons dying from AIDS present different challenges than those of traditional hospice patients. Furthermore, the results indicate the need for greater collaborative efforts among community agencies as well as specific and ongoing training for staff and volunteers who work with persons with AIDS (PWAs). Implications for the delivery of hospice social services to this population are discussed.     

Meeting parents'' postpartal needs with a telephone information line

Early clinical trials for new anti-cancer drug treatments typically use patients with cancer as research subjects. This paper identifies some of the ethical and practical concerns that arise from the recruitment of a vulnerable group of patients and their exposure to a drug of unknown risk or benefit. This review discusses the ethical principles related to recruitment and informed consent in cancer trials, and indicates that there is a lack of consensus concerning the requirements, process and practice of informed consent. It is suggested that, as yet, little is known about patients' decision making framework in this situation, and the need for further work that concentrates on the patient's point of view is highlighted. The paper concludes by discussing some of the difficulties associated with obtaining patients' opinions, and suggests that the use of a qualitative approach may overcome some of these problems.     

Retinal arterial occlusions in young adults

Stereotactic posteroventral pallidotomy can improve motor performance in Parkinson's disease. Interruption of inhibitory pallidal projections to ventrolateral thalamus, components of a cortical-basal ganglia motor loop allows for this clinical benefit. We hypothesized that pallidotomy would lead to increased movement related activity in motor cortical areas receiving projections from ventrolateral thalamus. This was tested in 6 Parkinson's disease patients who underwent stereotactic posteroventral pallidotomy. Each patient was imaged with positron emission tomography (PET) measures of regional cerebral blood flow (rCBF) during performance of a simple prehension task and at rest. Scans were acquired before and 17 weeks after surgery. After pallidotomy, movement-related changes of rCBF increased significantly in both the supplementary motor area (SMA) and premotor cortex but not in primary motor cortex. The results demonstrate the importance of pallidothalamic circuitry for regulating volitional movements and confirm that disruption of inhibitory input to the ventrolateral thalamus can augment movement-related activity in motor association areas.     

Pediatric HIV infection and the primary care physician. Meeting unique needs

The number of HIV-infected children and adolescents is expected to increase during the next decade. Most of these patients are likely to receive nearly all of their healthcare from primary care physicians. Management must be multifaceted and consist of medical care for acute illnesses, routine pediatric care that includes immunizations, and social service intervention.     

Meeting the bereavement needs of kids in patient/families--not just playing around

Children grieve differently than adults. Although the unit of care in hospice is the patient and family, emphasis is often on the grown members of the family and the anticipatory grief and bereavement needs of children and adolescents are sometimes not met adequately. In this paper, hands-on strategies for working with children both before and after a significant death are presented, as well as appropriate context information on the grieving process for youth under age 18.     

Are they getting enough? Meeting the oxygen therapy needs of postoperative patients

Many patients require oxygen therapy as part of their postoperative care. A study to assess whether patients were actually given the supplementary oxygen prescribed showed many received only intermittent therapy. Placing more emphasis on oxygen therapy in nurse education would do much to improve its use in practice.     

Psychological services to schools: Meeting educational needs of tomorrow.

During the last twenty years, school psychology has experienced extensive growth. While the origins of practice can be traced to the beginning of the century, subsequent alteration of services has been gradual, and usually in response to changes in education. The focus of this paper is the future, with an emphasis upon possible roles, functions, and areas of contribution. Appropriate projection, however, includes understanding the dynamic implications of past and current functioning and a commitment to the need for a changing education. School psychologists have an obligation not only in reflecting needs, but also in the establishment and implementation of appropriate educational objectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Encoding orientation and the remembering of schizophrenic young adults.

Schizophrenic memory following an experimenter-imposed encoding task was examined in a levels-of-processing framework. In Session 1, 17 schizophrenics (mean age 23.5 yrs), 17 nonschizophrenic psychiatric patients (mean age 24.3 yrs), and 17 normal college students (mean age 20.0 yrs) were required to make yes–no judgments about whether a probe word contained 2 letters, rhymed with a word, belonged to a conceptual category, or fitted into a sentence. In Session 2, they were required to produce an appropriate word for each question. The 3 groups recalled semantically processed words better than nonsemantically processed words and "yes" words better than "no" words and revealed similar recall and recognition patterns over the different levels of encodings. However, the schizophrenics' recall for "yes" words (Session 1) and for the self-generated words (Session 2) was inferior to that of normals. Theoretical implications are discussed. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vaginal replacement in children and young adults

PURPOSE: Absence of the vagina in the pediatric population most commonly results from congenital abnormalities, such as the Mayer-Rokitansky syndrome but it may also be seen after treatment for pelvic tumors, such as rhabdomyosarcoma, and in patients who have had previous gender reassignment. We review our experience using bowel for vaginal replacement in a group of children and young adults to assess outcome and satisfaction. MATERIALS AND METHODS: From 1980 to 1996 we evaluated 31 patients 1 to 20 years old who required vaginal replacement. Presenting diagnoses included müllerian failure (the Mayer-Rokitansky syndrome) in 20 patients, androgen insensitivity syndrome in 5, rhabdomyosarcoma in 3, penile agenesis in 1, cloacal exstrophy in 1 and 1 previously separated conjoint twin. A questionnaire was given to 26 of the 31 patients to assess postoperative sexual function and satisfaction. RESULTS: A total of 33 bowel segments in 31 patients were used for vaginal reconstruction, including sigmoid colon in 20, ileum in 8 and cecum in 5. Of the 31 patients 20 were sexually active, 8 were married and 3 had been previously married and divorced. Only 1 patient described chronic dyspareunia. Three patients were on chronic home dilation, while 4 required sanitary pads for vaginal secretions. There were 8 complications in the 31 patients, including stenosis of the bowel segment in 6. Three patients required a second procedure after total stenosis of the small bowel vagina (2) and prolapse of the neovagina (1), which required retroperitoneal fixation. CONCLUSIONS: Experience with this group of patients leads us to believe that isolated bowel segments provide excellent tissue for vaginal replacement. Furthermore, we believe that colon segments, particularly sigmoid, are preferable to small bowel for creation of the neovagina. In many instances the small bowel mesentery may be too short to provide an adequate, tension-free anastomosis in the perineum, particularly in obese patients. Our results would also suggest that sexual activity is more compatible with isolated bowel segments for vaginal replacement than with any of the more traditional methods, such as passive dilations and split thickness skin graft vaginoplasty.     

Neglected victims of homicide: the needs of young siblings of murder victims

Fifteen children, aged 7-18 years, were interviewed an average of five months after the murder of an older sibling. Although most showed significant symptoms of depression, anxiety, post-traumatic stress disorder, and psychosocial impairment, few had received any community or mental health system support or services for these symptoms. Specific problems and needs are identified, and implications for research and practice are discussed.