Stages of successful time-limited counseling: An interactional examination.

Six counselor/undergraduate dyads (the 3 most successful and the 3 least successful, as rated by client and counselor) were selected for intensive study from a sample pool of 15 dyads representative of time-limited counseling. It was hypothesized that successful counseling dyads would have 3 fairly distinct stages—high, low, and again high levels of complementarity—and that unsuccessful counseling dyads would not demonstrate this pattern. The sequence of topic-following/topic-initiation responses was used as an index of complementarity and was analyzed using a Markov chain model to test for differences in the sequence of topic responses over time. Moderate support was found for the hypothesized general stage model of high–low–high complementarity. The 3 successful dyads loosely fit the general pattern, but each showed individual variation in the length of each stage and the abruptness of stage changes. All 3 unsuccessful dyads had constant levels of complementarity over the course of counseling and thus did not fit the hypothesized model. (47 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping families with homosexual children: a model for counseling

In the last decade large amounts of intravenous immunoglobulin (i.v.Ig) have been used worldwide. Doubts exist as to whether this increased use is paralleled by a comparable growth of reliable data on the therapeutic effectiveness of i.v.Ig. We performed a literature search using MEDLINE from January 1981 to January 1997 and analysed articles on the use of i.v.Ig in hematological disorders and searched for published guidelines. For most hematological disorders, evidence to use i.v.Ig as first line therapy is not very strong. For many disorders no controlled trials have been performed. In published guidelines, i.v.Ig is only recommended, with a few exceptions, when other treatments have failed or are contraindicated. Therefore the increase of consumption of i.v.Ig can not be explained by an increase in established indications in hematology.     

A review of counseling analogue research methods.

Reviews counseling analog research methods used in the Journal of Counseling Psychology, including audiovisual studies (with both client and counselor behavior as dependent variables), quasi-counseling interviews, and experimental tasks not directly resembling a counseling interview. Emerging analog research models are identified and related methodological issues and boundary condition characteristics are discussed. Analog methodological features in need of further consideration are noted. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Timing variability in children with early-treated congenital hypothyroidism

Hypertonic acetate solution in small volumes greatly improves cardiac output and corrects acid-base disturbances in hemorrhaged animals. We hypothesized that the combination of alpha alpha-crosslinked human hemoglobin (alpha alpha Hb), an oxygen carrier and vasoconstrictor, with hypertonic sodium acetate (HAHb), a vasodilator, may be effective for small volume resuscitation of hemorrhagic shock. Six pigs hemorrhaged to a mean arterial pressure of 40 mmHg for 60 min (bled volume: 23.6 +/- 2.5 ml.kg-1) received a single bolus of 4 ml.kg-1 of HAHb infused over two min. HAHb restored arterial pressure, increased systemic vascular resistance and caused a modest increase in cardiac output and SvO2, while pulmonary arterial pressure and vascular resistance were markedly increased. In two animals, transient severe hypotension and low cardiac output may have been due to acute pulmonary hypertension during injection. Compared to our previous study, in which animals received 4 ml-kg-1 of alpha alpha Hb alone, HAHb produced higher cardiac output and a smaller increase in systemic and pulmonary vascular resistance. However, slower, titrated infusions may be needed when hemoglobin solutions are combined with drugs or solutions that cause vasodilation in order to decrease the likelihood of acute hemodynamic instability.     

Tracheobronchial anomalies in children with congenital cardiac disease

OBJECTIVE: To perform preoperative airway evaluations, using radiographic analysis, to review the tracheal anatomy in children with congenital cardiac disease. DESIGN: Prospective. SETTING: A university children's hospital. PARTICIPANTS: One hundred patients. MEASUREMENTS AND MAIN RESULTS: One magnified airway film (high kilovoltage filtered) was performed preoperatively on 100 consecutive children presenting for repair of congenital cardiac disease. Events at intubation, with respect to endotracheal tube size (internal diameter in millimeters) and difficulties with placement of the tube, were recorded. Postoperative morbidity, specifically related to underlying airway anomaly, was documented. Eleven children had positive radiographic findings after review of magnified airway films. Six of 11 patients had evidence of tracheobronchial pathology, and five patients had no tracheal pathology. Difficulties with intubation were noted in two children. No perioperative morbidity was noted in any patient. CONCLUSION: The use of preoperative magnified airway films for tracheal evaluations in children with cardiac disease should be considered.     

Quality of life in children with congenital heart defects

PURPOSE: The antiepileptic effects of zonisamide (ZNS) have been well documented experimentally and clinically. The purpose of this study was to examine whether ZNS reduces cerebral damage after transient focal ischemia in rats. METHODS: Ischemia was induced by a transient occlusion of the left middle cerebral artery (MCA) with a 3-0 nylon monofilament for 90 min. Neurological evaluation was performed by measuring the event of neurological deficit of the contralateral forepaw and hindpaw at 10 min and 1 day after MCA occlusion (MCAo). Brain infarct size was determined by measuring triphenyltetrazonium chloride-negative stained area of the serial brain sections 1 day after MCAo. RESULTS: The pre- or postischemic treatment with ZNS [(10-100 mg/kg p.o.), 30 min before and 4 h after or 15 min and 4 h after the occlusion] markedly reduced cerebral damage in the ipsilateral hemisphere and the neurological deficit induced by transient ischemia. The reducing effect on the damage was observed in the cortical and subcortical regions. Preischemic treatment with carbamazepine (CBZ 60 mg/kg p.o. twice 30 min before and 4 h after MCAo) tended to reduce the cerebral damage and neurological deficit, but the lower dose (20 mg/kg p.o. twice) did not. Valproate (VPA 1,000 mg/kg p.o. twice) also had no effect. CONCLUSIONS: ZNS at the anticonvulsant dose, unlike CBZ and VPA, ameliorated the brain infarction and the event of neurological deficit after transient focal cerebral ischemia. These data suggest that ZNS has therapeutic potential in protecting against ischemic cerebral damage, such as stroke.     

Incidence of febrile convulsions in children with congenital hypothyroidism

Brain excitability has been inconsistently reported to be increased both in hypo- and hyperthyroidism, but there have been few studies on the effects of thyroid hormones on brain excitability in children. With this in mind, we investigated the incidence of febrile convulsions (FCs) among patients with congenital hypothyroidism, who have been taking L-thyroxine since the age of 1 month. The incidence of FCs among congenital hypothyroid patients was 1.6% (1/63) which was significantly low (p < 0.05) compared with that of normal control children who visited our hospitals as outpatients (28/341, 8.2%) and that of others (322/3301, 9.8%) investigated 33 years ago in the same area. The incidence of FC among siblings of the 63 patients (7/74, 9.5%) was not statistically different from the controls. At least 8 of the 126 parents (6.4%) had experienced FC, however, only one child was affected in the 8 families. In conclusion, it seems likely that patients with congenital hypothyroidism on regular L-T4 replacement are less prone to experience FC. More studies on the incidence of convulsive disorders in children with thyroid diseases are needed to clarify the effects of thyroid hormones on brain excitability.     

Relative effectiveness of behavioral and reflective group counseling with parents of mentally retarded children.

Evaluated the relative effectiveness of behavioral and reflective group parent counseling. Ss were 51 mothers of mentally retarded children who were assigned to behavioral, reflective, or waiting-list control groups. 6 success criteria, including direct observations, attitudinal scales, maternal reports, and frequency counts, were used to measure outcome (e.g., Hereford Parent Attitude Survey and the Missouri Behavior Problem Checklist). Both types of counseling had a beneficial effect relative to the untreated controls, but the behavioral method resulted in a significantly greater magnitude of improvement. The consistency of these results across measures strongly suggests that the behavioral technique was the treatment of choice for counseling parents of the retarded. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of three methods of group vocational counseling.

Superimposed a group discussion process over a typical vocational counseling process in which the primary focus was on test information, and over 2 atypical vocational counseling processes, one in which occupational information was primary and the other in which test information and occupational information were optional and randomly presented upon a group member's request. All Ss selected goals in the initial stages of counseling. 57 undergraduates were studied in 6 single-sex experimental groups and 2 control groups. Data from a levels-of-decision-making scale, the Edwards Personal Preference Schedule, and the Kuder Occupational Preference Inventory show that the atypical groups learned significantly more and retained longer than did both the typical and control groups. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subendocardial blood flow in children with congenital aortic stenosis

Subendocardial blood flow may be estimated from the ratio of flow to the subendocardium to myocardial oxygen consumption. The first may be estimated from the diastolic pressure time index (area between aortic and left ventricular (LV) pressure during diastole) and the latter by the tension time index (integral of LV pressure during systolic ejection). Subendocardial flow index (SEFI) averaged 1.27 (0.96-1.78) in 13 children with normal aortic valves. SEFI averaged 0.88 (0.43-1.65) in asymptomatic children with congenital aortic stenosis and was never greater than 0.9 in symptomatic children. Aortic valve area and systolic pressure difference did not correlate well with symptoms. SEFI and aortic valve area increased in 26 of 28 patients after surgery. However, 23 of 28 had varying degrees of aortic regurgitation following valvotomy. Since calculation of SEFI is not affected by aortic regurgitation, it would appear to be a more useful measure of surgical success than aortic valve area.     

Counting dead birds: examination of methods

We studied three methods (line transect, circular quadrat, complete count) for estimating density of dead birds, using models of sparrows and meadowlarks placed at a density of 50 birds of each type/ha. Line transects with a 500-m search line were used in cultivated pasture and native prairie habitats. The number of birds found by individual searchers in line transects varied markedly, particularly, in pasture habitat. More birds were found, and birds were detected at a greater distance, in prairie than in pasture. More meadowlarks than sparrows were found in both habitats but the mean estimated density of meadowlarks was greater than that of sparrows only in prairie. The number of birds found during most searches was less than that suggested for estimating density accurately and longer search lines were required. Density estimates obtained using circular plots to sample 10% of the prairie area ranged from 20 to 80 birds/ha for meadowlarks and from 10 to 60 birds/ha for sparrows in prairie habitat. A complete search by 25 volunteers spaced at 4 m intervals detected 90% of meadowlarks but only 62% of sparrows in pasture habitat. Mean (SD) time for a single search, including searchers and recorders, was 3.0 (0.8), 1.5 (0.3), and 7.5 person-hours, for line transect, circular plot and complete search, respectively.     

The gynecologic examination in children and adolescents

Contraception for adolescents should be considered an important part of prophylactic medicine. Not enough attention has been given to this area, which could mean saving a young person from the destruction of his or her plans, and disruption of their family with an unwanted, unexpected child. This involves greater rapport with adolescents in schools on matters of sexual awareness and education. Noting that 15% of pregnancies between the ages of 12 and 16 are on the first sexual contact, the morning after pill and post coital progestins are thought appropriate as they require only single uses. The most frequently used methods are coitus interruptus (36%), followed by the male condom with vaginalspermicides, and the diaphragm. The use of hormonal contraceptives by adolescents raises questions about their effects on the development of the hypothalamal-hypophysial-ovarian system and the growth of the uterus. The use of intrauterine devices is generally countraindicated, as the uterus grows about 6 cm a month during adolescence and the action of these devices can have dangerous effects on this growth.     

Epilepsy and disorders of cortical development in children with congenital cytomegalovirus infection

INTRODUCTION: Neuroimaging and experimental studies have related cytomegalovirus (CMV) to certain neuronal migration disorders. MATERIAL AND METHODS: To define the electroclinical picture of children with epilepsy associated with disorders of cortical development (DCD) and congenital CMV infection, we conducted a clinical, electroencephalographic and neuroradiological study of 10 children with this condition. RESULTS: Eighty per cent of them had dismorphic traits, or malformations outside CNS. All showed other neuroradiological signs (cerebral calcification, white matter damage, porencephaly). Six patients with bihemispheric DCD (agyria-pachigyria, 2; 'poligyria', 1; schizencephaly, 1; bilateral opercular DCD, 2) showed: Tetraparesis, severe or profound mental deficiency, early onset epilepsy (mean age at onset: 11 months) with spasms, tonic seizures, partial seizures, and multifocal paroxysms or unusual diffuse sharp Alfa-Beta EEG activity. One child developed Epilepsia Partialis Continua. Children with bilateral opercular DCD evolved to a continuous spike and wave (SW) electrical status during wakefulness and sleep, linked to a worsening of psychomotor derangement. Four patients with unilateral hemispheric DCD (pachigyric or 'poligyric') showed: Congenital hemiparesis, mild intellectual deficiency, motor seizures (orofacial, hemiclonic, generalized) beginning in the third year of live, atypical absences with focal phenomena, frequent focal rhythmic SW discharges during wakefulness, and continuous SW status during sleep (CSWS). CONCLUSIONS: A wide spectrum of DCD due to congenital CMV infection is documented. Characteristic electroclinical pictures related to the extent and topographical distribution of the DCD are recognized, which may lead to an appropriate diagnosis and prognosis.