Family Functioning and Social Support in the Adaptation of Caregivers of Children With Sickle Cell Syndromes

Objective: To examine moderating effects of family functioningand social support on the relationship of child-related stressorsto caregivers' psychological adaptation in a sample of caregiversof children with a chronic illness. Method: Participants were 67 caregivers of children and adolescentswith sickle cell syndromes. We conducted MANOVAs and subsequenteffect size calculations to determine if family functioningwould buffer the effects of caring for difficult-to-manage childrenwith this illness. Results: Findings supported a moderator effect of family functioningon the association of children's externalizing behavioral problemsto caregivers symptoms of hostility. Greater levels of cohesiveand adaptive family functioning buffered the potential detrimentaleffects of caring for children perceived as hard to manage.No significant associations were obtained between measures ofcaregivers' psychological adaptation and the severity of theirchildren's disease. Conclusions: We make recommendations for family systems interventions,particularly for caregivers of children with behavior problems.     

Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare image quality, contrast reactions, and the number of aborted studies or studies in which images had to be repeated. Three hundred two patients received iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the patients given diatrizoate meglumine 60 had at least one adverse reaction thought to be related to contrast material during, or within 24 hr of, the body CT scan. When reactions of discomfort (heat or warmth, flushing, bad taste) were excluded, 16% (48/302) of the patients who received iohexol and 33% (99/298) of the patients who were given diatrizoate meglumine 60 had at least one adverse reaction. The differences in both types of reactions between the two agents were significant (p less than .001). Among scans evaluated for study quality, 71% (214/302) of the iohexol 300 group and 62% (184/298) of the diatrizoate meglumine 60 group had optimal enhancement (p = .02). However, when the optimal and adequate categories were combined, 301 of 302 patients given iohexol 300 and 292 of 298 patients given diatrizoate meglumine 60 had diagnostic-quality studies (no statistical difference). Studies were not terminated nor were images repeated in 97% (292/302) of the patients given iohexol 300 and in 94% (280/298) of those given diatrizoate meglumine 60. The CT study was repeated because of movement during the contrast injection or aborted because of contrast-related reactions in 0.7% of the patients given iohexol 300 and in 3.0% of the patients given diatrizoate meglumine 60. This difference was statistically significant (p = .04). Our results suggest that the difference in image quality, number of adverse reactions, and number of aborted/repeated CT scans performed with iohexol 300 or diatrizoate meglumine 60 are not sufficiently different to warrant conversion to nonionic agents for body CT scans.     

Setting targets: a three-stage model for determining priorities for health promotion

This paper describes a three-stage model for setting targets for health promotion. The model was developed in 1992 in response to the need to identify priority areas for health promotion for women in the Hunter Region of New South Wales. The approach enabled epidemiological data and views from the community to be synthesised and integrated with those of experts from health and social services (key informants), using a nominal group process. The reliability of the method was investigated by replicating the process with two groups of key informants. There was considerable commonality in the targets generated by the two groups. The process resulted in the identification of seven targets that reflected the concerns of the community and local experts as well as the health priorities suggested by local epidemiological data. The model used could be adapted for determining priorities in a wide range of health and health care settings, where available resources restrict the range of services or activities which can be offered. (Aust J Public Health 1995; 19: 263–9)     

Genetic differentiation between and within strains of the saw-toothed grain beetle, Oryzaephilus surinamensis (Coleoptera: Silvanidae) at RAPD loci

Nine strains of Oryzaephilus surinamensis have been kept in laboratory culture for periods ranging from 5 to 30 years (30–180 generations). Two RAPD primers provided sufficient information to separate the strains reliably and unambiguously. The strains are maintained at a population size of 200 breeding adults. The marked divergence between strains is consistent with the small population size, which for the older strains, according to population genetics theory, implies that roughly half the original genetic variation should now be lost from within strains. However, there is no indication that the older strains have less inter-strain variation. The results demonstrate RAPD loci can reliably detect population subdivision, which in field populations of pest species is of fundamental importance in understanding the population genetics of insecticide resistance.     

Single breath-holding scans of the abdomen using FISP and FLASH at 1.5 T

Single breath-holding gradient echo techniques fast imaging with steady-state free precession (FISP) and fast low angle shot (FLASH) images were evaluated in the study of the abdomen in 16 patients (13 liver, two kidney, and one pancreas examinations). Gradient echo images were compared retrospectively with conventional spin echo images for image quality (depiction of pathology and representation of anatomic detail), and contrast characteristics were evaluated. All lesions were shown on gradient echo images, and in three of 16 cases gradient echo images were more diagnostic than spin echo images. On both FISP and FLASH images, most hepatic metastases were hyperintense relative to normal liver. The predicted flip angles for maximal contrast for the liver were modeled from signal intensity equations for FISP and FLASH and yielded predicted flip angles of approximately 40-55 degrees for FISP and 15-25 degrees for FLASH. Peak signal-to-noise ratio in liver of normal volunteers occurred at approximately 30 degrees for both FISP and FLASH. Single breath-holding gradient echo images are useful in the evaluation of abdominal structures and this study provides a framework for future work.     

The effects of chondroitinase ABC on the rabbit intervertebral disc. A roentgenographic and histologic study

A series of intradiscal injections of chondroitinase ABC was performed in 31 young adult rabbits. Roentgenograms were taken immediately postinjection and were repeated at two, three, five, six, seven, or nine days after injection. All had roentgenographic evidence of disc space narrowing at all stages after the injection. Histologic evaluation of safranin-O fast green-stained sections indicated degradation of proteoglycans in the annulus fibrosus of chondroitinase ABC-injected discs. The cells of the chondroitinase ABC-injected discs, the end plates, and the growth-plate areas of adjacent vertebral bodies appeared unaffected.     

Effect of dietary fat content on the bioavailability of a sustained release quinidine gluconate tablet

Quinidine gluconate 324 mg sustained release tablets (Quinaglute) was administered as a single dose to 15 healthy male subjects following an overnight fast, immediately following a high fat (HF) breakfast or immediately following a low fat (LF) breakfast. Serum samples were obtained over a 48 h period and analyzed for quinidine content using a high performance liquid chromatographic assay. Under the conditions of the study, both the rate and extent of quinidine bioavailability was significantly affected by food. The extent of bioavailability was statistically significantly greater (p less than 0.05) following both the HF and LF meals as compared to that in the fasted state. Rate of bioavailability was significantly enhanced following the LF meal as compared to that of the other two treatment groups. Although peak concentrations were greater and time to peak concentrations somewhat later following the HF meal versus those under fasting conditions, these differences were not statistically significant. In addition, the characteristics of the serum concentration-time profile (as defined by the number, magnitude, and time of occurrence of the multiple absorption maxima) was unique for each of the three treatment groups. Possible mechanisms underlying these results are explored.     

Effect of the beta-adrenoceptor agonist clenbuterol and phytohaemagglutinin on growth, protein synthesis and polyamine metabolism of tissues of the rat.

1. The kidney bean lectin, phytohaemagglutinin (PHA), induced a marked atrophy of skeletal muscle which was evident from the changes in tissue composition (protein, RNA, DNA and polyamine content) and from the reduction in weight and protein synthesis of hind leg muscles of rats fed on kidney bean-diets for four days. The beta-adrenoceptor agonist, clenbuterol, induced skeletal muscle hypertrophy by transiently stimulating protein synthesis. As a consequence, the muscle loss caused by a short exposure to PHA was, in part, ameliorated by clenbuterol treatment. 2. Cardiac muscle was affected to a lesser extent than skeletal muscle by both clenbuterol and the lectin. However, there was evidence that protein synthesis in heart was reduced by PHA. 3. PHA had opposite effects on the gut, the lectin-induced hyperplasia of the jejunum was accompanied by a large increase in protein synthesis. Clenbuterol alone had no effect on the jejunum whereas a combination of PHA and clenbuterol appeared to exacerbate the effect of the lectin on gut. 4. Both the lectin-induced gut growth and the hypertrophy of skeletal muscle caused by clenbuterol were preceded by the accumulation of polyamines in the respective tissues. Of particular note was the observation that a significant increase in the proportion of the intraperitoneally injected 14C-labelled spermidine or putrescine taken up by the growing tissues could be detected by the second day. Therefore, the measurement of uptake of labelled polyamines may be used as a sensitive indicator of early alterations in tissue metabolism.