Changes in parents' mental distress after the violent death of an adolescent or young adult child: a longitudinal prospective analysis

This study examined changes in bereaved parents' mental distress following the violent deaths of their 12 - to 28 - year - old children . A community - based sample of 171 bereaved mothers and 90 fathers was recruited by a review of medical examiner records . Data were collected 4 , 12 , and 24 months post - death . Repeated measures analysis of variance showed significant reductions in 8 of 10 measures of mental distress among mothers and 4 of 10 for fathers , with the most change for both genders occurring between 4 and 12 months post - death . During the 2nd year of bereavement , mothers' symptoms continued to decline , whereas fathers , who started out with less distress than mothers , reported slight increases in 5 of 10 symptom domains . Nonetheless , 2 years after the deaths , mothers' mental distress scores were to 5 times higher than those of 'typical' U . S . women and fathers' scores were to 4 times higher than 'typical' U . S . men . Of the 7 intervening variables , higher scores on self - esteem and self - efficacy predicted lower distress for mothers and fathers 4 , 12 , and 24 months post - death . Repressive coping was of distress among fathers . It was concluded that violent death bereavement sustained , distressing consequences on parents of children who die as a result of , homicides , and suicide .     

Informed consent for blood transfusion: a regional hospital survey

Ninety-two hospitals in a three-state mid-Atlantic region were surveyed to determine their policy toward obtaining written informed consent for transfusion and to examine the content of written consent documents and the process by which consent is obtained. Of 81 hospitals responding, 50 (62%) required written informed consent. Hospitals with fewer than 200 beds were more likely to require written informed consent. The attending physicians had responsibility for obtaining consent in 28 (57%) of 49 institutions, most often on the day or evening before surgery. Twenty-seven of 48 forms mentioned complications: hepatitis in 80 percent, human immunodeficiency virus infection in 46 percent, nonhemolytic reactions in 32 percent, and hemolysis in 25 percent. Alternatives to allogeneic transfusion were mentioned infrequently; eight hospital forms listed autologous transfusion options and only two mentioned designated donation. The reading level required to comprehend 34 consent forms submitted was grade 14.6, which has been attained by only 23 percent of the adult United States population. Although the majority of respondent institutions require written informed consent, those forms, per se, do not document that the fundamental tenets of informed choice have been applied to the decision to transfuse blood.