The association between parent's and healthcare professional's behavior and children's coping and distress during venepuncture

Objectives: Examine the association between children’s distress and coping during venepuncture with parent’s and healthcare professional’s behavior in a sample from the UK. Methods: Fifty children aged 7–16 years accompanied by a carer were videotaped while having venepuncture. Verbalizations of children, parents, and healthcare professionals were coded using the Child–Adult Medical Procedure Interaction Scale-Revised. Results: Children’s distress was associated with child’s age, anxiety, and distress promoting behavior of adults (R2 = .91). Children’s coping was associated with age, anxiety, and coping promoting behaviors of adults (R2 = .57). Associations were stronger between healthcare professional’s behavior and child coping; and between parent’s behaviors and child distress. Empathizing, apologizing, and criticism were not frequently used by adults in this sample (<12%). Conclusion: This study supports and extends previous research showing adult’s behavior is important in children’s distress and coping during needle procedures. Clinical implications and methodological issues are discussed

Understanding needle-related distress in children with cystic fibrosis

Objective. To explore the nature and management of needle-related distress in children and adolescents with cystic fibrosis (CF). Design. Qualitative study using semi-structured interviews. Methods. Fourteen child–parent dyads took part. Children (5 male; 9 female) had a mean age of 12.4 years (range 7–17) and were mostly diagnosed with CF at birth (N= 11). Frequency of needle procedures ranged from once to six times a year. Parents (3 male; 11 female) had a mean age of 41.5 years and were from a variety of socio-economic backgrounds. Interviews were transcribed and analysed using thematic analysis. Results. Most participants identified previous needle experiences and pain as related to their needle anxiety. Over half of parents and children considered ‘taking control’ to be the optimum coping strategy. The majority of parents and children thought inhaled nitrous oxide gas during needle procedures was helpful in managing needle-related distress. Parent and staff influences on needle-related distress are also examined. Conclusions. Needle-related distress in children with CF has a substantial impact on children and their parents, and may lead to management problems and treatment refusal. Psychological and pharmacological interventions could reduce distress and aid management

A single-board preprocessor and pulse generator

The Aeronomy Lab. of NOAA has designed and built a single board, programmable radar controller for use with VHF ST (stratosphere troposphere) radars. The controller consists of a coherent integrator preprocessor and a radar pulse generator, both of which are described, as well as interfaces to an antenna beam switch and a receiver bandwidth switch. The controller occupies a single slot in a Data General Nova of Eclipse computer. The integrator and pulse generator take advantage of high density, dual port FIFO chips such as the 512 x 9 Mostek MK 4501. These FIFOs have separate input and output ports and independent read and write cycles with cycle times of less than 200 ns, making them very fast and easy to interface. A simple block diagram of the coherent integrator is shown. The integrator is designed to handle inputs from one receiver (2 channels) with 1 sec sample spacing. The pulse generator is based on controllers designed by R. F. Woodman for the Arecibo and SOUSY radars us a recirculating memory scheme

Haze in the Klang Valley of Malaysia

Continuous measurements of dry aerosol light scattering (Bsp) were made at two sites in the Klang Valley of Malaysia between December 1998 and December 2000. In addition 24-h PM2.5 samples were collected on a one-day-in-six cycle and the chemical composition of the aerosol was determined. Periods of excessive haze were defined as 24-h average Bsp values greater than 150 Mm-1 and these occurred on a number of occasions, between May and September 1999, during May 2000, and between July and September 2000. The evidence for smoke being a significant contributor to aerosol during periods of excessive haze is discussed and includes features of the aerosol chemistry, the diurnal cycle of Bsp, and the coincidence of forest fires on Sumatra during the southwest (SW) monsoon period, as well as transport modelling for one week of the southwest Monsoon of 2000. The study highlights that whilst transboundary smoke is a major contributor to poor visibility in the Klang Valley, smoke from fires on Peninsular Malaysia is also a contributor, and at all times, the domestic source of secondary particle production is present

Screening for birth-related PTSD: psychometric properties of the Turkish version of the Posttraumatic Diagnostic Scale in postpartum women in Turkey

Background: Evidence suggests that 4% of women develop posttraumatic stress disorder (PTSD) after childbirth, with a potentially negative impact on women and families. Detection of postpartum PTSD is essential but few measures have been validated in this population. Objective: This study aimed to examine psychometric properties of the Turkish version of the Posttraumatic Diagnostic Scale (PDS) to screen for birth-related PTSD among postpartum women and identify factorial structure of PTSD after birth. Method: PDS was administered to 829 postpartum women recruited from three maternity hospitals in Turkey. Participants with PTSD (N = 68) and a randomly selected group of women without PTSD (N = 66), underwent a structured clinical interview (SCID). Results: PDS demonstrated high internal consistency (α = .89) and test-retest reliability between 4–6 weeks and 6-months postpartum (rs = .51). PDS showed high concurrent validity with other measures of postpartum psychopathology, rs(829) = .60 for depression and rs(829) = .61 for anxiety. Satisfactory diagnostic agreement was observed between diagnoses obtained by PDS and SCID, with good sensitivity (92%) and specificity (76%). Exploratory and confirmatory factor analyses revealed that the latent structure of birth-related PTSD was best identified by a three-factor model: re-experiencing and avoidance (RA), numbing and dysphoric-arousal (NDA) and dysphoric-arousal and anxious-arousal symptoms (DAA). Conclusions: The findings supported use of PDS as an effective screening measure for birth-related PTSD among postpartum women

Depression, anxiety, PTSD and comorbidity in perinatal women in Turkey: A longitudinal population-based study

OBJECTIVE: (a) to assess prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) and their comorbidity among women during the perinatal period (b) to examine course of those disorders from pregnancy to 6 months postpartum (c) to determine the rates of new-onset cases at 4-6 weeks and 6 months postpartum. DESIGN: A longitudinal population-based study in which participants completed psychosocial measures of depression, anxiety and PTSD in pregnancy (n = 950), 4-6 weeks (n = 858) and 6 months (n = 829) after birth. SETTING: A consecutive sample of pregnant women were recruited from three maternity hospitals in three cities of Turkey: Istanbul, Ankara and Izmir. MEASURES: Edinburgh Postnatal Depression Scale (EPDS), Hospital Anxiety and Depression Scale (HADS), and Posttraumatic Diagnostic Scale (PDS) were used to assess depression, anxiety and PTSD, respectively. FINDINGS: Depression and PTSD peaked at 4-6 weeks postpartum and then fell at 6 months postpartum, whereas anxiety followed a gradually declining linear-pattern from pregnancy to 6 months postpartum. The prevalence of depression was 14.6% in pregnancy, 32.6% at 4-6 weeks and 18.5% at 6 months postpartum, respectively. The prevalence of PTSD was 5.8% in pregnancy, 11.9% at 4-6 weeks postpartum and 9.2% at 6 months postpartum. Anxiety was highest in pregnancy (29.6%) and then decreased to 24.6% 4-6 weeks after birth and to 16.2% 6 months after birth. New-onset cases were most apparent at 4-6 weeks postpartum: 24.6% for depression; 13.7% for anxiety and 8.9% for PTSD. KEY CONCLUSIONS: A relatively high prevalence of psychological disorders was identified during the perinatal period. Anxiety was most prevalent in pregnancy, and depression and PTSD were highest at 4-6 weeks postpartum. Depression was more common than anxiety 4-6 weeks and 6 months after birth and highly comorbid with anxiety throughout this period. New-onset cases were observed at both 4-6 weeks and 6 months postpartum. IMPLICATIONS: High rates of affective disorders in pregnancy and after birth highlight three main points: first, it is important to have effective perinatal screening to identify women with psychological needs; second, providing early treatment to women experiencing severe psychological problems is essential to ensure psychological well-being of those women and to prevent chronicity; and finally, psychosocial screening and interventions should be offered until at least 6 months after birth to catch new-onset cases

The relationship between adult attachment style and post-traumatic stress symptoms: A meta-analysis

There is increasing evidence that adult attachment plays a role in the development and perseverance of symptoms of posttraumatic stress disorder (PTSD). This meta-analysis aims to synthesise this evidence and investigate the relationship between adult attachment styles and PTSD symptoms. A random-effects model was used to analyse 46 studies (N = 9268) across a wide range of traumas. Results revealed a medium association between secure attachment and lower PTSD symptoms (ρ =-.27), and a medium association, in the opposite direction, between insecure attachment and higher PTSD symptoms (ρ =.26). Attachment categories comprised of high levels of anxiety most strongly related to PTSD symptoms, with fearful attachment displaying the largest association (ρ =.44). Dismissing attachment was not significantly associated with PTSD symptoms. The relationship between insecure attachment and PTSD was moderated by type of PTSD measure (interview or questionnaire) and specific attachment category (e.g. secure, fearful). Results have theoretical and clinical significance

Adult-Child Sexual Contact: Examining Mental Health Trainees’ Perception of the Impact on Adult Psychological-Emotional Status

Thirty-eight graduate students enrolled in mental health-related programs completed the Brief Symptom Inventory (BSI) indicating anticipated impact of adult-child sexual contact on the psychological status of a young adult woman from positive family environment and one from a negative family environment. BSI subscale scores were significantly higher than the BSI general population’s mean scores in both cases. Multiple regression analyses found that: in the healthy family scenario, practitioners’ background variables (parent education, family of origin climate, prior childhood sexual contact with an adult, and education) did not contribute significantly to the variance in their prediction of expectation of client’s overall psychological distress; and, in the dysfunctional family case, practitioners’ background (childhood experience with adult sexual contact, education level, and professional experience) contributed to 40% of the variance in their prediction of the client’s emotional state. Results of qualitative analyses are presented, and implications for training and service delivery discussed