Impact of Training on Parent Knowledge and Behavior

Immunizations are an essential part of children’s healthcare; however, the associated distress can have short- and long-term negative ramifications for children. Parents’ procedural behavior is one of the strongest predictors of children’s distress. The current study evaluated whether an interactive computer training program influenced parents’ knowledge of the impact that their behavior has on their children or their actual procedural behavior during children’s immunizations. 90 parents and their 4- to 6-year-old children receiving immunizations participated. Overall, findings suggest that using a computerized training module to enhance parent knowledge and behavior is helpful but requires improvements in some areas to optimize training

The Impact of Pain on Executive Functioning via Anxiety in Youths with Sickle Cell Disease without a History of Stroke

Research indicates that youths with SCD experience increased levels of pain-related anxiety and executive functioning impairments, even in the absence of stroke. Research also indicates that pain and anxiety predict executive functioning and that anxiety might mediate the relation between pain and executive functioning difficulties. The current study sought to evaluate the direct associations among pain, anxiety, and executive functioning, and to examine whether anxiety mediates the relation between pain and specific executive functioning impairments in a sample of youths (age 10 to 19 years) with SCD with no history of stroke. Findings did not support the hypothesis that pain-crisis frequency and anxiety predict executive functioning. Further, they did not indicate that anxiety mediated the relation between pain-crisis frequency and executive functioning

Behavioral Approaches for Infant Pain Relief

Infants experience a host of painful medical procedures including heel sticks, venipuncture, and immunizations. Historically, little attention was given to infant pain management due to misconceived myths and beliefs about the experience and long-term effects of pain in infants. Recent data suggest that there are both short- and long-term negative repercussions associated with unmanaged infant pain. In response, a number of non-pharmacological approaches have been developed to provide infants with pain relief associated with medical events. This paper will review these behavioral approaches including positioning, parent training, distraction, sucrose, and skin-to-skin contact. Recommendations for best practices will be provided and future direction for infant pain management will be outlined

Psychological Approaches to Acute Pediatric Pain Management

Children endure numerous acute painful events, most of which occur within the medical arena. For instance, by the time a child reaches the age of 6, the child will have experienced approximately 30 immunization injections (Centers for Disease Control and Prevention, 2008). Grounded in the Gate Control Theory (Melzack & Wall, 1965), psychological methods of pain management have focused on anxiety and pain management via behavioral means. In addition, ample research has been devoted to how best to prepare children and their parents for upcoming painful or distress-provoking procedures (e.g., surgery, hospitalization, injection). This paper will review the preparation literature, which details how to inform and arm children and their parents for impending procedures and will highlight the psychological pain management literature which includes distraction, cognitive behavioral therapy, and additional promising interventions

Homocysteinylated Albumin Promotes Increased Monocyte-Endothelial Cell Adhesion and Up-Regulation of MCP1, Hsp60 and ADAM17

RATIONALE:The cardiovascular risk factor homocysteine is mainly bound to proteins in human plasma, and it has been hypothesized that homocysteinylated proteins are important mediators of the toxic effects of hyperhomocysteinemia. It has been recently demonstrated that homocysteinylated proteins are elevated in hemodialysis patients, a high cardiovascular risk population, and that homocysteinylated albumin shows altered properties. OBJECTIVE:Aim of this work was to investigate the effects of homocysteinylated albumin - the circulating form of this amino acid, utilized at the concentration present in uremia - on monocyte adhesion to a human endothelial cell culture monolayer and the relevant molecular changes induced at both cell levels. METHODS AND RESULTS:Treated endothelial cells showed a significant increase in monocyte adhesion. Endothelial cells showed after treatment a significant, specific and time-dependent increase in ICAM1 and VCAM1. Expression profiling and real time PCR, as well as protein analysis, showed an increase in the expression of genes encoding for chemokines/cytokines regulating the adhesion process and mediators of vascular remodeling (ADAM17, MCP1, and Hsp60). The mature form of ADAM17 was also increased as well as Tnf-α released in the cell medium. At monocyte level, treatment induced up-regulation of ICAM1, MCP1 and its receptor CCR2. CONCLUSIONS:Treatment with homocysteinylated albumin specifically increases monocyte adhesion to endothelial cells through up-regulation of effectors involved in vascular remodeling

A cognitive decline precedes the onset of psychosis in patients with the 22q11.2 deletion syndrome

Patients with 22q11.2 deletion syndrome (22q11DS) have an elevated (25%) risk for developing schizophrenia. Recent reports have suggested that a subgroup of children with 22q11DS display a substantial decline in cognitive abilities, starting at a young age