Review of screening instruments for postpartum depression.

This paper presents a review and discussion of eight self-report measures used to assess for depressive symptoms in the postpartum period. Because postpartum depression is a significant mental health problem, there is a need for reliable and valid screening instruments. Published psychometric data (e.g., reliability, sensitivity, specificity, positive predictive value, concurrent validity) of each self-report instrument are presented and critiqued. Results suggest that the Edinburgh Postnatal Depression Scale is the most extensively studied measure with postpartum women with moderate psychometric soundness. This review illustrates the need for more research in this area. Issues involved in the selection of measures are considered. Implications for clinical practice, research, culture and language are discussed.

Emotional and behavioral impact of exposure to community violence in inner-city adolescents.

Used multiple methods and measures (i.e., youth report, psychiatric interviews, psychophysiological assessment) to investigate the emotional and behavioral impacts of exposure to community violence. Participants were 185 inner-city high school students (M age = 15.4 years; 42% female; 90% African American). Youth with high levels of community violence exposure reported more fears, anxiety, internalizing behavior, and negative life experiences than those with low exposure. No depression or externalizing behavior differences were observed. In a psychophysiological assessment in which adolescents watched a montage of media violence, youth exposed to high levels of community violence had lower baseline heart rates than those with low exposure. There were no between-group differences in physiologic reactivity. Regression analyses revealed that community violence exposure predicted posttraumatic stress and separation anxiety symptoms. The results suggest a significant link between community violence exposure and anxiety symptomatology. Clinical implications are discussed.

Public knowledge of dental registration and management of common dental problems.

The government has recently changed its policy on dental registration. There is now a requirement to attend a dentist within 15 months of the previous appointment or dental registration will lapse. The authors of this article undertook a survey of the patients attending for dental treatment at the accident and emergency department of their hospital to ascertain whether inappropriate attendance was due to ignorance about general dental services. Of the 501 respondents 14% had not seen their general dental practitioner within the last 15 months and were therefore no longer registered--only 21% realized that they had to keep regular appointments or dental registration would lapse. A proportion (30%) had tried to contact the dentist outside normal working hours; 27% of these were unhappy with the outcome. Telephone calls were unanswered in 38% of those expressing dissatisfaction and 45% subsequently attended hospital for treatment.

Psychological characteristics of child cochlear implant candidates and children with hearing impairments.

OBJECTIVE: To describe the psychological status of deaf children with hearing parents who were seeking a cochlear implant and to compare them with deaf children with hearing parents who were not seeking a cochlear implant. DESIGN: A sample of children consecutively referred for a cochlear implant at the University of Iowa Hospitals and Clinics was contrasted on a number of standardized psychological measures with a cohort of children from Boys Town National Research Hospital, who had hearing impairments and whose families had not sought a cochlear implant. RESULTS: Although the comparison group evidenced more externalizing and social problems than the implant group, the means of both groups fell well within the normal range. Similarly, although mothers of the implant group rated their child's home as characterized by more positive and supportive interactions than did mothers of the children in the comparison group, both group means were well within the average range. On measures of intelligence, the two groups also did not differ. CONCLUSION: Overall, the study indicated that children with hearing impairments and their families who were seeking cochlear implants are not significantly different from children with hearing impairments whose parents were not seeking a cochlear implant. The results provided no support for the notion that children with hearing impairments from families seeking a cochlear implants for their child evidence more behavioral deviance than children with hearing impairments whose parents have not sought an implant.

Observational assessments of the interaction of implant recipients with family and peers: preliminary findings.

Two experiments were conducted to determine the feasibility of direct observational methods in the assessment of social interactions between cochlear implant recipients and their families and peers. With laboratory analogs of parent-child interactions and peer interactions, children with implants and deaf children were videotaped. These videotapes were then coded for specific patterns of behavior. The results established the feasibility of direct observational assessments of deaf children and implant recipients and identified behavioral foci that could serve as effective indexes of implant outcome. The study also suggested that the peer entry paradigm may not be suitable for deaf children under the age of 7 years.

Acute digitalis toxicity during TURP.

Water entrainment into opened prostate venous sinuses during transurethral resection of the prostate (TURP) may lead to dilution of serum electrolytes. Dilutional hypokalemia may precipitate digitalis toxicity in the digitalized patient. Successful resuscitation of such a patient is reported.

Venous air embolism in a child undergoing posterior fossa craniotomy: a case report.

The incidence of venous air embolism in children undergoing neurosurgical procedures in the sitting position may be as high as 33 per cent. It may be more serious in children because smaller total volumes of air can produce serious physiologic disturbances or fatalities, and the risk of systemic air embolism through a patent foramen ovale or patent ductus arteriosus may be greater than in adults. The case of a six-year-old child who sustained four separate episodes of air embolism while undergoing posterior fossa exploration is presented. Early episodes were well tolerated, but later episodes produced clinical instability. A total of 11 cc of air was recovered from an indwelling right atrial catheter, and the patient recovered uneventfully. This case report illustrates the physiologic changes produced by venous air embolism and reviews the importance of adequate monitoring techniques and early treatment.

Suppression of phytohemagglutinin response by fungi from a "leukemia" house.

Fungal isolates from the house of a husband and wife who both developed acute myelomonocytic leukemia were assayed for effects on the in vivo response to phytohemagglutinin in guinea pigs. Skin responses to intradermal phytohemagglutinin were measured following injections of sterile fungal extracts. Isolates of Penicillium canescens, Curvularia, Fusarium sambucinum, Fusarium equiseti and Trichoderma koningii from the leukemia-associated house depressed the responses to phytohemagglutinin, but none of the fungal isolates obtained from a nearby control house depressed responses to phytohemagglutinin. Such environmental agents may contribute to development of malignancy by suppression of immune responses.

Aneurysmal bone cysts of the jaws.

Two cases of aneurysmal bone cyst are recorded. In the first there is clinical evidence to suggest that the lesion had been present for an unusually long period while incomplete clinical records of the other also indicate an unusual history. Histologically both lesions show a paucity of giant cells. It is not possible to make significant observations on aetiology other than support the theory that the lesion arises as a result of altered haemodynamics.