Techniques to comfort children during stressful procedures.

Medical procedures can be unpleasant experiences for children, their parents, and health care providers. We present this model of working with children having invasive procedures with the aim of helping to increase the comfort of infants and children and also parents and medical staff. The model has five parts: (1) Preparing the child and parent for the procedure and for their role during the procedure; (2) inviting the parent/caregiver to be present; (3) utilizing the treatment room for stressful procedures; (4) positioning the child in a comforting manner; and (5) maintaining a calm, positive atmosphere.

Techniques to comfort children during stressful procedures.

Medical procedures can be unpleasant experiences for children, their parents, and health care providers. We present this model of working with children having invasive procedures with the aim of helping to increase the comfort of infants and children and also parents and medical staff. The model has five parts: (1) Preparing the child and parent for the procedure and for their role during the procedure; (2) inviting the parent/caregiver to be present; (3) utilizing the treatment room for stressful procedures; (4) positioning the child in a comforting manner; and (5) maintaining a calm, positive atmosphere.

Characterization of the tobacco glycoprotein surface binding property of heart and skeletal muscle cells. I. Modulation of the heart cell membrane TGP interaction by anti-TGP IgG.

Monolayers of L6 rat skeletal myoblast cells formed surface binding isotherms with the purified tobacco leaf glycoprotein TGP1 and the enriched cigarette tar glycoprotein TGP2. Scatchard analysis showed that the binding in the range of the limited concentrations tested was to a single class molecule and the calculated affinity constant (Kd) for TGP1 and TGP2 showed similar values (9.78 x 10(-13) M and 3.09 x 10(-13) M, respectively). The bound TGPs were almost totally displaced by excess nonradiolabeled molecules. The calculated Bmax of the L6 myoblast monolayer was 2.93 fmol for TGP1 and 0.217 fmol for TGP2 per 32.2 mm2. Guinea pig heart sarcolemma binding isotherms were also formed with radiolabeled TGP1 and TGP2. The interaction of tobacco leaf TGP1 with the heart cell membranes was irreversible because only 15-20% of the bound TGP1 was displaced by 100-fold, non-labeled molecules but the interaction of tar TGP2 with heart sarcolemma was reversible and probably saturable. The heart sarcolemma TGP2 affinity constant (Kd) was 5.88 x 10(-7) M and the Bmax, 2.45 x 10(-8) M per 12.5 micrograms sarcolemma. Pretreatment of heart sarcolemma with increasing concentrations of leaf TGP1 did not displace tar TGP2 binding but its absorption on the membrane resulted in increased TGP2 sarcolemma attachment by a complex and unexplained mechanism. Increasing concentrations of the sera of 10 of 15 guinea pigs (67%) that received mainstream emissions of tobacco smoke from a University of Kentucky cigarette smoking machine for 152 days, displaced cigarette tar TGP2 heart cell sarcolemma attachment and this inhibition was significantly different from that produced by the sera of sham smoked and of non-exposed animals (Mann-Whitney test, p = 0.0082). Staphylococcus protein A inhibited the displacement of TGP2 produced by the sera of cigarette smoke exposed guinea pigs and this observation indicated that this action was mediated by IgG molecules. The specific immunoprecipitation of a radiolabeled surface epitope of the L6 myoblast monolayers pretreated with TGP1 or TGP2 by immune IgG against TGP2 and by the IgG of an antiserum against standard TGP showed that the tobacco glycoproteins attached to a unit polypeptide of the plasma membrane of the muscle cells of approximately 76 kDa. These data support the notion that TGP molecules in cigarette smoke are absorbed systemically on smoking and may have a direct toxic effect when they attach to the surface TGP binding proteins of heart and skeletal muscle cells.

Voluntary immunomodulation: a preliminary study.

This study explored the effects of relaxation and imagery procedures on the voluntary self-regulation of immune responses. Immune studies of 19 adults were made before and after a 45 minute intervention consisting of relaxation with imagery aimed at enhancing immune activity. A self-report measure of psychological distress was completed before each blood sample. Results indicate that the seven blood measures of immune functioning were measured with adequate reliability and consisted of two sets of immune parameters. A statistically significant increase in one of the mitogen measures and a marginally significant increase in one of the blood count measures was found following the relaxation/imagery procedure. Age, hypnotizability, and their interaction significantly predicted change on the set of blood count measures but not on the set of mitogen measures. As expected, level of subjective psychological distress generally decreased following the intervention. The methodological limitations of this study included limited sample size and absence of a control group.

Voluntary modulation of neutrophil adhesiveness using a cyberphysiologic strategy.

In a study of voluntary immunomodulation, 45 subjects were assigned either to a control group or one of two experimental groups. All groups had blood and saliva samples collected before and after either a 30 minute rest condition (Control group) or a 30 minute cyberphysiologic strategy (Experimental groups) to increase neutrophil adherence. These samples were analyzed on a range of immunologic measurements including neutrophil adherence. The second experimental group practiced a cyberphysiologic strategy two weeks prior to the experimental session. Subjects in each group returned to repeat their exercise in a second session the following week. Analysis of all immune measurements revealed statistical significance for changes in neutrophil adherence. These studies suggest that such strategies may be used to effect changes in immune cell functions. Analysis further revealed that those subjects with prior cyberphysiologic training were able, by the second session, to induce a significant increase in neutrophil adherence.

The effects of relaxation/imagery training on recurrent aphthous stomatitis: a preliminary study.

Recurrent aphthous stomatitis (RAS) is one of the most common diseases of the oral mucosa. Although etiology remains unknown, immunological and emotional disturbances have been implicated in the pathogenesis of RAS. No consistently effective therapeutic regimen has been found. The present study investigates the voluntary modulation of RAS employing hypnosis-like relaxation/imagery training procedures. A multiple baseline design was used to evaluate change in frequency of ulcer recurrence. The role of psychological distress, ratings of perceived pain, and hypnotizability in the treatment of RAS were also examined. Results suggest that the relaxation/imagery treatment program was associated with a significant decrease in the frequency of ulcer recurrence for all subjects. Psychological distress was examined for relationship to ulcer recurrence and symptomatic changes with treatment, but no pattern was found. Finally, little support was found for the role of high hypnotic ability in the treatment of RAS.

Research in the area of voluntary immunomodulation: complexities, consistencies and future research considerations.

In this paper it was speculated that the successful voluntary alteration of one's immune functioning was a complex phenomenon associated with a number of possible factors. Evidence suggests the importance of prior experience in self-regulation and the role of practice, the ability of subjects to become relaxed and reduce sympathetic arousal, the importance of the nature and content of images, the complex role of hypnosis and hypnotizability, the importance of individual differences, and the choice of immune measures. Conclusions were drawn about the need for more experimental attention to these variables and future research with both experienced and inexperienced subjects.

Effects of hypnosis and imagery training on naming behavior in aphasia.

The effects of hypnosis and imagery training on the naming behavior of three subjects with Broca's aphasia were investigated using a multiple baseline design across subjects. Treatment consisted of the induction of hypnosis, followed by guided imagery focused on the physical and functional attributes of stimulus objects. Measures of naming ability on both trained and untrained items were taken at baseline, after every training session, and a few hours after training each day. Measures were also taken of imagery ability, hypnotic susceptibility, and psychological state. Results indicated that treatment facilitated improvement in naming ability, over baseline level, for two subjects. In the case of the third subject, the verbal label was incorporated into the imagery procedure following 10 training sessions. Subsequently, this subject's naming behavior improved over baseline level. The results are discussed in terms of current theory and research in neuropsychology and cognitive psychology.