Psychology and self-help groups. Predictions on a partnership.

Continued growth and increased legitimacy are anticipated for the American self-help group (SHG) phenomenon. Currently estimated at six and a quarter million participants annually, self-help groups will assume a central role in the nation's mental health delivery system over the next two decades. The first part of this article illuminates the self-help group phenomenon itself. Its scope, characteristics, supporting social climate, and associated research issues are reviewed. The second part is a futuristic examination of its interface with the newly industrializing world of health care. Massive increases in mental health services are predicted, especially via the SHG format. Theory development, research sophistication, changing SHG formats, a place in public policy, and acceptance into graduate curricula are also expected, as are collaborative relationships with a variety of professional disciplines. Psychologists are urged to enhance the relevance of the profession by taking an early leadership role in these developments.

Determination of normal variation in skin blood flow velocity in healthy adults.

This study noninvasively measured cutaneous microcirculatory blood flow velocity at six clinically significant sites on the feet, legs, and abdomen. Subjects were 51 healthy adult volunteers, 44 females and 7 males, with a mean age of 32 years. A laser Doppler velocimeter (LDV) was used to measure skin blood flow velocity. Skin temperatures and LDV measures were concurrently obtained from the dorsal surface of the feet, medial aspects of the lower legs, and at two contralateral midabdominal sites. Ambient and oral temperatures were repeatedly measured and remained stable among subjects. Using paired t tests, there were no statistical significances for contralateral comparisons of mean flow velocity and skin temperature differences. Regional differences among feet, legs, and abdomen were significantly different. The findings suggest that blood flow velocity of contralateral sites is similar. Unilateral circulatory disturbances such as surgical and nonsurgical traumas, primary cutaneous lesions, and venous or arterial occlusions are often encountered clinically. Nursing care measures to improve blood flow can be evaluated on the basis of contralateral flow rates.

Leg volume changes with EPIC and posturing in dependent pregnancy edema.

This study explored the differential effects of external pneumatic intermittent compression (EPIC) and posturing on leg volume changes in healthy pregnant women with dependent leg edema. Thirty-five healthy pregnant women with severe pedal edema were randomly assigned to one of two treatment groups. The experimental group (n = 17) received EPIC for 30 minutes at 40 torr while in the left lateral recumbent position. Control women (n = 18) were similarly positioned, but received no EPIC. Both groups walked for 10 minutes following left lateral posturing. Circumference measures required for leg volume estimates were made: prior to posturing (Time 1), immediately after posturing (Time 2), and following the ambulation period (Time 3). Volume losses for the experimental group were greater than for the control group at Time 2. Although volume losses for the experimental group had reversed somewhat at Time 3, they remained greater than control group losses, which did not change from Time 2 to Time 3. Analysis of covariance revealed significant mean volume losses for both experimental and control groups, with ponderal index the only significant covariate.

Preventing coronary heart disease in high-risk families.

A preventive nursing intervention to reduce coronary heart disease (CHD) risk was tested. The sample was 19 families composed of 58 first-degreed relatives of young (age 30-55 years) victims of sudden cardiac death. Families were randomly assigned to control and experimental groups. The intervention at 3-5 months postdeath focused on assessment of health history, health behaviors, health beliefs, informing and educating about CHD risk factors, and methods for detecting and reducing these factors. The control group received mailed questionnaires and no intervention. The subject's reduction of CHD risk was measured at 7 months by changes in high risk CHD behaviors, changes in health beliefs, and adherence to screening for serum cholesterol and blood pressure determination. Analysis of covariance (covarying age and pretest scores) demonstrated no differences between groups for health beliefs; however, significant differences for health beliefs existed between the sibling subgroups. The intervention was correlated with a significant reduction in alcohol intake. Reductions in high fat meat consumption were in the desired direction. Greater percentages of subjects in the intervention group obtained blood pressure and cholesterol screening.

External pneumatic intermittent compression for treatment of dependent pregnancy edema.

A portable external pneumatic intermittent compression (EPIC) device has been successful in reducing peripheral edema. This study explored the effectiveness of EPIC for treating dependent pregnancy edema. In the study, 42 healthy pregnant women received EPIC for 30 minutes at 40 torr while in the left lateral recumbent position: Group One with mid-thigh boots, and Group Two with below-knee boots. Prior to compression, descriptive data were gathered, leg circumference measurements made, and surface skin temperatures recorded for three sites per leg. Vital signs were taken and pedal edema subjectively indexed. Following compression, circumferences, skin temperatures, vital signs, and edema indices were rerecorded. Three volumes were calculated for each leg using a mathematical model of leg segments as conical frustum units. Mean volume reductions for each leg were significant. The mid-thigh-length boots produced greater mean volume decreases. The volume decrease for calf, lower leg, and foot frustum units were significant. EPIC holds promise as a useful treatment for dependent pregnancy edema.

Preprosthetic management of severe alveolar ridge atrophy.

The preprosthetic management of individuals with denture instability caused by severe alveolar ridge atrophy is discussed with respect to augmentation by bone grafting or implantation of denture retention devices. Specific indications were made for the use of each surgical procedure and the clinical effectiveness of each was illustrated with a case presentation. In the maxilla and mandible, there is a range of functional alveolar ridge heights that results in unsatisfactory denture retention. If the alveolar morphology lends itself to a soft tissue procedure, a vestibuloplasty will often provide satisfactory improvement in stability. However, if the alveolar height is severely diminished, denture retention can be satisfactorily enhanced only by ridge augmentation procedures such as bone grafting or the placement of metal implants. Implantation of denture retention devices can improve denture stability on certain severely atrophic mandibular alveolar ridges. The staple is a precision appliance that must be placed during a surgical procedure under general anesthesia, requires close attention by patient and prosthodontist following placement, and is expensive. The ramus frame is a less expensive alternative that can be placed on an extremely atrophic mandible under local anesthesia with conscious sedation. The morbidity associated with harvesting autogenous iliac crest or rib for bone grafting, though it requires a general anesthetic, is relatively minimal in the healthy patient. Vigilant postoperative care and aggressive physical therapy lead to rapid rehabilitation of the individuals who must recover from the additional surgery.