ABSTRACT
The authors review the multiple roles of the pediatric psychologist in hospital medicine practice, which is commonly referred to as pediatric consultation-liaison (CL) psychology. A brief history of development of training of CL psychologists is discussed as well as current models of practice. The authors describe specific populations that CL psychologists assist in managing when hospitalized as well as how the CL psychologist can contribute to health care systems and public policy advocacy. Physicians are encouraged to request the services of pediatric CL psychologists to help promote psychological adjustment, coping, and well-being in hospitalized youth.
Subject(s)
Hospital Medicine , Hospitals, Pediatric , Adaptation, Psychological , Adolescent , Child , Humans , Psychology, Child , Referral and ConsultationABSTRACT
BACKGROUND: Advances in radiation treatment (RT), specifically volumetric planning with detailed dose and volumetric data for specific brain structures, have provided new opportunities to study neurobehavioral outcomes of RT in children treated for brain tumor. The present study examined the relationship between biophysical and physical dose metrics and neurocognitive ability, namely learning and memory, 2 years post-RT in pediatric brain tumor patients. PROCEDURE: The sample consisted of 26 pediatric patients with brain tumor, 14 of whom completed neuropsychological evaluations on average 24 months post-RT. Prescribed dose and dose-volume metrics for specific brain regions were calculated including physical metrics (i.e., mean dose and maximum dose) and biophysical metrics (i.e., integral biological effective dose and generalized equivalent uniform dose). We examined the associations between dose-volume metrics (whole brain, right and left hippocampus), and performance on measures of learning and memory (Children's Memory Scale). RESULTS: Biophysical dose metrics were highly correlated with the physical metric of mean dose but not with prescribed dose. Biophysical metrics and mean dose, but not prescribed dose, correlated with measures of learning and memory. CONCLUSIONS: These preliminary findings call into question the value of prescribed dose for characterizing treatment intensity; they also suggest that biophysical dose has only a limited advantage compared to physical dose when calculated for specific regions of the brain. We discuss the implications of the findings for evaluating and understanding the relation between RT and neurocognitive functioning.
