[Dental gel Cholisal at the stage of conservative treatment of inflammatory periodontal diseases]. / Stomatologicheskii gel' Kholisal na etape konservativnogo lecheniya vospalitel'nykh zabolevanii parodonta.

PURPOSE OF THE STUDY: To study the effectiveness of using the drug Cholisal as part of the conservative treatment of chronic periodontitis. MATERIAL AND METHODS: We selected 100 patients aged 35 to 65 years of both sexes with a diagnosis of moderate chronic periodontitis in the acute phase with a periodontal pocket depth of 3.5-5 mm. Depending on the tactics of conservative treatment of CGP, patients were divided into two groups of 50 people. In the main group, in addition to standard treatment, the dental gel Cholisal was used, and in the control group, therapy was standard. 10 days after professional hygiene, patients in both groups were examined and underwent an index assessment of the condition of periodontal tissues and adherence to treatment. RESULTS: In patients of the control group, 10 days from the start of treatment, the depth of periodontal pockets in the control group decreased slightly from 4.7±0.28 mm to 4.2±0.21 mm (p=0.074), and the Green-Vermillion hygiene index decreased by 25.3±1.79% (p=0.041), Silnesse-Loe plaque index by 59.1±2.16% (p<0.001), PMA index by 51.5±1.92% (p<0.001) and Muhlemann-Cowell bleeding index by 42.2±1.75% (p<0.001). In the main group, the effectiveness of treatment of chronic periodontitis with conservative therapy using Cholisal was higher. There was a statistically significant decrease in the depth of periodontal pockets from 4.8±0.23 mm to 3.5±0.19 mm (p=0.043), the Green-Vermillion hygiene index decreased by 47.6±2.13% (p=0.0003), Silnesse-Loe plaque index by 78.2±3.05% (p<0.001), PMA index by 69.4±2.74% (p<0.001) and Muhlemann-Cowell bleeding index by 66.9±1.62% (p<0.001). CONCLUSIONS: The use of the drug Cholisal in the conservative treatment of chronic periodontitis has shown convincing positive dynamics in both subjective and objective assessments, which suggests its effective use.

The New Beginnings Program for Divorcing and Separating Families: Moving from Efficacy to Effectiveness.

This article describes a program of research on effectively transporting the New Beginnings Program (NBP), a university-tested prevention program for divorced families, to community settings. The status of four steps in this research are described: (1) Selecting a community partner; (2) Developing effective methods of engaging parents; (3) Redesigning the NBP to be easily delivered with high quality and fidelity in community agencies, and (4) Adapting the NBP to meet the needs of the full population of divorcing families. The article concludes with a discussion of plans for an effectiveness trial to evaluate the NBP when delivered in community settings.

Modification of the Bu/Cy myeloablative regimen using daily parenteral busulfan: reduced toxicity without the need for pharmacokinetic monitoring.

Pharmacokinetic and clinical outcome measures among three groups of patients undergoing hematopoietic transplant were assessed: group A: Parenteral busulfan (Bu) 3.2 mg/kg i.v. given qd, n=20; group B: parenteral Bu 0.8 mg/kg i.v. given every 6 h, n=11; group C: Bu 1 mg/kg p.o. given every 6 h, n=25. All groups received Bu over 4 days followed by Cy 60 mg/kg i.v. qd over 2 days; followed by an infusion of allogeneic stem cells. Median Bu clearance was 3.21 ml/min/kg and median daily AUC was 4071 micromol/min for the group A patients. The dosing formula for Bu i.v. qd was highly predictive of the AUC for patients whose mass < or =IBW+20%. For patients of greater mass, the dosing formula uniformly resulted in lower-than-predicted AUC. Neurologic toxicity, hepatic toxicity, hematologic engraftment, and relapse at 100 days were comparable across all three groups. Severe AGVHD was least among group A, followed by group B when compared with group C. Bu i.v. qd is a safe and effective regimen for allogeneic transplantation and is at least clinically equivalent to every 6 h dosing schemes using either oral or parenteral Bu.

Quality and ecology of adversity as common mechanisms of risk and resilience.

This paper proposes common mechanisms to explain the effects of adversities and of resources that promote resilience. Adversities threaten the satisfaction of basic human needs and the acquisitions of competencies to carry out valued social roles. Adversities can also be characterized in terms of their ecological properties of occurrence in time, and place. Resilience resources at the individual, microsystem and macro levels reduce the negative effects of adversities through their effects on satisfaction of basic human needs and their effects on the occurrence of adversities. The effects of resilience resources are described as preventive, protective and promotive. Implications are presented for the development of interventions to promote resilience.

An experimental evaluation of theory-based mother and mother-child programs for children of divorce.

This study evaluated the efficacy of 2 theory-based preventive interventions for divorced families: a program for mothers and a dual component mother-child program. The mother program targeted mother-child relationship quality, discipline, interparental conflict, and the father-child relationship. The child program targeted active coping, avoidant coping, appraisals of divorce stressors, and mother-child relationship quality. Families with a 9- to 12-year-old child (N = 240) were randomly assigned to the mother, dual-component, or self-study program. Postintervention comparisons showed significant positive program effects of the mother program versus self-study condition on relationship quality, discipline, attitude toward father-child contact, and adjustment problems. For several outcomes, more positive effects occurred in families with poorer initial functioning. Program effects on externalizing problems were maintained at 6-month follow-up. A few additive effects of the dual-component program occurred for the putative mediators; none occurred for adjustment problems.

Coping efficacy and psychological problems of children of divorce.

Three models of the relations of coping efficacy, coping, and psychological problems of children of divorce were investigated. A structural equation model using cross-sectional data of 356 nine- to twelve-year-old children of divorce yielded results that supported coping efficacy as a mediator of the relations between both active coping and avoiding coping and psychological problems. In a prospective longitudinal model with a subsample of 162 of these children, support was found for Time 2 coping efficacy as a mediator of the relations between Time 1 active coping and Time 2 internalizing of problems. Individual growth curve models over four waves also found support for coping efficacy as a mediator of the relations between active coping and psychological problems. No support was found for alternative models of coping as a mediator of the relations between efficacy and symptoms or for coping efficacy as a moderator of the relations between coping and symptoms.

Coping and negative appraisal as mediators between control beliefs and psychological symptoms in children of divorce.

Examined control beliefs of children of divorce as predictors of their coping, negative appraisals for stressful events, and mental health problems. We tested whether coping and negative appraisal for stressful events mediated the relations between multiple dimensions of control beliefs and mental health problems. Different dimensions of control beliefs were related to different aspects of coping and negative stress appraisal. Internal control beliefs for positive events were related to both active and avoidant coping. Unknown control beliefs for positive events were related to higher active coping and higher negative appraisal. Unknown control beliefs for negative events were related to higher avoidant coping. In addition, evidence for mediation was found such that the effect of unknown control beliefs for positive events on mental health problems was mediated by negative appraisal. Implications and directions for further research are discussed.

The additive and interactive effects of parenting and temperament in predicting adjustment problems of children of divorce.

Investigated the interaction between parenting and temperament in predicting adjustment problems in children of divorce. The study utilized a sample of 231 mothers and children, 9 to 12 years old, who had experienced divorce within the previous 2 years. Both mothers' and children's reports on parenting, temperament, and adjustment variables were obtained and combined to create cross-reporter measures of the variables. Parenting and temperament were directly and independently related to outcomes consistent with an additive model of their effects. Significant interactions indicated that parental rejection was more strongly related to adjustment problems for children low in positive emotionality, and inconsistent discipline was more strongly related to adjustment problems for children high in impulsivity. These findings suggest that children who are high in impulsivity may be at greater risk for developing problems, whereas positive emotionality may operate as a protective factor, decreasing the risk of adjustment problems in response to negative parenting.

Maternal acceptance and consistency of discipline as buffers of divorce stressors on children's psychological adjustment problems.

This study examines whether two aspects of mothering--acceptance and consistency of discipline--buffer the effect of divorce stressors on adjustment problems in 678 children, ages 8 to 15, whose families had divorced within the past 2 years. Children reported on divorce stressors; both mothers and children reported on mothering and internalizing and externalizing problems. Multiple regressions indicate that for maternal report of mothering, acceptance interacted with divorce stressors in predicting both dimensions of adjustment problems, with the pattern of findings supporting a stress-buffering effect. For child report of mothering, acceptance, consistency of discipline, and divorce stressors interacted in predicting adjustment problems. The relation between divorce stressors and internalizing and externalizing problems is stronger for children who report low acceptance and low consistency of discipline than for children who report either low acceptance and high consistency of discipline or high acceptance and low consistency of discipline. Children reporting high acceptance and high consistency of discipline have the lowest levels of adjustment problems. Implications of these results for understanding variability in children's postdivorce adjustment and interventions for divorced families are discussed.

Stressful life events, psychological distress, coping, and parenting of divorced mothers: a longitudinal study.

This was a prospective longitudinal study of the relationships among life stress, psychological distress, coping, and parenting behaviors in a sample of divorced custodial mothers. First, the differential effects of major events and daily stressors on psychological distress and parenting were explored. Second, the mediational links among stress, distress, and 3 dimensions of parenting behaviors were studied. Third, 3 coping strategies were studied as moderators of the relationship between distress and parenting. The results showed that both major and small events had significant effects on parental distress, with the effects of daily negative events being greater than those of major events. Parental distress mediated the relationships between stressful life events and parental acceptance of their children's behaviors. Parental coping strategies moderated the relationship between mothers' psychological distress and mothers' discipline practice.

Cognitive moderators of children's adjustment to stressful divorce events: the role of negative cognitive errors and positive illusions.

This study examined whether children's cognitive appraisal biases moderate the impact of stressful divorce-related events on psychological adjustment in 355 children ages 9 to 12, whose families had experienced divorce within the past 2 years. Multiple regression indicated that endorsement of negative cognitive errors for hypothetical divorce events moderates the relations between stressful divorce events and self- and maternal reports of internalizing and externalizing symptoms, but only for older children. Positive illusions buffer the effects of stressful divorce events on child-reported depression and mother-reported externalizing problems. Implications of these results for theories of stress and coping, as well as for interventions for children of divorced families, are discussed.

Emotionality and self-regulation, threat appraisal, and coping in children of divorce.

A model of the effects of children's temperament (negative and positive emotionality, impulsivity and attention focusing) on post-divorce threat appraisals, coping (active and avoidant), and psychological symptoms (depression and conduct problems) was investigated. The study utilized a sample of 223 mothers and children (ages 9 to 12 years) who had experienced divorce within the last two years. Evidence was found of direct effects of child-report negative emotionality on children's threat perceptions and of child-report positive emotionality and impulsivity on children's coping. Indirect effects of negative emotionality on active and avoidant coping through threat appraisal were found. Direct effects of the temperament variables on symptoms were also found. Cross group analyses indicated that the models were robust to age differences, but gender differences were found in the relation between negative emotionality and depression. The results of this study indicate that temperament and threat appraisals are important predictors of children's post-divorce symptoms, and that temperament is a predictor of children's appraisal and coping process.

Stress and coping as predictors of children's divorce-related ruminations.

Examined stress and coping variables as predictors of divorce-related ruminations in children whose parents had recently divorced. Simultaneous multiple regression was used to analyze the cross-sectional data of 351 children of divorce. Divorce-related stressful events and threat appraisal were positively related to children's ruminations. A prospective longitudinal design was employed to predict rumination at Time 2 (T2) controlling for Time 1 (T1) rumination. Efficacy of coping was negatively related to T2 rumination after controlling for T1 rumination and all other predictors. This study also provided descriptive data on the frequency of children's divorce-related ruminations.

Temperament as a predictor of symptomatology in children: addressing contamination of measures.

Temperament has been conceptualized as an important predictor of children's psychological adjustment. However, even with reliable and valid measures, there is the additional problem of overlapping item content across measures of temperament and symptoms that threatens the interpretability of such associations. This study assessed this possible confounding using both confirmatory factor analysis (CFA) and expert ratings. A number of items from temperament measures of negative and positive emotionality, impulsivity, and attention focusing were shown to overlap with items measuring depressive and conduct problem symptoms. CFAs demonstrated that temperament could be reliably measured after eliminating overlapping items. Negative emotionality and impulsivity showed a positive relation to symptom measures, whereas positive emotionality and attention showed a negative relation to symptom measures. The pattern of associations indicated consistent relations between negative emotionality and depression and between impulsivity and conduct problems. The results show that even after removal of the threat to validity presented by overlap in measures, there continue to be significant, interpretable relations between temperament and symptoms.

Locus of control as a stress moderator and mediator in children of divorce.

This paper examined the stress moderator and mediator effects of four dimensions of perceived control in children of divorce. The dimensions of locus of control included internal control for positive events, internal control for negative events, unknown control for positive events, and unknown control for negative events. The sample consisted of 222 children between the ages of 8 and 12 whose parents had divorced in the previous 2 years. Moderational analyses showed that unknown control for positive events interacted with negative events to predict total symptoms. Plots of the simple slopes indicated a stress buffering effect whereby the slope of negative events on symptoms was higher for high than for low levels of unknown control for positive events. Mediational analysis showed that the relations between negative events and symptoms were mediated by both unknown control for positive events and unknown control for negative events. In contrast, evidence was not found for either a stress mediational or a moderational model for perceived internal control for positive or negative events. These results suggest that unknown control beliefs may be a particularly important dimension of control for children of divorce.

Alcohol abuse and psychopathic deviance in noncustodial parents as predictors of child-support payment and visitation.

In a three-stage study, noncustodial parents' psychopathic deviance and alcohol use accounted for significant variance in custodial parents' reports of child support and visitation. In noncustodial parents 'reports' compliance with child support, but not frequency of visitation, was related to measures of deviance. Implications for policy, research, and psychoeducational interventions are discussed.

A dispositional and situational assessment of children's coping: testing alternative models of coping.

Dispositional and situational measures of children's coping were developed using a theoretically based approach. Two studies (N1 = 217; N2 = 303) assessed the psychometric characteristics of these measures in fourth- through sixth-grade children. Confirmatory factor analyses indicated that a four-factor model of dispositional coping (active, distraction, avoidant, and support seeking) provided a better fit to the data than either the problem- versus emotion-focused (Lazarus & Folkman, 1984) or passive versus active (Billings & Moos, 1981) coping models. The four-factor model was largely invariant with respect to age and gender. Moderate to high correlations were found between the parallel subscales of the dispositional and situational measures of coping. Although the four factor structures of the dispositional and situational measures were generally similar, factor loadings and correlations between dimensions were not equivalent.

Self-regulation as a moderator of the relation between coping and symptomatology in children of divorce.

Investigated the effects of self-regulation as a moderator of the relations between coping efforts and psychological symptoms of children of divorce. The interactions of two dimensions of self-regulation (task orientation and approach-flexibility) and two dimensions of coping (active and avoidant) predicting children's postdivorce symptoms were tested using a sample of 199 divorced mothers and their children, ages 8 to 12. The approach-flexibility dimension moderated the relations of both active and avoidant coping with children's self-report of anxiety. At higher levels of approach-flexibility, active coping was negatively related to anxiety, while at lower levels of approach-flexibility, active coping was unrelated to anxiety. Avoidant coping was unrelated to anxiety at higher levels of approach-flexibility, whereas at lower levels of approach-flexibility, avoidant coping was positively related to anxiety. The task orientation dimension did not interact with coping, but had direct, independent effects on children's self-report of conduct problems, depression, and parent-report of internalizing and externalizing behavior problems. The implications for understanding children's coping with divorce and future directions for research are discussed.