Long-term Adjustment After Surviving Open Heart Surgery: The Effect of Using Prayer for Coping Replicated in a Prospective Design.

PURPOSE: despite the growing evidence for effects of religious factors on cardiac health in general populations, findings are not always consistent in sicker and older populations. We previously demonstrated that short-term negative outcomes (depression and anxiety) among older adults following open heart surgery are partially alleviated when patients employ prayer as part of their coping strategy. The present study examines multifaceted effects of religious factors on long-term postoperative adjustment, extending our previous findings concerning prayer and coping with cardiac disease. DESIGN AND METHODS: analyses capitalized on a preoperative survey and medical variables from the Society of Thoracic Surgeons' National Database of patients undergoing open heart surgery. The current participants completed a mailed survey 30 months after surgery. Two hierarchical regressions were performed to evaluate the extent to which religious factors predicted depression and anxiety, after controlling for key demographics, medical indices, and mental health. RESULTS: predicting lower levels of depression at the follow-up were preoperative use of prayer for coping, optimism, and hope. Predicting lower levels of anxiety at the follow-up were subjective religiousness, marital status, and hope. Predicting poorer adjustment were reverence in religious contexts, preoperative mental health symptoms, and medical comorbidity. Including optimism and hope in the model did not eliminate effects of religious factors. Several other religious factors had no long-term influences. MPLICATIONS: the influence of religious factors on the long-term postoperative adjustment is independent and complex, with mediating factors yet to be determined. Future research should investigate mechanisms underlying religion-health relations.

The life course of psychological resilience: A phenomenological perspective on deflecting life's slings and arrows.

Notably lacking in the promising new literature on psychological resilience are longitudinal studies of adults who have not only survived extreme early life stresses, but have actually thrived in the face of them. The present study compared 31 resilient adults who were middle-aged, upper-middle class and well educated with 19 controls from comparable life circumstances who had not been exposed to severe early adversity. The experimental group reported exceedingly high scores for early life stress, with emotional abuse by parents being the most pervasive compliant. They felt and showed extreme signs of emotional oppression as children, but normal (or even superior) intellectual development. The majority sought and received substantial support outside the family, including religious counseling and formal psychotherapy, but healing was tediously slow and probably not entirely complete. Most attributed their success to relentless effort and self-reliance, but the groups did not differ significantly on psychological measures of internal locus of control. "Transcenders" appeared remarkably normal as adults, showing significant improvement in interpersonal relations. Their self-descriptions of exceptional fortitude may have been slightly exaggerated but probably contributed to their growing self-esteem. There was only limited support for the hypothesis that resilient people become scrupulously appropriate in their own parenting attitudes and behavior. Their enthusiasm to promote disclosure about their stressful early lives, and about the possibilities for successful outcome seemed to fulfill altruistic needs to counter the popular myth that extreme adversity in early life inexorably leads to adult patholog, and also provided some validation for themselvesas people.

Rapid diagnosis of respiratory viral infections by using a shell vial assay and monoclonal antibody pool.

We compared the detection of seven respiratory viruses by using a commercially available monoclonal antibody pool in a 2-day shell vial assay with that by using standard cell culture with respiratory syncytial virus (RSV) enzyme-linked immunosorbent assay (ELISA)-negative nasal secretions from hospitalized children. We found 179 respiratory virus isolates by either method in 675 specimens. Overall, the shell vial assay detected 147 of 179 (79%) of the positives after 2 days; cell culture detected 148 of 179 (80%) after a mean incubation period of 7.6 days (range, 1 to 14 days). The sensitivity of the shell vial assay was 78% for RSV, 94% for influenza B virus, 83% for adenovirus, and 80% for parainfluenza viruses. The sensitivity of the cell culture was 70% for RSV, 79% for influenza B virus, 90% for adenovirus, and 89% for parainfluenza viruses. The 2-day shell vial assay allowed the detection of respiratory viruses in a clinically relevant time frame and rapidly detected RSV in specimens lacking RSV antigen by ELISA.