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Purpose: This article reviews the relevant literature on treatment-induced alopecia in women with cancer and describes the development of a computer-assisted intervention to reduce distress associated with this side effect. Description of program: Alopecia has been cited as the most disturbing anticipated side effect by up to 58% of women preparing for chemotherapy, with 8% being at risk for avoiding treatment. Women with cancer who experience alopecia as a side effect, compared with women with cancer and no alopecia, report lower self-esteem, poorer body image, and lower quality of life. Although physicians' recommendations are the most influential factor on cancer treatment choice, body image and effects on sexuality are the next most influential factors. A study of a computer-imaging intervention, based on concepts related to guided imagery and anticipatory grief, has been launched in an effort to aid women in coping with anticipated treatment-related alopecia. Results: While we are still waiting for final data collection and analysis from the computer intervention study, the feedback thus far has been positive. Clinical implications: The intervention described here may prove to be effective in desensitizing women with cancer to hair loss and facilitating an adjustment to self-acceptance. As such, a higher quality of life during the difficult time of coping may be maintained. The development of a computer-imaging intervention offers an opportunity to integrate a standard psychosocial intervention, personalized for each patient, into the routine patient care in the oncology setting.

Studies of extensive, full-time child care in infancy and early childhood have shown negative, positive and no effects on children's social-emotional development. The current study explored the prediction of children's behavioral adjustment 4 years after assessments of daycare center quality (e.g. caregiver-child interactions, caregiver-to-child ratios) and of the home and family environment (e.g. parental stress, discipline). Participants included 141 school-age children (73 girls) and their employed mothers (91% Euro-American) who had made use of full-time child care when the children were toddlers or preschoolers. Home environment factors and earlier behaviors were predictive of individual differences in adjustment 4 years later, particularly for maternal ratings of child behaviors. By contrast, indicators of center quality were generally unrelated to mother and teacher ratings of behavioral adjustment.