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Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.

This case describes a 29-year-old woman who presented with an acute severe anaphylactic reaction to penicillin. In addition to other medications administered in the emergency department, she received 0.1 mg intravenously of 1:10 000 epinephrine, after which she immediately developed severe chest pain. Her ECG showed ST elevations consistent with an anterior myocardial infarction, and her serum troponin level was elevated. A CT angiogram showed no signs of coronary artery disease or abnormal anatomy. This case is an example of vasospasm-induced myocardial injury and illustrates a potential danger of intravenous epinephrine use. The authors were able to identify only 2 other case reports where therapeutic doses of epinephrine have been reported to cause this phenomenon. [ABSTRACT FROM AUTHOR]

People with global aphasia are known to have difficulty comprehending or using external symbols, such as line drawings of single objects, during conversations. It was hypothesized that remnants, actual objects, or photographs of events or items of personal significance, may be a more useful means of representing conversational topics for individuals with global aphasia than generic pictographic symbols. In this study, changes in the communication behaviors of two adults with global aphasia across the three conversational conditions of baseline (no symbols), pictographic topic symbols, and remnants were measured. Results indicated that participants with aphasia initiated more topics and had fewer unrepaired communication breakdowns in both of the symbol conditions than when no symbols were available. Participants engaged in more pointing behavior with remnants than with pictographic symbols, and communication partners' subjective evaluations also favored remnants over pictographs. As expected, some variability was observed between and within participants. Remnant books were still in use at the rehabilitation facility for patients with global and severe aphasia three years after termination of the study. [ABSTRACT FROM AUTHOR]

BACKGROUND Little is known about the relationship of mothers' psychological distress to the emotions they express toward their children. OBJECTIVE The purpose of this study was to determine the degree to which mothers' mental health status, perceived stress, and satisfaction with family relationships contribute to their expressed emotion with high-risk children. STUDY DESIGN A cross-sectional, correlational design was employed involving analysis of expressed emotion in videotaped mother-child interactions, self-report measures of stress and family satisfaction, and assessments of mothers' mental health status. RESULTS A mother's family satisfaction was significantly related to less criticism and more positive comments about the child. Perceived stress was associated with mother's emotional overinvolvement and less hostility. Mother's mental health was not a significant predictor of her expressed emotion. CONCLUSIONS Interventions to enhance a mother's family interactions and her ability to cope with stress may improve the quality of a mother's affective communication with her high-risk child. [ABSTRACT FROM AUTHOR]

Temperament profiles of pre-term, low birth weight (LBW) infants were assessed at 6 months of age using standardized norms from the Revised Infant Temperament Questionnaire (RITQ). The contributions of perinatal risk, ethnicity, and gender to various temperament dimensions were examined. The sample included 152 infants with a mean birth weight of 1687 g and a mean gestational age of 31 weeks. Eighty percent of the infants were classified as having temperaments that were difficult to manage. Irregularity of the infants' biorhythms, slowness in their ability to adapt to changes, and distractibility were the most problematic. Birth weight, gestational age, and gender were not associated with temperament. Perinatal morbidity was related to the temperament dimension of infant persistence, with implications for the infant's attention span and task performance. Euro American infants were rated as more persistent and less intense in emotional expression than were infants of other ethnic groups. Results suggest the need for a more direct assessment of the effects of neurobiological processes on development of temperament phenotypes and for measurement of temperament that is socioculturally appropriate. [ABSTRACT FROM AUTHOR]

BACKGROUND: The incidence of acute cases of intimate partner violence (IPV) in the Emergency Department (ED) patients is between 2 and 7.2%. Ongoing IPV may be an immediate cause of presentation for medical care, or it may not be readily apparent. Over the last two decades efforts to improve identification of IPV in the ED have been successful. METHODS: A medline literature search from 1981-2001 was performed. A review of intimate partner violence from the emergency department provider perspective is performed. A discussion of the screening/detection of intimate partner violence and the barriers to improving detection rates is provided. RESULTS: The review of the current literature shows that IPV is a frequent cause of illness or injury in patients presenting in the ED. Screening programs for intimate partner violence have shown to increase the identification of patients experiencing acute episodes of abuse and seeking treatment. The difficulty has been in sustaining the programs and improving the screening of patients. Patient, provider and systems barriers prevent adequate recognition and management of the problem. CONCLUSION: Detection of IPV in patients presenting to the ED can be improved by providing educational programs and screening tools to health care providers. Sustaining the screening programs is more difficult and requires a health care system-wide effort. [ABSTRACT FROM AUTHOR]

Alternative practitoners are using their hands more to steer patients toward better health. Methods range from the relatively familiar--like chiropractic--to the more obscure--such as Reiki and SHEN therapy. Are they useful? [ABSTRACT FROM AUTHOR]

Objective: Wider use of written advance directives may prevent many ethical dilemmas about life-sustaining interventions for patients who have lost decision-making capacity. We investigated whether a simple educational intervention increased patient completion of the durable power of attorney for health care.Design: A randomized, controlled trial.Setting: A health maintenance organization.Subjects: All patients aged 65 years and older and discharged from a hospital between January 1991 and May 1991 (n = 1101) were randomized to either an intervention group or a control group.Intervention: An educational pamphlet on the durable power of attorney for health care and a durable power of attorney for health care form were mailed to all patients in the intervention group. The control group received conventional care only.Main Outcome Measure: Completion of the durable power of attorney for health care form.Results: There were no significant baseline differences between the intervention group and the control group. Following our intervention, 18.5% of the subjects in the experimental group completed a durable power of attorney for health care form, compared with 0.4% of the control group (P < .0001).Conclusions: A simple educational intervention significantly increased the completion of the durable power of attorney for health care. Our findings should stimulate further efforts to empower patients to make informed decisions about their health care. [ABSTRACT FROM AUTHOR]