Objective Based on social ecological theory, this study was designed to examine the unique relationships between multi-level ecological factors and psychological symptoms in young adults with spina bifida (SB). Method A sample of 61 individuals with SB, 18–25 years of age, completed standardized self-report measures of attitude toward SB, satisfaction with family functioning, Chronic Care Model (CCM) services, and depressive and anxiety symptoms. A chart review yielded SB clinical data. Results High rates of depressive and anxiety symptoms were found. Hierarchical regression analysis identified the proximal individual (attitude toward SB) and family (satisfaction with family functioning) factors as more strongly related to depressive symptoms than the distal healthcare system factor (CCM services). Self-reported pain was the only ecological factor associated with anxiety symptoms. Conclusions Study findings provide a potential foundation for multi-factor screening of young adults with SB at risk for psychological symptoms.
In three generations of the proband's patrilineal relatives, 14 subjects were found to be carriers of a “shift” insertional chromosome No. 1 (46, XX or XY, ins(1)(p32q25q31)). The proband and three female relatives, who were mild to moderate mental retardates with minor congenital anomalies, were trisomic for the insertional segment, (1)q25q31. Another subject, who was a markedly immature female abortus with congenital abnormalities, was found to be monosomic for this same chromosomal segment. The cytogenetic evidence suggests that each of these unbalanced recombinant progeny was the result of a single crossing over in the noninsertional loop of a paternal pachytene bivalent of the balanced insertional chromosome No. 1.
At the State University of New York's (SUNY) Upstate Medical University's Center for Development, Behavior and Genetics (CDBG), Wednesday is Spina Bifida Clinic day. On any given Wednesday, six to 10 children with spina bifida and their families/caregivers come to Spina Bifida Clinic (the Clinic), where they are greeted, registered and weighed, a health history is taken, and any concerns the patient or family/caregiver have are listed. Then, a parade of providers enters and exits the patient room, bringing expertise and assessment skills. A multi-disciplinary report is produced a day or two after the visit and distributed to the family and to the primary care physician. The patient may also travel for various tests to other clinics at SUNY Upstate Medical University and other sites. Professionals who are typically involved with the care of a child with spina bifida include social workers, nurse specialists, physical therapists, occupational therapists, orthotists, developmental pediatricians, and surgeons in urology, orthopedics and neurosurgery.
IT HAS been demonstrated that hypothalamic-adenohypophyseal regulatory mechanisms maintain the production and release of thyroid hormone within euthyroid limits (1, 2). Previous observations from this laboratory have indicated that without exogenous thyroid or iodide intake the protein-bound iodine in healthy adults remains relatively constant (3). Granting adequate analytic precision, such constancy is compatible with, but does not necessarily support, the existence of a “feed-back” mechanism activated by changes in the plasma level of thyroid products. Introduction of exogenous thyroid products into such a system should provide evidence, however, concerning the presence and the efficiency of such adaptive responses. This report describes the effects of thyroid feeding on serum protein-bound iodine levels and other pertinent indices in euthyroid adult males. PROCEDURES Desiccated thyroid of the same lot number1 was administered in amounts ranging between 1 and 6 grains per day to 9 presumably healthy adu...
