A classroom mind/body wellness intervention for older adults with chronic illness: comparing immediate and 1-year benefits.

The authors tested the efficacy of a mind/body wellness intervention for older adults with chronic illness. They randomly assigned 243 physician-referred patients from an urban HMO to a classroom intervention or a wait-list control group. The intervention provided instruction on mind/body relationships; relaxation training; cognitive restructuring; problem-solving; communication; and behavioral treatment for insomnia, nutrition, and exercise. At posttreatment, the intervention group had significant decreases in self-reported sleep difficulties, pain, anxiety, and depression symptoms compared with controls. The intervention also led to a significant decrease in "chance" and "powerful others" health locus of control beliefs. At 1-year follow-up, the intervention group maintained benefits in sleep and health locus of control and also reported a significant increase in health behaviors compared with controls. Pain, anxiety, and depression benefits were not maintained. This type of classroom intervention appears to have some lasting effects on health behaviors and beliefs.

Personal and professional factors and suicide intervention skills.

This research investigated the relationship of professional and personal factors to the ability of counselors to respond appropriately to suicidal verbalizations using the Suicide Intervention Response Inventory (SIRI). Level of training, experience with suicidal clients, and death acceptance were positively related to suicide intervention competencies. A personal history of suicidality and a belief that suicide is a personal right were negatively related to such skills. Regression analysis revealed that personal history of suicidality and attitude toward suicide as a personal right accounted for a modest, but significant, percentage of the variance in SIRI scores, beyond that accounted for by professional factors. Post hoc analysis indicated that the negative relationship between personal history of suicidal behaviors and suicide counseling skills was significant in the professionally trained participants. These results highlight the importance of attitudes toward suicide and personal history of suicidality, as well as training and experience, in effectively counseling potentially suicidal clients.

Death anxiety in older adults: a quantitative review.

This literature review quantitatively summarized 49 published and unpublished research studies concerning the relationship between death anxiety and age, ego integrity, gender, institutionalization, physical and psychological problems, and religiosity in older adults. Results indicated that lower ego integrity, more physical problems, and more psychological problems are predictive of higher levels of death anxiety in elderly people. A suggestive but equivocal relationship was found for the predictor institutionalization. Furthermore, the review statistically demonstrated the importance of using sound methods for measuring death anxiety and sampling from the elderly population.

The effect of ascorbic acid on cutaneous and nasal response to histamine and allergen.

The effect of ascorbic acid (AA) on the skin wheal and flare response to histamine and allergen and on the nasal response to allergen was evaluated in eight adults with seasonal allergic rhinitis. The above parameters were measured after 3 days of AA administration (2 gm/day) and again after 3 days of a similar-appearing lactose placebo. An additional study was conducted in which six subjects took 0 (placebo), 1, 2, and 4 gm/day of AA to determine the dose-response effect of AA on histamine skin tests. Overall there was no difference in skin or nasal reactivity between AA and placebo regimens. The findings in this study suggest that AA in relatively high doses would have no beneficial effects on symptoms resulting from allergen exposure and that AA in doses of up to 4 gm/day will not suppress the histamine skin response.

The effects of weekly versus monthly ragweed allergen injections on immunological parameters.

The practice of administering injections of allergen extract at weekly intervals until maintenance levels are achieved is well established. However, no objective data exist to determine the optimal frequency of immunotherapy during the first few years after reaching maintenance therapy. Nine patients who had reached maintenance immunotherapy within the preceding year participated in a double-blind, crossover study to compare the effects of weekly versus monthly injections of ragweed antigen. The results were assessed by measurements of skin, nasal and conjunctival sensitivity to ragweed and serum levels of IgG and IgE antibodies specific for ragweed--all obtained at monthly intervals. There was a significant increase (P less than .05) in serum ragweed IgG levels when the subjects were receiving weekly injections as compared to monthly injections. There was also a definite trend toward decreased skin and conjunctival sensitivity to ragweed while receiving weekly injections. These data lend immunologic support to the practice of administering weekly injections during the pollen season in the first few years of allergy immunotherapy.