Prevention of immunization to D+ red blood cells with red blood cell exchange and intravenous Rh immune globulin.

BACKGROUND: Although young women who are D- occasionally receive unintentional transfusions with D+ red blood cells (RBCs), there are little data to assist with management of such an event. Two cases of D- girls transfused with D+ RBCs are reported. In an effort to prevent formation of anti-D, RBC exchange followed by administration of intravenous (IV) Rh immune globulin (RhIg) was used. CASE REPORTS: Patient 1, a 56-kg, 16-year-old D- girl, was involved in a motor vehicle crash. She received 4 units of Group O uncrossmatched D+ RBCs. Thirty-six hours after admission, she underwent RBC exchange with 10 units of D- RBCs, followed by a total of 2718 microg of IV RhIg over 32 hours. Six months later, her antibody screen was negative. Patient 2, a 39-kg, 10-year-old D- girl with aplastic anemia, received 1 unit of D+ RBCs. She underwent RBC exchange on the same day with 5 units of D- RBCs, followed by a total of 900 microg of IV RhIg over 8 hours. Six months later her antibody screen was negative. CONCLUSION: RBC exchange followed by a calculated dose of IV RhIg was successful in preventing allo-immunization to D. Several small studies suggest that both trauma and hematology patients may be less capable of becoming immunized with the transfusion of D+ blood components. Until these findings are more clearly defined, there will be times when prevention of immunization of any D- girl is desired. RBC exchange followed by RhIg appears to be one way to achieve this goal.

Measurement of physical activity, exercise, and physical fitness in children: issues and concerns.

Data to support the type and level of physical activity that are necessary for health benefits in children and for later prevention of disease as adults are not available. This lack of information may be caused by inconsistency in terminology and by issues and concerns with available instruments to measure the concept. The purpose of this article is to address measurement issues related to physical activity/exercise or physical fitness in children. Implications of these issues for researchers and practitioners are discussed.

Rage and women's sexuality after childhood sexual abuse: a phenomenological study.

TOPIC: One common long-term effect of childhood sexual abuse is rage. This phenomenological study deals with such rage as it is expressed through women's sexuality. METHODS: A guided interview method (N = 7). The constant comparative method was used for data analysis. FINDINGS: Results provide information about ways rage and maladaptive behaviors are learned in childhood and carry over into adult relationships. CONCLUSIONS: Healthcare professionals need to be sensitive to the sometimes devastating effects of sexual abuse on women in our society. There is a need to create treatment programs that empower survivors to avoid revictimization.

Anger and blood pressure readings in children.

This study investigated the relationship of state and trait anger measured by the Jacob's Pediatric Anger Scale, patterns of anger expression measured by Jacob's Pediatric Anger Expression Scale, and blood pressure readings (BPR) in 230 third-grade children. Analysis of data revealed significant inverse relationships between anger suppression and diastolic BPR and anger reflection and control and both diastolic and systolic BPR. As anger suppression increased, diastolic BPR decreased. As anger reflection and control increased, both systolic and diastolic BPR decreased. When gender was considered, the relationship between anger reflection and control and systolic BPR was apparent only for girls, whereas the relationship between anger reflection and control and diastolic BPR was apparent only for boys. When correlations were computed based on gender and race, a significant inverse relationship between anger reflection and control and systolic BPR in Black girls was found. The results suggest that the influence of race and gender on the relationships between anger expression and systolic and diastolic BPR, which has been documented in adults, may be present in childhood.

Clients with schizophrenia and their caregivers' perceptions of frequent psychiatric rehospitalizations.

The purpose of this phenomenological study was to achieve an understanding of the lived experience of the event of rehospitalization as seen by the schizophrenic patient and his or her designated caregiver. Five schizophrenic clients who met criteria and their designated caregivers were located using purposeful intensity sampling. A standardized open-ended interview was conducted with each informant using a dialogical approach. After redundancy was reached, data were analyzed using the constant comparative method. Five themes reflecting the meaning of recidivism evolved from the data. These included rehospitalization as an event that: provided a safe place, provided stabilization of medication, produced a renewal of hope, reinforced frustration with the mental health care system, and produced decreased individual control. Findings can be used to develop a more comprehensive model of care for intervention with patients and caregivers.

Autism: psychobiological perspectives.

The purpose of this article is to discuss the syndrome of autism and review current research findings related to this disorder. Emphasis is placed on autism as a disorder of brain function. In this context, theory and treatment approaches, including new pharmacological interventions, are explored. Implications for nursing practice also are discussed.

The relative influence of identified components of test anxiety in baccalaureate nursing students.

The relative influence on test anxiety of cognitive interference, self-concept, study and test-taking skills, and cumulative grade point average was investigated. Fifty-six female baccalaureate nursing students completed the following measures: Sarason's Test Anxiety Scale, Brown's Effective Study Test, Sarason's Cognitive Interference Questionnaire, and Brookover's Self-Concept of Ability Scale. Subjects also reported their cumulative grade point average (GPA). Data were analyzed through the use of correlation and stepwise multiple regression. Data analyses revealed significant negative relationships between test anxiety and the variables of academic self-concept and GPA (p less than .05). Academic self-concept was the most powerful predictor of test anxiety, while GPA and cognitive interference contributed significantly but minimally to the multiple regression equation. Results support Meichenbaum and Butler's (1980) contention regarding the multidimensional nature of the test anxiety construct.