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Biomedical subjects

G A Walco

Publications and source records attributed to G A Walco.

At least 19 recordsLinked to original sources
PubMed1999

Empirically supported treatments in pediatric psychology: disease-related pain.

OBJECTIVE: To evaluate psychological literature addressing interventions for disease-related pain in children. METHODS: We conducted a literature review of all studies using psychological interventions for pain stemming directly from disease process as well as pain secondary to disease treatment. RESULTS: Few empirically validated psychological approaches to the treatment of disease pain were found. Although existing intervention studies do not meet Chambless criteria, some promising strategies were identified. CONCLUSIONS: Clinical evidence suggests that cognitive-behavioral strategies for the management of disease pain in children are promising and manualized, controlled intervention studies are needed.

Child↗
PubMed1998

Cognitive and academic late effects among children previously treated for acute lymphocytic leukemia receiving chemotherapy as CNS prophylaxis.

OBJECTIVE: Examine cognitive and academic late effects among children and adolescents who had received central nervous system (CNS) prophylactic chemotherapy alone for acute lymphocytic leukemia (ALL); none had received whole brain radiation therapy (RT). METHOD: Subjects included 47 children and adolescents from 5 to 22 years of age who were treated on the same protocol and had been off treatment from 2 to 7 years at the time of assessment. RESULTS: As a group the survivors displayed generally average performance on measures of cognitive and academic abilities, although they differed from normative means on tests of nonverbal skills. Girls performed more poorly than the normative sample on nonverbal tasks, while no differences were found for boys. Age at diagnosis and time off treatment were not significantly associated with cognitive and academic functioning for survivors of this particular chemotherapy-only protocol. CONCLUSIONS: Data were interpreted to support generally modest potential late effects in specific areas for children and adolescents surviving ALL. These findings suggest a need for monitoring nonverbal cognitive skills for childhood survivors of ALL, particularly for girls.

Achievement↗
PubMed1997

Growing pains.

Explore the source record for details and available documents.

Adolescent↗
PubMed1992

Therapeutic adherence to oral medication regimens by adolescents with cancer. II. Clinical and psychologic correlates.

The focus of our study was to identify specific demographic, treatment, and psychologic factors that may differentiate patients who complied with cancer therapy from those who did not. In a companion study, bioassay techniques revealed frequent nonadherence to oral medication regimens among 50 adolescents and young adults with acute lymphoblastic leukemia or Hodgkin disease. In this sample, compliers and noncompliers did not differ with respect to either demographic variables (age, gender) or treatment variables (treatment duration, continuity, complexity, or parental involvement). Psychologic variables were assessed in 34 patients. Patients who adhered poorly to the therapeutic regimen had significantly less developed concepts of the illness (specifically, concepts of causality and prognosis), less perceived vulnerability (especially as related to subclinical disease), higher levels of denial as a psychologic defense, and less cohesive future orientation. The perceived health locus of control was not a significant factor. The results suggest that patients construct their own subjective view of the illness and its treatment, which then has implications for adherence to medication regimens.

Administration, Oral↗
PubMed1992

Assessment of pain in patients with juvenile rheumatoid arthritis: relation between pain intensity and degree of joint inflammation.

The relation between pain and joint inflammation in patients with juvenile rheumatoid arthritis has not previously been systematically evaluated. Eighteen patients with juvenile rheumatoid arthritis completed paediatric pain questionnaires and the joints affected were examined by thermography. Although significant correlations were shown between parent and doctor pain intensity ratings and joint temperature, correlations of patient pain intensity ratings and joint temperature were only significant in younger children. The degree of joint inflammation is only one factor of several contributing to the amount of subjective pain experienced by children with juvenile rheumatoid arthritis, indicating the need for a comprehensive assessment of the relatively independent variables of inflammation and pain in children with juvenile rheumatoid arthritis.

Adolescent↗
PubMed1992

Cognitive-behavioral intervention for juvenile primary fibromyalgia syndrome.

Seven girls between 8.6 and 17.7 years of age were treated for symptoms of juvenile primary fibromyalgia syndrome (JPFS) using cognitive-behavioral techniques (progressive muscle relaxation, guided imagery) aimed at reducing pain and facilitating sleep, as well as strategies aimed at increasing mastery over the pain and improving mood. Patients satisfying diagnostic criteria for JPFS based on the presence of chronic diffuse musculoskeletal pain lasting at least 3 months (mean = 9.4, SD = 8.28) and a minimum of 5 characteristic soft tissue trigger and/or tender points with absence of synovitis, were referred for intervention. Results indicated that in the majority of patients, such techniques were effective in reducing pain and facilitating improved functioning.

Adolescent↗
PubMed1992

Cognitive-behavioral pain management in children with juvenile rheumatoid arthritis.

Decreasing chronic joint pain is a major goal in the management of juvenile rheumatoid arthritis. Cognitive-behavioral self-regulatory techniques were taught to children with juvenile rheumatoid arthritis to reduce musculoskeletal pain intensity and to facilitate better adaptive functioning. Subjects were 13 children between the ages of 4.5 and 16.9 years who had pauciarticular or systemic onset juvenile rheumatoid arthritis. Baseline data included an initial comprehensive assessment of pain, disease activity, and level of functional disability, as well as pain intensity ratings gathered over a 4-week period. Subjects were seen for eight individual sessions in which self-regulatory techniques (progressive muscle relaxation, guided imagery, meditative breathing) were taught, and parents were seen for two sessions in which key aspects of behavioral pain management techniques were reviewed. Results indicated that these techniques led to substantial reduction of pain intensity, which generalized to outside the clinic setting. Six- and 12-month follow-up data showed consistent decreases in pain as well as improved adaptive functioning. The data suggest that cognitive-behavioral interventions for pain are an effective adjunct to standard pharmacologic interventions for pain in patients with juvenile rheumatoid arthritis.

Adolescent↗
PubMed1990

Pain in children and adolescents with sickle cell disease: a descriptive study.

In sickle cell disease, vaso-occlusion in the small blood vessels leads to bone or joint pain which is variable in intensity and duration. An essential first step toward the development of specific treatment guidelines for such painful episodes in children and adolescents is the accurate evaluation of pain. The systematic assessment of vaso-occlusive pain is addressed through two separate studies. In the first, 35 pediatric sickle cell disease patients between 5 and 16 years of age were evaluated in an outpatient clinic with the Varni/Thompson Pediatric Pain Questionnaire. In the second, data were gathered over the course of hospitalizations for uncomplicated vaso-occlusive episodes in 17 adolescent patients. Results showed that this pain experience can be quantified, that vaso-occlusive pain spans a broad range of intensity levels, and that there are a number of socioemotional factors associated with the pain experience. Further research to systematically assess the psychometric properties of pain assessment instrument is recommended.

Adolescent↗
PubMed1990

Otitis media in children with learning disabilities and in children with attention deficit disorder with hyperactivity.

A retrospective study was conducted to compare history of middle ear disease children with an attention deficit disorder with hyperactivity (ADD-H) and children with a learning disability. Of 138 children evaluated in a child development clinic, learning disability without ADD-H was diagnosed in 45 (29 boys, 16 girls; mean age = 9.5 years) and ADD-H without learning disability was diagnosed in 21 (17 boys, 4 girls; mean age = 8.5 years). Based on parental report, children with ADD-H had significantly more complaints of earaches during the preceding 3 months and significantly more ear infections during the preceding year. Specifically, no between-group differences were observed for total number of ear infections since birth, extended antibiotic therapy, tympanostomy tube placement, or recent hearing problems. Although middle ear disease in preschool children has repeatedly been linked to later language deficits, this study suggests that middle ear disease in school-age children may also be associated with hyperactivity and/or inattention, independently of learning disability.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Pain associated with juvenile rheumatoid arthritis.

Despite a comprehensive approach to the treatment of JRA patients, pain remains a largely underdeveloped area of research and an undertreated clinical problem. Pain is a highly prevalent condition in JRA patients, one that in adults has been shown to be highly predictive of current medication usage and future disability. This recurrent or chronic pain syndrome is currently treated primarily with nonsteroidal anti-inflammatory drugs, but inclusion of pain management specialists on the interdisciplinary team will allow for greater use of nonpharmacologic means of pain management.

Adolescent↗
PubMed1989

Assessment and management of chronic and recurrent pain in children with chronic diseases.

This paper provides an overview to the assessment and management of chronic and recurrent pain in children with chronic diseases. Relevant clinical research studies are cited, and practical guidelines are provided for the differential assessment and management issues inherent in the comprehensive care of chronic and recurrent pain in children and adolescents with hemophilia, juvenile rheumatoid arthritis, sickle cell disease, and cancer.

Child↗