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Biomedical subjects

L L Mullins

Publications and source records attributed to L L Mullins.

14 recordsLinked to original sources
PubMed1997

Transactional patterns of child, mother, and father adjustment in insulin-dependent diabetes mellitus: a prospective study.

Utilized both interview and self-report methods to examine transactional patterns of child, mother, and father adjustment in a sample of children and adolescents with insulin-dependent diabetes mellitus (IDDM). Overall, levels of child and parental adjustment were relatively stable over the 1-year study period. Regression analyses revealed that increases in fathers', but not mothers', distress over time contributed significant incremental variance to poorer subsequent children's adjustment, after controlling for demographic (age, gender, and SES) and disease parameters (illness duration and metabolic control). Decline in fathers' adjustment was a significant predictor of better mothers' adjustment at follow-up; child adjustment was not significantly associated with mothers' adjustment. Variations in both children's and mothers' adjustment made significant, independent contributions to predicting subsequent fathers' adjustment. Findings illustrate the transactional nature of relationships that exist in families of children with IDDM and underscore the importance of family systems or biobehavioral family treatment approaches in the clinical management of children with chronic illnesses.

Adaptation, Psychological↗
PubMed1996

Results of a clinical trial of the holmium:YAG laser in disc decompression utilizing a side-firing fiber: a two-year follow-up.

BACKGROUND AND OBJECTIVE: Laser-assisted disc decompression (LADD) is an operative technique for the treatment of symptomatic, nonsequestered herniated nucleus pulposus that has failed to respond to conservative treatment. The current study reports 2-year follow-up data. STUDY DESIGN MATERIALS AND METHODS: Patients were evaluated by an independent interviewer postoperatively, and at 1 week, 3 months, 6 months, 1 year, and 2 years. Ratings were based upon the modified Macnab criteria. All patients evidenced primarily leg pain with or without back pain that had failed a minimum of 6 weeks of conservative treatment. Patients with lateral recess or central stenosis, sequestered discs, or predominantly scar tissue from a previous discectomy were not considered candidates for LADD. RESULTS: Utilizing postoperative follow-up at 2 years, a surgical success rate of 86.9% was achieved. For patients requiring an additional LADD procedure, results at 6-month follow-up yielded a surgical success rate of 80%. CONCLUSION: LADD appears to be a viable treatment modality for symptomatic, nonsequestered lumbar disc herniation recalcitrant to conservative treatment. LADD may represent a more cost-effective and safer alternative to traditional surgical procedures.

Activities of Daily Living↗
PubMed1996

Laser assisted disc decompression: an alternative treatment modality in the Medicare population.

The current study evaluated the efficacy of LADD within the Medicare population, and examined the influence of coexisting medical conditions and previous surgical intervention on surgical outcome. Patients who met inclusion criteria underwent laser-assisted disc decompression (LADD) using the Holmium: YAG Laser with Sidefire laser fiber. All patients evidenced primarily leg pain, with or without back pain, which had failed a minimum of six weeks conservative treatment. Post-operative follow-up at one year yielded a surgical success rate of 80%. Surgical outcome was not related to coexisting medical conditions or previous surgical intervention on the lumbar spine. Findings of the current study suggest that LADD offers a viable alternative treatment modality for lumbar disc disease within the Medicare population.

Aged↗
PubMed1995

Child and maternal adaptation to cystic fibrosis and insulin-dependent diabetes mellitus: differential patterns across disease states.

Investigated the relationship between maternal and child emotional adaptation both across and within samples of children with cystic fibrosis (CF) and insulin-dependent diabetes mellitus (IDDM). Higher levels of maternal depression were associated with increased depression in children with IDDM. In addition, increased illness severity and greater length of time since diagnosis were related to increased depression in children with IDDM. Whereas maternal depression was related to decreased trait anxiety for children in the CF group, neither maternal anxiety or depression were associated with child depression or state anxiety. Empirical and clinical implications of a disease-specific approach to studying chronic disease in children are discussed.

Adaptation, Psychological↗
PubMed1994

Survey of pediatricians' management practices for recurrent abdominal pain.

Surveyed general pediatricians (N = 116) regarding six content areas: (a) diagnostic procedures utilized during the initial evaluation sequence of a child with recurrent abdominal pain (RAP); (b) factors that influence decisions to order additional evaluations; (c) management practices following negative evaluation results; (d) factors influencing decisions about consultation with or referral to a mental health professional; (e) attitudes about the etiology of RAP; and (f) the frequency in which pediatricians encountered children with RAP and referred them to mental health services. Results of this survey are presented and discussed from a biopsychosocial perspective. Limitations of the survey, implications of the results for integrating mental health professionals into the evaluation and treatment process of RAP patients, and directions for future research are discussed.

Abdominal Pain↗
PubMed1992

Changing medical students' attitudes about AIDS.

Medical students may have negative attitudes about persons with the acquired immunodeficiency syndrome (AIDS) as well as concerns about occupational infection with human immunodeficiency virus. We conducted a brief intervention to assess and modify attitudes of first-year students. The intervention was presented to small groups of students by peers, faculty, and a person with AIDS. Assessments of attitudes and knowledge were conducted one week prior to the intervention (pretest), and one (posttest 1) and 47 weeks (posttest 2) afterwards. Females had more positive attitudes about AIDS on pretest and posttest 1. Attitude scores improved significantly from pretest to posttest 1 but returned close to baseline by posttest 2. Knowledge scores were high on pretest and did not change significantly. Attitude scores were significantly correlated with knowledge, and with students' opinions regarding obligation to care for AIDS patients. Acquaintance with a homosexual was highly correlated with both scores. This intervention may serve as a model in improving students' attitudes about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Risk and resistance factors in the adaptation of mothers of children with cystic fibrosis.

Examined 35 mothers of children with cystic fibrosis (CF) to assess the relationship of risk and resistance factors to level of psychological adjustment. Dimensions of maternal adaptation, disease severity, family adaptability and cohesion, family life stress, and intrapersonal coping style were assessed. As a group, mothers evidenced significant levels of general psychological distress, and appear to constitute an at-risk population. Multiple regression analyses indicated higher levels of maternal distress were associated with increased levels of stressful family life events and an escape-avoidance coping style. Disease severity, family financial resources, and family adaptability and cohesion did not significantly contribute to the regression model.

Adaptation, Psychological↗
PubMed1991

Developing a program to assist Turner's syndrome patients and families.

Turner's Syndrome [TS] is a chromosomal disorder that affects one in 2500 women. It results in an array of physical difficulties, including short stature, lack of secondary sexual development and cognitive problems. Little research exists to document the psychosocial problems and needs of individuals with TS and their families. The current literature and the results of a regionally based needs assessment are reviewed to guide program development, with emphasis on the emotional and informational needs of these families. Suggestions are provided for strategic early communication and information sharing, development of skill-specific support groups, family networks and family therapy.

Aftercare↗
PubMed1989

Hate revisited: power, envy, and greed in the rehabilitation setting.

Hate has been recognized as an important psychological element in the rehabilitation setting. Hate emanates from a variety of sources, including the patient, his family, and staff; it can also stem from various systems influences and is perpetuated by power, envy, and greed. This article examines several systems factors that contribute to hate and conflict in the rehabilitation setting. It is argued that the growth and rapid expansion of rehabilitative services, the incorporation of rehabilitation enterprises along with new career opportunities, and quests for power potentially contribute to the enhancement of hate. Ultimately, this hate can interfere with the quality of care and outcomes in rehabilitation if it is not recognized and addressed.

Career Choice↗
PubMed1985

Cognitive problem-solving and life event correlates of depressive symptoms in children.

This study examined the relationship between a number of cognitive problem-solving and life event variables and depressive symptoms in a sample of non-referred grade school children. The results indicated that higher levels of depressive symptoms were associated with an external locus of control, increased levels of objective and subjective life stress, and lower performance levels on an impersonal problem-solving task. Level of depressive symptoms was also found to be inversely related to socioeconomic status as measured by father's occupation. Contrary to prediction, no consistent relationship was found between depression and interpersonal problem-solving ability.

Child↗
PubMed1985

Childhood depression: peer reactions to depression and life stress.

The present study investigated children's responses to a peer's childhood depression. Younger children in third and fourth grade and older children in fifth and sixth grade were exposed to one of four films. The four films portrayed a female peer who was either depressed or not depressed and who had experienced numerous recent life stresses or no recent life stress. Overall, children rated the depressed peers as less likeable and attractive, as engaging in fewer positive current and future behaviors, and as needing therapy more than a nondepressed peer. There was a tendency to rate the depressed peer with high life stress more positively than the depressed peer with low life stress; this tendency decreased with age. Girls rated all of the peers and especially the stressed peers more positively than did the boys. The results are discussed in terms of the implications of children's social interaction for the initiation or maintenance of childhood depression.

Adaptation, Psychological↗