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Biomedical subjects

M J Kupst

Publications and source records attributed to M J Kupst.

At least 19 recordsLinked to original sources
PubMed2002

Cognitive and psychosocial functioning of pediatric hematopoietic stem cell transplant patients: a prospective longitudinal study.

A prospective longitudinal study of cognitive and psychosocial functioning in pediatric hematopoietic stem cell transplant (HSCT) patients was conducted on three occasions: pre-HSCT, 1 year post-HSCT, and 2 years post-HSCT. In contrast to the previous hypothesis that cognitive declines would occur as a result of HSCT treatment, it was hypothesized that (1) global cognitive functioning (IQ scores), as well as specific areas would remain stable over time; (2) pre-transplant functioning would be predictive of later functioning; and (3) age would be negatively related to cognitive functioning. Based on previous research it was further hypothesized: that (4) while declines in psychosocial functioning might be seen at 1 year, functioning would improve by 2 years. 153 children and adolescents were evaluated pre-HSCT and at 1 year, with 2 year data available for 74 children. Longitudinal analyses of Wechsler IQ data were completed on 100 children (longitudinal exact test) and 52 children (repeated measures analysis of variance. Results of cognitive assessment indicated (1) stability of IQ scores over time; and (2) that the strongest predictor was pre-HSCT cognitive functioning. Psychosocial assessment results indicated: (1) a low prevalence of behavioral and social problems; (2) stability in functioning over time; (3) pre-HSCT functioning strongly predictive of later functioning.

Adolescent↗
PubMed1996

Unrelated donor bone marrow transplantation to treat severe aplastic anaemia in children and young adults.

Alternative donor bone marrow transplantation (BMT) to treat severe aplastic anaemia (SAA) in children and young adults has been complicated by high rates of graft rejection and severe graft-versus-host disease (GVHD). We hypothesized that increased immunosuppression combined with T-cell depletion of the marrow graft would enable successful use of unrelated donor BMT in this disease. Preconditioning consisted of cytosine arabinoside, cyclophosphamide, and total body irradiation (TBI). T-cell depletion was with the anti-CD3 antibody T10B9. GVHD prophylaxis consisted of cyclosporine A. 28 previously transfused patients were transplanted. Nine donor/recipient pairs were HLA matched. As of 1 January 1996, 15/28 (54%) patients are alive, transfusion independent and well with a range of follow-up of 13 months to 8 years (median 2.75 years). Fatalities include all three patients with nonengraftment and all three patients with grade III/IV GVHD. Other fatalities were due to infections or therapy-related toxicity. The incidence >or= grade II acute GVHD was 28%. These data show that in children with SAA who have failed immunosuppression, unrelated donor BMT offers a reasonable hope of long-term survival.

Adolescent↗
PubMed1995

Family coping with pediatric leukemia: ten years after treatment.

As part of a longitudinal study of family coping with pediatric leukemia, 28 former patients (16 male; 12 female; M age = 19.1 years) and their parents (23 mothers; 12 fathers) participated in a follow-up study at 10 years posttreatment. Measures included the Current Adjustment Rating Scale, the Brief Symptom Inventory, the Ways of Coping Scale, the Family Coping Scale, and a semistructured interview. Long-term survivors and their parents continued to be well-adjusted to life posttreatment. Coping and perceived adjustment in long-term survivors were positively related to socioeconomic status and mother's coping and negatively related to academic problems. A strong bidirectional relationship was found between survivors' and mother's adjustment. Coping strategies were variable and not significantly correlated with coping adequacy or adjustment.

Adaptation, Psychological↗
PubMed1993

Family coping. Supportive and obstructive factors.

Successful coping with pediatric cancer enables the family to participate in the effective care of the child. This article focuses on those family variables associated with coping and adjustment to pediatric cancer. Among the variables most commonly noted as risk factors are the following: low socioeconomic status, concurrent stresses, low level of support, pre-existing serious psychologic problems in a family member, and inadequate coping resources. Implications of these risk factors for poor coping are discussed as well as recommendations for further investigation.

Adaptation, Psychological↗
PubMed1990

Use of the timeout procedure in a child psychiatry inpatient milieu: combining dynamic and behavioral approaches.

An observational study of naturally-occurring timeouts was conducted in a child psychiatry inpatient milieu over a three-month period. Data from nine children were assessed. Child negative behavior was generally low in the timeout, processing, and return to activity phases. Results from individuals were discussed in terms of their diagnosis and events taking place on the unit. Staff behavior during timeouts were also described. The crucial role of processing after the timeout was discussed.

Behavior Therapy↗
PubMed1990

Sequences of staff-child interactions on a psychiatric inpatient unit.

Six psychiatry inpatients were observed during mealtimes to determine and evaluate staff intervention techniques. To extend and further elaborate the findings of a previous work (Pines, Kupst, Natta, & Schulman, 1985), staff behaviors (positive, punitive, isolating, and neutral) were investigated for their potential relationship to subsequent child behaviors (positive, negative, and inactive) via a lag sequential analytic approach. Staff punitive and isolating behaviors tended to be associated with significant increases in the likelihood of subsequent child negative behaviors and with significant decreases in child positive behaviors. Staff positive behaviors tended not to be related to a subsequent increase or decrease in any of the coded child behaviors. Findings demonstrate the utility of assessing conditional probabilities of sequences of staff-child behaviors in psychiatric inpatients.

Adolescent↗
PubMed1983

Psychosocial aspects of pediatric leukemia: from diagnosis through the first six months of treatment.

Newly diagnosed children with leukemia and their families were subjects of a longitudinal study to describe coping behaviors, to determine adequacy of coping, and to discover predictors of healthy coping with leukemia. Families were followed for six months during which time they were interviewed, completed tests and scales, and were rated by physicians, nurses, and psychosocial staff. Families showed a wide variety of reactions and coping behaviors. The data supported the hypothesis that most families cope well despite the stresses of the first six months post-diagnosis. Based on physicians' ratings, psychosocial intervention appeared to be effective for mothers during the early outpatient phase of treatment. Age of child, previous coping, coping of other family members, a good support system, and lack of additional stresses were significantly correlated with healthy coping. The need for longitudinal assessment of coping was stressed.

Adaptation, Psychological↗
PubMed1982

Strategies of intervention with families of pediatric leukemia patients: a longitudinal perspective.

As part of a longitudinal research study, families of children with leukemia were provided with a psychosocial intervention program over a two-year period. This paper describes the approaches used at specific times during the illness: diagnosis and initial treatment, early outpatient treatment, later outpatient treatment, remission, relapse, and death. The goals of the intervention strategies were to facilitate: an understanding of the realities of the illness; management of emotional distress; and utilization of resources to care for the child, attend to other responsibilities, and support and communicate with one another.

Age Factors↗
PubMed1981

The CPI subscales as predictors of parental coping with childhood leukemia.

Determined the role of the standard CPI subscales, the Summed Coping Scale, and the current Adjustment Rating Scale in prediction of parental coping with leukemia, with 30 mothers and 25 fathers of children with Leukemia. None of the standard CPI subscales was found to be a significant predictor of coping, as measured by a situation-specific instrument, the Family Coping Scale. The Summed Coping Scale and the CARS were significant as predictors for fathers, but not for mothers. It is suggested that coping with the specific situation may be a better predictor of later coping in a similar situation than more global assessments.

Adaptation, Psychological↗
PubMed1979

Instructions, feedback, and reinforcement in reducing activity levels in the classroom.

The biomotometer, an electronic device which simultaneously measures motor activity and provides auditory feedback, was used in combination with material reinforcers in an experiment to reduce children's activity level in a classroom setting. Subjects were nine boys and two girls, aged 9--13, from a day hospital program for emotionally disturbed children. After five baseline trials, each child had five contingent reinforcement trials in which he/she received feedback "beeps" from the biomotometer and was given toy or candy rewards after each trial in which activity fell at least 20% below mean baseline level. Then five noncontingent reinforcement trials were run in which children received rewards for wearing the apparatus without the feedback attachment. Results indicated that the intervention "package," including instructions, feedback, and contingent reinforcement, was successful in all five trials for 8 of 11 children. Activity levels increased during the final noncontingent phase.

Acoustic Stimulation↗
PubMed1978

Activity level: a comparison between actometer scores and observer ratings.

Activity level of 13 boys (aged 9-13) from a day hospital program was measured using actometers in classroom, gym, woodshop, and group therapy settings. Ratings of Ss' activity were obtained from mothers using the Werry scale, and from six clinical staff familiar with the Ss using the Davids scale. It was predicted that activity ratings would have situationally specific relationships with actometer-measured activity level according to the rater's opportunities for observation. Comparisons between measures indicated that all clinical staff ratings correlated significantly with actometer activity in the classroom (r = .49 to r = .73), while mothers' ratings correlated significantly with actometer activity in gym (r = .67), and woodshop (r = .77), and with overall activity (r = .65), a combined measure derived from actometer scores in the four conditions tested. Five of six clinical staff raters showed significant interrater reliability (r = .58 to r = .83). Results are discussed in terms of their implications for solution of current problems in assessment of activity level and hyperactivity.

Adolescent↗