Psychological stress is thought to undermine host resistance to infection through neuroendocrine-mediated changes in immune competence. Associations between stress and infection have been modest in magnitude, however, suggesting individual variability in stress response. We therefore studied environmental stressors, psychobiologic reactivity to stress, and respiratory illness incidence in two studies of 236 preschool children. In Study 1, 137 3- to 5-year-old children from four childcare centers underwent a laboratory-based assessment of cardiovascular reactivity (changes in heart rate and mean arterial pressure) during a series of developmentally challenging tasks. Environmental stress was evaluated with two measures of stressors in the childcare setting. The incidence of respiratory illnesses was ascertained over 6 months using weekly respiratory tract examinations by a nurse. In Study 2, 99 5-year-old children were assessed for immune reactivity (changes in CD4+, CD8+, and CD19+ cell numbers, lymphocyte mitogenesis, and antibody response to pneumococcal vaccine) during the normative stressor of entering school. Blood for immune measures was sampled 1 week before and after kindergarten entry. Environmental stress was indexed with parent reports of family stressors, and a 12-week respiratory illness incidence was measured with biweekly, parent-completed symptom checklists. The two studies produced remarkably similar findings. Although environmental stress was not independently associated with respiratory illnesses in either study, the incidence of illness was related to an interaction between child care stress and mean arterial pressure reactivity (beta = .35, p < .05) in Study 1 and to an interaction between stressful life events and CD19+ reactivity (beta = .51, p < .05) in Study 2.(ABSTRACT TRUNCATED AT 250 WORDS)

This research was conducted at a summer camp for siblings of children with cancer. Participants included 77 siblings (ages 6-17 years) and their parents. Before attending camp, 18 of the siblings had experienced the death of their brother or sister with cancer. Projective measures were administered before attending camp and 3 months after camp. These included the Human Figure Drawing (HFD) and the Kinetic Family Drawing-Revised (KFD-R). Siblings were administered both the HFD and KFD-R; parents were given the KFD-R. On the HFD, siblings' emotional distress scores decreased significantly pre- to postcamp. On the KFD-R, nonbereaved siblings and parents showed significant improvement in family environment scores. Bereaved siblings and parents also showed improvement (although nonsignificant). These results support Camp Okizu's effectiveness in increasing siblings' emotional well-being yet underscore the need to implement interventions to address family communication for both bereaved and nonbereaved families.

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The primary aim of this study was to ascertain the psychosocial issues faced by families affected by maple syrup urine disease (MSUD). The psychosocial adjustment and quality of life of children with MSUD were also described. Participants included 55 families and their children (ages 5 to 18 years) and teachers. Measures included a MSUD Family Survey, the Behavior Assessment System for Children (BASC) and the Pediatric Quality of Life Inventory (PedsQL). Parents reported via the MSUD Family Survey that the greatest sources of stress were financial and emotional. Many parents reported difficulty interacting with the medical staff and with schools. On the BASC, half of the children fell within the average range in psychosocial adjustment, although there were elevations in scales measuring attention, hyperactivity, and learning problems. On the PedsQL, the mean quality of life scores were closer to children with cancer than to a healthy sample. Despite the emotional and financial burden, parents reported that MSUD has also had a positive influence on their lives, leading to a world-view that is more compassionate and caring.

To determine whether protein change affects crying behaviour and whether this could be mediated by change in intestinal gas production, 32 normal 4-wk-old infants entered a randomized controlled trial consisting of two 8day feeding periods (FP1 & FP2). During FP1, all infants received cow's milk-lactose formula. During FP2, control infants continued cow's milk but experimental infants received soy-lactose formula. Parents blind to the study hypothesis recorded 6 behaviors (including cry/fuss) by pretested diaries. To monitor gas prcduction, breath hydrogen (H2) samples were taken over 4 hr. on days 1,4 & 7 of FP1, and 2,3,6 & 8 of FP2. Mean duration (min/24 hr) and frequency (epidsodes/24 hr) of cry/fuss behavior and average 4-hr HZ excretion (ppn) were calculated for each feeding perid. Compared to FP1, cry/fuss duration in FP2 was reduced 14 min/24 hr on soy, and 7 min/24 hr on cow's milk, a non-significant interaction (groups x formula period ANOVA:F=.35;df 1,3Cj;p=.56). Similarly, there was no significant r d~ tion for cry/fuss frequency (.3 vs .7 fewer episcdes/24 hr for soy and cow's milk, respectively: F=.l4;df 1,30;p=.71). Finally, H2 decreased 9 ppn after change to soy, canpared to a 3 ppn increase on cow's milk in FP2, also non-significant (F=2.34;df 1,30;p=.14). Conclusion: The change in formula protein from cow's milk to soy did not reduce duration or frequency of cry/fuss behavior at 4-6 wks of age, nor did it reduce intestinal gas production. The findings do not support use of soy protein to change cry behavior in normal infants.