This pilot study was conducted to identify factors responsible for promoting resilience in siblings of children with sickle cell disease. Twenty siblings (10-17 years of age) of children (5-13 years) with sickle cell disease were selected from the Pediatric Clinic of Howard University Center for Sickle Cell Disease. The siblings responded to questionnaires, and the data obtained was analyzed by chi-square for association. The results indicated that age, birth order, and gender had no effect on resilience in the siblings. However, family size, number of parents in the home, sibling's knowledge of the illness, degree of morbidity of the illness, socioeconomic status of the family, and parents' attitudes and childrearing practices were all found to affect resilience. These findings provide additional insight into the psychosocial aspects of, and genetic counseling for sickle cell disease, as well as for other chronic genetic disorders.

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Since t h e v a l i d i t y of t h e DPDQ has been examined only i n predominantly White middle c l a s s populations i n Denver, CO, a prospective study was conducted t o a s s e s s the v a l i d i t y of t h e quest i o n n a i r e i n a predominantly indigent Black population. The eff e c t of an educational package i n increasing the accuracy of pare n t a l response t o DPDQ a s a l s o assessed.127 i n f a n t s were enrolled i n a longitudinal follow-up program from age 2 wks t o 1 yr. Parents i n a randomly s e l e c t e d experimental group observed an audiovisfial presentation describing progressive developmental behavior and were asked t o record t h e i r c h i l d ' s subsequent development.78 of t h e 127 i n f a n t s were followed f o r 3 mos, while 53 and 33 have been followed f o r 6 and 9 mos, respectively. The mean agreement scores between parental responses t o the DPDQ and the observed development v i a DDST were 93.6%, 93.2% and 91% a t 3, 6, and 9 mos, respectively. Tliere were no s i g n i f i c a n t d i f f e r e n c e s i n t h e item agreement scores of the experimental group vs t h e control group thereby demonstrating f a i l u r e of t h e educational program i n increasing t h e accuracy of parents. The o v e r r e f e r r a l r a t e was q u i t e low (12.8%).The r e s u l t s a t t e s t t o the v a l i d i t y , generality and f e a s i b il i t y of DPDQ i n a lower socioeconomic population and r a i s e some questions about parent education through audiovisual and w r i t t e n materials. EFFECT OF PROBLEM ORIENTED RECORD COMPONENTS ON671 HOSPITAL CARE. Carmi Z. Margolis, Wilhelmina Cohen, Nurit Barak. Faculty of Health Sciences, Ben Gurion University of t h e Negev, Primary Care Unit, Beersheba, I s r a e l .W e implemented a standardized d a t a base (SDB) and problem l i s t (PL) i n two 50-bed general p e d i a t r i c wards X and Y, and measured number of problems i d e n t i f i e d and amount of d a t a c o l l e c t e d i n 100 randomly sampled records from each ward before (period I ) , immedi a t e l y a f t e r (period 2 ) , and one year a f t e r implementation (period 3 ) .Mean subjective d a t a score a t periods 1,2 and 3 was 14.96+S.D. 5.57, 28.18*S.D.9.76 (p=<0.005) and 28.7tS.D.9.53 respectively, (maximum possible=50). Mean objective d a t a score a t periods 1,2 and 3 was 10.97*S.D.4.96, 17.64fS.D.1.78 (p=<0.005) and 17.48tS.D. 1.7, r e s p e c t i v e l y (maximum possible=21). There was no s i g n i f i c a n t d i f f e r e n c e between wards X and Y, mean number of problems i d e n t if i e d on admission t o ward X a t periods 1,2 and 3 was 2.22 (range 1-6; mode 1; median 2), 2.08 (range 1-5; mode 1; median 2), 2.17(range 1-6; mode 1 ; median 2 ) , 2.18 (range 1-6; mode 1; median 2), 2.17 (range 1-6; mode 1 ; median 2 ) . Percentage of records with 3 problems on discharge from ward X a t periods 1,2 and 3 was SO%, 40% and 52%, respectively, and f o r ward Y, 25%, 39% (p=<0.025) and 42%.An SDB can increase s i g n i f i c a n t l y amount of d a t a ...

The c l i n i c a l course of 55 back-transported (BT) i n f a n t s was com~ared with t h a t of 49 i n f a n t s who remained a t a reqional ~e r i natal center f o r convalescent care (NT). Although the-mean b i r t hweight and mean gestational age of the BT i n f a n t s was s i g n i f ic a n t l y l e s s than t h a t of N T i n f a n t s (BT = 1614+522 gms and 32t2.7 wks, N T = 1902+626 and 33.112.5; p <0.