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Hot flushes and night sweats are associated with depression in perimenopausal women. Further investigation is warranted to elucidate the mechanism by which hot flushes may be associated with depression in perimenopausal women and not in postmenopausal or older premenopausal women.

ISSUES AND PURPOSE. Distraction during painful procedures has been shown to be effective in previous studies, yet this simple intervention is not used routinely. This study examined the effectiveness and feasibility of distraction in reducing behavioral distress, pain, and fear during ven ipu nct u re or intravenous insert ion. DESIGN AND METHODS. A two-group randomized design with 384 children in 13 children's hospitals. RESULTS.Age was a significant factor in observed behavioral distress, reports of fear, and selfreported pain. The use of a kaleidoscope, however, did not significantly reduce pain or distress during venipuncture or IV insertion. PRACTICE IMPLICATIONS. Failure of the distraction intervention to reach statistical significance in this study is puzzling, given anecdotal reports of clinical efficacy. Methodological issues may have obscured actual differences between experimental and control groups.

BACKGROUND: In the United States, 9% to 15% of children experience chronic teasing and bullying that may be harmful. OBJECTIVE: The purpose was to explore teasing and bullying experiences of middle school students as part of the Child-Adolescent Teasing Scale (CATS) project. STUDY DESIGN: Seven focus groups were conducted with 11-to 14-year-old middle school students from Massachusetts, New Mexico, and Mississippi. Moderators used a semistructured interview guide to elicit views. Recorded sessions were transcribed; content analysis of verbatim accounts was used to identify sources of teasing and bullying. RESULTS: Sources of teasing and bullying were physical appearance, personal behavior, family and environment, and school relations. “Being different in any way” was the underlying theme. CONCLUSIONS: Teasing and bullying were universal and distressing, and were affected by context, frequency, and individually attributed meanings. Clinicians and school staff may use findings to identify children who might be at risk for psychological and physical harm.

Children's pain is often poorly managed, and interventions other than medications are rarely used. Yet many nonpharmacological interventions are helpful in managing children's pain. These techniques are reviewed, and the physiological mechanisms underlying them are briefly addressed. A discussion of the three major classifications (sensory, cognitive, and cognitive-behavioral) of interventions follows. Factors that influence the use of nonpharmacological techniques, including type of pain and developmental level, are discussed.

The 4-factor, 32-item CATS is psychometrically defensible and has demonstrated potential as a screening measure to identify students who are at risk from distressing teasing.

Invasive and noninvasive investigations suggest that the hemodynamics of pregnant hypertensive patients are heterogeneous. Nineteen pregnant patients were evaluated before changes in antihypertensive therapy. Cardiac output was measured by Doppler technique. Blood pressure was measured by automated cuff. Systemic vascular resistance was calculated. Two distinct groups were identified on the basis of differences in cardiac output (p less than 0.0001) and systemic vascular resistance (p less than 0.0001). Those with high resistances were treated with hydralazine. A modest antihypertensive effect was achieved (-6.9 mmHg, p = 0.01), but systemic vascular resistance was dramatically reduced, (-534 dyne.sec.cm-5, p less than 0.0001) and was associated with a compensatory increase in cardiac output (2.0 liters/min, p less than 0.0001). Those with a high cardiac output were treated with atenolol. An antihypertensive effect was achieved, (-17.0 mm Hg, p = 0.008), which was associated with a reduction in cardiac output (-2.8 liters/min, p less than 0.0001).

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