This study was undertaken to understand and describe Latina mothers' cognitions and attitudes toward the use of medication for their young children's behavior problems under the premise that these factors are determinants of noncompliance and inadequate adherence to medication treatments. Quantitative and qualitative data were extracted from a multimethod study of professional help seeking. Participants were 62 mothers from Cuba, Puerto Rico, and the Dominican Republic. Findings indicated that mothers overwhelmingly preferred treatment options other than medication primarily because they understood medication to be addictive, dulling of cognitive processes, and inappropriate for behavior problems. Inadequate adherence was common and logically consistent with maternal cognitions. Maternal choices with respect to the use of medication were transactional and quite complex in nature and changed over time. The strongest agents in this process were schools and the mothers' immediate family. Implications for clinical practice are presented.

The authors undertook this study to describe Latina mothers' professional help seeking for their young children's disruptive behaviors. They interviewed 62 Cuban, Puerto Rican, and Dominican first-time help seekers and found four modes of entry: (a) coercion, (b) acceptance of offered referral, (c) responsive and resourceful help seeking subsequent to school reports of behavior problems, and (d) a laborious and convoluted path that was characteristic of 52% of the sample. Schools, maternal and child characteristics, and social network forces played significant roles for all mothers, but the final determinants of service entry varied by the mode of entry followed. Findings suggest that problem labeling is not a necessary precursor to service entry and that direct referrals might effectively shortcut the help-seeking process. Finally, the process that underlies service entry would be described more aptly as a Theory of Affective Action than a Theory of Reasoned Action.

We add to current understanding of maternal cognitions and attributions about their children with disruptive behaviors by describing and exploring mothers' naturalistic characterizations of their children. Participating mothers from Cuba, Puerto Rico and the Dominican Republic had 4-to 10-year-old children with disruptive behaviors. Data were collected with a structured interview that includedopen-ended questions, optional probes, questions with set response categories, and rating scales. Both qualitative and quantitative analyses were conducted. The three most common characterizations were "intelligent," "malcriado," (spoiled/rude mannered) and "carácter fuerte" (stubborn/willful). Cultural informants sorted these and other descriptors used by mothers into categories of their choosing which provided a basis for classifying maternal characterizations. These characterizations were statistically and significantly associated with the onset of maternal concerns, with the number of members from the mothers' social network who suggested professional services, with maternal perceptions of stigma, and with maternal ratings of the severity of the children's symptoms. Overall, mothers' naturalistic characterizations were structured differently from researcher dimensions typically used to study maternal cognitions about child behavior.

We report on an 8-year-old girl with an unbalanced 15;22 translocation and manifestations of DiGeorge syndrome (DGS), velocardiofacial syndrome (VCFS), and other abnormalities. The main manifestations of our patient were feeding difficulties, respiratory infections, short stature, peculiar face with hypertelorism, prominent nose, abnormal ears, microstomia and crowded teeth, short broad neck and shield chest with pectus deformity and widely spaced nipples with abnormal fat distribution, heart defect, scoliosis, asymmetric limb development, abnormal hands and feet, and hyperchromic skin patches. Cytogenetic studies demonstrated a 45,XX,der(15)t(15;22)(p11.2;q11.2), -22 karyotype. Fluorescence in situ hybridization (FISH) studies confirmed loss of the proximal DiGeorge chromosomal region (DGCR). This case adds to the diversity of clinical abnormalities caused by deletions within 22q11.2.

Mutational analysis provides accurate assessment of Gaucher risk for reproductive decision-making in Eastern European Ashkenazi Jews as a small number of mutations account for most of the mutant alleles. More than 30% of the GD alleles correspond to a variety of rare mutations in other populations. Carriers of known GD mutations who had a non-Jewish partner were ascertained through a screening program at New York University Medical Center. Each couple was recalled for counseling, results were reviewed and testing offered to the non-Jewish partner. Options included carrier testing by mutation analysis andlor enzymatic analysis and prenatal diagnosis. We report the choices of the first twelve couples with a mixed heritage after learning that the Jewish partner was a Gaucher carrier. They included 3% of the total couples screened during the last year. Eleven of those couples were in a pregnancy; seven of the non-Jewish partners were male and five were female; live non-Jewish partners had both DNA and enzyme analysis; two chose enzyme analysis alone and another one had DNA screening only; finally, one couple bad no additional testing; three couples elected prenatal Gaucher disease determination by amniocentesis with enzyme analysis; none of the non-Jewish partners were determined to be carriers: all of these pregnancies are ongoing but outcomes will be monitored for any affected infant. This study concludes that screening for Gaucher disease in couples with a mixed heritage is feasible. Guidelines for screening couples with mixed heritage need to be established. Both DNA and enzyme analysis should be performed on non-Jewish partners. Prenatal diagnosis should be offered for a definitive diagnosis.