WorldWideScience

Sample records for chronically ill children

  1. On the Agenda: Oregon's Chronically Ill Children and Their Families.

    Science.gov (United States)

    Oregon State Dept. of Education, Salem.

    This report describes the current status and needs of chronically ill children and their families in Oregon. An introductory chapter outlines the history of educational services for children with severe health needs, defines the term "chronically ill," reports on prevalence, and outlines trends. a survey of 49 parents of chronically ill children…

  2. Mothers' Attributions Regarding the Behavior of Chronically Ill Children.

    Science.gov (United States)

    Walker, Lynn S.

    Parents of chronically ill children are faced with the difficult task of being vigilant and yet not overprotective of their children. The literature suggests that parents hold a positive bias toward their ill children. Attribution theory gives a framework in which to study parents' ideas about their children's behavior. A study was conducted to…

  3. A NARRATIVE: MEDITATION IN THE LIVES OF CHILDREN WITH CHRONIC ILLNESS

    Directory of Open Access Journals (Sweden)

    Taunya WIDEMAN-JOHNSTON

    2012-01-01

    Full Text Available The presence of chronic illness in one’s life often entails endless appointments, tests, medications, treatments, and procedures. In the instances of children with chronic illness, they do not know what life consists of without their illness, and consequently, have lived with many restrictions. Children with chronic illness and their families are not only in need of traditional methods and strategies from the medical model but are often in need of additional strategies to support and cope with the nature and effects of the chronic illness. This paper focuses on how mediation, mindfulness, and visualization strategies aid individuals with chronic illness.

  4. Parental Involvement of Mothers with Chronic Illness and Children's Academic Achievement

    Science.gov (United States)

    Chen, Yung-Chi; Fish, Marian C.

    2013-01-01

    This study examined how maternal chronic illnesses may affect children's academic achievement through parental involvement. A total of 189 mothers diagnosed with chronic illnesses, such as multiple sclerosis, diabetes, cancer, HIV/AIDS, chronic pain, asthma, myelodysplasic syndrome, and fibromyalgia, and with a child in middle school or high…

  5. A review of factors associated with mental health in siblings of children with chronic illness.

    Science.gov (United States)

    Incledon, Emily; Williams, Lauren; Hazell, Trevor; Heard, Todd R; Flowers, Alexandra; Hiscock, Harriet

    2015-06-01

    This article reviews the literature on modifiable factors associated with mental health in siblings of children with chronic illness. Three clinical databases were searched. A total of 17 studies met the inclusion criteria. Several key themes emerged from the review. Better sibling mental health was associated with camp attendance, perceived parent/peer support, illness education and enhancing control through cognitive coping strategies and routine. Parental and sibling psychoeducation interventions and social support may enhance children's mental health when their sibling has a chronic illness. PMID:24270987

  6. A Multi-Modal Digital Game-Based Learning Environment for Hospitalized Children with Chronic Illnesses.

    Science.gov (United States)

    Chin, Jui-Chih; Tsuei, Mengping

    2014-01-01

    The aim of this study was to explore the digital game-based learning for children with chronic illnesses in the hospital settings. The design-based research and qualitative methods were applied. Three eight-year-old children with leukemia participated in this study. In the first phase, the multi-user game-based learning system was developed and…

  7. Home Care for Children with Chronic Illnesses and Severe Disabilities: A Bibliography and Resource Guide.

    Science.gov (United States)

    Wells, Alice; And Others

    The bibliography and resource guide summarizes relevant research and information on home care for children with disabilities and chronic illnesses, including those with such diagnoses as spina bifida, cerebral palsy, severe mental retardation, acquired immune deficiency syndrome (AIDS), hemophilia, sickle cell anemia, autism, or failure-to-thrive…

  8. Helping a Child Manage a Chronic Illness

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160011.html Helping a Child Manage a Chronic Illness Feeling they have control over their ... News) -- Children and teens who feel confident handling a chronic illness on their own appear better able ...

  9. Screening for anxiety symptoms and social desirability in children and adolescents living with chronic illnesses in Jordan.

    Science.gov (United States)

    Arabiat, Diana H; Jabery, Mohammad Al; Wardam, Lina

    2013-03-01

    This research aims to investigate the rate and nature of anxiety symptoms in a group of children and adolescents living with chronic illnesses in Jordan, and their relation to social desirability in a cultural sample not previously researched. Using the Revised Children's Manifest Anxiety Scale (R-CMAS), anxiety and social desirability data were obtained from 114 children diagnosed with chronic illnesses and 162 healthy control participants. Based on children's self-report, participants were categorized according to their adaptive style paradigm as either high anxious, low anxious, or repressor. It was proposed that children who score high on social desirability and low on anxiety are repressors. The prevalence of these categories was compared across the two groups. Anxiety was reported in 9.64 percent of the chronic illnesses and 12.34 percent of the healthy peers. Using the data obtained in the present study, the rate and nature of anxiety in children with chronic illnesses were lower for children in Jordan when compared to previous studies. However, social desirability values were similar to those established in Western societies suggesting a significantly higher percentage of children identified as repressors in children with long-term illnesses. These results supported the hypothesis regarding the relationship between social desirability and expressed anxiety symptoms. PMID:23242812

  10. Life after the Shock! The Impact on Families of Caring for Young Children with Chronic Illness

    Science.gov (United States)

    Ashton, Jean

    2004-01-01

    The stresses experienced by most families include limitations on time, conditions of employment, financial burdens and sibling rivalry. For the families of a child with a chronic illness, these stresses are often compounded, making family functioning problematic. Chronic illness is marked by permanency and the need for ongoing vigilance with…

  11. Coping with Chronic Illness

    Science.gov (United States)

    ... of the management of the illness little by little as she gets older. Some children avoid accepting more independence and self-management of their condition. Families may not mean to but foster dependency because they find it ...

  12. Development of a measure of the impact of chronic parental illness on adolescent and adult children. The parental illness impact scale (Parkinson's disease).

    Science.gov (United States)

    Schrag, Anette; Morley, David; Quinn, Niall; Jahanshahi, Marjan

    2004-10-01

    Although chronic illness is likely to affect the well-being of patients' children, no assessment tools are currently available to measure this impact of parental illness. We therefore developed such an instrument based on interviews with children of patients with Parkinson's disease (PD). This questionnaire and other measures of psychological well-being were completed by 89 children, aged 12-48, years of patients with PD. Factor analysis revealed six domains with 38 questions. These six domains of the 'Parental Illness Impact Scale (Parkinson's disease)' or PIIS (PD) had satisfactory internal consistency and validity. Its six sub-scales correlated significantly and differentially with corresponding measures, including the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48; r = -0.2 to 0.85), the Beck Depression Inventory (r = -0.07 to -0.40) or Birleson Depression Self-Rating Scale (r = 0.04 to -0.62), and the Rosenberg Self-Esteem Scale (r = -0.01 to 0.33) as well as age (r = -0.37 to 0.28) and parent's disease duration (r = -0.31 to 0.34). The PIIS is the first instrument to assess the impact of parental illness on children. Its psychometric properties should be tested further in larger samples, including children of patients with other chronic disorders such as multiple sclerosis or chronic heart disease. PMID:15465395

  13. [Psychosocial situation of families with chronically ill children: a survey of parent initiatives].

    Science.gov (United States)

    Nehring, I; Riedel, C; Baghi, L; Moshammer-Karb, T; Schmid, R; Kries, R V

    2015-02-01

    Children with chronic illness or disabilities and their families require more support than healthy families. The working group "custodial and psychosocial supply" defined 4 theses to figure out deficits and targets of family support: 1) my child is different; 2) my child is not devisable; 3) my child needs strong helpers; and 4) my child needs safety.Based on these theses, a questionnaire for parents was designed of which 20 were sent to 34 parent initiatives in Germany each, for distribution to a random sample of member families.499/680 questionnaires were returned of which 419 could be included in the analysis. Less than 50% of the parents felt adequately and timely informed about their child's condition, and support for coping with the child's diagnosis was rarely given. Less than half of the parents reported to have been informed about the options for support within the German social system, and less than 15% were aware of instructions for clearing houses on care and support. About a third of the parents reported needs for managing family, siblings or household, but only a third of these had been offered organised and structured family support. More than 50% of the families reported restraints in participating in social life: such restraints were associated with problems in partnership and loss of friends. Half of the parents felt restraints of the family income because of their child's condition.There is need for improvement of the psychosocial condition of families with chronically ill or disabled children by better, more and timely information about the child's clinical condition, access to the social support system and availability of support services. PMID:24771100

  14. Adaptation of children to a chronically ill or mentally handicapped sibling.

    OpenAIRE

    Seligman, M

    1987-01-01

    The presence of a chronically ill or mentally handicapped child in a family can be a stress for the child's siblings, who often are ill informed about the nature and prognosis of the illness, may be uncertain what is expected of them in the caregiving role, may feel their own identities threatened, and may experience ostracism by their friends and misunderstanding at school. Although individual reactions vary widely, feelings of anger, guilt, resentment and shame are commonly reported. Excess...

  15. Sexuality and chronic illness.

    Science.gov (United States)

    Steinke, Elaine E

    2013-11-01

    Sexual function is often affected in individuals living with chronic illness and their partners, and multiple comorbidities increase the likelihood of sexual dysfunction. This review focuses on the areas of cardiovascular disease, respiratory conditions, and cancer, all areas for which there are practical, evidence-based strategies to guide sexual counseling. Although nurses have been reluctant to address the topic of sexuality in practice, a growing number of studies suggest that patients want nurses to address their concerns and provide resources to them. Thus, nurses must be proactive in initiating conversations on sexual issues to fill this gap in practice. PMID:24066783

  16. Psihiatrična obravnava otrok in mladostnikov s kronično telesno boleznijo: The role of the psychiatrist in the care of children and adolescents with chronic somatic illness:

    OpenAIRE

    DROBNIČ RADOBULJAC, Maja

    2014-01-01

    Children with chronic illness and their families are at a higher risk for the development of mental disorders, and these may negatively affect the psychosocial development of children at different developmental stages. Mental disorders in children or their families affect the compliance in the treatment of chronic somatic illness and consequently cause higher disability. The present article describes various ways in which a chronic illness can influence mental states of children and their fam...

  17. Guidelines for Psychological Assistance to Chronically Ill Children and Their Parents

    Directory of Open Access Journals (Sweden)

    Buslayeva A.S.,

    2016-04-01

    Full Text Available This study explored psychological features in 33 children aged 8—17 years suffering from rheumatic disorder and in their mothers. 11 children were in the emergency department, 22 in the department of rheumatology. The following methods were used: observation, conversation, the Draw-a-Person and Three Wishes tests, the Dembo-Rubinstein self-esteem scales, and the Parent’s Essay technique. According to the level of their mental activity the children were divided into 4 groups: ‘inactive’, ‘passive’, ‘relatively active’ and ‘active’. Working with the ‘inactive’ children was impossible; the main task was to help their mothers cope with emotional distress. The ‘passive’ children received emotional support and were taught how to understand and express their needs; their parents were taught how to communicate with the child in various ways. Working with the ‘relatively active’ children and their parents had the aim of reestablish- ing productive interactions between them. Working with the ‘active’ children consisted of supporting their self-esteem, self-respect and interests; their parents were taught to better understand age-specific and indi- vidual psychological features of the child and to take into account limitations caused by the illness.

  18. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schuengel Carlo

    2011-07-01

    Full Text Available Abstract Background Coping with a chronic illness (CI challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the intervention program may enhance the use of learned coping strategies in daily life, especially on the long-term. The primary aim of the present study is to examine the effectiveness of a cognitive behavioral based group intervention (called 'Op Koers' 1 for children with CI and of a parallel intervention for their parents. A secondary objective is to investigate why and for whom this intervention works, in order to understand the underlying mechanisms of the intervention effect. Methods/design This study is a multicentre randomized controlled trial. Participants are children (8 to 18 years of age with a chronic illness, and their parents, recruited from seven participating hospitals in the Netherlands. Participants are randomly allocated to two intervention groups (the child intervention group and the child intervention combined with a parent program and a wait-list control group. Primary outcomes are child psychosocial functioning, wellbeing and child disease related coping skills. Secondary outcomes are child quality of life, child general coping skills, child self-perception, parental stress, quality of parent-child interaction, and parental perceived vulnerability. Outcomes are evaluated at baseline, after 6 weeks of treatment, and at a 6 and 12-month follow-up period. The analyses will be performed on the basis of an intention-to-treat population. Discussion This study evaluates the effectiveness of a group intervention improving psychosocial functioning in children with CI and their parents. If proven effective, the intervention will be implemented in clinical practice. Strengths and limitations of the study design are discussed

  19. Chronic Illness & Mental Health

    Science.gov (United States)

    ... factors include a personal or family history of depression or loss of family members to suicide. However, there are some risk factors directly related to having another illness. For example, conditions ... role in depression. Illness-related anxiety and stress can also trigger ...

  20. Chronic Critical Illness

    Science.gov (United States)

    ... everyday activities than they needed before this illness. Doctors, nurses, and other members of the health care team ... pain. Some have difficulty sleeping. Some are depressed. Doctors, nurses, and other members of the health care team ...

  1. Program for the Chronically Ill.

    Science.gov (United States)

    Schoenherr, Arline; Schnarr, Barbara

    The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

  2. [Chronic illness and contraception].

    Science.gov (United States)

    Saarikoski, S

    1987-01-01

    In recent years sterilization that can cause problems of the psyche and marital life has been recommended much less frequently with respect to chronic diseases. As regards heart and hypertensive diseases pregnancy is always contraindicated in case of 3rd and 4th disease categories and sterilization is recommended according to the New York Heart Association. As far as 1st and 2nd category patients are concerned if the load carrying capacity is normal pregnancy could be undertaken. Combination pills are not recommended for contraception because they can cause fluid retention or increase the risk of thrombosis. If the patient has a higher-than-normal risk of developing thrombosis or infection, for instance, those who wear pacemakers only tablets containing progesterone or subdermal capsule implants can be used. In those with blood pressure problems the additional use of the IUD is also advised. Among diseases of neurological and psychic origin the effect of hormonal contraceptives is weakened by antiepileptics, but even in such cases older combination pills of larger doses of active ingredients can be employed. Migraine is exacerbated in 1/3 of patients; here IUDs can be used. Even the contraceptive tablets themselves can induce depression. In psychosis methods requiring regular attention can be easily forgotten, therefore the IUD is the most suitable device. In diabetes progesterone and other progestogens reduce insulin response, harm carbohydrate metabolism; therefore in young people the IUD is preferred an in older women with children even sterilization can be employed. Hormonal tablets must not be used in hyperlipidemia and liver diseases. Caution must be exercised in hyperthyroidism and in endocrine disorders (e.g., Cushing's syndrome); if it is accompanied by blood pressure disorders appropriate treatment is required. In kidney diseases pregnancy is contraindicated if it is accompanied by blood pressure increase or a higher level of creatine. On the other hand

  3. 'Chronic' identities in mental illness.

    Science.gov (United States)

    von Peter, Sebastian

    2013-04-01

    The term 'chronicity' is still widely used in psychiatric discourse and practice. A category employed in political, administrative and therapeutic contexts, it guides practitioners' beliefs and actions. This paper attempts a review of the attitudes and procedures that result as a consequence of identifying 'chronically' disturbed identities in clinical practice. An essentially social, relational and materialist understanding of mental illness is used to highlight the kind of thinking underlying the notion of 'chronic' identities in day-to-day psychiatric routines. Problematising the notions of singularity and expressiveness, as well as mind/body- and self/other-distinctions, it claims the category itself is responsible for creating a 'chronic' kind of being. A spatial metaphor is presented in the conclusion, illustrating a mental strategy by which we can re-shape our thinking about 'chronic' identities. It attempts to describe how the shift from an epistemological to a praxeographic approach could build a more complete understanding of mental illness. PMID:23528064

  4. Multiculturalism, chronic illness, and disability.

    Science.gov (United States)

    Groce, N E; Zola, I K

    1993-05-01

    To gain at least an initial understanding of the underlying beliefs and attitudes in a cross-cultural situation, we believe that the three key points discussed in this paper should prove a significant point of departure: 1. Traditional beliefs about the cause of chronic illness or disability will play a significant role in determining family and community attitudes toward individuals with a disability and will influence when, how, and why medical input is sought. 2. The expectation of survival on the part of parents and community will have an effect on the amount of time, energy, and cooperation shown by family and community for the individual who has an impairment. 3. The expectations by family and community for the social role(s) and individual with a chronic illness or disability will hold will affect a broad range of issues, including education, social integration, and independence. Furthermore, although chronic illness and disability are often considered as issues distinct from the full range of problems encountered in society for immigrant and minority groups, in fact, these issues could not be more closely tied. The frequently discussed concerns within the ethnic and minority community about the role of the family, integration and acculturation, social articulation with the greater American society, stress, cross-cultural misunderstanding, and outright prejudice can all compound the problems encountered for the chronically ill or disabled individual in a multicultural society. PMID:8479830

  5. Looking after chronically ill dogs

    DEFF Research Database (Denmark)

    Christiansen, Stine B.; Kristensen, Annemarie Thuri; Sandøe, Peter;

    2013-01-01

    Studies in human medicine show that care of chronically ill family members can affect the caregiver's life in several ways and cause "caregiver burden." Companion animals are offered increasingly advanced veterinary treatments, sometimes involving home care. Owners choosing such treatments could ...

  6. Guidelines for Psychological Assistance to Chronically Ill Children and Their Parents

    OpenAIRE

    Buslayeva A.S.,; Venger A.L.,; Lazurenko S.B.,

    2016-01-01

    This study explored psychological features in 33 children aged 8—17 years suffering from rheumatic disorder and in their mothers. 11 children were in the emergency department, 22 in the department of rheumatology. The following methods were used: observation, conversation, the Draw-a-Person and Three Wishes tests, the Dembo-Rubinstein self-esteem scales, and the Parent’s Essay technique. According to the level of their mental activity the children were divided into 4 groups: ‘inactive’, ‘pass...

  7. Meditation's impact on chronic illness.

    Science.gov (United States)

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease. PMID:14650573

  8. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

    OpenAIRE

    Hatzmann, J.; Maurice-Stam, H.; Heymans, H. S.; Grootenhuis, M.A.

    2009-01-01

    BACKGROUND: Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. METHODS: In a cross-sectional design, 543 parents of chron...

  9. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

    OpenAIRE

    Heymans Hugo SA; Maurice-Stam Heleen; Hatzmann Janneke; Grootenhuis Martha A

    2009-01-01

    Abstract Background Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. Methods In a cross-sectional design, 543 parents o...

  10. Stress in adolescents with a chronically ill parent: inspiration from Rolland's Family Systems-Illness model

    NARCIS (Netherlands)

    D.S. Sieh; A.L.C. Dikkers; J.M.A. Visser-Meily; A.M. Meijer

    2012-01-01

    This article was inspired by Rolland’s Family Systems-Illness (FSI) model, aiming to predict adolescent stress as a function of parental illness type. Ninety-nine parents with a chronic medical condition, 82 partners, and 158 adolescent children (51 % girls; mean age = 15.1 years) participated in th

  11. The importance of social support to chronically ill adolescents

    Directory of Open Access Journals (Sweden)

    Nišević Sanja

    2006-01-01

    Full Text Available Introduction. Improvements in medicine have significantly prolonged life of chronically ill children and adolescents in the past several decades. There is a great variability in adaptation to illness among chronically ill persons - some of them seem to be very well adapted, with almost no problems. However, research results suggest that chronically ill children are more likely to have psychological problems than their healthy peers. Material and methods. Eighty-four subjects, all elementary school pupils, participated in the study. The first group included adolescents with chronical illness (malignant illness, insulin dependent diabetes mellitus, epilepsy, or asthma, and the second their healthy peers. Depression and social support were evaluated. The Birleson's Depression Scale and Perceived Social Support Scales (forms for friends and for family members were used. Results and discussion. The results show significant differences for two of the three variables: depression, and perceived social support from family, while there was no significant difference for perceived social support from friends. The results suggest that chronically ill adolescents are more depressed and that they perceive that the social support they receive from their families is lower when compared to their healthy peers. Conclusion. The results of this study showed that chronically ill adolescents are more depressed than their healthy peers. This group of adolescents also perceives that they have less social support from their families than their healthy peers. When it comes to perceived social support from friends, these two groups do not differ. .

  12. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

    Directory of Open Access Journals (Sweden)

    Heymans Hugo SA

    2009-07-01

    Full Text Available Abstract Background Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL. Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. Methods In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data. Results The model fitted the data closely (CHISQ(14 = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: β = .21 and emotional support (PCS: β = .14; MCS: β = .28. Also, female gender (β = -.10, age (β = .10, being chronically ill as a parent (β = -.34, and care dependency of the child (β = -.14; β = -.15 were directly related to parental HRQoL. Conclusion The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.

  13. Mind-Body Approaches and Chronic Illness: Status of Research

    Science.gov (United States)

    Riccio, Cynthia A.; Pliego, Jessica; Rae, William A.

    2016-01-01

    An increasing number of children experience chronic health issues that affect their academic and behavioral functioning, as well as psychological well-being. At the same time, psychological stress can exacerbate the chronic illness. The first line of treatment most often is medical (e.g., pharmacology, surgery, radiation). Even when the medical…

  14. Transfusion in critically ill children

    DEFF Research Database (Denmark)

    Secher, E L; Stensballe, J; Afshari, A

    2013-01-01

    Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects of...... transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than...... evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors...

  15. Impact of childhood chronic illnesses on siblings: a literature review.

    LENUS (Irish Health Repository)

    O' Brien, Irene

    2012-02-01

    BACKGROUND: Childhood illness can have a significant impact on families, particularly on the ill child\\'s siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. AIM: This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. METHOD: A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: \\'siblings\\

  16. Coping with Chronic Illness in Childhood and Adolescence

    OpenAIRE

    Compas, Bruce E.; Jaser, Sarah S.; Dunn, Madeleine J.; Rodriguez, Erin M.

    2011-01-01

    Chronic illnesses and medical conditions present millions of children and adolescents with significant stress that is associated with risk for emotional and behavioral problems and interferes with adherence to treatment regimens. We review research on the role of child and adolescent coping with stress as an important feature of the process of adaptation to illness. Recent findings support a control-based model of coping that includes primary control or active coping (efforts to act on the so...

  17. Adaptive Leadership Framework for Chronic Illness

    OpenAIRE

    Anderson, Ruth A.; Bailey, Donald E.; Wu, Bei; Corazzini, Kirsten; Eleanor S. McConnell; Thygeson, N. Marcus; Docherty, Sharron L.

    2015-01-01

    We propose the Adaptive Leadership Framework for Chronic Illness as a novel framework for conceptualizing, studying, and providing care. This framework is an application of the Adaptive Leadership Framework developed by Heifetz and colleagues for business. Our framework views health care as a complex adaptive system and addresses the intersection at which people with chronic illness interface with the care system. We shift focus from symptoms to symptoms and the challenges they pose for patie...

  18. Summarizing activity limitations in children with chronic illnesses living in the community: a measurement study of scales using supplemented interRAI items

    Directory of Open Access Journals (Sweden)

    Phillips Charles D

    2012-01-01

    Full Text Available Abstract Background To test the validity and reliability of scales intended to measure activity limitations faced by children with chronic illnesses living in the community. The scales were based on information provided by caregivers to service program personnel almost exclusively trained as social workers. The items used to measure activity limitations were interRAI items supplemented so that they were more applicable to activity limitations in children with chronic illnesses. In addition, these analyses may shed light on the possibility of gathering functional information that can span the life course as well as spanning different care settings. Methods Analyses included testing the internal consistency, predictive, concurrent, discriminant and construct validity of two activity limitation scales. The scales were developed using assessment data gathered in the United States of America (USA from over 2,700 assessments of children aged 4 to 20 receiving Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT services, specifically Personal Care Services to assist children in overcoming activity limitations. The Medicaid program in the USA pays for health care services provided to children in low-income households. Data were collected in a single, large state in the southwestern USA in late 2008 and early 2009. A similar sample of children was assessed in 2010, and the analyses were replicated using this sample. Results The two scales exhibited excellent internal consistency. Evidence on the concurrent, predictive, discriminant, and construct validity of the proposed scales was strong. Quite importantly, scale scores were not correlated with (confounded with a child's developmental stage or age. The results for these scales and items were consistent across the two independent samples. Conclusions Unpaid caregivers, usually parents, can provide assessors lacking either medical or nursing training with reliable and valid information

  19. Chronic physical illness: a psychophysiological approach for chronic physical illness.

    Science.gov (United States)

    Purdy, Jana

    2013-03-01

    Growing evidence demonstrates that psychological risk variables can contribute to physical disease. In an effort to thoroughly investigate potential etiological origins and optimal interventions, this broad review is divided into five sections: the stress response, chronic diseases, mind-body theoretical models, psychophysiological interventions, and integrated health care solutions. The stress response and its correlation to chronic disorders such as cardiovascular, gastrointestinal, autoimmune, metabolic syndrome, and chronic pain are comprehensively explored. Current mind-body theoretical models, including peripheral nerve pathway, neurophysiological, and integrative theories, are reviewed to elucidate the biological mechanisms behind psychophysiological interventions. Specific interventions included are psychotherapy, mindfulness meditation, yoga, and psychopharmacology. Finally, the author advocates for an integrated care approach as a means by which to blur the sharp distinction between physical and psychological health. Integrated care approaches can utilize psychiatric nurse practitioners for behavioral assessment, intervention, research, advocacy, consultation, and education to optimize health outcomes. PMID:23483831

  20. Probiotics in critically ill children.

    Science.gov (United States)

    Singhi, Sunit C; Kumar, Suresh

    2016-01-01

    Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing either Lactobacillus alone or in combination with Bifidobacterium reduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administered Lactobacillus casei subspecies rhamnosus, Lactobacillus reuteri, and Lactobacillus rhamnosus were effective in the prevention of late-onset sepsis and GIT colonization by Candida in preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization by Candida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics, optimum dosage regimens

  1. Probiotics in critically ill children

    Science.gov (United States)

    Singhi, Sunit C.; Kumar, Suresh

    2016-01-01

    Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing either Lactobacillus alone or in combination with Bifidobacterium reduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administered Lactobacillus casei subspecies rhamnosus, Lactobacillus reuteri, and Lactobacillus rhamnosus were effective in the prevention of late-onset sepsis and GIT colonization by Candida in preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization by Candida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics, optimum dosage regimens

  2. Chronic Diarrhea in Children

    Science.gov (United States)

    ... can include cramping abdominal pain nausea or vomiting fever chills bloody stools Children with chronic diarrhea who have ... can include cramping, abdominal pain, nausea or vomiting, fever, chills, or bloody stools. Children with chronic diarrhea who ...

  3. Valiant Girls and Vulnerable Boys: The Impact of Gender and Race on Mothers' Caregiving for Chronically Ill Children.

    Science.gov (United States)

    Hill, Shirley A.; Zimmerman, Mary K.

    1995-01-01

    Thirty-two in-depth interviews with low-income African American mothers of children with Sickle Cell Disease revealed a gender-based pattern of caregiving: mothers of sons saw their children as sicker, were more likely to restrict their children's activities, and invested more effort in their caregiving than did mothers of daughters. (JPS)

  4. Stress in Adolescents with a Chronically Ill Parent: Inspiration from Rolland’s Family Systems-Illness Model

    OpenAIRE

    Sieh, D. S.; Dikkers, A. L. C.; Visser-Meily, J. M. A.; Meijer, A.M.

    2012-01-01

    This article was inspired by Rolland’s Family Systems-Illness (FSI) model, aiming to predict adolescent stress as a function of parental illness type. Ninety-nine parents with a chronic medical condition, 82 partners, and 158 adolescent children (51 % girls; mean age = 15.1 years) participated in this Dutch study. The Dutch Stress Questionnaire for Children was used to measure child report of stress. Ill parents completed the Beck Depression Inventory. Children filled in a scale of the Invent...

  5. Quality of life in chronic illness: perceptions of parents and paediatricians

    OpenAIRE

    2005-01-01

    Aims: To investigate the differences in perception of quality of life between parents of chronically ill children and paediatricians at diagnosis and follow up. Quality of life was assessed using the (HUI3).

  6. Support and education of immigrants with chronically ill children: Identified needs from a case study of Turkish and Kurdish families

    DEFF Research Database (Denmark)

    Povlsen, L.; Karlberg, I.; Ringsberg, K.C.

    2008-01-01

    Objective The aim of the study was to analyse how parents of Turkish and Turkish/Kurdish children with diabetes and health care professionals perceived the education and support provided, and to assess what was required to improve the collaboration between the families and the team in order to...... optimize selfcare and metabolic control. Design A case study including semi-structured interviews, participant observation and information from medical records. Setting The study was carried out in Copenhagen, Denmark. Method The study included 11 children aged 4-17 years of Turkish and Kurdish origin...

  7. Support and Education of Immigrants with Chronically Ill Children: Identified Needs from a Case Study of Turkish and Kurdish Families

    Science.gov (United States)

    Povlsen, Lene; Karlberg, Ingvar; Ringsberg, Karin C

    2008-01-01

    Objective: The aim of the study was to analyse how parents of Turkish and Turkish/Kurdish children with diabetes and health care professionals perceived the education and support provided, and to assess what was required to improve the collaboration between the families and the team in order to optimize selfcare and metabolic control. Design: A…

  8. A Retrospective Study of Dental Treatment under General Anesthesia of Children with or without A Chronic Illness and/or A Disability

    OpenAIRE

    Chia-Ling Tsai; Yi-Ling Tsai; Yng-Tzer Lin; Yai-Tin Lin

    2006-01-01

    Background: The indications for dental treatment under general anesthesia have beendescribed by various authors as extensive decay, behavioral managementproblems, a medically compromised patient, a handicapped patient, and acombination of these. Few studies have been undertaken to identify the rangeof treatment provided for chronically sick children. The aim of this studywas to identify the characteristics of dental procedures performed under generalanesthesia on children with a chronic illne...

  9. Parent-Child Collaborative Decision Making for the Management of Chronic Illness: A Qualitative Analysis

    OpenAIRE

    Miller, Victoria A.

    2009-01-01

    Parent-child collaborative decision making (CDM) is a potentially important precursor to full decision making independence and may be particularly significant for the management of childhood chronic illnesses. The primary aim of this qualitative study was to explore the concept of CDM from the perspective of children and parents. Children (ages 8-19 years) with asthma, type 1 diabetes, or cystic fibrosis and parents of children with these illnesses participated in focus groups and individual ...

  10. [Palliative care needs in advanced chronic illness].

    Science.gov (United States)

    Tripodoro, Vilma A; Rynkiewicz, María C; Llanos, Victoria; Padova, Susana; De Lellis, Silvina; De Simone, Gustavo

    2016-01-01

    About 75% of population will die from one or more chronic progressive diseases. From this projection WHO urged countries to devise strategies for strengthening palliative treatment as part of comprehensive care. In Catalonia, Spain, direct measurement of the prevalence of these patients with NECPAL CCOMS-ICO© tool was 1.5% of the population. This tool is an indicative, not dichotomous, quali-quantitative multifactorial evaluation to be completed by the treating physician. In Argentina there is no information on these patients. Our goal was to explore and characterize the proportion of chronically ill patients in palliative care needs, by NECPAL CCOMS-ICO© tool, in an accessible population of the City of Buenos Aires. General hospitals of the Health Region 2 (Piñero, álvarez and Santojanni) and its program areas were surveyed. In Health Region 1, we surveyed the Udaondo gastroenterology hospital. A total of 53 physicians (704 patients) were interviewed. It was identified that 29.5% of these patients were affected by advanced chronic diseases; 72.1% of them were NECPAL positive, younger (median 64) than in others studies, and more than 98% presented high levels of comorbidity. Palliative care demand (31.4%) and needs (52.7%) were recorded. Specific indicators of fragility, progression, severity and kind of chronic disease were described. The main finding was to identify, with an instrument not based on mortality that, in Buenos Aires City, 1 in 3 patients with chronic diseases could die in the next year and had palliative care needs. PMID:27295702

  11. 国外慢性病患儿父母亲职压力的研究%Research of parenting stress among caregivers of children with chronic illness in abroad

    Institute of Scientific and Technical Information of China (English)

    刘晓丹; 任静; 任琴; 杜柯凝

    2014-01-01

    Parenting stress is regarded as a criterion to evaluate the parent's mentation of children with chronic illness,it not only influence parent's care of children,but also decrease the quality of children's life.Si multaneously,it is a main reason of family imbalance.This paper introduces the definition of parenting stress and evaluation tool summarizes the cunent situation of research in abwad,provides a foundation in order to promote the research of parenting stress among caregivers of children with chronic illness.%亲职压力是评价慢性病患儿父母心理状态的指标,它不仅直接影响父母对患儿的照顾效果,使得患儿的生存质量下降;同时也是家庭功能失调的主要原因.本文介绍亲职压力的概念和测评工具,总结国外目前研究现状,为促进国内对慢性病患儿父母亲职压力的研究提供参考.

  12. Attributional analysis of chronic illness outcomes.

    Science.gov (United States)

    Lowery, B J; Jacobsen, B S

    1985-01-01

    The Weiner et al. attribution model has generated a great deal of research on attributions for success and failure in academic achievement situations. Studies of success and failure attributions in real-life situations of high personal concern are limited. If the attribution model is to lead to a general theory of motivation, such tests in real-life situations are critical. In this study, causal attributions for success and failure outcomes of chronically ill patients were examined. Results indicated at least partial support for the model. Patients tended to attribute success internally and failure externally, but stability and expectations were not linked in this sample. Moreover, a tendency to respond with no cause to an open-ended measure and to hold little commitment to any causes on a closed-ended measure was characteristic of failure subjects. PMID:3844736

  13. Labour participation of the chronically ill: a profile sketch.

    OpenAIRE

    Baanders, A.N.; Rijken, P.M.; Peters, L.

    2002-01-01

    To improve our understanding of the problematic labour market position of people with a chronic disease, this paper describes the participation rates of several subgroups of the chronically ill in the Netherlands, as well as the aspects by which the working chronically ill differ from those who are fully work-disabled and from those who are not working for other reasons. Methods: Data for this study are derived from the Panel of Patients with Chronic Diseases, a nationwide study in the Nether...

  14. The MMPI-2 in chronic psychiatric illness.

    Science.gov (United States)

    Bosch, Peggy; Van Luijtelaar, Gilles; Van Den Noort, Maurits; Schenkwald, Julia; Kueppenbender, Nicole; Lim, Sabina; Egger, Jos; Coenen, Anton

    2014-10-01

    While previous studies on the MMPI-2 in patients with schizophrenia and depression have used mixed samples of both early stage and chronic psychiatric patients. Here, it is investigated whether chronicity itself might have a differential effect on the MMPI-2 profiles of these patients and whether demoralization 'associated with long-term illness' affects the scales of the MMPI-2. Thirty long-term patients with schizophrenia, 30 long-term patients with depression, and 30 healthy participants completed the MMPI-2. Groups were compared on Clinical Scales and on the Restructured Clinical (RC) Scales. Patients with schizophrenia differed from patients with depression on 14 MMPI-2 scales and from healthy controls on 10 scales, generally showing mean UT-scores 65, indicating impaired functioning. Demoralization was higher in patients with depression than in patients with schizophrenia and both psychiatric groups differed from the healthy control group. It is concluded that long-term patients with depression show impaired functioning and high demoralization, while long-term patients with schizophrenia surprisingly show near normal functioning and less demoralization. PMID:25059636

  15. Peer interaction in adolescents with a chronic illness

    NARCIS (Netherlands)

    Meijer, SA; Sinnema, G; Bijstra, JO; Mellenbergh, GJ; Wolters, WHG

    2000-01-01

    This study examined behavioural, cognitive and affective aspects of peer interaction of adolescents with a chronic illness. The aim of the study was twofold: (1) describe peer interaction of adolescents with a chronic illness in comparison with norms of healthy adolescents; (2) examine the relations

  16. Psychosocial Aspects of Chronic Illness in Adolescents with Thalassaemia Major.

    Science.gov (United States)

    Zani, B.; And Others

    1995-01-01

    Evaluated the impact of chronic illness on the psychological functioning and social behavior of adolescent patients. A questionnaire was given to thalassaemics (n=90) and a control group (n=100) investigating coping strategies in stressful situations. Study supports hypothesis that chronic illness does not necessarily imply psychopathologies, but…

  17. The therapeutic effects of traditional Turkish Marbling Art on the treatment of children with suffering from chronic illnessesGeleneksel Türk Ebru Sanatının kronik hastalığı olan çocukların terapisi üzerine etkisi

    OpenAIRE

    Meltem Kürtüncü; Latife Utaş Akhan; Çelik Sevecen

    2014-01-01

    Chronic illness is defined as follows: “aberration or anomaly, a situation in which the patient may be left with permanent disability with no chances of recovery, where the patient is required to be treated for a long period of time, and maintained under constant supervision that would necessitate special training in terms of rehabilitation”. It is possible to obtain beneficial results in different areas in the case where children afflicted with chronic illnesses  are treated via art therapy....

  18. Use of the Internet by Patients with Chronic Illness

    OpenAIRE

    Richard W. Millard; Fintak, Patricia A.

    2002-01-01

    Objective: To understand how patients with chronic illness use the Internet to manage their health. Design and Participants: An online survey was conducted among 10 069 patients with chronic illnesses. Survey results were obtained from patients with 35 separate chronic conditions, with at least 50 respondents for each condition. The survey was administered online at a dedicated, password-protected web site. Data were analyzed to identify how online behavior varied by disease state and other d...

  19. Nutritional demands in acute and chronic illness.

    Science.gov (United States)

    Richardson, Rosemary A; Davidson, H Isobel M

    2003-11-01

    Common to both acute and chronic disease are disturbances in energy homeostasis, which are evidenced by quantitative and qualitative changes in dietary intake and increased energy expenditure. Negative energy balance results in loss of fat and lean tissue. The management of patients with metabolically-active disease appears to be simple; it would involve the provision of sufficient energy to promote tissue accretion. However, two fundamental issues serve to prevent nutritional demands in disease being met. The determination of appropriate energy requirements relies on predictive formulae. While equations have been developed for critically-ill populations, accurate energy prescribing in the acute setting is uncommon. Only 25-32% of the patients have energy intakes within 10% of their requirements. Clearly, the variation in energy expenditure has led to difficulties in accurately defining the energy needs of the individual. Second, the acute inflammatory response initiated by the host can have profound effects on ingestive behaviour, but this area is poorly understood by practising clinicians. For example, nutritional targets have been set for specific disease states, i.e. pancreatitis 105-147 kJ (25-35 kcal)/kg; chronic liver disease 147-168 kJ (35-40 kcal)/kg, but given the alterations in gut physiology that accompany the acute-phase response, targets are unlikely to be met. In cancer cachexia attenuation of the inflammatory response using eicosapentaenoic acid results in improved nutritional intake and status. This strategy poses an attractive proposition in the quest to define nutritional support as a clinically-effective treatment modality in other disorders. PMID:15018475

  20. Return Migration among Elderly, Chronically Ill Bosnian Refugees

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian;

    2015-01-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...... Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show...

  1. An intelligent partner system for improving chronic illness care

    Directory of Open Access Journals (Sweden)

    Tibor Deutsch

    2003-02-01

    Full Text Available Chronic care consists of a sequence of actions to treat a specific clinical disorder over time as a function of the ways in which illness progresses and patients respond to management actions. Outcomes depend on physicians' skills to select the actions best suited for their patients and competent self-management. This paper presents the architecture of an intelligent partner system (IPS, which helps to provide doctors with relevant data and skills and empowers chronically ill patients with the information and confidence to manage their health wisely. The services of this intelligent system are presented as 'therapies' for the information-processing 'pathologies' associated with traditional chronic illness care.

  2. Quality of life and uncertainty in illness for chronic patients

    Directory of Open Access Journals (Sweden)

    Valeria Caruso

    2014-09-01

    Full Text Available The experience of chronic illness, together with physical impairment and hospitalization in some cases, can be a difficult occurrence to manage. Illness determines changes in patients’ life style and limitations, that often cause psychological distress. It may happen that patients neither understand the meaning of the events correlated with illness, nor can predict when such events will occur. This uncertainty augments the negative impact of the state of chronic illness on patients’ quality of life. The present study has the purpose to examine the correlations between uncertainty due to  chronic disease and patients’ quality of life, keeping into account the diverse coping strategies adopted and the anxiety/depression feelings developed during hospitalization. There is an inverse correlation between chronic patients’ quality of life and the diverse dimensions of uncertainty in illness as identified by the Mishel Uncertainty in Illness Scale. The paper suggests how uncertainty hampers the possibility that patients choose coping strategies, involving their active management of illness. The lower the uncertainty, the higher is the possibility of activate coping mechanisms based on the acceptance of illness, together with a reflexive attitude concerning the actions to be taken to reduce the risk of anxiety/depression during hospitalization. Finally, the present study presents some policy implications, suggesting how the medical staff should not only treat patients, but also help patients to elaborate problem solving strategies and to positively accept their chronic health state.

  3. Chronic cough in children.

    Science.gov (United States)

    Wagner, Johana B Castro; Pine, Harold S

    2013-08-01

    The management of chronic cough, a common complaint in children, is challenging for most health care professionals. Millions of dollars are spent every year on unnecessary testing and treatment. A rational approach based on a detailed interview and a thorough physical examination guides further intervention and management. Inexpensive and simple homemade syrups based on dark honey have proved to be an effective measure when dealing with cough in children. PMID:23905830

  4. Living with a chronic illness - dealing with feelings

    Science.gov (United States)

    ... a chronic illness can bring up many different feelings. Learn about common emotions you might have when you are diagnosed and ... and how to take care of yourself, your feelings may change. Fear or shock may give way ...

  5. Chronic kidney disease in children.

    Science.gov (United States)

    Becherucci, Francesca; Roperto, Rosa Maria; Materassi, Marco; Romagnani, Paola

    2016-08-01

    Chronic kidney disease (CKD) is a major health problem worldwide. Although relatively uncommon in children, it can be a devastating illness with many long-term consequences. CKD presents unique features in childhood and may be considered, at least in part, as a stand-alone nosologic entity. Moreover, some typical features of paediatric CKD, such as the disease aetiology or cardiovascular complications, will not only influence the child's health, but also have long-term impact on the life of the adult that they will become. In this review we will focus on the unique issues of paediatric CKD, in terms of aetiology, clinical features and treatment. In addition, we will discuss factors related to CKD that start during childhood and require appropriate treatments in order to optimize health outcomes and transition to nephrologist management in adult life. PMID:27478602

  6. From Controlling to Letting Go: What Are the Psychosocial Needs of Parents of Adolescents with a Chronic Illness?

    Science.gov (United States)

    Akre, Christina; Suris, Joan-Carles

    2014-01-01

    While one of the main objectives of adolescence is to achieve autonomy, for the specific population of adolescents with a chronic illness (CI), the struggle for autonomy is accentuated by the limits implied by their illness. However, little is known concerning the way their parents manage and cope with their children's autonomy acquisition.…

  7. Benzodiazepine pathways in the chronically ill

    NARCIS (Netherlands)

    Van Hulten, Rolf; Heerdink, Eibert R.; Bakker, Albert; Leufkens, Hubert G.

    1999-01-01

    The association between patterns of use of benzodiazepines and chronic somatic morbidity was examined by applying the Chronic Disease Score (CDS). In the only pharmacy in a Dutch community, 6921 patients with data available covering a 10-year period (1983-1992) were included. In 1992, two-thirds of

  8. Examining the Education Gradient in Chronic Illness

    Science.gov (United States)

    Chatterji, Pinka; Joo, Heesoo; Lahiri, Kajal

    2015-01-01

    We examine the education gradient in diabetes, hypertension, and high cholesterol. We take into account diagnosed as well as undiagnosed cases and use methods accounting for the possibility of unmeasured factors that are correlated with education and drive both the likelihood of having illness and the propensity to be diagnosed. Data come from the…

  9. Merging the person and the illness: the lived experience of emerging adults with childhood onset chronic illness

    OpenAIRE

    MacDermott , Siobhan J.

    2015-01-01

    Chronic illness is emerging as major health problem in the developing and developed world. The increased prevalence of childhood chronic conditions such as asthma and diabetes coupled with the successful management of childhood onset disease has altered the landscape of chronic illness among young people. The purpose of this study is to explore the lived experiences of emerging adults who have grown up and live with chronic illness since childhood. The health of emerging adults (18 to 25 year...

  10. Bullying e a criança com doença crónica Bullying y el niño con enfermedad crónica Bullying and children with chronic illness

    Directory of Open Access Journals (Sweden)

    Margarida Rita de Jesus Azenha

    2012-03-01

    guiar la revisión se utilizaron las palabras de búsqueda: “niño”, “bullying”, “necesidades especiales”, “enfermedad crónica”, “victimización”, “violencia”, “agresión” y “daños psicológicos”, tras lo cual se identificaron 97 artículos de los cuales se seleccionaron 40, se localizaron 10 y se utilizaron 6. Los resultados de la búsqueda fueron analizados de acuerdo con el tema investigado y los aspectos metodológicos clasificados. Los principales tópicos tratados en los estudios fueron la incidencia del bullying, las distintas formas de bullying y la quiebra del silencio por parte del niño. Los estudios analizados muestran la relación entre el hecho de que el niño sea portador de enfermedad crónica y que sea víctima de bullying, tras compararlos con el grupo de niños sanos. Los estudios revelaron que existen diferencias significativas entre tener o no una enfermedad crónica y ser víctima de bullying.Awareness of the very high prevalence of chronic illness in children led us to carry out a systematic literature review of studies indexed in the databases SciElo, LILACS, CINAHL, PubMed, Nursing Reference Center, PepsiCo, Medline, PsycoInfo and ScienceDirect published between 2001 and 2010, related to the topic bullying in Children with Chronic Illness, in which we tried to determine whether children with a chronic illness are more likely to be victims of bullying than healthy children. To guide the review we used the search words “child,” “bullying”, “special needs”, “chronic disease”, “victimization,” “violence”, “aggression” and “psychological damage”, and identified 97 articles, 40 of which were selected, 10 were located and 6 were used. The results were analyzed according to the topic investigated and the methodological aspects were categorized. The main topics covered in the study were the incidence of bullying, different forms of bullying and breaking of silence by the child. The studies

  11. [Compliance among adolescents with a chronic illness: review].

    Science.gov (United States)

    Bouteyre, E; Loue, B

    2012-07-01

    The continual progress in medicine has increased patient life expectation. However, treatments for chronic diseases are often consequential. This leads to problems of patient compliance, most particularly in teenage patients. Depression is frequently observed in persons affected by a chronic illness. These diseases can cause despair, which contributes to the risk of suicide. This article investigates the various notional and explanatory approaches to compliance. The literature review was based on the CAIRN, Medline, and EBSCOhost databases. The period investigated extended from 1999 to 2009. The keywords used were "adhésion thérapeutique", "observance", "compliance", "adolescence", "chronic illness", and "depression". Three axes stand out from this review: (1) the theoretical definition of compliance, (2) the frequency of depressive disorders among adolescents affected by a chronic illness, (3) the different ways to interpret compliance. We introduce and discuss the contents of each of these axes and discuss how they could orient research on the compliance of adolescents with a chronic illness. PMID:22658866

  12. Salivary Amylase Level in Bronchoalveolar Fluid as a Marker of Chronic Pulmonary Aspiration in Children

    OpenAIRE

    Abu-Hasan, Mutasim; Elmallah, Mai; Neal, Dan; Brookes, James

    2014-01-01

    Background: Chronic pulmonary aspiration is a common cause of chronic respiratory symptoms in children. However, there is no gold standard diagnostic test for aspiration. In this study, we explore the diagnostic value of measuring salivary amylase in bronchoalveolar lavage (BAL) fluid as a marker of chronic aspiration in children with different chronic respiratory illnesses.

  13. Older Adults’ Perception of Chronic Illness Management in South Korea

    OpenAIRE

    Kang, Minah; Kim, Jaiyong; Bae, Sang-Soo; Choi, Yong-Jun; Shin, Dong-Soo

    2014-01-01

    Objectives: Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness. Methods: We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed...

  14. Economic hardship associated with managing chronic illness: a qualitative inquiry

    Directory of Open Access Journals (Sweden)

    Jan Stephen

    2009-10-01

    Full Text Available Abstract Background Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness. Methods Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66. Content analysis guided the interpretation of data. Results The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in self-management and risk reduction behaviours. Factors exacerbating hardship included ineligibility for government support, co-morbidity, health service flexibility, and health literacy. Participants who were on multiple medications, from culturally and linguistically diverse or Indigenous backgrounds, and/or not in paid employment, experienced economic hardship more harshly and their management of chronic illness was jeopardised as a consequence. Economic hardship was felt among not only those ineligible for government financial supports but also those receiving subsidies that were insufficient to meet the costs of managing long-term illness over and above necessary daily living expenses. Conclusion This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity

  15. Divorce and Childhood Chronic Illness: A Grounded Theory of Trust, Gender, and Third-Party Care Providers.

    Science.gov (United States)

    Russell, Luke T; Coleman, Marilyn; Ganong, Lawrence H; Gayer, Debra

    2016-05-01

    Divorced parents face distinct challenges in providing care for chronically ill children. Children's residence in two households necessitates the development of family-specific strategies to ensure coparents' supervision of regimen adherence and the management of children's health care. Utilizing a risk and resilience perspective, a grounded theory study was conducted with 14 divorced parents of children with chronic illnesses. The importance of trust, gender, and relationships with third-party care providers emerged as key themes related to the development of effective coparenting relationships for maintaining children's health. Divorced parents were best able to support the management of their children's chronic conditions when care providers operated as neutral third parties and intermediaries. Collaborative family care may require health care practitioners to avoid being drawn into contentious inter-parental conflicts. PMID:27021310

  16. Smoking cessation and reduction in people with chronic mental illness

    Science.gov (United States)

    Miller, Mollie E

    2015-01-01

    The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness. PMID:26391240

  17. Return Migration among Elderly, Chronically Ill Bosnian Refugees

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian;

    2015-01-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...

  18. The role of illness perceptions in labour participation of the chronically ill.

    NARCIS (Netherlands)

    Boot, C.R.L.; Heijmans, M.; Gulden, J.W.J. van der; Rijken, M.

    2008-01-01

    OBJECTIVE: We aimed to investigate associations between work disability and illness perceptions, over and above medical assessment and self-reported health. METHODS: A representative sample of people aged 15-64 years with various chronic physical diseases was derived from the Panel of Patients with

  19. Home Health Care for Chronically Ill Children: Hearing before the Committee on Labor and Human Resources, United States Senate, Ninety-Ninth Congress, First Session on Examining the Needs for Pediatric Home Care for Children with Long-Term Illnesses and Disabilities.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    The proceedings of the 1985 hearing address issues in pediatric home care for children with long-term illnesses and disabilities. Statements of parents center on extreme expenses of home care and the difficulties of finding financial aid. Additional testimony is offered by representatives of home health care agencies, physicians involved in care…

  20. Nursing the chronically critically ill patient.

    Science.gov (United States)

    Carasa, Miriam; Nespoli, Grace

    2002-07-01

    The provision of care to the CCI patient is complex, challenging, and unique. The advanced practice nursing model at Mount Sinai Hospital is one successful care delivery model that fills the needs of both CCI patients and the nurses who work with them. The following transferable aspects of the RCU add to the unit's successful outcomes: (1) an interdisciplinary approach assures that all aspects of care are included in the clinical plan; (2) clinical care pathways, algorithms, and standard protocols based on physician, NP, and clinical nurse collaboration are successful management strategies; (3) formal discharge planning meetings with participation of patients, families, NPs, and social workers provide a forum for discharge planning and an avenue to address ethical issues such as advance directives, resuscitation status, and patient self-determination decisions; (4) full participation by nurses in all aspects of the unit's activities is a cost-effective strategy for maximizing positive outcomes for patients and their families. RCU patients and their families are in great need of emotional support. Patients have survived catastrophic illnesses, and are facing the arduous task of pulmonary rehabilitation as the desired outcome. Those patients unable to wean need to plan for a life dependent on ventilatory support. Presently in New York, there are not enough facilities to care for ventilator-dependent patients or patients who are weaned but in need of further pulmonary care and rehabilitation. The RCU LOS reflects this situation. Although a cost-benefit analysis is an effective way to evaluate the RCU program, the human element must not be forgotten. This is the daily challenge for the RCU staff and other health professionals engaged in the care of the CCI patient. Although the aim of this paper is to share the experience of patients and health care providers in the RCU, the reader should be aware that the RCU operates in the context of health care delivery at an

  1. Parent-child collaborative decision making for the management of chronic illness: a qualitative analysis.

    Science.gov (United States)

    Miller, Victoria A

    2009-09-01

    Parent-child collaborative decision making (CDM) is a potentially important precursor to full decision-making independence and may be particularly significant for the management of childhood chronic illnesses. The primary aim of this qualitative study was to explore the concept of CDM from the perspective of children and parents. Children (ages 8-19 years) with asthma, type 1 diabetes, or cystic fibrosis and parents of children with these illnesses participated in focus groups and individual interviews. Participants described various ways they collaborate with one another (e.g., asking for the other's opinion; providing information). Participants viewed collaboration as beneficial, regardless of who ultimately makes the decision. Several factors emerged as potential predictors of CDM, including parent/family factors (e.g., parental time; parent-child conflict), child factors (e.g., maturity; emotional/behavioral functioning), and decision/situation factors (e.g., seriousness of the decision; extent to which the child is experiencing symptoms). These data suggest ways to enhance collaborative decision-making interactions between children with a chronic illness and their parents, as well as several areas for future quantitative research. PMID:19803619

  2. Solar Injury and Heat Illness. Treatment and Prevention in Children.

    Science.gov (United States)

    Gutierrez, Greg

    1995-01-01

    Children are especially vulnerable to solar injury and heat illness. Physicians can lower children's risk through education about short-term and long-term sequelae and through various prevention efforts. The paper discusses how to screen for risk factors and how to prevent and treat heat illness and solar injury. (SM)

  3. Children's Illnesses: Their Beneficial Effects on Behavioral Development.

    Science.gov (United States)

    Parmelee, Arthur H. Jr.

    1986-01-01

    Discusses potential beneficial effects of children's illnesses on their behavioral development. It is argued, on the basis of clinical experience and related research, that minor illnesses give children many opportunities to increase knowledge of self, other, prosocial behavior, and empathy and to realistically understand the sick role. (Author/RH)

  4. [Care and chronic illness: family caregiver's viewpoint in northeast Brazil].

    Science.gov (United States)

    Pinto, Juliana Maria de Sousa; Nations, Marilyn Kay

    2012-02-01

    The provision of care causes stress in everyday family dynamics leading to physical, mental and emotional complications in caregivers and spouses' loss of liberty and/or overwork. Between March and November 2006, this anthropological research examined family caregiving in the context of Chronic Obstructive Pulmonary Disease (COPD). By means of ethnographic interviews, illness narratives and participant observation, the scope was to describe family reorganization and coexistence with the disease and its evolution, caregiver perceptions about patient difficulties and limitations experienced and strategies employed to tackle their illness. Six low-income family caregivers, living in poor, urban areas in the outskirts of the capital city, Fortaleza, Ceará, Brazil, participated in the study. From the Content Analysis, two categories arose: "sharing suffering" and "attitudes and behavior perceived and experienced by caregivers." In-depth narratives revealed marked affection between patients and their family caregivers. Despite poverty, structural violence, unemployment, social prejudice and low salaries endemic in the Northeast of Brazil, the caregivers find effective ways to cope with chronic illness besides creating strategies to diminish suffering caused by the illness. PMID:22267046

  5. Serving the Student-Survivor: Exploring the Transitional and Psychosocial Needs of School-Aged Children with Cancer and Chronic Illness

    Science.gov (United States)

    Lanin, Devon Malia

    2014-01-01

    The advances in medicine today have created an emerging population of student-survivors, school-aged children living with and/or recovering from serious health conditions (Bauman, 2010). Each school day in the United States, 46 young people, or the equivalent of two classrooms of students, learn they have cancer (Cure Search National Childhood…

  6. Daily life for chronically ill oldest old persons

    Directory of Open Access Journals (Sweden)

    Aud Moe

    2012-06-01

    Full Text Available In the past, the study of old age often focused on the losses and problems associated with ageing. In recent times, the focus has been on the positive aspects, such as quality of life, inner strength, and enjoying life. The aims of this study were to highlight the ways in which chronically ill older persons experience the meaning of daily life and to understand what it means to live at home with chronic disease. In-depth interviews were used to illustrate individual experiences. The sample consisted of 13 chronically ill persons, aged 80 to 94 years, living at home and receiving assistance in the form of home nursing care. Data were analyzed using the phenomenological hermeneutical method. After a naïve reading and a structural analysis of the text, we identified three themes: being insufficient, becoming dependent, and enjoying life. The comprehensive understanding suggested that daily life involved bad days, described as illness with dysfunctions, limited energy, and dependency on others. Daily life also had its positive aspects, described as enjoying life. Dignity was threatened by feelings of being a burden to others and was affirmed by experiencing a will to live. It was concluded that bad days with experiences of suffering and good days that provided the older with experiences of enjoying life could help them meet adversity through qualities of resilience that gave meaning to daily life and helped them to think positively in times of greater difficulty.

  7. Just regionalisation: rehabilitating care for people with disabilities and chronic illnesses

    Directory of Open Access Journals (Sweden)

    Wagner Frank

    2006-08-01

    Full Text Available Abstract Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs. The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i rehabilitation and services for people with disabilities; (ii chronic illness and cancer care; (iii senior's health; (iv community support services; (v children's health; (vi health promotion; and (vii mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper

  8. Chronic Rhinosinusitis in Children

    OpenAIRE

    Ramadan, Hassan H.

    2012-01-01

    Rhinosinusitis is a very common disease worldwide and specifically in the US population. It is a common disease in children but may be underdiagnosed. Several reasons may account to the disease being missed in children. The symptoms in children are limited and can be very similar to the common cold or allergic symptoms. Cough and nasal discharge may be the only symptoms present in children. A high index of suspicion is necessary to make the diagnosis of rhinosinusitis in these children. The m...

  9. Psychosocial correlates of illness burden in chronic fatigue syndrome.

    Science.gov (United States)

    Antoni, M H; Brickman, A; Lutgendorf, S; Klimas, N; Imia-Fins, A; Ironson, G; Quillian, R; Miguez, M J; van Riel, F; Morgan, R

    1994-01-01

    We related reported physical symptoms, cognitive appraisals (e.g., negative style of thinking), and coping strategies (e.g., denial/disengagement strategies) with illness burden across several functional domains separately in subsets of chronic fatigue syndrome (CFS) patients with (n = 26) and without (n = 39) concurrently diagnosed major depressive disorder (MDD). In regard to cognitive appraisal measures, automatic thoughts and dysfunctional attitudes were strongly associated with a higher illness burden, as indicated in sickness impact profile (SIP) scores. Active-involvement coping strategies measured on COPE scales (active coping, planning, and positive reinterpretation and growth) were not associated with SIP scores, while other coping strategies (mental disengagement, behavioral disengagement, and denial) were positively correlated with psychosocial and physical SIP scales, especially those pertaining to interpersonal life-style arenas. After we accounted for the number of different CFS-specific physical complaints reported and DSM-III-R depression diagnosis status, cognitive appraisals and coping strategies predicted a substantial proportion of the variance in the severity of illness burden. For the most part, the magnitude of these relationships between our predictor model variables and illness burden severity was similar in the MDD and non-MDD subgroups. PMID:8148457

  10. Exploring the spiritual needs of families with seriously ill children.

    Science.gov (United States)

    Ferrell, Betty; Wittenberg, Elaine; Battista, Vanessa; Walker, Gay

    2016-08-01

    Although we know that families of seriously ill children experience spiritual distress, especially at the end of the child's life, there is little information on the specific spiritual needs of families. In order to develop further training for nurses in paediatrics and help nurses develop skills for communicating about spirituality, this research examined the spiritual needs of families based on nurses' experiences with families of seriously ill children. Nurses' experiences revealed that families' anger with God, blame/regret, forgiveness, and ritual and cultural traditions are salient spiritual needs requiring effective nurse communication skills to support families of ill children. PMID:27568778

  11. The injustice of it all: caring for the chronically ill.

    Science.gov (United States)

    Zaner, Richard M; Bliton, Mark J

    1991-01-01

    ... While Spiegelberg emphasizes these "cosmic" -- perhaps more accurately, ontological -- features of birth and undeserved inequalities, it seems to us not inappropriate to suggest that what Douard terms "outrage" and Annas "instinct" go in the same direction. When impairment occurs without desert, something should be done to help. This is all the more true when, as in cases of chronic affliction that concern Douard or the case of the Siamese twins that fascinates Annas, something helpful can be done. Then, in Spiegelberg's words, what is "undeserved" demands redress. In these terms, each of these authors points to a deeply rooted sense of our common human lot. Or, in Albert Schweitzer's apt phrase, to witness such undeserved misfortune is to awaken "a moral sense that is usually dormant but that on special occasions can be brought to the surface." Chronic illnesses, we suggest -- no less than the "accidents of birth" that concern Spiegelberg -- are just such "special occasions" for awakening that "moral sense" suggested by Douard in his appeal to the "outrage" of doing nothing for, or refusing to help, the chronically ill. PMID:11642945

  12. The Impact of Chronic Illness on Psychosocial Stages of Human Development.

    Science.gov (United States)

    Lapham, E. Virginia, Ed.; Shevlin, Kathleen M., Ed.

    This book addresses critical issues regarding the impact of chronic illness and disability on human development. It was written for health care professionals who help chronically ill and disabled persons deal with the psychological and social as well as the biological aspects of their illness or disability. An expanded version of Erik Erikson's…

  13. Continuous glucose monitors prove highly accurate in critically ill children

    OpenAIRE

    Bridges, Brian C.; Preissig, Catherine M; Maher, Kevin O.; Rigby, Mark R

    2010-01-01

    Introduction Hyperglycemia is associated with increased morbidity and mortality in critically ill patients and strict glycemic control has become standard care for adults. Recent studies have questioned the optimal targets for such management and reported increased rates of iatrogenic hypoglycemia in both critically ill children and adults. The ability to provide accurate, real-time continuous glucose monitoring would improve the efficacy and safety of this practice in critically ill patients...

  14. Collaborative Chronic Care Networks (C3Ns) to Transform Chronic Illness Care

    OpenAIRE

    Margolis, Peter A; Peterson, Laura E.; Seid, Michael

    2013-01-01

    Despite significant gains by pediatric collaborative improvement networks, the overall US system of chronic illness care does not work well. A new paradigm is needed: a Collaborative Chronic Care Network (C3N). A C3N is a network-based production system that harnesses the collective intelligence of patients, clinicians, and researchers and distributes the production of knowledge, information, and know-how over large groups of people, dramatically accelerating the discovery process. A C3N is a...

  15. Children's Moral Reasoning about Illness in Chhattisgarh, Central India

    Science.gov (United States)

    Froerer, Peggy

    2011-01-01

    This article is about children's moral reasoning about illness and supernatural retribution in a rural tribal community in Chhattisgarh, central India. Detailed ethnographic analysis is devoted to the norms and experiences within which conceptions about illness causality and morality are formed. The author is principally interested in the…

  16. Chronic unremitting headache associated with Lyme disease-like illness

    Directory of Open Access Journals (Sweden)

    Pedro Andre Kowacs

    2013-07-01

    Full Text Available The Brazilian Lyme-disease-like illness (BLDLI or Baggio-Yoshinari syndrome is a unique zoonosis found in Brazil. It reproduces all the clinical symptoms of Lyme disease except for the high frequencies of relapse and the presence of autoimmune manifestations. Two cases of borreliosis manifesting with unremitting headache, which is a symptom associated with late-stage BLDLI, were presented. Clinical, therapeutic, and prognostic aspects of the BLDLI and its associated headaches were showed and discussed in this article. BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse one. Special attention should be paid to patients with headaches who have traveled to endemic areas.

  17. Efficiency of physical rehabilitation at chronic gastroduodenit for children

    Directory of Open Access Journals (Sweden)

    Grygus I.М.

    2011-04-01

    Full Text Available For the rehabilitation of patients chronic gastroduodenit on a background medicinal treatment the special program of physical rehabilitation is offered in permanent establishment that includes the modified methods of medical physical culture, massage and use of mineral water of «Red viburnum». Application of physical rehabilitation in complex therapy of chronic gastroduodenit for children resulted in normalization of acidogenic function of stomach, assisted to more rapid regress of clinical displays of illness, promoted a physical health level.

  18. Experiences of SKYPE Communication in Education and Research--Data Collection Concerning Young Children with Long-Term Illness

    Science.gov (United States)

    Svensson, Agneta Simeonsdotter; Samuelsson, Ingrid Pramling; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt

    2014-01-01

    The purpose of this paper is to provide knowledge about communication using SKYPE with young children with chronic illness; advantages and barriers are investigated related to education and data issues collection. A qualitative exploratory research method was applied to interviews and notes via SKYPE between children and their web teachers. The…

  19. Adolescents with Chronic Illnesses: School Absenteeism, Perceived Peer Aggression, and Loneliness

    OpenAIRE

    Shute, Rosalyn H.; Christine Walsh

    2005-01-01

    Frequent school absence is often cited as a risk factor for peer relationship problems in youngsters with chronic illnesses, but this assumption has not been subjected to quantitative empirical examination. This issue was examined in the present study by exploring the relationship between school absenteeism, peer aggression, and loneliness in adolescents with chronic illnesses. Forty-one adolescents with chronic illnesses completed a modified version of the Direct and Indirect Aggression Scal...

  20. The Depiction of Mental Illnesses in Children's Television Programs

    Science.gov (United States)

    Wahl, Otto; Hanrahan, Erin; Karl, Kelly; Lasher, Erin; Swaye, Janel

    2007-01-01

    Concern has been expressed that negative attitudes toward people with mental illnesses begin to develop early in childhood. This study examines one of the possible sources of learning of such negative attitudes--children's television programs. Two hundred sixty-nine (269) hours of children's television programming were videotaped, viewed, and…

  1. Continuous renal replacement therapy for critically ill infants and children

    DEFF Research Database (Denmark)

    Pedersen, Ole; Jepsen, Søren Bruun; Toft, Palle

    2012-01-01

    Continuous renal replacement therapy (CRRT) is an important treatment in critically ill children with acute kidney injury (AKI). Over the past decade, CRRT has been the preferred method of renal replacement therapy. We compared children with CRRT-treated adults with AKI in terms of return of kidney...

  2. [Illness concepts of children. Validation of a modified locus of control test in illness and health].

    Science.gov (United States)

    Schmidt, A; Altmann-Herz, U

    1992-12-01

    We investigated the health and illness concepts of 53 healthy children aged 8 to 14 years using a modified illness and health locus of control scale (KKG, Lohaus and Schmitt, 1989) with the scales internal, external-p (powerful others) and external-c (chance). A comparison of the results with those on self-esteem (FSK 4-6), anxiety (CMAS-R) and hopelessness (HSC) scales showed a decrease in externality, but not an increase in internality, with increasing age and a correlation between self-confidence and a more internal locus of control. The influence of children's health locus of control on treatment compliance is discussed. PMID:1288033

  3. The crisis in the chronic physical illness of the child and the adjustment difficulties of its family

    Directory of Open Access Journals (Sweden)

    Chrysa Valamoutopoulou

    2014-01-01

    Full Text Available Chronic physical illness burdens children and their families with organic and functional problems, repeated medical visits, complicated tests, frequent hospitalizations, uncertainty about the future and complex secondary psychological, social and educational problems. Purpose: The purpose of the present study was the presentation and the critical approach to the adjustment difficulties of a child with chronic disease (7-11 years and of its family as recorded in Greece and internationally. Material and Methods: In this review, the methodology followed included specialized electronic search of articles in PubMed, in international and Greek biomedical journals that explore the process of adaptation of children to chronic diseases such as asthma, diabetes, thalassemia, cardiovascular diseases and neoplasms using special keywords e.g. chronic physical illness, chronic disease and family, child and chronic disease. There were 29 foreign articles and 16 greek ones during the last fifteen years. Results: Children with chronic physical diseases face psycho-emotional difficulties (depression, increased anxiety, behavioural disorders (hyperactivity, social isolation and learning difficulties. Their families are equally affected by chronic disease on multiple levels as their cohesion is disrupted as well as the emotional relationships between them, the roles they should adopt towards the new situation (difficulties between the couple and the siblings. This situation in Greece highlights major problems and failures that require immediate attention (on grants and donations to associations, insurance providers, staffing and operation of hospital units, public awareness, etc. Conclusions: The comprehensive treatment of the effects of chronic physical illness, both medical and psychosocial in level, requires the provision of comprehensive care through coordinated medical, psychological, educational and social services.

  4. Indications and Effects of Plasma Transfusions in Critically Ill Children

    DEFF Research Database (Denmark)

    Karam, Oliver; Demaret, Pierre; Shefler, Alison;

    2015-01-01

    critically ill children admitted to a participating unit were included if they received at least one plasma transfusion. MEASUREMENTS AND MAIN RESULTS: During the 6 study weeks, 13,192 children were eligible. Among these, 443 (3.4%) received at least one plasma transfusion and were included. The primary......RATIONALE: Plasma transfusions are frequently prescribed for critically ill children, although their indications lack a strong evidence base. Plasma transfusions are largely driven by physician conceptions of need, and these are poorly documented in pediatric intensive care patients. OBJECTIVES: To...... identify patient characteristics and to characterize indications leading to plasma transfusions in critically ill children, and to assess the effect of plasma transfusions on coagulation tests. METHODS: Point-prevalence study in 101 pediatric intensive care units in 21 countries, on 6 predefined weeks. All...

  5. "What we want": Chronically ill adolescents' preferences and priorities for improving health care

    NARCIS (Netherlands)

    A.L. van Staa (AnneLoes); S. Jedeloo (Susan); H.A. van der Stege (Heleen)

    2011-01-01

    textabstractBackground: As important users of health care, adolescents with chronic conditions deserve to be consulted about their experiences and expectations. This study aimed to explore chronically ill adolescents' preferences regarding providers' qualities, and outpatient and inpatient care. Fur

  6. [Opinions on the prevention and treatment of chronic critical illness].

    Science.gov (United States)

    An, Youzhong

    2016-07-01

    Chronic critical illness (CCI) is an inevitable result of overpopulation and aging, as well as the development of medicine. The number of CCI patients will constantly increase and become an unaffordable economic burden for families, societies and countries. CCI could be prevented by multiple measures. Firstly, doctors must know about the pathophysiology and etiology of the disease. When providing organ function support for CCI patient, we have to know and treat the cause of the disease as early as possible. Secondly, we need to precisely monitor the insults caused by the disease and/or improper host response to the disease, evaluate the organ reserve function, and predict the outcomes and life quality after discharging from hospital. In addition, it is necessary to strengthen the humanity training of health care workers, publicize the correct thanatopsis in the whole society that every life is "born to die", and define the core role of medicine as "to comfort always". PMID:27452750

  7. Training young parents to identify and report their children's illnesses.

    OpenAIRE

    Delgado, L E; Lutzker, J R

    1988-01-01

    We developed a comprehensive training program to teach young parents what symptoms to look for to judge the severity of their children's illnesses, what to do at home to comfort their children, and when to consult their children's physician or take them for emergency treatment. Three pairs of subjects received training that included written handouts, verbal instructions, modeling, positive practice, and verbal reinforcement. Skill acquisition was assessed by a behavioral test in which parents...

  8. Pertussis immunisation and serious acute neurological illness in children.

    OpenAIRE

    Ebrahim, Shah

    1981-01-01

    The first 1000 cases notified to the National Childhood Encephalopathy Study were analysed. The diagnoses included encephalitis/encephalopathy, prolonged convulsions, infantile spasms, and Reye's syndrome. Eighty-eight of the children had had a recent infectious disease, including 19 with pertussis. Only 35 of the notified children (3.5%) had received pertussis antigen within seven days before becoming ill. Of 1955 control children matched for age, sex, and area of residence, 34 (1.7%) had be...

  9. Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions

    Science.gov (United States)

    ... severe illness, and at times can lead to death. Children younger than five, but especially children younger than 2 years old, and children and adolescents with chronic health conditions are at ... in hospital stays and even death. The best way to prevent the flu is ...

  10. Chronic Hemodialysis in Small Children.

    Science.gov (United States)

    Novljan, Gregor; Rus, Rina R; Premru, Vladimir; Ponikvar, Rafael; Battelino, Nina

    2016-06-01

    When peritoneal dialysis is inapplicable, chronic hemodialysis (HD) becomes the only available treatment option in small children. Due to small patient size, central venous catheters (CVC) are mainly used for vascular access. Over the past 4 years, four children weighing less than 15 kg received chronic HD in our unit. A total of 848 dialysis sessions were performed. Altogether, 21 catheters were inserted. In all but one occasion, uncuffed catheters were used. Catheter revision was performed 15 times during the study period, either due to infection or catheter malfunction. The median number of catheter revisions and the median line survival was 3.0/patient-year and 53 days (range; 6-373 days), respectively. There were 14 episodes of catheter related infections requiring 11 CVC revisions (78.6%). The median rate of line infections was 2.8/patient-year. Chronic HD in small children is demanding and labor intensive. Issues pertain mainly to CVCs and limit its long-term use. PMID:27312919

  11. Health-related financial catastrophe, inequality and chronic illness in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Mizanur Rahman

    Full Text Available BACKGROUND: Bangladesh has a high proportion of households incurring catastrophic health expenditure, and very limited risk sharing mechanisms. Identifying determinants of out-of-pocket (OOP payments and catastrophic health expenditure may reveal opportunities to reduce costs and protect households from financial risk. OBJECTIVE: This study investigates the determinants of high healthcare expenditure and healthcare- related financial catastrophe. METHODS: A cross-sectional household survey was conducted in Rajshahi city, Bangladesh, in 2011. Catastrophic health expenditure was estimated separately based on capacity to pay and proportion of non-food expenditure. Determinants of OOP payments and financial catastrophe were estimated using double hurdle and Poisson regression models respectively. RESULTS: On average households spent 11% of their total budgets on health, half the residents spent 7% of the monthly per capita consumption expenditure for one illness, and nearly 9% of households faced financial catastrophe. The poorest households spent less on health but had a four times higher risk of catastrophe than the richest households. The risk of financial catastrophe and the level of OOP payments were higher for users of inpatient, outpatient public and private facilities respectively compared to using self-medication or traditional healers. Other determinants of OOP payments and catastrophic expenses were economic status, presence of chronic illness in the household, and illness among children and adults. CONCLUSION: Households that received inpatient or outpatient private care experienced the highest burden of health expenditure. The poorest members of the community also face large, often catastrophic expenses. Chronic illness management is crucial to reducing the total burden of disease in a household and its associated increased risk of level of OOP payments and catastrophic expenses. Households can only be protected from these situations by

  12. Continuous EEG in Critically Ill Children

    OpenAIRE

    Jonathan E Kurz; Wainwright, Mark S

    2015-01-01

    Investigators from the Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society reported a consensus statement on indications for the use of critical care continuous electroencephalographic monitoring (ccEEG) in adults and children.

  13. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    OpenAIRE

    Martin Carmel M; Peterson Chris; Robinson Rowena; Sturmberg Joachim P

    2009-01-01

    Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in gener...

  14. Physician acceptance of home care for terminally ill children.

    OpenAIRE

    Edwardson, S R

    1985-01-01

    The study reported here explored the factors associated with the implementation of Martinson's model of home care and treatment for children in the terminal stages of illness with cancer. The model is described as an example of a health care strategy that was dramatically different from the prevalent model of care and may have conflicted with existing values. Data for the study were gathered from the hospital records of the children and from a survey of their oncologists. The findings suggest...

  15. Interpretation of illness in patients with chronic diseases from Shanghai and their associations with life satisfaction, escape from illness, and ability to reflect the implications of illness

    Institute of Scientific and Technical Information of China (English)

    Arndt Bssing; Ariane von Bergh; Xiao-feng Zhai; Chang-quan Ling

    2014-01-01

    OBJECTIVE:The aim of this study is to analyze how patients with chronic diseases from Shanghai interpret their disease, and how these interpretations inlfuence patients’ life satisfaction, intention to escape from their illness and their ability to relfect on the implications of their illness. METHODS:A cross-sectional study enrolling 142 patients (mean age (50 ± 16) years;63%men, 37%women) with chronic diseases (60%cancer) was recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China and surveyed using standardized questionnaires. RESULTS: Patients with chronic diseases from Shanghai interpreted their illness mostly as an Adverse Interruption of Life (55%), as a Threat/Enemy (50%), but also as a Challenge (49%), and only rarely as a Call for Help (18%) or as a Punishment (13%). Particularly fatalistic negative (i.e., Threat/Enemy, Adverse Interruption of Life) and strategy-associated disease interpretations (i.e., Relieving Break, Call for Help) were moderately associated with patients’ intention to escape from illness. In contrast, positive interpretations (i.e., something of Value, Challenge) and also the guilt-associated negative interpretation Failure were moderately related with patients’ ability to relfect on their illness. However, life satisfaction was weakly associated only with the view that il ness might be a Chal enge. Interestingly, 58%of those who would see their il ness as an Adverse Interruption (AI+) could see it also as a Challenge (Ch+). Detailed analyses showed that AI+Ch+patients differ from their AI+Ch- counterparts signiifcantly with respect to their ability to relfect life and implications of illness (F=9.1;P=0.004). CONCLUSION: The observed interpretations of illness, particularly the negative perceptions, could be used as indicators that patients require further psychological assistance to cope with their burden. Helping AI+patients see their illness also as a Challenge, and thus develop a higher

  16. Sexual dysfunction and chronic illness: the role of flexibility in coping.

    Science.gov (United States)

    Barsky, Jennifer L; Friedman, Michael A; Rosen, Raymond C

    2006-01-01

    Sexual dysfunction is common among individuals with chronic illnesses and is associated with distress and reduced quality of life. Because of the long-term, often irreversible nature of sexual dysfunction in chronic illness and limitations of pharmacological treatments, there is a need to understand cognitive and behavioral coping processes in this population. We present a model of coping with sexual dysfunction that focuses on the construct of flexibility, including the definition of sexual functioning and its centrality to overall self-concept. We describe how this model can be applied in a comprehensive approach to treating sexual dysfunction in individuals with chronic illnesses. PMID:16809251

  17. Inter-hospital transport of critically ill children.

    LENUS (Irish Health Repository)

    Aherne, E

    2009-10-01

    Most Irish paediatric tertiary care services are centralised in Dublin. Many children are transferred there each year from regional paediatric units around the country. We aimed to quantify and describe all children transferred from one regional tertiary hospital over a two year period. Seventy three out of 75 identified transfers were examined. Sixty nine transfers (94.5%) were sent to the major tertiary centre. Fifteen (20.5%) required intensive care services for transfer. Seventeen seriously ill neonates required transfer, however only 4 (23.5%) of those met both the criteria for and the availability of the National Neonatal Transfer Team (NNTT). Significant events during transfer were only documented in 3 cases. Most transfers arrived in Dublin outside normal working hours. Standards of documentation were found to be very inconsistent. In conclusion, a national transport service for all critically ill children is urgently needed in Ireland.

  18. Peer victimization and subjective health among students reporting disability or chronic illness in 11 Western countries

    DEFF Research Database (Denmark)

    Sentenac, Mariane; Gavin, Aoife; Nic Gabhainn, Saoirse;

    2013-01-01

    BACKGROUND: To compare the strength of the association between peer victimization at school and subjective health according to the disability or chronic illness (D/CI) status of students across countries. METHODS: This study used data from 55 030 students aged 11, 13 and 15 years from 11 countries...... participating in the 2005-06 Health Behaviour in School-aged Children survey. Self-completed questionnaires were administered in classrooms. Multivariate models of logistic regression (controlled for confounding factors and countries) were used to investigate differences in the association between peer...... victimization and poor subjective health according to the D/CI status. RESULTS: Overall, 13.5% of the students reported having been bullied at least two or three times a month. The percentage of victims was significantly higher among those reporting D/CI than among others in all countries studied. Victims of...

  19. [Biography-oriented diagnostics in counselling of patients with chronic illness].

    Science.gov (United States)

    Darmann-Finck, Ingrid; Sahm, Martina

    2006-10-01

    The article examines two concepts of counselling of patients by nurses that are popular in the German-speaking area with regard to their underlying scientific standpoint and ideals and their implications on counselling-process and -result. The authors determine that both concepts disregard the biographic construction processes which are so important for coping with and tackling chronic illness. The article concludes with a discussion of prospective use of biographic diagnostics in counselling of patients with chronic illness. PMID:17051514

  20. Impact of Chronic Critical Illness on the Psychological Outcomes of Family Members

    OpenAIRE

    Hickman, Ronald L.; Douglas, Sara L.

    2010-01-01

    The uncertain trajectory of chronic critical illness exposes the patient’s family to heightened levels of psychological distress. Symptoms of psychological distress affect more than half of family members exposed to the patient’s chronic critical illness. Although symptoms often dissipate over time, a significant proportion of family members will remain at moderate to high risk for psychological distress well after the patient’s death or discharge from the intensive care unit. Family members ...

  1. The therapeutic effects of traditional Turkish Marbling Art on the treatment of children with suffering from chronic illnessesGeleneksel Türk Ebru Sanatının kronik hastalığı olan çocukların terapisi üzerine etkisi

    Directory of Open Access Journals (Sweden)

    Meltem Kürtüncü

    2014-09-01

    Full Text Available Chronic illness is defined as follows: “aberration or anomaly, a situation in which the patient may be left with permanent disability with no chances of recovery, where the patient is required to be treated for a long period of time, and maintained under constant supervision that would necessitate special training in terms of rehabilitation”. It is possible to obtain beneficial results in different areas in the case where children afflicted with chronic illnesses  are treated via art therapy. Traditional Marbling art presents us not only with visual grace but with interesting beauties from the micro and macro realms unseen by the naked eye as well. Furthermore, therapeutic healing power of marbling art is incontestable. Each marbling art that is created is differs from one another; this means that for children endowed with different features, then each marbling art shall constitute a different experience for each child. Due to the aforementioned factors, it can be said that Traditional Turkish Art may contribute significantly in the treatment of children suffering from chronic illnesses. ÖzetKronik hastalık, ‘normalden sapma veya bozukluk gösteren, kalıcı yetersizlik bırakabilen, geriye dönüşü olmayan, patolojik değişiklikler sonucu oluşan, hastanın rehabilitasyonu için özel eğitim gerektiren, uzun süre bakım, gözetim ve denetim gerektireceği beklenen durum’ olarak tanımlanmaktadır. Sanat terapileri ile kronik hastalığı olan çocuklarda farklı alanlarda yararlar sağlanabilmektedir. Geleneksel Türk ebru sanatı, görsel zerafetin yanı sıra, bizlere mikro ve makro alemlerden, çıplak gözün göremeyeceği ilginç güzellikler sunar. Ayrıca Ebru’nun terapi özelliğine sahip olduğu, tartışılmayan bir gerçektir. Yapılan her bir ebrunun birbirinden farklı olması, farklı özellikteki çocuklar için ayrı bir deneyim demektir. Bu nedenle, Geleneksel Türk Ebru Sanatı; kronik hastalığı olan

  2. Food-borne bacteremic illnesses in febrile neutropenic children

    OpenAIRE

    Anselm Chi-wai Lee; Nellie Dawn Siao-ping Ong

    2011-01-01

    Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses a...

  3. Gastroesophageal Reflux in Critically Ill Children: A Review

    OpenAIRE

    Maria José Solana García; Jesús López-Herce Cid; César Sánchez Sánchez

    2013-01-01

    Gastroesophageal reflux (GER) is very common in children due to immaturity of the antireflux barrier. In critically ill patients there is also a high incidence due to a partial or complete loss of pressure of the lower esophageal sphincter though other factors, such as the use of nasogastric tubes, treatment with adrenergic agonists, bronchodilators, or opiates and mechanical ventilation, can further increase the risk of GER. Vomiting and regurgitation are the most common manifestations in in...

  4. Parental perceptions of child vulnerability in a community-based sample: Association with chronic illness and health-related quality of life.

    Science.gov (United States)

    Houtzager, Bregje A; Möller, Eline L; Maurice-Stam, Heleen; Last, Bob F; Grootenhuis, Martha A

    2015-12-01

    The study aimed to assess the prevalence of parental perceptions of a child's vulnerability (PPCV) in a Dutch community-based sample and its relationship with children's health and health-related quality of life (HRQoL). Parents completed the Child Vulnerability Scale and a socio-demographic questionnaire. The Pediatric Quality of Life Inventory 4.0 was administered to measure HRQoL. The prevalence of PPCV was assessed in relation to socio-demographic and health-related characteristics. In a three-step multiple hierarchical regression model, the mediational role of PPCV in the association between chronic illness and HRQoL was investigated. Participants were 520 Dutch children aged 5-18 years from nine Dutch schools. In all, 69 (13.3%) had a chronic illness; 1.9% was perceived vulnerable, 3.0% in groups 5-7 and 1.7% in groups 8-12 and 13-18. Younger age of the child, presence of a chronic illness and low HRQoL were associated with PPCV. PPCV partially mediated the negative association between chronic illness and HRQoL. In conclusion, PPCV is associated with adjustment to chronic illness. More research is needed regarding the mechanisms through which PPCV affects HRQoL and to examine whether PPCV can be targeted in parenting interventions. PMID:24842887

  5. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L

    2015-06-01

    Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. PMID:24674302

  6. Gastroesophageal Reflux in Critically Ill Children: A Review

    Science.gov (United States)

    Solana García, Maria José; López-Herce Cid, Jesús; Sánchez Sánchez, César

    2013-01-01

    Gastroesophageal reflux (GER) is very common in children due to immaturity of the antireflux barrier. In critically ill patients there is also a high incidence due to a partial or complete loss of pressure of the lower esophageal sphincter though other factors, such as the use of nasogastric tubes, treatment with adrenergic agonists, bronchodilators, or opiates and mechanical ventilation, can further increase the risk of GER. Vomiting and regurgitation are the most common manifestations in infants and are considered pathological when they have repercussions on the nutritional status. In critically ill children, damage to the esophageal mucosa predisposes to digestive tract hemorrhage and nosocomial pneumonia secondary to repeated microaspiration. GER is mainly alkaline in children, as is also the case in critically ill pediatric patients. pH-metry combined with multichannel intraluminal impedance is therefore the technique of choice for diagnosis. The proton pump inhibitors are the drugs of choice for the treatment of GER because they have a greater effect, longer duration of action, and a good safety profile. PMID:23431462

  7. Gastroesophageal reflux in critically ill children: a review.

    Science.gov (United States)

    Solana García, Maria José; López-Herce Cid, Jesús; Sánchez Sánchez, César

    2013-01-01

    Gastroesophageal reflux (GER) is very common in children due to immaturity of the antireflux barrier. In critically ill patients there is also a high incidence due to a partial or complete loss of pressure of the lower esophageal sphincter though other factors, such as the use of nasogastric tubes, treatment with adrenergic agonists, bronchodilators, or opiates and mechanical ventilation, can further increase the risk of GER. Vomiting and regurgitation are the most common manifestations in infants and are considered pathological when they have repercussions on the nutritional status. In critically ill children, damage to the esophageal mucosa predisposes to digestive tract hemorrhage and nosocomial pneumonia secondary to repeated microaspiration. GER is mainly alkaline in children, as is also the case in critically ill pediatric patients. pH-metry combined with multichannel intraluminal impedance is therefore the technique of choice for diagnosis. The proton pump inhibitors are the drugs of choice for the treatment of GER because they have a greater effect, longer duration of action, and a good safety profile. PMID:23431462

  8. Intimacy needs and chronic illness: strategies for sexual counseling and self-management.

    Science.gov (United States)

    Steinke, Elaine E

    2005-05-01

    Individuals experiencing a chronic illness have many needs and concerns. One area frequently overlooked is that of intimacy. Those experiencing cardiovascular illnesses have concerns about the strain of sexual activity on their heart. Individuals with lung diseases may perceive that sexual activity is no longer possible because of breathing difficulties. Accurate information and strategies for self-management are needed to address the intimacy needs and concerns of these individuals. The purpose of this article is to identify intimacy needs and strategies for sexual counseling for individuals with cardiovascular illnesses such as myocardial infarction, heart failure, implantable defibrillators, hypertension, and for chronic lung problems. PMID:15916202

  9. Chronic Illness as a Source of Happiness: Paradox or perfectly normal?

    Directory of Open Access Journals (Sweden)

    S. Hoppe

    2013-11-01

    Full Text Available In this paper I analyse the relation between happiness and chronic illness from the perspective of medical anthropology and disability studies. By looking at the disability paradox I deconstruct society’s view of people with a disability. I argue that the disability paradox is problematic as it ignores the views of people with a disability. Moreover, such a paradox reinforces the idea that living with a chronic illness or disability is a devastating experience and that happiness and disability are mutally exclusive realities. Based on empiric examples of people who suffer from Multiple Sclerosis I demonstrate that people with a chronic illness can experience happiness in spite of illness, but also as a consequence of it. 

  10. Probiotics in critically ill children [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sunit C. Singhi

    2016-03-01

    Full Text Available Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT, and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing either Lactobacillus alone or in combination with Bifidobacterium reduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administered Lactobacillus casei subspecies rhamnosus, Lactobacillus reuteri, and Lactobacillus rhamnosus were effective in the prevention of late-onset sepsis and GIT colonization by Candida in preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization by Candida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics

  11. Theory of planned behavior and adherence in chronic illness: a meta-analysis

    NARCIS (Netherlands)

    A. Rich; K. Brandes; B. Mullan; M.S. Hagger

    2015-01-01

    Social-cognitive models such as the theory of planned behavior have demonstrated efficacy in predicting behavior, but few studies have examined the theory as a predictor of treatment adherence in chronic illness. We tested the efficacy of the theory for predicting adherence to treatment in chronic i

  12. A meta-ethnographic synthesis on phenomenographic studies of patients’ experiences of chronic illness

    Directory of Open Access Journals (Sweden)

    Marta Röing

    2015-02-01

    Full Text Available Phenomenography is a qualitative research approach developed within an educational framework, focusing on the qualitative experience of learning. It is also being used, to a lesser degree, in healthcare research. In the present study, we conducted a meta-ethnographic synthesis of phenomenographic studies on chronic illness, in order to give a broader perspective of how chronic illness can be experienced. Our aim was not to describe patients’ various individual experiences of illness, but instead to identify the different ways chronic illness can be experienced by patients. Our synthesis and phenomenographic interpretation of 12 selected articles found that patients’ experiences of chronic illness can be described in terms of a different lived body, a struggle with threat to identity and self-esteem, a diminished lifeworld, and a challenging reality. These experiences relate to each other in a process of recurring loops, where the different ways of experiencing continue to influence each other over time. According to these findings, the use of phenomenography as a research approach has the potential to add to the understanding of how chronic illness can be experienced. Patients may benefit from seeing that their illness can be experienced in many different ways and that it has many aspects, which then can lead to a better understanding and coping with their illness. We suggest that it may be worthwhile to expand the scope of phenomenography outside pedagogics. This presupposes a revision of the application to include a wider and more comprehensive description, for instance, of the different ways illness and healthcare phenomena can be experienced, and how these different ways are related to each other, with less focus on hierarchical relations.

  13. Filicide: mental illness in those who kill their children.

    Directory of Open Access Journals (Sweden)

    Sandra M Flynn

    Full Text Available BACKGROUND: Most child victims of homicide are killed by a parent or step-parent. This large population study provides a contemporary and detailed description of filicide perpetrators. We examined the relationship between filicide and mental illness at the time of the offence, and care received from mental health services in the past. METHOD: All filicide and filicide-suicide cases in England and Wales (1997-2006 were drawn from a national index of homicide perpetrators. Data on people in contact with mental health services were obtained via a questionnaire from mental health teams. Additional clinical information was collected from psychiatric reports. RESULTS: 6144 people were convicted of homicide, 297 were filicides, and 45 cases were filicide-suicides. 195 (66% perpetrators were fathers. Mothers were more likely than fathers to have a history of mental disorder (66% v 27% and symptoms at the time of the offence (53% v 23%, most often affective disorder. 17% of mothers had schizophrenia or other delusional disorders. Overall 8% had schizophrenia. 37% were mentally ill at the time of the offence. 20% had previously been in contact with mental health services, 12% within a year of the offence. CONCLUSION: In the majority of cases, mental illness was not a feature of filicide. However, young mothers and parents with severe mental illness, especially affective and personality disorder who are providing care for children, require careful monitoring by mental health and other support services. Identifying risk factors for filicide requires further research.

  14. Perceived resource support for chronic illnesses among diabetics in north-western China.

    Science.gov (United States)

    Zhong, Huiqin; Shao, Ya; Fan, Ling; Zhong, Tangshen; Ren, Lu; Wang, Yan

    2016-06-01

    A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P analysis, age (OR, 3.42; 95%CI, 1.19-9.84) and monthly income (OR, 5.27; 95%CI, 1.86-14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13-6.05) and college (OR, 3.02; 95%CI, 1.13-8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income. PMID:27075460

  15. “What we want”: chronically ill adolescents’ preferences and priorities for improving health care

    Directory of Open Access Journals (Sweden)

    van Staa A

    2011-06-01

    were least important. Regarding priorities for improvement, 52% of the respondents felt that more attention should be paid to older children, followed by enabling more contact with family and friends (45%, shorter waiting times (43%, and more activities to meet fellow patients (35%.Conclusion: Adolescents prefer technically competent providers, who are honest and trustworthy, and attend to their needs. As they gradually grow out of the pediatric environment, they desire staff attitudes to become less childish and more age-appropriate, and welcome being treated as an equal partner in care. Health care professionals should inquire into preferences and adjust their communication style accordingly.Keywords: chronic illness, patient participation, mixed methods research, hospital care

  16. Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children

    DEFF Research Database (Denmark)

    Denbæk, Anne Maj; Bonnesen, Camilla Thørring; Andersen, Anette;

    2016-01-01

    parent of each child were invited to participate in the Hi Five baseline study. The response rate for children answering a questionnaire was 89% (n = 7,525), and 36% of the parents (n = 3,008) participated in a weekly illness registration study using text messages (short message service) over a period of...... 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child-parent pairs in the analysis, corresponding to 27% of the eligible sample. RESULTS: The agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute......OBJECTIVES: To examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents. STUDY DESIGN AND SETTING: A total of 8,438 schoolchildren aged from 5 to 15 years (grade 0-8) and one...

  17. Counseling Families with Chronic Illness. Family Psychology and Counseling Series.

    Science.gov (United States)

    McDaniel, Susan H., Ed.

    Regardless of whether a patient's health-care provider works from a traditional biomedical or a new biopsychosocial model, therapists and counselors need to work with patients and their families challenged by the onset of a serious illness. This book addresses this need and outlines the five goals of medical family therapy: (1) help the family…

  18. Condition based payment: improving care of chronic illness

    OpenAIRE

    DiPiero, Albert; Sanders, David G

    2005-01-01

    Fee-for-service is more than a payment method; it defines the method of care. Fee-for-condition—a payment method that rewards superior results and encourages innovation—could greatly improve care for chronic conditions

  19. Integration of Biosensors and Drug Delivery Technologies for Early Detection and Chronic Management of Illness

    Directory of Open Access Journals (Sweden)

    Viness Pillay

    2013-06-01

    Full Text Available Recent advances in biosensor design and sensing efficacy need to be amalgamated with research in responsive drug delivery systems for building superior health or illness regimes and ensuring good patient compliance. A variety of illnesses require continuous monitoring in order to have efficient illness intervention. Physicochemical changes in the body can signify the occurrence of an illness before it manifests. Even with the usage of sensors that allow diagnosis and prognosis of the illness, medical intervention still has its downfalls. Late detection of illness can reduce the efficacy of therapeutics. Furthermore, the conventional modes of treatment can cause side-effects such as tissue damage (chemotherapy and rhabdomyolysis and induce other forms of illness (hepatotoxicity. The use of drug delivery systems enables the lowering of side-effects with subsequent improvement in patient compliance. Chronic illnesses require continuous monitoring and medical intervention for efficient treatment to be achieved. Therefore, designing a responsive system that will reciprocate to the physicochemical changes may offer superior therapeutic activity. In this respect, integration of biosensors and drug delivery is a proficient approach and requires designing an implantable system that has a closed loop system. This offers regulation of the changes by means of releasing a therapeutic agent whenever illness biomarkers prevail. Proper selection of biomarkers is vital as this is key for diagnosis and a stimulation factor for responsive drug delivery. By detecting an illness before it manifests by means of biomarkers levels, therapeutic dosing would relate to the severity of such changes. In this review various biosensors and drug delivery systems are discussed in order to assess the challenges and future perspectives of integrating biosensors and drug delivery systems for detection and management of chronic illness.

  20. Cough . 2: Chronic cough in children

    OpenAIRE

    de Jongste, Johan; Shields, M D

    2003-01-01

    textabstractChronic cough is a common problem in childhood. Viral infections are the most prevalent cause, but other rarer disorders should be excluded whenever cough appears unusually severe and/or frequent, and when there is evidence of failure to thrive and growth retardation. The younger the child, the more the need to exclude underlying disease at an early stage. Passive smoking is an important contributor to chronic cough in children. Chronic productive cough with purulent sputum is alw...

  1. Perceived conflict in the couple and chronic illness management: Preliminary analyses from the Quebec Health Survey

    Directory of Open Access Journals (Sweden)

    Hudon Catherine

    2006-10-01

    Full Text Available Abstract Background The quality of the relationship with the spouse/partner appears crucial among patients with multiple chronic conditions where illness management is complex and multifaceted. This study draws on data from the Quebec Health Survey (QHS to examine, among patients with one or more chronic conditions, the relation between marital status, the perceived conflict with the spouse/partner, and what the patients do to manage their illness as well as how they perceive their health. Methods Data from the QHS 1998 were used. The sample included 7547 coupled adults who had one or more chronic health problems lasting more than 6 months. Independent variables included marital status, perceived conflict with the spouse/partner, and the number of chronic conditions. Illness management was defined broadly as a measure of the patient's efforts at self-care and an illness status indicator, including visits to the generalist and the specialist, the use of telephone health line in the last 12 months, self-rated general health, mental health, and a measure of psychological distress. Linkages between the independent variables and illness management were assessed for males and females separately with logistic regressions, while accounting for the survey sampling design and household clustering. Results Female patients who did not live with their partner and had never been married were more likely to report a negative perception of their general health and a higher psychological distress than those who were married. Perceived conflict with the partner was linked to a negative perception of mental health and a higher psychological distress among both men and women. Compared to patients with only one chronic condition, males who reported more than one chronic condition were more likely to have consulted a generalist prior to the survey and used the telephone health line, whereas females were more likely to have consulted a specialist. Both males and

  2. Tactics of diabetes control: Turkish immigrant experiences with chronic illness in Berlin, Germany.

    OpenAIRE

    Guell, Cornelia

    2009-01-01

    This thesis explores Turkish migrants’ practices of diabetes care in Germany. Health statistics frequently identify minority groups as vulnerable to chronic illness and Turkish-origin Germans are said to be more likely to suffer from type 2 diabetes than Germans or Turks in Turkey. Anthropological studies on marginal population groups with diabetes explore experiences of social suffering and inequality that influence such high illness prevalence, or investigate how conflictual ...

  3. Comorbidity Factors and Brain Mechanisms Linking Chronic Stress and Systemic Illness

    OpenAIRE

    Vanja Duric; Sarah Clayton; Mai Lan Leong; Li-Lian Yuan

    2016-01-01

    Neuropsychiatric symptoms and mental illness are commonly present in patients with chronic systemic diseases. Mood disorders, such as depression, are present in up to 50% of these patients, resulting in impaired physical recovery and more intricate treatment regimen. Stress associated with both physical and emotional aspects of systemic illness is thought to elicit detrimental effects to initiate comorbid mental disorders. However, clinical reports also indicate that the relationship between ...

  4. The distinct clinical profile of chronically critically ill patients: a cohort study

    OpenAIRE

    Estenssoro, Elisa; Reina, Rosa; Canales, Héctor S; Saenz, María Gabriela; Gonzalez, Francisco E; Aprea, María M; Laffaire, Enrique; Gola, Victor; Dubin, Arnaldo

    2006-01-01

    Introduction Our goal was to describe the epidemiology, clinical profiles, outcomes, and factors that might predict progression of critically ill patients to chronically critically ill (CCI) patients, a still poorly characterized subgroup. Methods We prospectively studied all patients admitted to a university-affiliated hospital intensive care unit (ICU) between 1 July 2002 and 30 June 2005. On admission, we recorded epidemiological data, the presence of organ failure (multiorgan dysfunction ...

  5. Quality of life, treatment adherence, and locus of control: multiple family groups for chronic medical illnesses.

    Science.gov (United States)

    López-Larrosa, Silvia

    2013-12-01

    The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393). PMID:24329410

  6. The role of parental and adolescent attributions in adjustment of adolescents with chronic illness.

    Science.gov (United States)

    Guion, Kimberly; Mrug, Sylvie

    2012-09-01

    Previous literature has demonstrated the separate contributions of parental attributions and adolescent attributions to psychosocial adjustment of adolescents with chronic illness. However, it is unknown whether parental attributions affect adolescents' mental health directly or indirectly by influencing the youths' attributional style. This study evaluated the direct and indirect (through adolescent attributions) effects of parental attributions on internalizing and externalizing problems of adolescents with chronic illness. Adolescents (N = 128; M = 14.7 years) diagnosed with cystic fibrosis or diabetes and their caregivers completed measures of attributional style and adolescent adjustment. Parents' optimistic attributions were associated with fewer adolescent internalizing and externalizing problems. These effects were partly mediated by adolescent attributions. These results suggest that targeting both adolescent and parent attributions may be important for improving adolescents' adjustment to a chronic illness. PMID:22430813

  7. Suicidal ideation and suicide attempts in older adults: Influences of chronic illness, functional limitations, and pain.

    Science.gov (United States)

    Kim, Su Hyun

    2016-01-01

    This study aimed to examine the associations between suicidal behavior in older Korean adults and chronic illnesses, functional limitations, and pain. Data were obtained and analyzed for 8500 adults over 65 years of age from the 2007-2012 Korea National Health and Nutrition Examination Survey IV and V. Multivariate logistic regression analyses were conducted to examine the associations between suicidal behavior, chronic illness, functional limitations, and pain. The presence of arthritis and renal failure were significantly associated with a higher risk of suicidal ideation and suicide attempts. Moderate limitation in usual activities and extreme pain significantly increased the risk of both suicidal ideation and suicide attempts, over and above the existence of chronic illnesses and depression status. PMID:26318163

  8. The economic impact of the insured patients with severe chronic and acute illnesses: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Budi Aji

    2014-10-01

    Full Text Available Background: Little research has focused on the economic hardship among the insured with severe illnesses and high treatment costs, in particular, the consequence of poorer insurance coverage for high-cost illnesses. Therefore, we presented the case for identifying the experiences of insured patients with severe chronic and acute illnesses. This study identified a qualitative understanding of the economic impact of severe chronic and acute illnesses and household strategies to deal with high treatment costs. Design: Interviews were conducted with 19 insured households of three different health insurance programs with a family member that had been hospitalized for severe chronic or acute illnesses in either Banyumas or Margono Sukarjo hospitals in Banyumas, Central Java, Indonesia. A thematic analysis was applied to guide the interpretation of the data. Results: Insured households with a family member that had been hospitalized for severe chronic and acute illnesses were greatly affected by the high treatment costs. Four major issues emerged from this qualitative study: insured patients are still burdened with high out-of-pocket payments, households adopt various strategies to cope with the high cost of treatments, households experience financial hardships, and positive and negative perceptions of the insured regarding their health insurance coverage for acute and chronic illnesses. Conclusions: Askes and Jamsostek patients faced financial burdens from high cost sharing for hospital amenities, non-covered drugs, and treatments and other indirect costs. Meanwhile, Jamkesmas beneficiaries faced no financial burden for related medical services but were rather burdened with indirect costs for the carers. Households relied on internal resources to cover hospital bills as the first strategy, which included the mobilization of savings, sale of assets, and borrowing of money. External support was tapped secondarily and included financial support from

  9. Drug dosage in continuous venoveno hemofiltration in critically ill children.

    Science.gov (United States)

    Assadi, Farahnak; Shahrbaf, Fatemeh Ghane

    2016-01-01

    The dosage of drugs in patients requiring continuous renal replacement therapy need to be adjusted based on a number of variables that that affect pharmacokinetics (PK) including patient weight, CRRT modality (convention, vs. diffusion), blood and/or effluent flow, hemofilter characteristics, physiochemical drug properties, volume of distribution, protein binding and half-life as well as residual renal function. There is a paucity of data on PK studies in children with acute kidney injury requiring CRRT. When possible, therapeutic drug monitoring should be utilized for those medications where serum drug concentrations can be obtained in a clinically relevant time frame. Also, a patient-centered team approach that includes an intensive care unit pharmacist is recommended to prevent medication-related errors and enhance safe and effective medication use is highly recommended. The aim of this article is to review the current guidelines for drug dosing in critically ill children who require continuous venovenous hemofiltration. PMID:26709896

  10. Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

    Directory of Open Access Journals (Sweden)

    Dennis Drotar

    2010-03-01

    Full Text Available Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit collaborative decision making and can disrupt treatment adherence. However, models of provider-family communication that emphasize communication and shared goal-setting inform an anticipatory guidance model of collaborative decision-making that can enhance treatment adherence. Salient challenges and strategies involved in implementing collaborative decision-making in pediatric chronic illness care are described. Research is needed to: 1 describe the communication and decision-making process in the management of pediatric chronic illness; and 2 evaluate the impact of interventions that enhance collaborative decision-making on provider-family communication, illness management, and treatment adherence.Keywords: collaborative decision-making, shared decision-making, treatment adherence, pediatric chronic illness

  11. Adaptive leadership framework for chronic illness: framing a research agenda for transforming care delivery.

    Science.gov (United States)

    Anderson, Ruth A; Bailey, Donald E; Wu, Bei; Corazzini, Kirsten; McConnell, Eleanor S; Thygeson, N Marcus; Docherty, Sharron L

    2015-01-01

    We propose the Adaptive Leadership Framework for Chronic Illness as a novel framework for conceptualizing, studying, and providing care. This framework is an application of the Adaptive Leadership Framework developed by Heifetz and colleagues for business. Our framework views health care as a complex adaptive system and addresses the intersection at which people with chronic illness interface with the care system. We shift focus from symptoms to symptoms and the challenges they pose for patients/families. We describe how providers and patients/families might collaborate to create shared meaning of symptoms and challenges to coproduce appropriate approaches to care. PMID:25647829

  12. Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital.

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy; Nag, Goutam; Kundu, Monojit; Mondal, Ramkumar; Purkait, Rajib; Patra, Supratim; Ali, Seikh Swaif

    2016-01-01

    Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM) has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC)-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility) was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC) 0.57-0.75; positive to strong positive correlations; p  0.05); however, monthly household income had a significant influence (p < 0.05) on the subscales except for "delivery system or practice design." Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital. PMID:26933640

  13. Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers

    Directory of Open Access Journals (Sweden)

    Meerman Martha GM

    2011-05-01

    Full Text Available Abstract Background Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs and human resource managers (HRM. Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue. Methods Concept mapping methodology was used to elicit and map statements (ideas from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization. Results Participants generated 35 statements. Each group (LMs and HRM sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support. Conclusions There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health

  14. Etiologies of chronic liver disease in children

    Directory of Open Access Journals (Sweden)

    Farahmand F

    2001-11-01

    Full Text Available Chronic Liver diseases in children is the result of many different diseases including: metabolic, genetic, infectious, toxic and idiopathic causes. This was a case series study on 133 infants and children with age range 6 month to 12 years old, who presented clinically with manifestation of chronic liver disease and were admitted to Children Hospital Medical Center from year 1999 to 2000. In this study, 32 (24.5 percent patients had autoimmune chronic hepatitis, 15 (11.3 percent Glycogen storage diseases, 12 (9 percent extrahepatic biliary atresia, 11 (8.2 percent willson disease, 10 (7.5 percent cryptogenic cirrhosis, 6 (4.5 percent chronic hepatitis C, 5 (3.8 percen chronic hepatitic B, 5 (3.8 percent galactosemia 3 (2.25 percent congenital hepatic fibrosis, 3 (3.8 percent histiocytosis X, 3 (2.25 percent sclerosing cholangitis, 2 (1.5 percent byler’s disease 2 (1.5 percent primary tuberculosis, 1 (0.75 percent choledocalcyst, 1 (0.75 percent Alagyle syndrome. According to our data, chronic liver disease should be considered in infants and children. In our study, the most common causes are found to be: metabolic and genetic diseases (37.5 percent, chronic autoimmune hepatitis (24 percent and biliary disorders (14 percent, that encompass 86 percent of the patients.

  15. Children's conceptions of mental illness: a naïve theory approach.

    Science.gov (United States)

    Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

    2010-09-01

    This paper reports two studies that investigated children's conceptions of mental illness using a naïve theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing and card selection tasks to assess 6- to 11-year-old children's conceptions of the causes and consequences (Study 1) and the curability and timeline (Study 2) of different mental and physical illnesses/ailments. The studies revealed that, at all ages, the children held coherent causal-explanatory ideas about the causes, consequences, curability, and timeline of both mental and physical illnesses/ailments. However, while younger children tended to rely on their knowledge of common physical illnesses when thinking about mental illnesses, providing contagion and contamination explanations of cause, older children demonstrated differences in their thinking about mental and physical illnesses. No substantial gender differences were found in the children's thinking. It is argued that children hold coherent conceptions of mental illness at all ages, but that mental illness only emerges as an ontologically distinct conceptual domain by the end of middle childhood. PMID:20849036

  16. Applicability of the assessment of chronic illness care (ACIC instrument in Germany resulting in a new questionnaire: questionnaire of chronic illness care in primary care

    Directory of Open Access Journals (Sweden)

    Campbell Stephen

    2011-07-01

    Full Text Available Abstract Background The Chronic Care Model (CCM is an evidence based, population based approach to improve care for people with chronic conditions. The Assessment of Chronic Illness Care (ACIC instrument is widely used to measure to what extent within a healthcare system the CCM is implemented. The aim of this study was to translate and culturally adapt the ACIC Instrument for the German healthcare system. Methods For translating the ACIC instrument, principles of Good Practice for the Translation and Cultural Adaptation Process by the ISPOR Task Force were followed. Focus groups were additionally conducted with general practitioners to adapt the items culturally. Results The ACIC instrument can not be used in the German healthcare system easily due to a multifaceted understanding of words, different levels of knowledge of the CCM and fundamental differences between health systems. Conclusions As following the CCM leads to benefits for patients with chronic illnesses, measuring to which extent it is implemented is of major interest. A new questionnaire using the CCM as its theoretical basis, sensitive to the healthcare systems of the host country has to be created. Knowledge transfer between countries by using an instrument from a different healthcare system can lead to a completely new questionnaire.

  17. Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers

    OpenAIRE

    Meerman Martha GM; Kopnina Helen; Haafkens Joke A; van Dijk Frank JH

    2011-01-01

    Abstract Background Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job r...

  18. Resiliencia en niños enfermos crónicos: aspectos teóricos Resiliência em crianças com doenças crônicas: aspectos teóricos Resilience in children with physical chronic illness: theoretical aspects

    Directory of Open Access Journals (Sweden)

    Elisa Kern de Castro

    2007-04-01

    refers to the children, adolescent and adults positive adaptation in the presence of adverse and risk circumstances, like is pediatric chronic disease. Currently there are few studies on the topic, but despite that, evidences showed that adaptation of chronic ill children is higher than would be expected. In contrast, some chronic ill children present emotional and behavior problems. Resilience related to pediatric chronic disease means a perspective change in health field because the focus is on child positive development. Practical applications of resilience findings are a challenge to health professionals.

  19. Return Migration among Elderly, Chronically Ill Bosnian Refugees: Does Health Matter?

    Science.gov (United States)

    Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian; Kristiansen, Maria; Norredam, Marie Louise

    2015-10-01

    Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show that physical health, in the sense of the absence of illness and easy access to necessary health-care services and medicines, was not highly prioritized when the decision was made whether or not to return. However, if health is regarded more broadly as involving more than mere physical health and the absence of illness, health did matter. Viewed as physical, social and mental well-being in line with WHO's definition of health, health was indeed one of the most important factors when the decision to return was made. PMID:26473899

  20. Self-regulatory fatigue in chronic multisymptom illnesses: scale development, fatigue, and self-control

    Directory of Open Access Journals (Sweden)

    Solberg Nes L

    2013-03-01

    Full Text Available Lise Solberg Nes,1,3 Shawna L Ehlers,1 Mary O Whipple,2 Ann Vincent21Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; 2Fibromyalgia and Chronic Fatigue Clinic, General Internal Medicine, Mayo Clinic, Rochester, MN, USA; 3Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Oslo, NorwayBackground: Self-regulatory capacity involves ability to regulate thoughts, emotions, and behavior. Chronic multisymptom illnesses such as fibromyalgia and chronic fatigue syndrome are accompanied by numerous challenges, and have recently been associated with self-regulatory fatigue (SRF. Chronic multisymptom illnesses are also frequently associated with physical fatigue, and through development of a scale measuring SRF, the current study aimed to examine how SRF can be distinguished from physical fatigue. The study also sought to distinguish SRF from self-control.Methods: Two self-regulation researchers developed 30 items related to self-regulatory capacity. These items were distributed to patients (n = 296 diagnosed with chronic multisymptom illness together with validated measures of physical fatigue and self-control. A principal factor analysis was employed to examine factor structures, identify inter-item relationships, and aid in scale development.Results: The final proposed scale consisted of 18 items measuring self-regulatory capacity (SRF-18 with cognitive, emotional, and behavioral SRF components. Internal consistency and reliability was acceptable (Cronbach's α = 0.81. The final scale was moderately correlated with self-control (r = −0.48 and highly correlated with physical fatigue (r = 0.75, although more so with emotional (r = 0.72 and mental (r = 0.65 than physical (r = 0.46 fatigue components.Conclusion: The current study suggests a new scale for measurement of SRF in chronic multisymptom illness. Although cross-validation studies are necessary, such a scale may contribute to a

  1. The Role of Parental and Adolescent Attributions in Adjustment of Adolescent with Chronic Illness

    OpenAIRE

    Guion, Kimberly; Mrug, Sylvie

    2012-01-01

    Previous literature has demonstrated the separate contributions of parental attributions and adolescent attributions to psychosocial adjustment of adolescents with chronic illness. However, it is unknown whether parental attributions affect adolescents’ mental health directly or indirectly by influencing the youths’ attributional style. This study evaluated the direct and indirect (through adolescent attributions) effects of parental attributions on internalizing and externalizing problems of...

  2. Rethinking ‘risk' and self-management for chronic illness

    Science.gov (United States)

    Morden, Andrew; Jinks, Clare; Ong, Bie Nio

    2012-01-01

    Self-management for chronic illness is a current high profile UK healthcare policy. Policy and clinical recommendations relating to chronic illnesses are framed within a language of lifestyle risk management. This article argues the enactment of risk within current UK self-management policy is intimately related to neo-liberal ideology and is geared towards population governance. The approach that dominates policy perspectives to ‘risk' management is critiqued for positioning people as rational subjects who calculate risk probabilities and act upon them. Furthermore this perspective fails to understand the lay person's construction and enactment of risk, their agenda and contextual needs when living with chronic illness. Of everyday relevance to lay people is the management of risk and uncertainty relating to social roles and obligations, the emotions involved when encountering the risk and uncertainty in chronic illness, and the challenges posed by social structural factors and social environments that have to be managed. Thus, clinical enactments of self-management policy would benefit from taking a more holistic view to patient need and seek to avoid solely communicating lifestyle risk factors to be self-managed. PMID:23226974

  3. Concerned about Their Learning: Mathematics Students with Chronic Illness and Their Teachers at School

    Science.gov (United States)

    Wilkie, Karina J.

    2014-01-01

    Chronic illness often goes hand-in-hand with absence from school, and students miss out on learning opportunities at school for extended or accumulative periods of time. Many young people seek to continue their school studies nonetheless. The need to consider viable ways to support them academically arose in the context of a project called…

  4. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review.

    Science.gov (United States)

    Rosland, Ann-Marie; Heisler, Michele; Piette, John D

    2012-04-01

    In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts); however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient's autonomous motivation. PMID:21691845

  5. Adults Living with Limited Literacy and Chronic Illness: Patient Education Experiences

    Science.gov (United States)

    King, Judy; Taylor, Maurice C.

    2010-01-01

    The purpose of this study was to investigate how Canadian adults living with limited literacy and chronic illness made meaning of their patient education experiences. The study used a hermeneutic phenomenological research design and employed three data sources over a nine-month period. Data was interpreted and analyzed as it was collected,…

  6. Does chronic illness cause adverse social and economic consequences among Swedes?

    DEFF Research Database (Denmark)

    Lindholm, C; Burström, B; Diderichsen, F

    2001-01-01

    interviewed twice (Swedish Surveys of Living Conditions performed by Statistics Sweden), including subjects (n = 12,556) at interview I, without chronic illness or adverse socioeconomic conditions. RESULTS: The odds ratios for labour market exclusion, unemployment, and financial difficulties among people who...... question raised here is therefore to examine chronic illness (defined as limiting longstanding illness. LLSI) as a causal factor contributing adverse financial conditions, unemployment or labour market exclusion. METHODS: A longitudinal design was employed with data from a sample of 27,773 people...... had acquired LLSI at interview II varied between 1.4 and 4.0 for the outcomes. The elevated OR decreased after testing for the mediating effect of social context and the labour market position for financial difficulties but remained significantly elevated. CONCLUSIONS: The results suggest that LLSI...

  7. Determinants of levels and changes of physical functioning in chronically ill persons: results from the GLOBE Study

    NARCIS (Netherlands)

    J.P. Mackenbach (Johan); G.J.J.M. Borsboom (Gerard); W.J. Nusselder (Wilma); C.W.N. Looman (Caspar); C.Th.M. Schrijvers (Carola)

    2001-01-01

    textabstractSTUDY OBJECTIVE: Declines in physical functioning are a common result of chronic illness, but relatively little is known about factors not directly related to severity of disease that influence the occurrence of disability among chronically ill persons. The aim of this

  8. Effect of hyperglycemia on mortality rates in critically ill children

    Directory of Open Access Journals (Sweden)

    Seongkuk Kim

    2010-03-01

    Full Text Available Purpose : To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis. Methods : From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU at Asan Medical Center and who survived for more than 7 days were retrospectively reviewed. We analyzed the maximum glucose value within 7 days in PICU, PRISM-III score and SOFA score within 24 hours, and mortality. We did not perform an adjustment analysis of drugs affecting glucose level. Results : The maximum glucose level within 7 days in PICU was higher in the nonsurvival group than in the survival group. Using 4 cutoff values (125, 150, 175, and 200 mg/dL, the mortality of patients with hyperglycemia was found to be 13.0 %, 14.4%, 19.8%, and 21.1%, respectively, and the cutoff values of 175 and 200 mg/dL revealed significant differences in mortalities between the hyperglycemic and normoglycemic groups. The PRISM-III score was not significantly different between the hyperglycemic and normoglycemic groups under a glucose cutoff value of 175 mg/dL, but the SOFA score was higher in the hyperglycemic group. Under a glucose cutoff value of 200 mg/dL, the PRISM-III score was higher in the hyperglycemic group, and the SOFA score did not differ between the 2 groups. Conclusion : Hyperglycemia with a maximal glucose value ?#241;75 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.

  9. Emergency and disaster preparedness for chronically ill patients: a review of recommendations

    Directory of Open Access Journals (Sweden)

    Tomio J

    2014-12-01

    Full Text Available Jun Tomio,1 Hajime Sato2 1Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 2Department of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Japan Abstract: Recent disasters, especially those in developed countries, have highlighted the importance of disaster preparedness measures for chronic diseases. A number of surviving patients experienced the exacerbation of a chronic illness, such as hypertension, diabetes, cancer, and chronic respiratory diseases, due to disaster-related stress, interruption of care, or both; for some patients, these exacerbations resulted in death. Here, we review reports from recent disasters in developed countries and summarize the recommendations for disaster preparedness of chronically ill patients. A considerable number of recommendations based on the lessons learned from recent disasters have been developed, and they provide practical and essential steps to prevent treatment interruption during and after a disaster. To improve preparedness efforts, we suggest that health care providers should be aware of the following three suggestions: 1 recommendations should be evidence-based; 2 recommendations should contain consistent messages; and 3 recommendations should be feasible. Keywords: disaster, chronic illness, preparedness

  10. A Research Agenda Concerning Depictions of Mental Illness in Children's Media

    Science.gov (United States)

    Coverdale, John H.; Nairn, Raymond

    2006-01-01

    Objective: To review research on depictions of mental illness in mass media directed to children and to identify requirements for further research in this important field. Methods: The authors identified published research on depictions of mental illness in children's media and the important strengths and weaknesses of such research. Results: Only…

  11. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    Directory of Open Access Journals (Sweden)

    Martin Carmel M

    2009-01-01

    Full Text Available Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core

  12. [Chronic pain and regional anesthesia in children].

    Science.gov (United States)

    Dadure, C; Marec, P; Veyckemans, F; Beloeil, H

    2013-10-01

    Chronic pain is usually underestimated in children, due to lack of knowledge and its specific signs. In addition to suffering, chronic pain causes a physical, psychological, emotional, social, and financial burden for the child and his family. Practitioners may find themselves in a situation of failure with depletion of medical resources. Some types of chronic pain are refractory to conventional systemic treatment and may require the use of regional anesthesia. Cancer pain is common in children and its medical management is sometimes insufficient. It is accessible to neuroaxial or peripheral techniques of regional anesthesia if it is limited to an area accessible to one of these techniques and no contraindications (e.g., thrombopenia) are present. Complex regional pain syndrome 1 is not rare in children and adolescents, but it often goes undiagnosed. Regional anesthesia may contribute to the treatment of complex regional pain syndrome 1, mainly in case of recurrence, because it provides rapid effective analgesia and allows rapid implementation of intensive physiotherapy. These techniques have also shown interest in phantom limb pain after limb amputation, but they remain controversial for erythromelalgia pain or chronic abdominopelvic pain. Finally, the treatment of postdural puncture headache due to cerebrospinal fluid leak can be treated by performing an epidural injection of the patient's blood, called a blood-patch. Finally, the management of children with chronic pain should be multidisciplinary (pediatrician, physiotherapist, psychologist, surgeon, anesthesiologist) to support the child and her problem in its entirety. PMID:23953871

  13. The degree of parental awareness of using means of physical rehabilitation on the frequently ill children

    Directory of Open Access Journals (Sweden)

    Ludmyla Demchenko

    2016-04-01

    Full Text Available Purpose: to establish the degree of parental awareness of using means of physical rehabilitation on the frequently ill children with acute respiratory viral infections. Material & Methods: analysis of scientific and methodological literature, surveys and questionnaires. Results: the research involved 54 families with the frequently ill children. The paper characterizes and establishes the degree of parental awareness in the sphere of physical rehabilitation of the frequently ill children, determines the level of parental interest in cooperation, presents the plan of seminars with parents. Conclusions: increasing the degree of parental awareness by studying and explaining is a prerequisite to achieve high effectiveness in health recovery process of the frequently ill children. Keywords: frequently ill children, parental awareness, physical rehabilitation.

  14. The abortion debate: can this chronic public illness be cured?

    Science.gov (United States)

    Callahan, D

    1992-12-01

    Abortion has provided one of the most noxious, disturbing, and unending of all American moral and legal struggles. The issue forces us to think about the most difficult kind of ethical issues, e.g., the moral status of the fetus and the meaning of human "life" and "personhood." The win-at-all-costs attitude among the leading advocacy groups has created gross stereotypes. While most arguments heard today were also heard prior to the Roe vs. Wade decision, the tone has radically changed. Better organization has meant hotter rhetoric and a nastier public style. We need to move the abortion debate along; it is now as stagnate as it is nasty. We need creative discussion and realistic compromise. The pre-Roe arguments in favor of choice have changed. Then, the movement to legalize abortion rested on the following: 1) illegal abortions were killing and maiming women; 2) women should have a backup to ineffective contraception; 3) the number of unwanted pregnancies should be reduced; only wanted children should be born, as a matter of child welfare; 4) women should have the right to make the abortion decision; 5) everything possible should be done to change the economic and domestic circumstances forcing women into unwanted pregnancies. The argument benefited women, children, and society. The many abortion myths that have since taken prominence cloud an already difficult issue. The ongoing tension rests with the conflict between the moral and legal issues. Is it possible to combine legal freedom and seriousness about the moral questions? Only if we recognize the equality of both positions' moral traditions, accept public discussion, the need for compromise, the need to do everything possible to change the economic and social circumstance leading to the abortion choice, and the need for meaningful counseling of women considering abortion. PMID:1451361

  15. Review and Meta-analysis of Couple-Oriented Interventions for Chronic Illness

    Science.gov (United States)

    Schulz, Richard; Helgeson, Vicki S.; Small, Brent J.; Saghafi, Ester M.

    2014-01-01

    Background Evidence continues to build for the impact of the marital relationship on health as well as the negative impact of illness on the partner. Targeting both patient and partner may enhance the efficacy of psychosocial or behavioral interventions for chronic illness. Purpose The purpose of this report is to present a cross-disease review of the characteristics and findings of studies evaluating couple-oriented interventions for chronic physical illness. Methods We conducted a qualitative review of 33 studies and meta-analyses for a subset of 25 studies. Results Identified studies focused on cancer, arthritis, cardiovascular disease, chronic pain, HIV, and Type 2 diabetes. Couple interventions had significant effects on patient depressive symptoms (d=0.18, p<0.01, k=20), marital functioning (d=0.17, p<0.01, k=18), and pain (d=0.19, p<0.01, k=14) and were more efficacious than either patient psychosocial intervention or usual care. Conclusions Couple-oriented interventions have small effects that may be strengthened by targeting partners’ influence on patient health behaviors and focusing on couples with high illness-related conflict, low partner support, or low overall marital quality. Directions for future research include assessment of outcomes for both patient and partner, comparison of couple interventions to evidence-based patient interventions, and evaluation of mechanisms of change. PMID:20697859

  16. Food-borne bacteremic illnesses in febrile neutropenic children.

    Science.gov (United States)

    Lee, Anselm Chi-Wai; Siao-Ping Ong, Nellie Dawn

    2011-08-31

    Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14%) episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets. PMID:22184532

  17. Food-borne bacteremic illnesses in febrile neutropenic children

    Directory of Open Access Journals (Sweden)

    Anselm Chi-wai Lee

    2011-08-01

    Full Text Available Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14% episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets.

  18. Caring, chronicity and community: an emergent model of community health services provision for people living with chronic illness

    OpenAIRE

    Ryan, Denis

    2008-01-01

    Purpose An evaluation of an Integrated Care approach with the aim of exploring the components of the service which contributed to its functioning. Theory There is growing recognition internationally that conventional approaches to the management of chronic illness are not adequately meeting the needs of people with such conditions. This concern is also shared in Ireland and a pilot programme to provide an alternative community based approach was established in Callan, Co. Kilkennny, Ireland f...

  19. Q Fever Chronic Osteomyelitis in Two Children.

    Science.gov (United States)

    Costa, Beatriz; Morais, Andreia; Santos, Ana Sofia; Tavares, Delfin; Seves, Graça; Gouveia, Catarina

    2015-11-01

    We report 2 cases of chronic Q fever osteomyelitis in 10- and 5-year-old girls who presented with distal right femoral and left parasternal granulomatous osteomyelitis, respectively. Both were treated with ciprofloxacin and rifampin with good response. Q fever osteomyelitis is a challenging diagnosis in children, and the choice of antimicrobial treatment is difficult because of limited available data. PMID:26226441

  20. Complications of continuous renal replacement therapy in critically ill children: a prospective observational evaluation study

    OpenAIRE

    Santiago, Maria J; López-Herce, Jesús; Urbano, Javier; Solana, María José; del Castillo, Jimena; Ballestero, Yolanda; Botrán, Marta; Bellón, Jose María

    2009-01-01

    Introduction Continuous renal replacement therapy (CRRT) frequently gives rise to complications in critically ill children. However, no studies have analyzed these complications prospectively. The purpose of this study was to analyze the complications of CRRT in children and to study the associated risk factors. Methods A prospective, single-centre, observational study was performed in all critically ill children treated using CRRT in order to determine the incidence of complications related ...

  1. Chronic Hepatitis B in Children - A Review.

    Science.gov (United States)

    Rukunuzzaman, M; Karim, M B

    2015-07-01

    Hepatitis B Virus (HBV) infection is prevalent worldwide. The prevalence is lowest (0.2-0.5%) in countries having high standard of living. About 10 million people are chronically infected with HBV in Bangladesh and it is possible that most infections occur during childhood. Overall prevalence is about 3% in Bangladesh. Perinatal transmission is more common in hyper-endemic areas of South East Asia. Chronic hepatitis B infection evolves through five phases. Most of the children belong to immune tolerant phase. About 57% patients of chronic hepatitis B are asymptomatic. Treatment of chronic hepatitis B is difficult. Decision regarding when, whom and how to treat in children is complex. Moreover, there are only limited drugs that can be used in treating chronic hepatitis B in children. Goal of therapy are to reduce viral replication, to minimize liver injury, to reduce consequence of liver injury like cirrhosis, hepatocellular carcinoma and to reduce infectivity of HBV. Treatment should be considered in chronic hepatitis B if patient have persistently elevated ALT of more than twice normal and evidence of viral replication. There are some special circumstances where treatment of chronic hepatitis B can be given in absence of standard criteria. These conditions are cirrhosis, chemotherapy, immunosuppression, presence of co-infection (HBV-HIV), family history of HCC and pregnant women with high viral load. Sero-conversion occurs in about 17-32% cases if treated with oral nucleot(s)ide analogue and in about 58% cases if treated with interferon. These expensive drugs with limited treatment success are not suitable for the people of Bangladesh. Therefore, risk factors identification and prevention of HBV infection is the logical and rational approach for a country like Bangladesh. Vaccination against HBV play central role in preventing infection. HBV vaccine has been incorporated in EPI schedule since 2004 in Bangladesh. Immunoprophylaxis of babies of HBsAg positive mother

  2. A Cost-Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness.

    Science.gov (United States)

    Distelberg, Brian J; Emerson, Natacha D; Gavaza, Paul; Tapanes, Daniel; Brown, Whitney N; Shah, Huma; Williams-Reade, Jacqueline; Montgomery, Susanne

    2016-07-01

    Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs-benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre-post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost-benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed. PMID:27282311

  3. Continuity in care trajectories of older chronically ill patients in a battlefield of competing rationales

    DEFF Research Database (Denmark)

    Kjerholt, Mette; Wagner, L.; Delmar, C.;

    2014-01-01

    perspective in older, chronically ill patients' care as reflected in nursing staff's communication about the patients. DESIGN: Explorative Participatory Action Research (PAR). SETTING: An acute, general medical ward at a Danish university hospital. PARTICIPANTS: Hospital and municipality nurses (n = 29......BACKGROUND: Continuity is crucial when caring for older chronically ill patients. Research has shown that the integration of patients' own perspectives on their situation is of utmost importance for continuity and quality of care. Studies have, however, demonstrated a number of problems with health......). Nursing records (n = 12). METHOD: Field studies: observations, interviews, nursing records audits and logs. Data were subject to manifest and latent content analysis. RESULTS: Participants were aware of the importance of ensuring continuity, a comprehensive approach and integration of the patient...

  4. Prediction of chronic critical illness in a general intensive care unit

    Directory of Open Access Journals (Sweden)

    Sérgio H. Loss

    2013-06-01

    Full Text Available OBJECTIVE: To assess the incidence, costs, and mortality associated with chronic critical illness (CCI, and to identify clinical predictors of CCI in a general intensive care unit. METHODS: This was a prospective observational cohort study. All patients receiving supportive treatment for over 20 days were considered chronically critically ill and eligible for the study. After applying the exclusion criteria, 453 patients were analyzed. RESULTS: There was an 11% incidence of CCI. Total length of hospital stay, costs, and mortality were significantly higher among patients with CCI. Mechanical ventilation, sepsis, Glasgow score < 15, inadequate calorie intake, and higher body mass index were independent predictors for cci in the multivariate logistic regression model. CONCLUSIONS: CCI affects a distinctive population in intensive care units with higher mortality, costs, and prolonged hospitalization. Factors identifiable at the time of admission or during the first week in the intensive care unit can be used to predict CCI.

  5. When should managed care firms terminate private benefits for chronically mentally ill patients?

    Science.gov (United States)

    Gerson, S N

    1994-01-01

    Corporate America's healthcare cost crisis and the country's budget deficit are forcing limits on the resources used to finance healthcare, including mental healthcare. At the same time, the 1990 Americans with Disabilities Act bars discrimination against patients with chronic illnesses, including chronic mental illness. Therefore, corporate benefits managers need guidance on how to ethically and rationally allocate scarce clinical resources to those high-morbidity insureds who utilize disproportionate amounts of these resources. In particular, how should we define the public/private interface: When do patients who repeatedly fail to respond to treatment fall out of the private sector's responsibility? The author, medical director for a leading behavioral healthcare utilization management company, offers the following guidelines recommending reasonable and practical limitations on trials of treatment for seven common categories of difficult psychiatric patients. PMID:10141406

  6. Improving Confidence for Self Care in Patients with Depression and Chronic Illnesses

    OpenAIRE

    Ludman, Evette J; Peterson, Do; Katon, Wayne J; Lin, Elizabeth H. B.; Von Korff, Michael; Ciechanowski, Paul; Young, Bessie; Gensichen, Jochen

    2013-01-01

    The aim of this study was to examine whether patients who received a multi-condition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy is positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention th...

  7. Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

    OpenAIRE

    Dennis Drotar, Dennis

    2010-01-01

    Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit colla...

  8. Self-esteem in adolescents with chronic physical illness vs. controls in Northern Russia

    OpenAIRE

    Zashikhina, Anna; Hägglöf, Bruno

    2014-01-01

    Objective: This work aims to study self-esteem in adolescents with diabetes, asthma and epilepsy; compare the results with those of the representative sample of healthy adolescents; and evaluate the predictive value of certain demographic, family-related, and disease-related factors on self-esteem. Methods: A total of 148 chronically ill adolescents and 301 matched healthy counterparts completed the Rosenberg Self Esteem Scale and the "I think I am" questionnaire. Adolescents' parents answere...

  9. The role of disease management programs in the health behavior of chronically ill patients

    OpenAIRE

    Cramm, Jane; Adams, Samantha; Hipple-Walters, Bethany; Tsiachristas, Apostolos; Bal, Roland; Huijsman, Robbert; Rutten-van Mölken, Maureen; Nieboer, Anna

    2014-01-01

    markdownabstract__Abstract__ Objective: Investigate the effects of disease management program (DMP) implementation on physical activity, smoking, and physical quality of life among chronically ill patients. Methods: This study used a mixed-methods approach involving qualitative (35 interviews with project managers) and quantitative (survey of patients from 18 DMPs) data collection. Questionnaire response rates were 51% (2010; 2619/5108) at T0 and 47% (2011; 2191/4693) at T1. Results: Physical...

  10. Compliance to treatment in patients with chronic illness: A concept exploration

    OpenAIRE

    Rafii, Forough; Fatemi, Naima Seyed; Danielson, Ella; Johansson, Christina Melin; Modanloo, Mahnaz

    2014-01-01

    Background: Patients’ compliance to treatment is an important indicator for evaluating the successful management in chronic illnesses. Despite the fact an applicable definition of compliance is required to suitable intervention and research, this concept is not clear and there is no consensus concerning its meaning, definition, and measurement. The aim of this study was to explore the concept of compliance and to formulate a working definition. Materials and Methods: Theoretical phase of Schw...

  11. Renal imaging in children with chronic kidney disease

    OpenAIRE

    Wiwit Rahmawati; Heru Muryawan; Farah Prabowo

    2013-01-01

    Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were in...

  12. Reducing Workplace Barriers to Enhance Job Satisfaction: An Important Post-Employment Service for Employees with Chronic Illnesses.

    Science.gov (United States)

    Roessler, Richard T.; Rumrill, Phillip D., Jr.

    1998-01-01

    A study of 41 employed people with chronic illness found that job satisfaction was related to accessibility, performance of essential functions, and job mastery. Reduction of workplace barriers to productivity through job accommodation and career counseling is needed. (SK)

  13. Risk factors for asthma prevalence and chronic respiratory illnesses among residents of different neighbourhoods in Buffalo, New York

    OpenAIRE

    Lwebuga-Mukasa, J.; Oyana, T.; Wydro, P.

    2004-01-01

    Study objective: The aim of this study is to identify risk factors for asthma prevalence and chronic respiratory illnesses in Buffalo's neighbourhoods after previous studies reported increased levels of asthma among residents on Buffalo's west side.

  14. Validation of the Spanish Translation of the Patient Assessment of Chronic Illness Care (PACIC Survey

    Directory of Open Access Journals (Sweden)

    Abraham Aragones, MD, MSCI

    2008-10-01

    Full Text Available IntroductionThe Patient Assessment of Chronic Illness Care (PACIC survey is a patient-centered instrument for evaluating the quality and patient-centeredness of chronic illness care received according to the Chronic Care Model paradigm. This study validates the Spanish translation of the PACIC in an urban, Spanish-speaking population.MethodsOne hundred Spanish-speaking patients with diabetes completed the translated PACIC and sociodemographic and cultural questionnaires. Test-retest reliability was assessed in a subset of 20 patients who completed the questionnaire 2 to 4 months later. Internal consistency was evaluated with Cronbach α. PACIC score and subscale associations with sociodemographic characteristics were examined.ResultsTest-retest reliability for the overall translated PACIC scale was 0.77. Scores were not associated with patient sociodemographic characteristics, including age, country of birth, years living in the United States, or education level (P >.05.ConclusionThe Spanish translation of the PACIC survey demonstrated high reliability, internal consistency, and test-retest reliability. Scores showed no association with sociodemographic or cultural characteristics. The Spanish version can reliably be used to assess care delivered according to the Chronic Care Model in a heterogeneous Spanish-speaking population.

  15. Putative invasive pulmonary aspergillosis in critically ill patients with chronic obstructive pulmonary disease: a matched cohort study

    OpenAIRE

    Delsuc, Claire; Cottereau, Aurélie; Frealle, Emilie; Bienvenu, Anne-Lise; Dessein, Rodrigue; Jarraud, Sophie; Dumitrescu, Oana; Le Maréchal, Marion; Wallet, Florent; Friggeri, Arnaud; Argaud, Laurent; Rimmelé, Thomas; Nseir, Saad; Ader, Florence

    2015-01-01

    Introduction Patients with advanced chronic obstructive pulmonary disease (COPD) are at risk for developing invasive pulmonary aspergillosis. A clinical algorithm has been validated to discriminate colonization from putative invasive pulmonary aspergillosis (PIPA) in Aspergillus-positive respiratory tract cultures of critically ill patients. We focused on critically ill patients with COPD who met the criteria for PIPA. Methods This matched cohort study included critically ill patients with CO...

  16. The Stigmatization of Mental Illness in Children and Parents. Data Trends #124

    Science.gov (United States)

    Research and Training Center on Family Support and Children's Mental Health, 2005

    2005-01-01

    "Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" reviews theory and research on stigma and mental health with a focus on the stigmatization of mental illness in the family when either a child or a parent has a mental illness.…

  17. Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

    OpenAIRE

    Stewart Allison; Dowden Michelle; Robinson Gary; Cunningham Joan; Bailie Ross; Si Damin; Connors Christine; Weeramanthri Tarun

    2008-01-01

    Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territ...

  18. Treatment of critically ill children with kidney injury by sustained low-efficiency daily diafiltration

    OpenAIRE

    Lee, Chia-Ying; Yeh, Huang-Chieh; Lin, Ching-Yuang

    2012-01-01

    Background Continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) offer diverse benefits and drawbacks for critically ill children with acute kidney injury (AKI). Sustained low-efficiency daily diafiltration (SLEDD-f) involves a conceptual and technical hybrid of CRRT and IHD. We report our SLEDD-f application to critically ill children in the pediatric intensive care unit (PICU). Methods SLEDD-f was delivered by the new Fresenius 5008 therapy system with blood flow 5...

  19. Personal Prayer in Patients Dealing with Chronic Illness: A Review of the Research Literature

    Directory of Open Access Journals (Sweden)

    Karin Jors

    2015-01-01

    Full Text Available Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1 why do people turn to prayer in times of illness?, (2 what are the main topics of their prayers?, and (3 how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1 participants in the study were patients dealing with an illness, (2 the study examined the use of private rather than intercessory prayer, and (3 the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1 disease-centered prayer, (2 assurance-centered prayer, (3 God-centered prayer, (4 others-centered prayer, and (5 lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness.

  20. An 81-year-old woman with chronic illnesses and a strong faith.

    Science.gov (United States)

    Harris, Susie T; Koenig, Harold G

    2016-03-01

    Mrs. Smith is an 81-year-old woman who has several medical problems. Despite these problems, however, her faith and spirituality strength give her the strength and determination to move forward in life. She stresses that, "My faith helps me cope with my illnesses." This article describes Mrs. Smith's roller coaster life and how faith, prayer, and hope have allowed her to continue to press forward. She interprets pain and illnesses as challenges, not obstacles. Her physician who has been treating her for about 20 years indicates that she has continued to have multiple chronic health issues and has maintained an incredibly positive spirit, particularly when traditional medicine has failed to make a difference. Spiritual care is being increasingly documented as an important component of whole person medicine. For some, religiosity and spirituality are important aspects of patient-provider relationship. God, faith, and hope are essential factors to Mrs. Smith who uses spirituality and religion daily to cope with her chronic illnesses. PMID:26461846

  1. A prospective study of the causes of febrile illness requiring hospitalization in children in Cambodia.

    OpenAIRE

    Chheng, K; Carter, MJ; Emary, K; Chanpheaktra, N; Moore, CE; Stoesser, N.; Putchhat, H.; Sona, S; Reaksmey, S; Kitsutani, P; Sar, B.; van Doorn, HR; Uyen, NH; Tan, L.; Paris, D.

    2013-01-01

    Febrile illnesses are pre-eminent contributors to morbidity and mortality among children in South-East Asia but the causes are poorly understood. We determined the causes of fever in children hospitalised in Siem Reap province, Cambodia. A one-year prospective study of febrile children admitted to Angkor Hospital for Children, Siem Reap. Demographic, clinical, laboratory and outcome data were comprehensively analysed. Between October 12(th) 2009 and October 12(th) 2010 there were 1225 e...

  2. Chronic Kidney Disease in Southwestern Iranian Children

    Directory of Open Access Journals (Sweden)

    Ali Ahmadzadeh

    2009-06-01

    Full Text Available Objective:The aim of the study was to determine the etiology of Chronic Kidney Disease (CKD among children attending the pediatric nephrology service at Abuzar children's hospital in Ahvaz city, the referral center in Southwest of Iran.Methods:We reviewed the records of 139 children, diagnosed to have CKD over a 10-year period. CKD was defined a glomerular filtration rate (GFR below 60 ml/1.73 m2/min persisting for more than 3 months.Findings: Among 139 children 81 (58% were males. The mean age at diagnosis of CKD in the patients was 4.2 (�3.6 years. Mean level of serum creatinine at presentation was 1.9 (�1.4 mg/dl. The mean GFR at presentation was 33.5 (�15.4 ml/1.73m2/min while 22% of the patients were already at end stage renal failure indicating that these children were referred too late. Congenital urologic malformation was the commonest cause of CKD present in 70 (50.4% children [reflux nephropathy (23.1%, hypo/dysplastic kidney (15.8%, obstructive uropathy (10.8%, and prune belly syndrome (0.7%]. Other causes included hereditary nephropathies (17.2%, chronic glomerulo-nephritis (6.5%, multisystemic diseases (4.3%, miscellaneous and unknown (each one 10.8%. The mean duration of follow-up was 26 (�24.67 months. Peritoneal or hemodialysis was performed in 10 patients. Six patients underwent (4 live-related and 2 non-related renal transplantation. The rest have died or received standard conservative management for CKD.Conclusion: The commonest causes of CKD were reflux nephropathy, hypo/dysplastic kidney, hereditary nephropathy and obstructive uropathy. Patients presented late, had severe CKD and were malnourished and stunted.

  3. Chronic Kidney Disease in Southwestern Iranian Children

    Directory of Open Access Journals (Sweden)

    Mehrnaz Zangeneh Kamali

    2009-04-01

    Full Text Available Objective: The aim of the study was to determine the etiology of Chronic Kidney Disease (CKD among children attending the pediatric nephrology service at Abuzar children's hospital in Ahvaz city, the referral center in Southwest of Iran.Methods: We reviewed the records of 139 children, diagnosed to have CKD over a 10-year period. CKD was defined a glomerular filtration rate (GFR below 60 ml/1.73 m2/min persisting for more than 3 months.Findings: Among 139 children 81 (58% were males. The mean age at diagnosis of CKD in the patients was 4.2 (±3.6 years. Mean level of serum creatinine at presentation was 1.9 (±1.4 mg/dl. The mean GFR at presentation was 33.5 (±15.4 ml/1.73m2/min while 22% of the patients were already at end stage renal failure indicating that these children were referred too late. Congenital urologic malformation was the commonest cause of CKD present in 70 (50.4% children [reflux nephropathy (23.1%, hypo/dysplastic kidney (15.8%, obstructive uropathy (10.8%, and prune belly syndrome (0.7%]. Other causes included hereditary nephropathies (17.2%, chronic glomerulo-nephritis (6.5%, multisystemic diseases (4.3%, miscellaneous and unknown (each one 10.8%. The mean duration of follow-up was 26 (±24.67 months. Peritoneal or hemodialysis was performed in 10 patients. Six patients underwent (4 live-related and 2 non-related renal transplantation. The rest have died or received standard conservative management for CKD.Conclusion: The commonest causes of CKD were reflux nephropathy, hypo/dysplastic kidney, hereditary nephropathy and obstructive uropathy. Patients presented late, had severe CKD and were malnourished and stunted.

  4. Nursing care gestion of chronically ill elderly people. Policlinico 2, year 2007

    OpenAIRE

    Liudmila Carbonell Sanamé

    2009-01-01

    A descriptive prospective study was made to those patients aged more than 60 years who are attended in the Policlinico 2 “Leonilda Tamayo Matos” in Isla de la Juventud during the year 2007. The study population was 1254 and 700 chronically ill elderly people were taken as representative sample, using a simple random sampling. The Mini Mental State Examination and a satisfaction survey was made to old people, all these with their informed consent. The main variables to study were: sex, age, ra...

  5. [Effect of exercise training on rehabilitation of the chronic critical illness patients].

    Science.gov (United States)

    Gu, Guosheng; Ren, Jianan

    2016-07-01

    Over the past decades, the evolution of the techniques used in the intensive care has led on one side to better survival rates in ICU patients. On the other side, it has resulted in a growing number of patients who survive an acute event to chronic condition, and who then become dependent on one or more life support treatments. Such patients are called chronic critical illness(CCI) patients. Even these patients can dismiss from intensive care unit (ICU) or transfer to specialized rehabilitation care settings, the mortality of these patients is still very high. Therefore, how to promote the rehabilitation of CCI patients is one of the most important research points of epidemiology, public health and social economics. Exercise training can promote rehabilitation, improve quality of life and independent functional status in these patients, which should be used as one of the standard treatment protocols for CCI patients. PMID:27452749

  6. Diversity of Outcomes Among Adolescent Children of Mothers With Mental Illness

    Science.gov (United States)

    Mowbray, Carol T.; Bybee, Deborah; Oyserman, Daphna; Allen -Meares, Paula; MacFarlane, Peter; Hart-Johnson, Tamera

    2004-01-01

    Children of parents with mental illness are an at-risk population according to research on psychiatric outcomes using White, middle-class samples of depressed parents and infants and preschool children. The current study expands this evidence by exploring within-group heterogeneity across psychosocial outcomes, in a racially diverse, low-income…

  7. Online support for children of parents suffering from mental illness : A case study

    NARCIS (Netherlands)

    Drost, Louisa M.; Schippers, Gerard M.

    2015-01-01

    From epidemiologic research, we know that children of parents with a mental illness (COPMI) have an elevated risk of developing a serious mental disorder. Aside from studies based on risk and resilience, there has been little research on the children's own perceptions. The aim of this study was to e

  8. Patient-perceived self-management tasks and support needs of people with chronic illness: generic or disease specific?

    OpenAIRE

    Houtum, L. van; Rijken, M; Heijmans, M.; Groenewegen, P

    2015-01-01

    Background: Self-management is widely accepted as an essential component of chronic care. Nevertheless, little is known about patients’ perceptions of self-management. Purpose: This study aims to explore which self-management tasks and support needs people with chronic illness perceive for themselves, and to establish whether these tasks and support needs are disease specific. Methods: A nationwide representative sample of 2,064 people with chronic disease filled in the Patient Assessment of ...

  9. Impairment and Coping in Children and Adolescents with Chronic Fatigue Syndrome: A Comparative Study with Other Paediatric Disorders

    Science.gov (United States)

    Garralda, M. Elena; Rangel, Luiza

    2004-01-01

    Background: Functional impairment is a key feature of chronic fatigue syndrome (CFS) of childhood. Aim: To compare impairment, illness attitudes and coping mechanisms in childhood CFS and in other paediatric disorders. Method: Participants were 28 children and adolescents with CFS, 30 with juvenile idiopathic arthritis (JIA) and 27 with emotional…

  10. Family Stress, Resources, and Family Types: Chronic Illness in Children.

    Science.gov (United States)

    McCubbin, Marilyn A.

    1988-01-01

    Measured family stress, resources, parental coping, and family types in families who had a child with myelomeningocele. Determined the relationships between the family characteristics, the child's health status, and number of active health problems based on level of impairment. Demonstrated an increasing level of family system involvement…

  11. Use of the Internet for Health Information by the Chronically Ill

    Directory of Open Access Journals (Sweden)

    Todd H. Wagner

    2004-10-01

    Full Text Available Introduction Chronic conditions are among the leading causes of death and disability in the United States. The Internet is a source of health information and advice for individuals with chronic conditions and shows promise for helping individuals manage their conditions and improve their quality of life. Methods We assessed Internet use for health information by people who had one or more of five common chronic conditions. We conducted a national survey of adults aged 21 and older, then analyzed data from 1980 respondents who had Internet access and who reported that they had hypertension, diabetes, cancer, heart problems, and/or depression. Results Adjusted rates for any Internet use for health information ranged from 33.8% (heart problems only to 52.0% (diabetes only. A sizable minority of respondents — particularly individuals with diabetes — reported that the Internet helped them to manage their condition themselves, and 7.9% said information on the Internet led them to seek care from a different doctor. Conclusion Use of the Internet for health information by chronically ill patients is moderate. Self-reported effects on choice of treatment or provider are small but noteworthy.

  12. Children's Explanations of the Causes of Wellness, Illness, and Injury.

    Science.gov (United States)

    Phillips, G. M.; And Others

    This study examined children's explanatory style for health- and safety-related events. Fifty children (ages 8 to 11) were interviewed using 12 health-related questions based on Seligman's Content Analysis of Verbatim Explanations (CAVE) method. Children and their mothers also completed a health status form, which included questions on the…

  13. A Storybook Method for Exploring Young Children's Views of Illness Causality in Relation to the Familial Context

    Science.gov (United States)

    McIntosh, Caroline; Stephens, Christine

    2012-01-01

    In this paper we describe a method for exploring young children's views of illness causality in social context. Studies of children's conceptualisation of illness have predominantly focused on the nature of children's knowledge rather than locating that knowledge within socio-cultural contexts. Adopting a socio-constructivist perspective we sought…

  14. Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: II. Intervention

    NARCIS (Netherlands)

    Doesum, K.T.M. van; Hosman, C.M.H.; Santvoort, F. van

    2009-01-01

    Children of parents with a mental illness are at significant risk of developing mental disorders and other adverse outcomes at some point in their lives compared to children of healthy parents. During the last 20 years, a comprehensive preventive program for children of parents with a mental illness

  15. Nursing care gestion of chronically ill elderly people. Policlinico 2, year 2007

    Directory of Open Access Journals (Sweden)

    Liudmila Carbonell Sanamé

    2009-01-01

    Full Text Available A descriptive prospective study was made to those patients aged more than 60 years who are attended in the Policlinico 2 “Leonilda Tamayo Matos” in Isla de la Juventud during the year 2007. The study population was 1254 and 700 chronically ill elderly people were taken as representative sample, using a simple random sampling. The Mini Mental State Examination and a satisfaction survey was made to old people, all these with their informed consent. The main variables to study were: sex, age, race, civil state, educational level, work, assistance to the Grandparent’s Circle and satisfaction level. There exists a feminine predominance (61% over male, as well as the age group from 60 to 64 years old. Mixed race is the most common one (43%, followed by black (35%. 43% of these elders have secondary studies, and 64% of them are retired. The assistance to the Grandparent’s Circle is good, 338 of all the elders studied (48.2% assist to it. The results were expressed with real numbers and percentages, and were represented in bar and pie charts. There exists a predominance of arterial hypertension and diabetes mellitus in the elders studied. The quality of the nursing cares to the chronically ill old people of the policlinic 2 in 2007 was good.

  16. A shared respite—The meaning of place for family well-being in families living with chronic illness

    Science.gov (United States)

    Årestedt, Liselott; Benzein, Eva; Persson, Carina; Rämgård, Margareta

    2016-01-01

    Living with chronic illness is a family affair that involves ongoing changes and challenges in everyday life. When life changes, the environment is important for family health and well-being. The relation between a place and a family is rarely described, and therefore the aim of this study was to explore the meaning of place for family well-being in families living with chronic illness. A qualitative design was chosen. Data were collected by photovoice combined with narrative family research interviews with 10 families living with chronic illness. A phenomenological hermeneutic analysis was used to interpret the data. The results showed that the meaning of place for family well-being in families living with chronic illness can be described as “a shared respite.” This main theme included three subthemes: “a place for relief,” “a place for reflection,” and “a place for re-creation.” These results were further understood by means of the concept place security. Feeling well means having place security in these families. Through knowledge about the meaning of place for family well-being, health care personnel can stimulate families living with chronic illness to find respite in places that contribute to well-being, both in familiar and new places. PMID:26956097

  17. A shared respite--The meaning of place for family well-being in families living with chronic illness.

    Science.gov (United States)

    Årestedt, Liselott; Benzein, Eva; Persson, Carina; Rämgård, Margareta

    2016-01-01

    Living with chronic illness is a family affair that involves ongoing changes and challenges in everyday life. When life changes, the environment is important for family health and well-being. The relation between a place and a family is rarely described, and therefore the aim of this study was to explore the meaning of place for family well-being in families living with chronic illness. A qualitative design was chosen. Data were collected by photovoice combined with narrative family research interviews with 10 families living with chronic illness. A phenomenological hermeneutic analysis was used to interpret the data. The results showed that the meaning of place for family well-being in families living with chronic illness can be described as "a shared respite." This main theme included three subthemes: "a place for relief," "a place for reflection," and "a place for re-creation." These results were further understood by means of the concept place security. Feeling well means having place security in these families. Through knowledge about the meaning of place for family well-being, health care personnel can stimulate families living with chronic illness to find respite in places that contribute to well-being, both in familiar and new places. PMID:26956097

  18. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2009-01-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  19. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2012-02-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  20. Effects of Qigong Exercise on Fatigue, Anxiety, and Depressive Symptoms of Patients with Chronic Fatigue Syndrome-Like Illness: A Randomized Controlled Trial

    OpenAIRE

    Chan, Cecilia L. W.; Sham, Jonathan S. T.; Lai Ping Yuen; Chong-wen Wang; Jessie S. M. Chan; Ho, Rainbow T. H.

    2013-01-01

    Background. Anxiety/depressive symptoms are common in patients with chronic fatigue syndrome- (CFS-) like illness. Qigong as a modality of complementary and alternative therapy has been increasingly applied by patients with chronic illnesses, but little is known about the effect of Qigong on anxiety/depressive symptoms of the patients with CFS-like illness. Purpose. To investigate the effects of Qigong on fatigue, anxiety, and depressive symptoms in patients with CFS-illness. Methods. One hun...

  1. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis

    OpenAIRE

    Philpott, J; Houghton, K.; Luke, A

    2010-01-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for ‘safe’ physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an...

  2. The Future of Psychotherapy for Mentally Ill Children and Adolescents

    Science.gov (United States)

    March, John S.

    2009-01-01

    Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy…

  3. Adopting the qualitative paradigm to understanding children's perspectives of illness: barrier or facilitator?

    Science.gov (United States)

    Woodgate, R

    2001-06-01

    Reliance on the traditional quantitative paradigm has been the norm for exploring the phenomenon of children's illness experiences. Although it provides valuable information on the psychosocial sequelae of children in response to illness, an account of children's perspectives of the illness experience is missing. Accordingly, researchers since the early 1980s have been advocating the need to adopt the qualitative paradigm in the study of children's illness experiences. Nonetheless, even though there is a call for more qualitative research, the majority of research being conducted today still supports the quantitative paradigm. This report examines why researchers may be reluctant to adopt the qualitative paradigm. Specifically, the author proposes that this reluctance may stem from researchers' perceiving children as being less competent and social than adults, which would explain the need to research children solely from an objective, impersonal stance. Primary philosophical principles of the qualitative paradigm may be seen as barriers to accessing children's thoughts. The author suggests, however, that when children are viewed from an alternative perspective, the major principles of the qualitative paradigm may actually serve as facilitators to apprehending their thoughts and feelings. The following key principles of the qualitative research paradigm are examined: (a) realities are constructed by human beings who are viewed as active agents making sense out of the realities they encounter; (b) realities are multiple and must be perceived holistically and from various vantage points; and (c) realities are shared and mutually shaped by the researcher and research participants. Key strategies that promote successful use of the qualitative paradigm in the study of children's illness experiences are also discussed. PMID:11398125

  4. Hand sanitiser provision for reducing illness absences in primary school children: a cluster randomised trial.

    Directory of Open Access Journals (Sweden)

    Patricia Priest

    2014-08-01

    Full Text Available BACKGROUND: The potential for transmission of infectious diseases offered by the school environment are likely to be an important contributor to the rates of infectious disease experienced by children. This study aimed to test whether the addition of hand sanitiser in primary school classrooms compared with usual hand hygiene would reduce illness absences in primary school children in New Zealand. METHODS AND FINDINGS: This parallel-group cluster randomised trial took place in 68 primary schools, where schools were allocated using restricted randomisation (1:1 ratio to the intervention or control group. All children (aged 5 to 11 y in attendance at participating schools received an in-class hand hygiene education session. Schools in the intervention group were provided with alcohol-based hand sanitiser dispensers in classrooms for the winter school terms (27 April to 25 September 2009. Control schools received only the hand hygiene education session. The primary outcome was the number of absence episodes due to any illness among 2,443 follow-up children whose caregivers were telephoned after each absence from school. Secondary outcomes measured among follow-up children were the number of absence episodes due to specific illness (respiratory or gastrointestinal, length of illness and illness absence episodes, and number of episodes where at least one other member of the household became ill subsequently (child or adult. We also examined whether provision of sanitiser was associated with experience of a skin reaction. The number of absences for any reason and the length of the absence episode were measured in all primary school children enrolled at the schools. Children, school administrative staff, and the school liaison research assistants were not blind to group allocation. Outcome assessors of follow-up children were blind to group allocation. Of the 1,301 and 1,142 follow-up children in the hand sanitiser and control groups, respectively, the

  5. Implementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled

    OpenAIRE

    Plant, Natalie; Mallitt, Kylie-Ann; Kelly, Patrick J.; Usherwood, Tim; Gillespie, James; Boyages, Steven; Jan, Stephen; McNab, Justin; Essue, Beverley M.; Gradidge, Kathy; Maranan, Nereus; Ralphs, David; Aspin, Clive; Leeder, Stephen

    2013-01-01

    Background Chronic illness is a significant driver of the global burden of disease and associated health care costs. People living with severe chronic illness are heavy users of acute hospital services; better coordination of their care could potentially improve health outcomes while reducing hospital use. The Care Navigation trial will evaluate an in-hospital coordinated care intervention on health service use and quality of life in chronically ill patients. Methods/Design A randomised contr...

  6. A qualitative investigation into the experiences of children who have a parent with a mental illness

    OpenAIRE

    Backer, Clare

    2011-01-01

    This thesis investigated the experiences of children who have a parent with a mental illness, using qualitative methods. It is divided into three separate sections, the first two written as standalone journal papers. Paper 1 is a systematic review and synthesis of qualitative studies exploring children‟s experiences of having a parent with a mental illness. The review used specific databases, a search of qualitative journals and a general internet search to identify relevant studies, and the ...

  7. Sinusitis and chronic cough in children

    Directory of Open Access Journals (Sweden)

    Wilson NW

    2012-07-01

    Full Text Available Nevin W Wilson, Mary Beth Hogan, Charles Bruce Harper, Kathy Peele, Sonia Budhecha, Vincent Loffredo, Vanessa WongUniversity of Nevada School of Medicine, Department of Pediatrics, Section of Allergy, Immunology and Pulmonology, Reno, NV, USABackground: Chronic cough in children is a common problem, and sinusitis is a common etiology. The diagnosis of sinusitis is often clinical, but confirmation is thought to require a CT scan due to the difficulty of interpreting a Water’s view sinus X-ray.Objectives: The purposes of the study were (1 to examine the frequency of an abnormal sinus X-ray in children with a chronic cough of more than 4 weeks duration; (2 to compare the interpretation of the sinus film between allergy/pulmonary clinicians and radiologists; and (3 to correlate symptoms with X-ray results.Methods: A chart review of 2- to 18-year-old patients with coughing exceeding 4 weeks was performed. Data was collected for patients who had received a Water’s view sinus film as part of their evaluation. Exam, X-ray results, and clinical outcomes were categorized and statistical analyses performed.Results: A total of 86 patients were included. Clinicians found that 65% of the children had positive Water’s view films, compared with the radiologist’s reading of 62% (non significant. Significant associations between post-tussive emesis (P = 0.01 and purulence (P = 0.03 were noted with a positive film. Positive sinus X-ray was highly associated with all findings except wheeze when present together (P < 0.001.Conclusions: Sinus abnormalities on X-ray are associated with prolonged cough in 65% of children. The Water’s view sinus film is a clinically useful screening tool for clinicians in the workup of chronic cough. Certain physical findings and clinical complaints, when present concurrently, correlate with the X-ray results.Keywords: Water’s view sinus X-ray, asthma, allergic rhinitis, radiologist, post-tussive emesis, wheezing

  8. Depressive Symptomatology in Children and Adolescents with Chronic Renal Insufficiency Undergoing Chronic Dialysis

    Directory of Open Access Journals (Sweden)

    Edith G. Hernandez

    2011-01-01

    Full Text Available This paper presents a descriptive study, using the Birleson Scale to determine the frequency of depressive symptomatology in children and adolescents with chronic renal insufficiency (CRI undergoing hemodialysis (HD and chronic peritoneal dialysis (CPD. There were 67 patients (40 female and 27 male with a mean age of 14.76±2.71 years, duration of illness ≥3 months, 43 (64.18% patients with CPD and 24 (35.82% undergoing HD. The frequency of high occurrence, low occurrence, and absence of depressive symptomatology was 10.45% (=7, 43.28% (=29, and 46.27% (=31, respectively; all of the seven (100% patients with high occurrence of depressive symptomatology were female (=0.04, and none of these (0% had a friend to confide in (=0.03. Depressive symptomatology in patients with CPD was associated with a lower weekly / compared to those without depressive symptomatology (2.15±0.68 versus 2.52±0.65; =0.01. There was no association with patient age, caregiver, time and dialysis type, anemia, bone disease, nutritional or financial status, origin, schooling, or employment.

  9. Religious versus Conventional Psychotherapy for Major Depression in Patients with Chronic Medical Illness: Rationale, Methods, and Preliminary Results

    OpenAIRE

    Harold G. Koenig

    2012-01-01

    This paper (1) reviews the physical and religious barriers to CBT that disabled medically ill-depressed patients face, (2) discusses research on the relationship between religion and depression-induced physiological changes, (3) describes an ongoing randomized clinical trial of religious versus secular CBT in chronically ill patients with mild-to-moderate major depression designed to (a) overcome physical and religious barriers to CBT and (b) compare the efficacy of religious versus secular C...

  10. Prediction of exacerbation chronic bronchopulmonary diseases in children with influenza

    Directory of Open Access Journals (Sweden)

    O. I. Afanaseva

    2015-01-01

    Full Text Available The objective: To develop a method for predicting exacerbation of chronic illness in children with asthma and cystic fibrosis, patients with influenza, based on the study of the dynamics of cytokines. Materials and methods: Were examined 52 patients with bronchial asthma and 45 children with cystic fibrosis at the age from 1 year to 12 years, located in infectious pulmonary Department at the planned treatment of underlying pathology, in which influenza was in-hospital infection. Control group observations included 40 patients with the flu, without concomitant pulmonary disease. The etiology of viral infection was established by detection of viral RNA in nasopharyngeal swabs by PCR. Among the influenza viruses were identified influenza АH1N1, АH3N2, influenza B, and in 2009–2010 the predominant antigen was the pandemic influenza virus АH1N1pdm09. Determination of the concentration of serum interleukins IL-1β, IL-4, IL-8, IL-10, ТNF-α, IFN-γ was performed in the 1st and 3rd day of hospitalization cytokines by the solid-phase immune-enzyme assay. Analysis of the results performed using statistical package SPSS 17.0 EN for Windows. Results: The flu caused the aggravation associated bronchopulmonary pathology in 2/3 of children, as MV patients, and patients with BA (65,4%-66,7%, respectively. With an increase of the ratio of IL-4 / IFN-γ and IL-10/IFN-γ, at least 5-6 times, influenza can be considered a trigger of exacerbation of chronic bronchopulmonary pathologies that require amplification of the therapy of bronchial asthma and of сystic fibrosis. The growth of prognostic coefficients in 2-3 times allows using for treatment of influenza in these patients only antiviral agents. Conclusion: The study has shown a method for predicting exacerbation of bronchial asthma and cystic fibrosis in children at an early stage of influenza by calculating the ratio of IL-4/IFN-γ and IL-10/IFN-γ in children aged from 1 year to 12 years. 

  11. Utility of CT-compatible EEG electrodes in critically ill children

    Energy Technology Data Exchange (ETDEWEB)

    Abend, Nicholas S. [Perelman School of Medicine at the University of Pennsylvania, Departments of Neurology and Pediatrics, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); CHOP Neurology, Philadelphia, PA (United States); Dlugos, Dennis J. [Perelman School of Medicine at the University of Pennsylvania, Departments of Neurology and Pediatrics, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Zhu, Xiaowei; Schwartz, Erin S. [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2015-05-01

    Electroencephalographic monitoring is being used with increasing frequency in critically ill children who may require frequent and sometimes urgent brain CT scans. Standard metallic disk EEG electrodes commonly produce substantial imaging artifact, and they must be removed and later reapplied when CT scans are indicated. To determine whether conductive plastic electrodes caused artifact that limited CT interpretation. We describe a retrospective cohort of 13 consecutive critically ill children who underwent 17 CT scans with conductive plastic electrodes during 1 year. CT images were evaluated by a pediatric neuroradiologist for artifact presence, type and severity. All CT scans had excellent quality images without artifact that impaired CT interpretation except for one scan in which improper wire placement resulted in artifact. Conductive plastic electrodes do not cause artifact limiting CT scan interpretation and may be used in critically ill children to permit concurrent electroencephalographic monitoring and CT imaging. (orig.)

  12. Utility of CT-compatible EEG electrodes in critically ill children

    International Nuclear Information System (INIS)

    Electroencephalographic monitoring is being used with increasing frequency in critically ill children who may require frequent and sometimes urgent brain CT scans. Standard metallic disk EEG electrodes commonly produce substantial imaging artifact, and they must be removed and later reapplied when CT scans are indicated. To determine whether conductive plastic electrodes caused artifact that limited CT interpretation. We describe a retrospective cohort of 13 consecutive critically ill children who underwent 17 CT scans with conductive plastic electrodes during 1 year. CT images were evaluated by a pediatric neuroradiologist for artifact presence, type and severity. All CT scans had excellent quality images without artifact that impaired CT interpretation except for one scan in which improper wire placement resulted in artifact. Conductive plastic electrodes do not cause artifact limiting CT scan interpretation and may be used in critically ill children to permit concurrent electroencephalographic monitoring and CT imaging. (orig.)

  13. Relation of antecedent illness to development of diabetes in children.

    OpenAIRE

    Gamble, D R

    1980-01-01

    Information was obtained by postal questionnaire in 1663 cases of childhood diabetes of recent onset about other illnesses for which the family doctor was consulted in the six months before onset. Consultation rates in each of these six months were compared with each other and with rates reported in a concurrent study of morbidity in general practices. There was a significant excess of consultations for mumps in the six months before onset of diabetes (p < 0.001), the greatest excess being in...

  14. The relationships between depression and other outcomes of chronic illness caregiving

    Directory of Open Access Journals (Sweden)

    Jirovec Mary M

    2005-02-01

    Full Text Available Abstract Background Many caregivers with chronically ill relatives suffer from depression. However, the relationship of depression to other outcomes of chronic caregiving remains unclear. This study tested a hypothesized model which proposed that hours of care, stressful life events, social support, age and gender would predict caregivers' outcomes through perceived caregiver stress. Depression was expected to mediate the relationship between perceived stress and outcomes of chronic caregiving (physical function, self-esteem, and marital satisfaction. Methods The sample for this secondary data analysis consisted of 236 and 271 subjects from the Americans' Changing Lives, Wave 1, 1986, and Wave 2, 1989, data sets. Measures were constructed from the original study. Structural equation modeling was used to test the hypothesized model, and an exploratory structural modeling method, specification search, was used to develop a data-derived model. Cross-validation was used to verify the paths among variables. Results Hours of care, age, and gender predicted caregivers' outcomes directly or through perceived caregiver stress (p Conclusion Depression predicted psychological outcomes. Whether depression predicts physical health outcomes needs to be further explored.

  15. Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment

    Directory of Open Access Journals (Sweden)

    Lisa M. McAndrew, PhD

    2016-02-01

    Full Text Available Many Veterans returning from service in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF experience chronic pain. What is not known is whether for some OIF/OEF Veterans this pain is part of a larger condition of diffuse multisystem symptoms consistent with chronic multisymptom illness (CMI. We use data from a prospective longitudinal study of OIF/OEF Veterans to determine the frequency of CMI. We found that 1 yr after deployment, 49.5% of OIF/OEF Veterans met criteria for mild to moderate CMI and 10.8% met criteria for severe CMI. Over 90% of Veterans with chronic pain met criteria for CMI. CMI was not completely accounted for either by posttraumatic stress disorder or by predeployment levels of physical symptoms. Veterans with symptoms consistent with CMI reported significantly worse physical health function than Veterans who did not report symptoms consistent with CMI. This study suggests that the presence of CMI should be considered in the evaluation of OIF/OEF Veterans. Further, it suggests that the pain management for these Veterans may need to be tailored to take CMI into consideration.

  16. Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory – use of the Chronic Care Model

    Directory of Open Access Journals (Sweden)

    Stewart Allison

    2008-05-01

    Full Text Available Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Results Participating health centres had distinct areas of strength and weakness in each component of systems: 1 organisational influence – strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2 community linkages – facilitated by working together with community organisations (e.g. local stores and running community-based programs (e.g. "health week", but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3 self management – promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4 decision support – facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5 delivery system

  17. Factors affecting illness in the developing world: chronic disease, mental health and traditional medicine cures.

    Science.gov (United States)

    Douthit, Nathan T; Astatk, Hailemariam Alemu

    2016-01-01

    This is a case report of a 24-year-old Ethiopian woman with a medical history of hepatosplenic schistosomiasis. She suffers from chronic liver failure and portal hypertension. She has been hospitalised for 'hysteria' in the past but did not receive follow-up, outpatient treatment or psychiatric evaluation. After discontinuing her medications and leaving her family to use holy water, a religious medicine used by many Ethiopians, she was found at a nearby monastery. She was non-communicative and difficult to arouse. The patient was rushed to nearby University of Gondar Hospital where she received treatment for hepatic encephalopathy and spontaneous bacterial peritonitis. Her illness is the result of neglected tropical disease, reliance on traditional medicine as opposed to biomedical services and the poor state of psychiatric care in the developing world. PMID:27485874

  18. Psychosocial Adaptation to Chronic Illness and Disability: A Virtue Based Model.

    Science.gov (United States)

    Kim, Jeong Han; McMahon, Brian T; Hawley, Carolyn; Brickham, Dana; Gonzalez, Rene; Lee, Dong-Hun

    2016-03-01

    Purpose Psychosocial adaptation to chronic illness and disability (CID) is an area of study where a positive psychology perspective, especially the study of virtues and character strengths, can be implemented within the rehabilitation framework. A carefully developed theory to guide future interdisciplinary research is now timely. Methods A traditional literature review between philosophy and rehabilitation psychology was conducted in order to develop a virtue-based psychosocial adaptation theory, merging important perspectives from the fields of rehabilitation and positive psychology. Results The virtue-based psychosocial adaptation model (V-PAM) to CID is proposed in the present study. Conclusions The model involves five qualities or constructs: courage, practical wisdom, commitment to action, integrity and emotional transcendence. Each of these components of virtue contributes to an understanding of psychosocial adaptation. The present study addresses the implications and applications of V-PAM that will advance this understanding. PMID:26781509

  19. Passive smoking, as measured by hair nicotine, and severity of acute lower respiratory illnesses among children

    Directory of Open Access Journals (Sweden)

    Al-Delaimy WK

    2002-01-01

    Full Text Available Abstract The aim of this study was to describe the association between passive smoking and the severity of acute lower respiratory illnesses (ALRI among 351 children aged 3–27 months admitted to hospital. A total of 297 children provided hair samples, which were analysed for hair nicotine levels as an indicator of passive smoking. A severity of illness grading system was developed by using clinical and management criteria used by the medical staff at hospital. The OR for children with more severe illness being exposed to higher nicotine levels was 1.2, 95% CI: 0.57–2.58 when using dichotomised respiratory severity levels and upper versus lower nicotine quartile levels. In an ordinal logistic regression model, the OR of more severe illness being associated with higher nicotine levels was 1.07 (95% CI: 0.92–1.25. When analysis was limited to the more severe cases, the OR of the least severe category compared to the most severe category, in relation to nicotine levels in hair, was 1.79 (95% CI: 0.5–6.30. The ordinal logistic regression of this group of severely-ill children (OR 1.1 (95% CI: 0.94–1.29 was not substantially different from the overall study subjects. Conclusion In general, children with more severe illness tended to have higher levels of nicotine in their hair, although the results were within the limit of chance. Possible explanations of our results include environmental tobacco smoke (ETS being an initiator of ALRI rather than a risk to severity, exposure levels of ETS were too low to demonstrate an effect on severity, or the power of this study was not high enough to detect an association.

  20. Latex Allergy, a Special Risk for Patients with Chronic Illness and Health Care Workers

    Directory of Open Access Journals (Sweden)

    A.Zafer Caliskaner

    2008-06-01

    Full Text Available Natural rubber latex allergy is a new illness whose prevalence has reached epidemic proportions in highly exposed populations such as health care workers and who has chronic illness. After anaphylactic type reactions due to latex has been shown as case reports. The major risk factors in latex are intense exposure to latex allergens (surgical gloves, catheters, etc, atopy, hand eczema, female gender, history of multiple operations and dental interventions. An association between latex allergy and allergy to various fruits (banana, kiwi, avocado, pineapple, etc has been reported. Latex allergy is responsible for a wide spectrum of clinical symptoms ranging from a mild dermatitis to severe anaphylaxis. In this report, we present that latex related systemic allergic reactions cases; the first one is 24 years old nurse woman who is working at the blood bank in our hospital and the other one is 32 years old woman patient who has repeatative medical examination, and in vitro fertilisation therapy plan and suffered for systemic allergic reaction due to latex gloves which was used in her last concha operations. [TAF Prev Med Bull 2008; 7(3.000: 265-268

  1. Oral protein calorie supplementation for children with chronic disease

    OpenAIRE

    Francis, Damian K.; Smith, Joanne; Saljuqi, Tawab; Watling, Ruth M

    2015-01-01

    Background Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. the development of inappropriate eating behaviour patterns. This is a new update of a Cochrane review last updated in 2009. Objectives To examine evidence that in children with chronic disease, oral protein calorie supplements alter daily ...

  2. Migraine in Gulf War Illness and Chronic Fatigue Syndrome: Prevalence, potential mechanisms, and evaluation

    Directory of Open Access Journals (Sweden)

    Rakib eRayhan

    2013-07-01

    Full Text Available Objective: To assess the prevalence of headache subtypes in Gulf War Illness and Chronic Fatigue Syndrome compared to controls. Background: Migraines are reported in Chronic Fatigue Syndrome (CFS. Approximately, 25% of the military personnel who served in the 1990-1991 Persian Gulf War have developed Gulf War Illness (GWI. Symptoms in GWI share considerable overlap with CFS, including headache complaints. The type and prevalence of headaches in GWI have not been adequately assessed.Methods: 50 GWI, 39 CFS and 45 controls were examined. Participants had structured headache evaluations based on the 2004 International Headache Society criteria. All subjects had history and physical examinations, measurements of systemic hyperalgesia (dolorimetry, assessments for exclusionary indicators, fatigue and symptom related questionnaires. Results: Migraines were detected in 64% of GWI (odds ratio, 11.6, [±95% CI, 4.1 to 32.5] and 82% of CFS subjects (odds ratio, 22.5, [±95% CI, 7.8 to 64.8] compared to only 13% of controls. There was a predominance of females in the CFS compared to GWI and controls. However, gender did not influence migraine status (x2= 2.7; P = 0.101. Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache. Conclusion: Results validate previous findings of migraine in CFS and confirms similar increased prevalence in GWI compared to controls. This suggests GWI and CFS subjects share pathophysiological mechanisms that underlie migraine attacks and contribute to the extensive overlap of symptom constructs and disease pathophysiology. The high migraine prevalence warrants the inclusion of a structured headache evaluation that coincides with clinical assessments of GWI and CFS diagnosis.

  3. Chronic and Episodic Stress in Children of Depressed Mothers.

    Science.gov (United States)

    Feurer, Cope; Hammen, Constance L; Gibb, Brandon E

    2016-01-01

    The goal of this study was to examine chronic and episodic stress in children of mothers with and without a history of major depressive disorder (MDD) during the children's lives. Participants were 255 mothers selected according to their history of MDD (present vs. absent during child's life) and their children (age 8-14; 53% girls, 81% Caucasian). Mothers' and children's histories of MDD were assessed using diagnostic interviews, and their depressive symptoms were assessed via self-report measures. Children's levels of chronic and episodic stress were assessed using a semistructured contextual threat interview. Children of mothers with a history of recurrent MDD, compared to single MDD or no depression, experienced more chronic stress within several domains including peers, mother-child relations, and other family member relations as well as greater episodic dependent interpersonal stress. Each of these group differences was maintained after excluding children with a history of MDD themselves and controlling for their current depressive symptoms. However, only the group difference in chronic peer stress was maintained when controlling for mothers' current depression. The results suggest that children exposed to recurrent maternal MDD experience higher levels of both chronic and episodic stress, at least some of which they contribute to themselves (dependent interpersonal stress) and which is at least partially independent of the effects of children's depression. In addition, much of this stress is associated primarily with current depression in the mother, though it appears that chronic peer stress may remain elevated even after the remission of maternal depression. PMID:25496371

  4. Conducta del enfermo ante el dolor crónico Illness behavior in chronic pain

    Directory of Open Access Journals (Sweden)

    Pilar Lavielle

    2008-04-01

    Full Text Available OBJETIVO: Describir la "conducta de enfermedad" en pacientes con dolor crónico. MATERIAL Y MÉTODOS: Durante el año 2000 se realizaron entrevistas semiestructuradas a 53 pacientes en una institución del tercer nivel de atención. Allí se exploró su interpretación y respuesta inicial al dolor crónico y prácticas subsecuentes hasta sentirse satisfechos con el diagnóstico recibido. RESULTADOS: La conducta de enfermedad estuvo determinada por la intensidad, discapacidad y creencias de las causas del dolor, recomendaciones de las redes de apoyo, la calidad y satisfacción con los sistemas de atención. En términos de la toma de decisión, la primera opción fue acudir al sector popular, y consultar al médico general, para finalmente acudir a un tercer nivel de atención ("con el especialista". CONCLUSIONES: La conducta de enfermedad es un proceso en el que se utilizan los diferentes sectores de la atención por parte de los mismos sujetos y que es determinado por el resultado de la atención brindada.OBJECTIVE: To describe the illness behaviour in patients with chronic pain. MATERIAL AND METHODS: We conducted semi-structured interviews to 53 patients during 2000, in a tertiary care center. We explored their initial interpretations, responses and subsequent practices to chronic pain, until they received a diagnosis that satisfied them. RESULTS: Illness behaviour was determined by pain intensity and disability; beliefs regarding pain causes, trust in social networks, and quality and satisfaction with the health care systems. In terms of the decision to seek care, the first option was to go to the popular sector, followed by consulting a general physician, and as last resort, to go to a tertiary care center ("with a specialist". CONCLUSIONS: Illness behaviour should be conceptualized as a process, which combines the use of different health care sectors by the same subjects, as a result of care provided sequentially by each previous sector.

  5. Acute respiratory infection as a cause of non-malarial febrile illness in African children.

    Directory of Open Access Journals (Sweden)

    Florida Muro

    2015-01-01

    Full Text Available The replacement of “presumptive treatment for malaria” by “test before treat” strategies for the management of febrile illness is raising awareness of the importance of knowing more about the causes of illness in children who are suspected to have malaria but return a negative parasitological test. The most common cause of non-malarial febrile illness (NMFI in African children is respiratory tract infection. Whilst the bacterial causes of NMFI are well known, the increasing use of sensitive techniques such as polymerase chain reaction (PCR tests is revealing large numbers of viruses that are potential respiratory pathogens. However, many of these organisms are commonly present in the respiratory tract of healthy children so causality and risk factors for pneumonia remain poorly understood. Infection with a combination of viral and bacterial pathogens is increasingly recognised as important in the pathogenesis of pneumonia. Similarly, blood stream infections with organisms typically grown by aerobic culture are well known but a growing number of organisms that can be identified only by PCR, viral culture, or serology are now recognised to be common pathogens in African children. The high mortality of hospitalised children on the first or second day of admission suggests that, unless results are rapidly available, diagnostic tests to identify specific causes of illness will still be of limited use in guiding the potentially life‑saving decisions relating to initial treatment of children admitted to district hospitals in Africa with severe febrile illness and a negative test for malaria. Malaria control and the introduction of vaccines against Haemophilus influenzae type b and pneumococcal disease are contributing to improved child survival in Africa. However, increased parasitological testing for malaria is associated with increased use of antibiotics to which resistance is already high.

  6. Classroom intervention for illness-related problem behavior in children with developmental disabilities.

    Science.gov (United States)

    Carr, Edward G; Blakeley-Smith, Audrey

    2006-11-01

    There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone (N = 11) versus behavioral plus medical intervention (N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted. PMID:17050770

  7. Children with Rare Chronic Skin Diseases: Hemangiomas and Epidermolysis Bullosa.

    Science.gov (United States)

    Jones, Sheila Dove; Miller, Cynthia Dieterich

    The paper reports on studies involving children having the rare chronic skin diseases of hemangiomas and epidermolysis bullosa (characterized by easy blistering). One study compared the self-concept and psychosocial development of young (mean age 46 months) children (N=19) with hemangiomas with 19 children without hemangiomas. Findings indicated…

  8. Early recognition and management of fabricated or induced illness in children.

    Science.gov (United States)

    Bass, Christopher; Glaser, Danya

    2014-04-19

    Fabricated or induced illness (previously known as Munchausen syndrome by proxy) takes place when a caregiver elicits health care on the child's behalf in an unjustified way. Although the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders specifies deception as a perpetrator characteristic, a far wider range is encountered clinically and is included in this Review. We describe the features of fabricated or induced illness, its effect on the child, and the psychosocial characteristics of caregivers and their possible motives. Present evidence suggests that somatoform and factitious disorders are over-represented in caregivers, with possible intergenerational transmission of abnormal illness behaviour from the caregiver to the child. Paediatricians' early recognition of perplexing presentations preceding fabricated or induced illness and their management might obviate the development of this disorder. In cases of fully developed fabricated or induced illness, as well as protection, the child will need help to return to healthy functioning and understand the fabricated or induced illness experience. Management of the perpetrator is largely dependent on their capacity to acknowledge the abusive behaviour and collaborate with helping agencies. If separation is necessary, reunification of mother and child is rare, but can be achieved in selected cases. More collaborative research is needed in this specialty, especially regarding close study of the characteristics of women with somatoform and factitious disorders who involve their children in abnormal illness behaviour. We recommend that general hospitals establish proactive networks including multidisciplinary cooperation between designated staff from both paediatric and adult mental health services. PMID:24612863

  9. Acute respiratory infection and bacteraemia as causes of non-malarial febrile illness in African children: a narrative review.

    OpenAIRE

    Florida Muro; Rita Reyburn; Hugh Reyburn

    2015-01-01

    The replacement of “presumptive treatment for malaria” by “test before treat” strategies for the management of febrile illness is raising awareness of the importance of knowing more about the causes of illness in children who are suspected to have malaria but return a negative parasitological test. The most common cause of non-malarial febrile illness (NMFI) in African children is respiratory tract infection. Whilst the bacterial causes of NMFI are well known, the increasing use of sensitive ...

  10. Patient Assessment of Chronic Illness Care (PACIC) in Type 2 Diabetes: A Longitudinal Study.

    Science.gov (United States)

    Aung, Eindra; Ostini, Remo; Dower, Jo; Donald, Maria; Coll, Joseph R; Williams, Gail M; Doi, Suhail A R

    2016-06-01

    The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed. PMID:25380699

  11. Influences of Maternal Mental Illness on Psychological Outcomes for Adolescent Children.

    Science.gov (United States)

    Oyserman, Daphna; Bybee, Deborah; Mowbray, Carol

    2002-01-01

    Explores the effects of maternal psychiatric symptoms and community functioning on child outcomes in a diverse sample of seriously mentally ill women caring for their teenaged children. In hierarchical multiple regression, for youth depression, we find effects for parenting style and maternal mental health; for youth anxiety and efficacy, effects…

  12. Effects of preventive family service coordination for parents with mental illnesses and their children, a RCT

    NARCIS (Netherlands)

    Wansink, H.J.; Janssens, J.M.A.M.; Hoencamp, E.; Middelkoop, B.J.C.; Hosman, C.M.H.

    2015-01-01

    Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as de

  13. Comfortably Calm: Soothing Sedation of Critically Ill Children without Withdrawal Symptoms

    NARCIS (Netherlands)

    E. Ista (Erwin)

    2008-01-01

    textabstractCritically ill children admitted to an intensive care unit (ICU) are bound to experience some degree of discomfort, distress and pain, more than in other settings in a children’s hospital. Inserting intravenous lines, catheters and tubes is a major source of these adverse effects. In ord

  14. Measurement of Intra-abdominal Pressure in Critically-ill Children

    OpenAIRE

    Singhal, Jyoti; Shanbag, Preeti

    2014-01-01

    Introduction: It is being increasingly recognized that intra-abdominal hypertension is an important cause of organ dysfunction. This pilot study was done to determine the feasibility of measuring intra-abdominal pressures (IAP) in critically-ill children using simple inexpensive equipment available in the PICU.

  15. CAN FLU-LIKE ILLNESS BE AN INDICATION OF RECENT ORGANOPHOSPHATE PESTICIDE EXPOSURE IN PRESCHOOL CHILDREN?

    Science.gov (United States)

    Can flu-like illness be an indication of recent organophosphate pesticide exposure in preschool children? P Mendola*, D Barr, D Walsh, S Hern, S Rhoney, L Needham, E Hilborn, M Gonzales, C Carty, G Robertson, J Creason (US EPA, ORD, NHEERL, Research Triangle Park, NC 27711)<...

  16. Intervention programs for children whose parents have a mental illness: a review

    NARCIS (Netherlands)

    Reupert, A.E.; Cuff, R.; Drost, L.; Foster, K.; Doesum, K.T.M. van; Santvoort, F. van

    2012-01-01

    Objective: To identify and describe intervention programs to improve outcomes for children whose parents have a mental illness. Data sources: Grey and black literature was sourced from (i) three previous reviews/scoping studies, (ii) PsycINFO and MEDLINE searches of English, German and Dutch papers,

  17. Playing with Moon Sand: A Narrative Inquiry into a Teacher's Experiences Teaching Alongside a Student with a Chronic Illness

    Science.gov (United States)

    Davis, Beth; Murphy, M. Shaun

    2016-01-01

    This paper inquires into the experiences of an early childhood educator named Claire who taught a young girl with a chronic illness at East Willows Elementary School, a western Canadian elementary school. Using narrative inquiry as the methodology, Claire's experiences in her curriculum making alongside Madeline a young girl with Turner syndrome…

  18. "Absence Makes the Heart Grow Fonder": Students with Chronic Illness Seeking Academic Continuity through Interaction with Their Teachers at School

    Science.gov (United States)

    Wilkie, Karina J.

    2012-01-01

    Increasing numbers of young people experience disruption to their schooling owing to chronic illness. Absence from the day-to-day life of their school for prolonged or accumulative periods of time can erode their sense of belonging and create anxiety about falling behind academically. Maintaining positive connections to school can meet their…

  19. AN ASSESSMENT OF PATIENT NEED FOR A TECHNOLOGY-ENABLED REMOTE EXERCISE REHABILITATION PROGRAMME AMONG A CHRONIC ILLNESS POPULATION

    Directory of Open Access Journals (Sweden)

    Deirdre Walsh

    2015-10-01

    Conclusion: This study provides evidence of patient desire for a technology-enabled remote exercise rehabilitation programme. Further to this, the current study provides promising preliminary evidence for both the high level of technology use and capability among a cohort of people with chronic illness.

  20. Health-related quality of life and mental health problems after a disaster: are chronically ill survivors more vulnerable to health problems?

    NARCIS (Netherlands)

    Berg, B. van den; Velden, P.G. van der; Yzermans, C.J.; Stellato, R.K.; Grievink, L.

    2006-01-01

    Studies have shown that the chronically ill are at higher risk for reduced health-related quality of life (HRQL) and for mental health problems. A combination with traumatic events might increase this risk. This longitudinal study among 1216 survivors of a disaster examines whether chronically ill s

  1. Health-related quality of life and mental health problems after a disaster: Are chronically ill survivors more vulnerable to health problems?

    NARCIS (Netherlands)

    Berg, Bellis van den; Velden, Peter G van der; Yzermans, C Joris; Stellato, Rebecca K; Grievink, Linda

    2006-01-01

    Studies have shown that the chronically ill are at higher risk for reduced health-related quality of life (HRQL) and for mental health problems. A combination with traumatic events might increase this risk. This longitudinal study among 1216 survivors of a disaster examines whether chronically ill s

  2. Nutritional Needs of the Child with a Handicap or Chronic Illness. Manual II: Clinical Nutrition. Presentations from a National Interdisciplinary Symposium.

    Science.gov (United States)

    Ekvall, Shirley M.; Wheby, Elizabeth A.

    The following papers were presented at a symposium on clinical nutrition for the child who is chronically ill or handicapped: (1) "Food Allergy"; (2) "Anemia and the Chronically Ill or Handicapped Child"; (3) "Nutrition and Neurotransmitters--Clinical Implications"; (4) "The Importance of Lipid Type in the Diet after Burn Injury"; (5) "Advances of…

  3. Serious mental illness and disrupted caregiving for children

    DEFF Research Database (Denmark)

    Ranning, Anne; Munk Laursen, Thomas; Thorup, Anne;

    2015-01-01

    Health Problems, 8th revision (ICD-8) and ICD, 10th revision (ICD-10), were analyzed. The rates were compared with those of children with parents from the general population. RESULTS: A parental diagnosis of schizophrenia was the most prominent risk factor for children placed outside the home, with an...... diagnosis of schizophrenia had the overall highest IRRs of placement in care. Having a mother with bipolar disorder was the second most prominent risk factor (IRR = 5.76; 95% CI, 4.50-7.36), followed by a maternal diagnosis of unipolar depression (IRR = 4.28; 95% CI, 3.73-4.90). Risks were especially high......OBJECTIVE: To study how often severe psychiatric disorders adversely affect a person's ability to be a parent, indicated by the child being placed in out-of-home care. METHOD: This study was conducted in 2013 as a prospective, register-based cohort study covering all first-born singletons in the...

  4. Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

    Directory of Open Access Journals (Sweden)

    Aspin Clive

    2012-06-01

    Full Text Available Abstract Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16 and family carers (n = 3. Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait

  5. The longest illness. Effects of nuclear war in children

    Energy Technology Data Exchange (ETDEWEB)

    Kappy, M.S.

    1984-03-01

    The destruction of civilization that would follow a nuclear war would render any disaster ever recorded insignificant. Millions of people would perish during the first few hours, and many more would die in the months to come. Survival would exist only in the strictest sense of the word, since societal disorganization, famine, drought, darkness, and nuclear winter would envelope the earth. The comparative frailty of children and their dependence on adults would render them most susceptible to the acute effects of a nuclear holocaust. Furthermore, studies of the Hiroshima and Nagasaki, Japan bombings showed a disproportionate propensity for children to experience leukemias and other cancers years after the bombings. There were also great increases in perinatal deaths and cases of microcephaly and retardation in children exposed in utero to the bombs. In the event that there are future generations after a nuclear war, the issue of heritable genetic effects will become important. Suggestions of permanent genetic damage are emerging from the Hiroshima and Nagasaki studies. By comparison, the genetic effects of modern weaponry will be incalculable.

  6. The longest illness. Effects of nuclear war in children

    International Nuclear Information System (INIS)

    The destruction of civilization that would follow a nuclear war would render any disaster ever recorded insignificant. Millions of people would perish during the first few hours, and many more would die in the months to come. Survival would exist only in the strictest sense of the word, since societal disorganization, famine, drought, darkness, and nuclear winter would envelope the earth. The comparative frailty of children and their dependence on adults would render them most susceptible to the acute effects of a nuclear holocaust. Furthermore, studies of the Hiroshima and Nagasaki, Japan bombings showed a disproportionate propensity for children to experience leukemias and other cancers years after the bombings. There were also great increases in perinatal deaths and cases of microcephaly and retardation in children exposed in utero to the bombs. In the event that there are future generations after a nuclear war, the issue of heritable genetic effects will become important. Suggestions of permanent genetic damage are emerging from the Hiroshima and Nagasaki studies. By comparison, the genetic effects of modern weaponry will be incalculable

  7. Pathogenetic approaches to the treatment of children with chronic pneumonia

    OpenAIRE

    Rano Musajanova

    2011-01-01

    We observed 60 children with chronic pneumonia aged from 3 to 14 years compared with 20 healthy children of the same age. Analysis of the biochemical data in children who received thiotriazoline showed reliable reduce of malondialdehyde and dien conjugates in comparison with control group. The levels of superoxidismutase and catalase increased. The results of immunological investigations showed that in children who took thiotriazoline noted reliable increase of T-lymphocytes, T-helpers, T-sup...

  8. Needs, expectations and consequences for children growing up in a family where the parent has a mental illness.

    Science.gov (United States)

    Tabak, Izabela; Zabłocka-Żytka, Lidia; Ryan, Peter; Poma, Stefano Zanone; Joronen, Katja; Viganò, Giovanni; Simpson, Wendy; Paavilainen, Eija; Scherbaum, Norbert; Smith, Martin; Dawson, Ian

    2016-08-01

    The lack of pan-European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parent's attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi-agency collaboration is necessary; schools should provide counselling and prevent stigma. PMID:27278508

  9. Extending The P4P Agenda, Part 2: How Medicare Can Reduce Waste And Improve The Care Of The Chronically Ill: By targeting Americans with chronic illnesses, Medicare can begin to solidify a strategy of rewarding providers for truly improving care.

    OpenAIRE

    Wennberg, John E.; Fisher, Elliott S; Skinner, Jonathan S.; Bronner, Kristen K

    2007-01-01

    The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all Americans with severe chronic illnesses have access to accountable health care organizations providi...

  10. Care in the home for seriously ill children with complex needs: A narrative literature review.

    Science.gov (United States)

    Ward, Cynthia; Glass, Nel; Ford, Rosemary

    2015-12-01

    This article reviews contemporary literature on home care of the seriously ill child with complex care needs and the sick child/parent dyad. The literature search revealed three major themes, namely the increasing acuity of child illness, the evolving role of the parent as care provider, and the health professional as care provider. While there is much known about the complexity of care of children and the role of family in that care, little is known about what families require in terms of support and sustenance during the long years of care provision. PMID:24982427

  11. Is liver biopsy mandatory in children with chronic hepatitis C?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, risk of sampling error and diagnostic inconsistencies due to inter- and intra-observer error. On the basis of histological studies performed so far, chronic hepatitis C in children appears morphologically benign in the majority of cases.At the Pediatric Liver Unit of our university, a total of 67 children with chronic hep, atitis C underwent liver biopsy.Liver biopsy was repeated 5.5 years after the initial histological evaluation in 21 children. On a total number of 88 liver biopsies, micronodular cirrhosis was detected only in one genotype 1b-infected obese child. Since liver histology investigation of a child with chronic hepatitis C has few chances to highlight severe lesions, we question how liver biopsy helps in the management of children with chronic hepatitis C.

  12. Recurrent multifocal chronic osteitis in children

    International Nuclear Information System (INIS)

    We have studied retrospectively a series of 10 children presenting with chronic multifocal osteomyelitis (8 girls, 2 boys, 7 to 16 years). All patients had plain films, bone scintigraphies and histological studies. Three had CT scan and/or MRI. Compared with literature data, we observed only one case of palmo-plantar pustulosis and only 2 cases of lysis of the medial extremity of the clavicle; in addition, we report one case of lateral extremity of the clavicle and 2 vertebral locations. The radiological pattern was typical: at the beginning of the disease, plain films showed lytic areas which became progressively osteosclerotic with enlargement of the bone. In all the cases, bone scintigraphy revealed high uptake areas which were often infra-clinical. The diagnosis was delayed from 3 months to 3 years. This emphasizes the difficulty of the diagnosis which relies on the association of clinical, biological and radiological elements. Biopsies are required to rule out an infectious bacterial osteomyelitis or a tumoral process. The pathogenesis of OCMR remains unknown, but the relation with the SAPHO (synovitis, acne, pustulosis, Hyperostosis, osteitis) syndrome is general accepted because of the similar features of the osteitis. The long term follow up appears to be uncertain: 6 of our patients are still symptomatic after five years despite anti inflammatory treatment. (authors)

  13. What is chronic cough in children?

    Directory of Open Access Journals (Sweden)

    Iulia eIOAN

    2014-08-01

    Full Text Available The cough reflex is modulated throughout growth and development. Cough – but not expiration reflex – appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient towards specific aetiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, paediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.

  14. Treatment Preferences for CAM in Children with Chronic Pain

    OpenAIRE

    Tsao, Jennie C. I.; Marcia Meldrum; Kim, Su C.; Jacob, Margaret C.; Zeltzer, Lonnie K

    2006-01-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years ± 2.4; range = 8–18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examin...

  15. Clinical and morphological characteristics of chronic duodenitis in children

    OpenAIRE

    Tishchenko D.V.; Matveeva O.V.; Chernenkov Yu.V.; Maslyakova G.N.; Bucharskaya A.B.

    2012-01-01

     

    The research goal is to determine clinical, endoscopic and morphological signs of chronic duodenitis in children. Materials and methods: The diagnostic value of molecular markers has been revealed by immunohistochemical research of biopsy. It has been received from endoscopic examination of 32 children aged from 3 to 17 years old with chronic duodenitis. Morphometric investigation of markers expression has been ca...

  16. Can a father's exposure lead to illness in his children

    International Nuclear Information System (INIS)

    There is an urgent need for studies to elucidate mechanisms underlying evidence mechanisms underlying evidence that many different types of paternal exposure induce changes in sperm or semen that could affect children's health. Epidemiology, of course, is only half of the equation that describes male-mediated toxicity. The other half is the biological examination of mechanisms whereby damage to sperm might affect the next generation. In this area, geneticists and toxicologists have had a firm starting point: It's been known for decades that certain toxins and radiation can damage sperm. Research suggests that different chemicals exert their maximum damage on sperm at three stages of sperm production, with most chemicals tested affecting the stage during which early spermatozoa and late spermatids are formed. The problem, however, is that none of these defects has been linked specifically to certain types of birth defects or diseases

  17. Opportunistic illnesses in Brazilian children with AIDS: results from two national cohort studies, 1983-2007

    Directory of Open Access Journals (Sweden)

    Heukelbach Jorg

    2011-07-01

    Full Text Available Abstract Background HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil. Methods This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT, between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed. Results In total, 1,218 (65.5% had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region, age Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p Conclusions Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.

  18. Disease painting or painting disease: how does illness and hospitalisation affect children's artistry?

    Science.gov (United States)

    Bayrakci, Benan; Forouz, Aria; Sahin, Ahmet B; Abali, Mustafa; Aliyeva, Gyulten Z

    2009-01-01

    There are numerous speculations about famous artists and how their perception was affected by their medical conditions. In this study, we examined how illness and hospitalisation affect children's art. A total of 157 paintings by 122 hospitalised children were interpreted by three reputed artists. Works of ill children were compared with those of a control group from an international art exhibition. We also comment on how diseases influenced the technique of famous artists to further examine the possible impact of illness on the artistry of hospitalised children. Developmental delay in painting was evident in the study group. Use of ready-made schemas was a common practice (55%). 56% of the work from patients older than eight years failed in perspective and site perception. The theme in 89% of the drawings had no human figures. Projection of self sufferings, prominent elementary lines, and reflection of distorted perception could be clearly recognised in various study materials; anxiety about assigned surgery was exhibited by scribbling. There exists a close relationship between medicine and humanities. The interpretation of fine art from a medical perspective may help to increase our appreciation of the suffering of an individual. It is obvious that diseases change the artistic style and inner perspective. The question is how do healthcare specialists view this? PMID:20120269

  19. Predicting mortality among hospitalized children with respiratory illness in Western Kenya, 2009-2012.

    Directory of Open Access Journals (Sweden)

    Gideon O Emukule

    Full Text Available BACKGROUND: Pediatric respiratory disease is a major cause of morbidity and mortality in the developing world. We evaluated a modified respiratory index of severity in children (mRISC scoring system as a standard tool to identify children at greater risk of death from respiratory illness in Kenya. MATERIALS AND METHODS: We analyzed data from children <5 years old who were hospitalized with respiratory illness at Siaya District Hospital from 2009-2012. We used a multivariable logistic regression model to identify patient characteristics predictive for in-hospital mortality. Model discrimination was evaluated using the concordance statistic. Using bootstrap samples, we re-estimated the coefficients and the optimism of the model. The mRISC score for each child was developed by adding up the points assigned to each factor associated with mortality based on the coefficients in the multivariable model. RESULTS: We analyzed data from 3,581 children hospitalized with respiratory illness; including 218 (6% who died. Low weight-for-age [adjusted odds ratio (aOR = 2.1; 95% CI 1.3-3.2], very low weight-for-age (aOR = 3.8; 95% CI 2.7-5.4, caretaker-reported history of unconsciousness (aOR = 2.3; 95% CI 1.6-3.4, inability to drink or breastfeed (aOR = 1.8; 95% CI 1.2-2.8, chest wall in-drawing (aOR = 2.2; 95% CI 1.5-3.1, and being not fully conscious on physical exam (aOR = 8.0; 95% CI 5.1-12.6 were independently associated with mortality. The positive predictive value for mortality increased with increasing mRISC scores. CONCLUSIONS: A modified RISC scoring system based on a set of easily measurable clinical features at admission was able to identify children at greater risk of death from respiratory illness in Kenya.

  20. Towards a wireless patient: chronic illness, scarce care and technological innovation in the United Kingdom.

    Science.gov (United States)

    May, Carl; Finch, Tracy; Mair, Frances; Mort, Maggie

    2005-10-01

    'Modernization' is a key health policy objective in the UK. It extends across a range of public service delivery and organizational contexts, and also means there are radical changes in perspective on professional behaviour and practice. New information and communications technologies have been seen as one of the key mechanisms by which these changes can be engendered. In particular, massive investment in information technologies promises the rapid distribution and deployment of patient-centred information across internal organizational boundaries. While the National Health Service (NHS) sits on the edge of a pound sterling 6 billion investment in electronic patient records, other technologies find their status as innovative vehicles for professional behaviour change and service delivery in question. In this paper, we consider the ways that telemedicine and telehealthcare systems have been constructed first as a field of technological innovation, and more recently, as management solutions to problems around the distribution of health care. We use NHS responses to chronic illness as a medium for understanding these shifts. In particular, we draw attention to the shifting definitions of 'innovation' and to the ways that these shifts define a move away from notions of technological advance towards management control. PMID:15893864

  1. Improving confidence for self care in patients with depression and chronic illnesses.

    Science.gov (United States)

    Ludman, Evette J; Peterson, Do; Katon, Wayne J; Lin, Elizabeth H B; Von Korff, Michael; Ciechanowski, Paul; Young, Bessie; Gensichen, Jochen

    2013-01-01

    The aim of this study was to examine whether patients who received a multicondition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy was positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention that combined self-management support and collaborative care management. At 6 and 12 month outcomes the intervention group showed significant improvements over the usual care group in confidence in ability to follow through with medical regimens important to managing their conditions and to maintain lifestyle changes even during times of stress. Improvements in self care-efficacy were significantly related to improvements in depression, and early improvements in confidence to maintain lifestyle changes even during times of stress explained part of the observed subsequent improvements in depression. PMID:23398269

  2. Risk factors associated with recurrent diarrheal illnesses among children in Kabul, Afghanistan: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Adam R Aluisio

    Full Text Available Childhood diarrheal illnesses are a major public health problem. In low-income settings data on disease burden and factors associated with diarrheal illnesses are poorly defined, precluding effective prevention programs. This study explores factors associated with recurrent diarrheal illnesses among children in Kabul, Afghanistan.A cohort of 1-11 month old infants was followed for 18 months from 2007-2009. Data on diarrheal episodes were gathered through active and passive surveillance. Information on child health, socioeconomics, water and sanitation, and hygiene behaviors was collected. Factors associated with recurrent diarrheal illnesses were analyzed using random effects recurrent events regression models.3,045 children were enrolled and 2,511 (82% completed 18-month follow-up. There were 14,998 episodes of diarrheal disease over 4,200 child-years (3.51 episodes/child-year, 95%CI 3.40-3.62. Risk of diarrheal illness during the winter season was 63% lower than the summer season (HR = 0.37, 95%CI 0.35-0.39, P<0.001. Soap for hand washing was available in 72% of households and 11.9% had toilets with septic/canalization. Half of all mothers reported using soap for hand washing. In multivariate analysis diarrheal illness was lower among children born to mothers with post-primary education (aHR = 0.79, 95%CI 0.69-0.91, p = 0.001, from households where maternal hand washing with soap was reported (aHR = 0.83, 95%CI 0.74-0.92, p<0.001 and with improved sanitation facilities (aHR = 0.76, 95%CI 0.63-0.93, p = 0.006. Malnourished children from impoverished households had significantly increased risks for recurrent disease [(aHR = 1.15, 95%CI 1.03-1.29, p = 0.016 and (aHR = 1.20, 95%CI 1.05-1.37, p = 0.006 respectively].Maternal hand washing and improved sanitation facilities were protective, and represent important prevention points among public health endeavors. The discrepancy between soap availability and utilization suggests barriers to access and

  3. Gut Microbial Translocation in Critically Ill Children and Effects of Supplementation with Pre- and Pro Biotics

    Directory of Open Access Journals (Sweden)

    Paola Papoff

    2012-01-01

    Full Text Available Bacterial translocation as a direct cause of sepsis is an attractive hypothesis that presupposes that in specific situations bacteria cross the intestinal barrier, enter the systemic circulation, and cause a systemic inflammatory response syndrome. Critically ill children are at increased risk for bacterial translocation, particularly in the early postnatal age. Predisposing factors include intestinal obstruction, obstructive jaundice, intra-abdominal hypertension, intestinal ischemia/reperfusion injury and secondary ileus, and immaturity of the intestinal barrier per se. Despite good evidence from experimental studies to support the theory of bacterial translocation as a cause of sepsis, there is little evidence in human studies to confirm that translocation is directly correlated to bloodstream infections in critically ill children. This paper provides an overview of the gut microflora and its significance, a focus on the mechanisms employed by bacteria to gain access to the systemic circulation, and how critical illness creates a hostile environment in the gut and alters the microflora favoring the growth of pathogens that promote bacterial translocation. It also covers treatment with pre- and pro biotics during critical illness to restore the balance of microbial communities in a beneficial way with positive effects on intestinal permeability and bacterial translocation.

  4. Gut microbial translocation in critically ill children and effects of supplementation with pre- and pro biotics.

    Science.gov (United States)

    Papoff, Paola; Ceccarelli, Giancarlo; d'Ettorre, Gabriella; Cerasaro, Carla; Caresta, Elena; Midulla, Fabio; Moretti, Corrado

    2012-01-01

    Bacterial translocation as a direct cause of sepsis is an attractive hypothesis that presupposes that in specific situations bacteria cross the intestinal barrier, enter the systemic circulation, and cause a systemic inflammatory response syndrome. Critically ill children are at increased risk for bacterial translocation, particularly in the early postnatal age. Predisposing factors include intestinal obstruction, obstructive jaundice, intra-abdominal hypertension, intestinal ischemia/reperfusion injury and secondary ileus, and immaturity of the intestinal barrier per se. Despite good evidence from experimental studies to support the theory of bacterial translocation as a cause of sepsis, there is little evidence in human studies to confirm that translocation is directly correlated to bloodstream infections in critically ill children. This paper provides an overview of the gut microflora and its significance, a focus on the mechanisms employed by bacteria to gain access to the systemic circulation, and how critical illness creates a hostile environment in the gut and alters the microflora favoring the growth of pathogens that promote bacterial translocation. It also covers treatment with pre- and pro biotics during critical illness to restore the balance of microbial communities in a beneficial way with positive effects on intestinal permeability and bacterial translocation. PMID:22934115

  5. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

    Science.gov (United States)

    2010-01-01

    Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250) fulfilling inclusion criteria (new patients with chronic cough) are randomised (allocation concealed) to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks) or usual care (existing care until review by specialist at 6 weeks). Cough diary, cough-specific quality of life (QOL) and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses). A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years). This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471 PMID:21054884

  6. What Is Mental Illness: Mental Illness Facts

    Science.gov (United States)

    ... children. Mental illness usually strike individuals in the prime of their lives, often during adolescence and young ... Illness page. Get more Mental Illness: Facts and Numbers from NAMI's Fact Sheet . Back

  7. The differences in aspects of parent-child interactions in healthy and oncologically ill children

    Czech Academy of Sciences Publication Activity Database

    Slezáčková, Alena; Jamrichová, J.; Blatný, Marek; Jelínek, Martin; Kepák, T.

    2011-01-01

    Roč. 26, č. 2 (2011), s. 59-60. ISSN 0887-0446. [European Health Psychology Conference: Engaging with Other Health Professions: Challenges and Perspectives /25./. 20.09.2011-24.09.2011, Hersonissos, Kréta] R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional research plan: CEZ:AV0Z7025918 Keywords : oncologically ill children * parent-child interactions * family functioning Subject RIV: AN - Psychology

  8. Integrated management of childhood illness (IMCI) strategy for children under five

    OpenAIRE

    Gera, Tarun; Shah, Dheeraj; Garner, Paul; Richardson, Marty; Sachdev, Harshpal S.

    2016-01-01

    Background More than 7.5 million children younger than age five living in low- and middle-income countries die every year. The World Health Organization (WHO) developed the integrated management of childhood illness (IMCI) strategy to reduce mortality and morbidity and to improve quality of care by improving the delivery of a variety of curative and preventive medical and behavioral interventions at health facilities, at home, and in the community. Objectives To evaluate the effects of progra...

  9. Children of mentally ill parents—a pilot study of a group intervention program

    OpenAIRE

    Christiansen, Hanna; Anding, Jana; Schrott, Bastian; Röhrle, Bernd

    2015-01-01

    Objective: The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and ...

  10. Gut Microbial Translocation in Critically Ill Children and Effects of Supplementation with Pre- and Pro Biotics

    OpenAIRE

    Paola Papoff; Giancarlo Ceccarelli; Gabriella d'Ettorre; Carla Cerasaro; Elena Caresta; Fabio Midulla; Corrado Moretti

    2012-01-01

    Bacterial translocation as a direct cause of sepsis is an attractive hypothesis that presupposes that in specific situations bacteria cross the intestinal barrier, enter the systemic circulation, and cause a systemic inflammatory response syndrome. Critically ill children are at increased risk for bacterial translocation, particularly in the early postnatal age. Predisposing factors include intestinal obstruction, obstructive jaundice, intra-abdominal hypertension, intestinal ischemia/reperfu...

  11. Child Neurology: Chronic inflammatory demyelinating polyradiculoneuropathy in children

    OpenAIRE

    Markowitz, JA; Jeste, SS; Kang, PB

    2008-01-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disorder characterized by patchy demyelination of nerve roots and distal nerves. The course may be monophasic progressive or relapsing-remitting. CIDP is less common in children than in adults. As in adults, children with CIDP present with proximal and distal weakness and loss of deep tendon reflexes. Children are most often brought to medical attention due to gait disturbance and falling. As in adults, immunomo...

  12. Complete Genomes of Three Human Bocavirus Strains from Children with Gastroenteritis and Respiratory Tract Illnesses in Jiangsu, China

    OpenAIRE

    Wang, Xiaochun; Zhang, Xiaodan; Tian, Hua; Ling, Feng; Yu, Min; Sun, Guangming; Yang, Shixing; Shen, Quan; Wang, Yan; Shao, Shihe; Zhang, Wen

    2012-01-01

    Human bocavirus (HBoV) is a newly discovered parvovirus associated with acute respiratory tract illness (ARTI) and gastrointestinal illness. No previous reports indicated the presence of HBoV infection in Jiangsu Province, China. Here we report three complete genomic sequences of HBoV strains from children with gastroenteritis and respiratory tract illnesses in Jiangsu, China. Phylogenetic analysis indicated that the three HBoV strains in the present study belong to the HBoV1 lineage, where j...

  13. The Patients Assessment Chronic Illness Care (PACIC questionnaire in The Netherlands: a validation study in rural general practice

    Directory of Open Access Journals (Sweden)

    Hermsen Jan

    2008-09-01

    Full Text Available Abstract Background Many patients with chronic illness receive health care in primary care settings, so a challenge is to provide well-structured chronic care in these settings. Our aim was to develop and test a Dutch version of the PACIC questionnaire, a measure for patient reported structured chronic care. Methods Observational study in 165 patients with diabetes or COPD from four general practices (72% response rate. Patients completed a written questionnaire, which included instruments for assessing chronic illness care (PACIC, evaluations of general practice (Europep, enablement (PEI, and individual characteristics. Results The patients had a mean age of 68.0 years and 47% comprised of women. Twenty-two to 35% of responding patients did not provide answers to specific items in the PACIC. In 11 items the lowest answering category was used by 30% or more of the responders and in 6 items the highest answering category was used by this number of responders. Principal factor analysis identified the previously defined five domains reasonably well. Cronbach's alpha per domain varied from 0.71 to 0.83, and the intraclass coefficient from 0.66 to 0.91. Diabetes patients reported higher presence of structured chronic care for 14 out of the 20 PACIC items. The effect of patient evaluations of general practice on the PACIC score was positive (b = 0.72, p Conclusion A translated and validated Dutch version of the PACIC questionnaire is now available. Further research on its validity is recommended.

  14. Patterns of resistance: African American mothers and adult children with HIV illness.

    Science.gov (United States)

    Boyle, J S; Hodnicki, D R; Ferrell, J A

    1999-01-01

    Although the research on caregiving and caregivers has been extensive, there have been few studies on the cultural context and meaning of African American caregiving in relation to HIV illness. Many Black feminists have argued that African American women experience a world different from those who are not Black and that failure to take account of race, class, and gender is paramount in an attempt to authentically portray the lives of African American women. This study argues that rural African American culture and experiences of racism and discrimination in the rural South shaped the responses of mothers when their adult children developed HIV illness. The study employed the ethnographic techniques of participant observation and in-depth interviews with 14 rural, poor, African American mothers who cared for adult children with HIV illness. Analysis of the data identified patterns of resistance that mothers employed throughout the caregiving experience. Mothers resisted labels and other controlling images that they believed marginalized them and negated what was happening to their children. Mothers used culturally patterned behaviors to protect their families and resist the stigma of HIV/AIDS. PMID:10530083

  15. The stigma of mental illness in children and adolescents: A systematic review.

    Science.gov (United States)

    Kaushik, Anya; Kostaki, Evgenia; Kyriakopoulos, Marinos

    2016-09-30

    One in ten children and adolescents suffer with mental health difficulties at any given time, yet less than one third seek treatment. Untreated mental illness predisposes to longstanding individual difficulties and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness, identified as a key deterrent to treatment, have been disappointing. This indicates the need for a clearer understanding of the stigmatizing processes faced by young people, so that more effective interventions are employed. A systematic review of the literature, assessing public stigma and self-stigma (i.e. internalized public stigma) specifically in children and adolescents with mental health difficulties (YP-MHD), was conducted. Forty-two studies were identified, confirming that stigmatization of YP-MHD is a universal and disabling problem, present amongst both children and adults. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and an avoidance of interventions. The findings confirm that stigmatization of mental illness is poorly understood due to a lack of research and methodological discrepancies between existing studies. Implications for the findings are discussed, and suggestions made for future research. PMID:27517643

  16. Children of mentally ill parents – a pilot study of a group intervention program

    Directory of Open Access Journals (Sweden)

    Hanna eChristiansen

    2015-10-01

    Full Text Available The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009 and adapted it for groups. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28, a Wait Control group (n = 9, and a control group of healthy children (n = 40. Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention children’s knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group and externalizing symptoms were reduced for this group as well. This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of children’s enhanced knowledge about parental psychopathology need to be explored in future studies.

  17. Reasons for default from treatment of chronic illnesses in a primary healthcare program in rural Tamil Nadu

    OpenAIRE

    Henry R Jennens; Rajkumar Ramasamy; Brigitte Tenni

    2013-01-01

    Chronic illnesses are an increasing cause of morbidity and mortality in rural India. Many patients default from treatment, and exploring their reasons for the same may suggest strategies to improve service accessibility and acceptability. A qualitative study was conducted of 22 patient interviews, six key informant interviews, and two patient focus group discussions for investigating the reasons for default at the KC Patty Primary Health Centre and surrounding villages in Kodaikanal Taluk, Di...

  18. LONELINESS EXPERIENCED BY INFORMAL CAREGIVERS OF THE CHRONICALLY ILL IN THEIR HOMES. PROPOSED SOLUTIONS AND PRACTICAL RECOMMENDATIONS FOR LOCAL COMMUNITIES

    OpenAIRE

    Krakowiak, Piotr; Wasilewska-Ostrowska, Katarzyna

    2016-01-01

    Loneliness experienced by family caregivers of the chronically ill in their homes is described starting with different aspects of solitude in social sciences. Family care as part of informal care should cooperate with formal careers from health and social systems. Welfare institutions and home care in Poland are described in front of growing challenges of ageing societies in Europe. Good practices and practical recommendations for local communities, including better coordination of care, as w...

  19. An exploratory study of the personal health records adoption model in the older adult with chronic illness

    Directory of Open Access Journals (Sweden)

    Melanie D Logue

    2013-05-01

    Full Text Available Background Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chronically ill older adult has unique circumstances that impact their decision to participate in self-directed care, a theoretical framework to help understand factors that influence the adoption of PHRs is important. Here we describe the results of an exploratory study that provided an initial test of such a framework.Methods The study used a descriptive survey methodology with 38 older adults. The survey questionnaire asked about the personal barriers and facilitators associated with personal health record adoption and included items measuring each of the PHRAM’s four interacting factors (environmental factors, personal factors, technology factors, and self-management, and the resulting behavioural outcome.Results Younger seniors had a more positive attitude toward computers, knew what health resources were available on the internet, agreed that they had the resources in place to use PHRs, and would be more influenced by a family member than a healthcare provider to use them. Conversely, older seniors reported less confidence in their ability to use Internet-based PHRs and did not perceive that they had the resources in place to use them.Conclusions The results of this study indicated that personal, environmental, technology, chronic illness, and behavioral factors operated concurrently as personal barriers and/or facilitators to the adoption of PHRs among the older adult with chronic illness. These factors cannot be isolated because the person commonly

  20. HealthDesk for Hemophilia: an interactive computer and communications system for chronic illness self-management.

    OpenAIRE

    Carl, F.; Gribble, T. J.

    1995-01-01

    HealthDesk for Hemophilia is an interactive computer software application designed on the premise that successful chronic illness self-management requires information, self-care skills, on-going communication with health care providers, and user-friendly record keeping. The software was pilot tested for six months in the homes of eight hemophilia patients. The purpose of the pilot was to assess the impact of HealthDesk for Hemophilia on patient satisfaction, patient-provider communication, an...

  1. Working as a doctor when chronically ill or disabled: comments made by doctors responding to UK surveys

    OpenAIRE

    Lambert, TW; Smith, F; Goldacre, M

    2016-01-01

    Objectives: To report a qualitative study of themes doctors raised spontaneously, in a large-scale prospective cohort study covering many aspects of their medical careers, when referring to their own chronic illness or disability. Design: Questionnaire survey. Setting: UK. Participants: Questionnaires were sent one, five and 10 years after graduation to 44,539 doctors who qualified between 1993 and 2012 in the UK: 38,613 questionnaires were returned and 11,859 respondents provided co...

  2. Childhood Trauma and Chronic Illness in Adulthood: Mental Health and Socioeconomic Status as Explanatory Factors and Buffers

    OpenAIRE

    Mock, Steven E.; Arai, Susan M.

    2011-01-01

    Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typic...

  3. Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

    Science.gov (United States)

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

    Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

  4. Quality of Life as Medicine: A Pilot Studyof Patients with Chronic Illness and Pain

    Directory of Open Access Journals (Sweden)

    Soren Ventegodt

    2003-01-01

    Full Text Available An intensive 5-day quality-of-life (QoL session was constructed based on a psychosomatic model. The session was comprised of teaching on philosophy of life, psychotherapy, and body therapy. The three elements were put together in such a way that they mutually supported each other. The synergy attained was considerable. The pilot study demonstrated that in the course of only 1 week, patients had time to revise essential life-denying views and to integrate important, unfinished life events involving negative feelings. Consequently, the patients became more present in the body’s blocked-off areas and subjectively healthier. Nineteen persons with chronic illness and pain (fibromyalgia, chronic tiredness, whiplash, mild depression, and problems involving pain in arms and legs including osteoarthritis, and unemployed for 5–7 years attended the course. In the week before and after the 5-day course, the participants completed the validated SEQOL (Self-Evaluation of Quality of Life Questionnaire including questions on self-evaluated health and the unvalidated “Self-Evaluation of Working-Life Quality Questionnaire” (SEQWL. This pilot study was without a control group or clinical control. As far as diagnoses were concerned, the group was inhomogeneous. Common for the group was a low QoL, poor quality of working life QWL, and numerous health problems. The study showed an 11.2% improvement in QoL (p < 0.05, a 6.3% improvement in QWL (p < 0.05, and a 12.0% improvement in self-perceived physical health (p = 0.08. There was a 17.3% improvement in self-perceived psychological health (p < 0.05 and satisfaction with health in general improved by 21.4% (p < 0.05. Symptoms like pain were almost halved and several of the participants were free of pain for the first time in years. In conclusion it seemed that the combination of training in philosophy of life, psychotherapy, and body therapy can give patients a large, fast, and efficient improvement in QoL, QWL

  5. Peginterferon Treatment In Children: A Review Of Chronic Hepatitis B And Chronic Hepatitis C Treatment

    Directory of Open Access Journals (Sweden)

    Makbule EREN

    2009-11-01

    Full Text Available Despite of extensive blood product screening and national immunization programs, chronic hepatitis B and C infections continues to be a global problem with high mortality, morbidity and economic impact. Even though acquisition of these infections mostly occurs in childhood, major problems appear in adulthood. Cirrhosis and HCC are two major expected late events related to chronic hepatitis B and C infections. Rarely, children may also face these complications. To avoid these complications and increase the life expectancy in adults treatment of these two type infections should be started in childhood with appropriate patient selection. In contrast to children, adults are luckier in terms of treatment alternatives. They have the chance to use more potent antivirals with higher genetic barrier and pegylated form of interferons. Recently, the use of pegylated interferon and ribavirin combinations has been approved in children in Chronic HCV infection. However, chronic hepatitis B treatment in children is still dependent on the use of one type antiviral drug and conventional interferon. Treatment in early ages with an antiviral agent that has limited genetic barrier may block the chance of treatment or reduce the response rate in adulthood in chronic hepatitis B infection. This burden indicates the necessity of new therapeutic modalities in children. In this term pegylated interferons may be one of the optiones. In this article we aimed to reviewe the efficacy and safety of conventional and pegylated interferons, for the treatment of Hepatitis C and B infections in children.

  6. Managing Chronic Pain in Children and Adolescents: A Clinical Review.

    Science.gov (United States)

    Landry, Bradford W; Fischer, Philip R; Driscoll, Sherilyn W; Koch, Krista M; Harbeck-Weber, Cynthia; Mack, Kenneth J; Wilder, Robert T; Bauer, Brent A; Brandenburg, Joline E

    2015-11-01

    Chronic pain in children and adolescents can be difficult for a single provider to manage in a busy clinical setting. Part of this difficulty is that pediatric chronic pain not only impacts the child but also the families of these children. In this review article, we discuss etiology and pathophysiology of chronic pain, along with variables that impact the severity of chronic pain and functional loss. We review diagnosis and management of selected chronic pain conditions in pediatric patients, including headache, low back pain, hypermobility, chronic fatigue, postural orthostatic tachycardia syndrome, abdominal pain, fibromyalgia, and complex regional pain syndrome. For each condition, we create a road map that contains therapy prescriptions, exercise recommendations, and variables that may influence pain severity. Potential medications for these pain conditions and associated symptoms are reviewed. A multidisciplinary approach for managing children with these conditions, including pediatric pain rehabilitation programs, is emphasized. Lastly, we discuss psychological factors and interventions for pediatric chronic pain and potential complementary and alternative natural products and interventions. PMID:26568508

  7. Interpretation of Illness in Patients with Chronic Diseases from Poland and Their Associations with Spirituality, Life Satisfaction, and Escape from Illness—Results from a Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Arndt Büssing

    2015-06-01

    Full Text Available To analyse how patients with chronic diseases would interpret their illness, and how these interpretations were related to spirituality/religiosity, life satisfaction, and escape from illness, we performed a cross-sectional survey among patients with chronic diseases from Poland (n = 275 using standardized questionnaires. Illness was interpreted mostly as an Adverse Interruption of life (61%, Threat/Enemy (50%, Challenge (42%, and rarely as a Punishment (8%. Regression analyses revealed that escape from illness was the best predictor of negative disease perceptions and also strategy associated disease perceptions, and a negative predictor of illness as something of Value, while Value was predicted best by specific spiritual issues. Patients’ religious Trust and partner status were among the significant contributors to their life satisfaction. Data show that specific dimensions of spirituality are important predictors for patients’ interpretation of illness. Particularly the fatalistic negative perceptions could be indicators that patients may require further psychological assistance to cope with their burden.

  8. The Dutch health insurance reform: switching between insurers, a comparison between the general population and the chronically ill and disabled

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2008-03-01

    Full Text Available Abstract Background On 1 January 2006 a number of far-reaching changes in the Dutch health insurance system came into effect. In the new system of managed competition consumer mobility plays an important role. Consumers are free to change their insurer and insurance plan every year. The idea is that consumers who are not satisfied with the premium or quality of care provided will opt for a different insurer. This would force insurers to strive for good prices and quality of care. Internationally, the Dutch changes are under the attention of both policy makers and researchers. Questions answered in this article relate to switching behaviour, reasons for switching, and differences between population categories. Methods Postal questionnaires were sent to 1516 members of the Dutch Health Care Consumer Panel and to 3757 members of the National Panel of the Chronically ill and Disabled (NPCD in April 2006. The questionnaire was returned by 1198 members of the Consumer Panel (response 79% and by 3211 members of the NPCD (response 86%. Among other things, questions were asked about choices for a health insurer and insurance plan and the reasons for this choice. Results Young and healthy people switch insurer more often than elderly or people in bad health. The chronically ill and disabled do not switch less often than the general population when both populations are comparable on age, sex and education. For the general population, premium is more important than content, while the chronically ill and disabled value content of the insurance package as well. However, quality of care is not important for either group as a reason for switching. Conclusion There is increased mobility in the new system for both the general population and the chronically ill and disabled. This however is not based on quality of care. If reasons for switching are unrelated to the quality of care, it is hard to believe that switching influences the quality of care. As yet there

  9. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs) for physical activity in chronically ill and elderly people

    OpenAIRE

    Frei, Anja; Williams, Kate; Vetsch, Anders; Dobbels, Fabienne; Jacobs, Laura; Rüdell, Katja; Milo A Puhan; de Jong, Corina

    2011-01-01

    BACKGROUND: Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO) instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. METHODS: We conducted a syst...

  10. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs) for physical activity in chronically ill and elderly people

    OpenAIRE

    Frei, A; Williams, K.; Vetsch, A; Dobbels, F; Jacobs, L; Rudell, K; Puhan, M A

    2011-01-01

    BACKGROUND: Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO) instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. METHODS: We condu...

  11. Preferences and experiences of chronically ill and disabled patients regarding shared decision-making: does the type of care to be decided upon matter?

    OpenAIRE

    Brink-Muinen, A. van den; Spreeuwenberg, P.; Rijken, M.

    2011-01-01

    OBJECTIVE: (1) To describe the importance chronically ill and disabled patients attach to involvement in decision-making when various care types are considered, and (2) to analyse the degree to which these patients are involved in shared decision-making (SDM) regarding these care types, and whether their involvement reflects the importance they attach to SDM. METHODS: The study sample consisted of 812 chronically ill and disabled patients who experienced a situation of decision-making during ...

  12. Nutrition in Children with Chronic Kidney Disease

    Science.gov (United States)

    ... cereals Bran cereals Egg whites Egg yolks Sorbet Ice cream Source: Phosphorous: Tips for People with Chronic Kidney ... for Scientists Current Funding Opportunities Funded Grants & Grant History Funding Process Research Programs & Contacts Research Training & Career ...

  13. Selection of treatment modalities in children with chronic osteomyelitis

    OpenAIRE

    Unal, Vuslat Sema; Dayican, Avni; Demirel, Murat; Portakal, Suleyman; Ozkan, Guray; Ucaner, Ahmet

    2004-01-01

    Objectives: We evaluated clinical and follow-up findings and treatment methods of pediatric patients with chronic osteomyelitis. Methods: The study included 22 children (14 boys, 8 girls; mean age 8±7 years) who were treated for chronic osteomyelitis. Infection sites were the femur, tibia, ulna, and radius in 11, 8, 1, and 2 patients, respectively. Sixteen patients had a history of trauma. Fourteen patients had fractures, nine of which were associated with segmentary bone defects. All the ...

  14. Renal imaging in children with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Wiwit Rahmawati

    2013-04-01

    Full Text Available Background Chronic kidney failure is a cause of death in children. Diagnosing chronic kidney disease is often made by clinical manifestations, laboratory findings and ultrasonography or other imaging tests. Early detection of chronic kidney disease is needed for education and management of the disease. Objective To describe renal imaging findings and mortality in children with chronic kidney disease. Methods This was a cross-sectional study on children with kidney diseases who were inpatients at Dr. Kariadi Hospital from January 2008 to June 2011. Data were taken from medical records. Chronic kidney disease was confirmed by clinical manifestations, laboratory findings, and radiologic imaging. Renal ultrasound findings were determined by the radiologist responsible at that time. Results were presented as frequency distributions. Results Of 37 chronic kidney disease cases, 27 were males and 10 were females. Subjects’ most common complaints were dyspnea (7 out of 37 and edema (30 out of 37. Renal ultrasound imaging of subjects with chronic kidney disease yielded the following findings: reduced cortico-medullary differentiation (30 out of 37, bilateral echogenic kidneys (21 out of 37, reduced renal cortex thickness (4 out of 37 and small-sized kidneys (4 out of 37. Eight of the 37 children died. These 8 subjects had the following radiologic imaging findings: both kidneys appeared small in size (4 out of 8, reduced ‘renal cortex’ thickness (4 out of 8, echogenic kidneys (6 out of 8, and reduced cortico-medullary differentiation (8 out of 8. Conclusion Renal ultrasound imaging of pediatric subjects with chronic kidney disease revealed findings of reduced cortico-medullary differentiation, bilateral echogenic kidneys, reduced renal cortex thickness, and small kidneys bilaterally. [Paediatr Indones. 2013;53:193-9.].

  15. Medication cost problems among chronically ill adults in the US: did the financial crisis make a bad situation even worse?

    Directory of Open Access Journals (Sweden)

    Piette JD

    2011-04-01

    Full Text Available John D Piette1, Ann Marie Rosland1, Maria J Silveira1, Rodney Hayward1, Colleen A McHorney21Ann Arbor VA Healthcare System, Ann Arbor, MI, USA; 2US Outcomes Research, Merck and Co, Inc, North Wales, PA, USAAbstract: A national internet survey was conducted between March and April 2009 among 27,302 US participants in the Harris Interactive Chronic Illness Panel. Respondents reported behaviors related to cost-related medication non-adherence (CRN and the impacts of medication costs on other aspects of their daily lives. Among respondents aged 40–64 and looking for work, 66% reported CRN in 2008, and 41% did not fill a prescription due to cost pressures. More than half of respondents aged 40–64 and nearly two-thirds of those in this group who were looking for work or disabled reported other impacts of medication costs, such as cutting back on basic needs or increasing credit card debt. More than one-third of respondents aged 65+ who were working or looking for work reported CRN. Regardless of age or employment status, roughly half of respondents reporting medication cost hardship said that these problems had become more frequent in 2008 than before the economic recession. These data show that many chronically ill patients, particularly those looking for work or disabled, reported greater medication cost problems since the economic crisis began. Given links between CRN and worse health, the financial downturn may have had significant health consequences for adults with chronic illness.Keywords: medication adherence, cost-of-care, access to care, chronic disease

  16. Altered food cue processing in chronically ill and recovered women with Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Nicole eSanders

    2015-02-01

    Full Text Available Anorexia Nervosa (AN is a severe mental disorder characterized by food restriction and weight loss.This study aimed to test the model posed by Brooks et al. (2012, that women suffering from chronic AN show decreased food cue processing activity in brain regions associated with energy balance and food reward (bottom-up; BU and increased activity in brain regions associated with cognitive control (top-down; TD when compared to long term recovered AN (REC and healthy controls (HC. Three groups of women, 15 AN (mean illness duration 7.8 ± 4.1 y, 14 REC (mean duration of recovery 4.7 ± 2.7 yr and 15 HC viewed alternating blocks of food and non-food images preceded by a short instruction during functional magnetic resonance imaging (fMRI, after fasting overnight. Functional ROIs (fROIs were defined in BU (e.g. striatum, hippocampus, amygdala, hypothalamus and cerebellum, TD (e.g. medial and lateral prefrontal cortex, anterior cingulate, the insula and visual processing areas (VPA. Food-cue processing activation was extracted from all fROIs and compared between the groups. In addition, functional connectivity between the fROIs was examined by modular partitioning of the correlation matrix of all fROIs.We could not confirm the hypothesis that BU areas are activated to a lesser extent in AN upon visual processing of food images. Among the BU areas the caudate showed higher activation in both patient groups compared to HC. In accordance with Brooks et al.’s model, we did find evidence for increased TD control in AN and REC. The functional connectivity analysis yielded two clusters in HC and REC, but three clusters in AN. In HC fROIs across BU, TD and VPA areas clustered, in AN one cluster span across BU, TD and insula, one across BU, TD and VPA areas and one was confined to the VPA network. In REC BU, TD and VPA or VPA and insula clustered.In conclusion, despite weight recovery, neural processing of food cues is also altered in recovered AN patient

  17. Systematic review of chronic ankle instability in children

    OpenAIRE

    Mandarakas, Melissa; Pourkazemi, Fereshteh; Sman, Amy; Burns, Joshua; Hiller, Claire E

    2014-01-01

    Background Chronic ankle instability (CAI) is a disabling condition often encountered after ankle injury. Three main components of CAI exist; perceived instability; mechanical instability (increased ankle ligament laxity); and recurrent sprain. Literature evaluating CAI has been heavily focused on adults, with little attention to CAI in children. Hence, the objective of this study was to systematically review the prevalence of CAI in children. Methods Studies were retrieved from major databas...

  18. Chronic diseases in children and adolescents-some psychological characteristics

    OpenAIRE

    Nada POP JORDANOVA; Fustić, Stojka; Zorčec, Tatjana

    2008-01-01

    A significant number of children suffer from chronic diseases, which demand careful adjustment, and the coping and active role of all involved in the treatment. Psychological problems in this population are increased by the long duration of procedures, specific diet and low physical activity. In this study various psychometric instruments are used to evaluate the psychological characteristics of children and adolescents suffering from cystic fibrosis, juvenile rheumatoid arthritis, diabetes m...

  19. Cognitive development in children with chronic protein energy malnutrition

    OpenAIRE

    Chandramouli B A; Rao Shobini L; Kar Bhoomika R

    2008-01-01

    Abstract Background Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM) causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age). The present study examined the effect of stunted growth on the rate of development of cognitive processes usin...

  20. Evaluating PRISM (Pictorial Representation of Illness and Self Measure) as a measure of life quality for children with skin diseases

    DEFF Research Database (Denmark)

    Melbardis Jørgensen, K.; Jemec, G.B.E.

    2011-01-01

    of age-dependant cognitive development on children's self-reported QoL. Methods and materials: A total of 43 children of both sexes aged 5-16, with a diagnosed dermatologic disease were asked to complete both PRISM and CDLQI. Children with a mental handicap, children who did not speak Danish or who......-verbal instrument may therefore be of particular relevance to pediatric patients. Purpose: To evaluate PRISM (Pictorial Representation of Illness and Self Measure) as a non-verbal measure of QoL for children with skin diseases compared to CDLQI (Children's Dermatology Life Quality Index) and the possible influence...

  1. Physical therapists should integrate illness perceptions in their assessment in patients with chronic musculoskeletal pain; a qualitative analysis.

    Science.gov (United States)

    van Wilgen, Paul; Beetsma, Anneke; Neels, Hedwig; Roussel, Nathalie; Nijs, Jo

    2014-06-01

    In the past decade, scientific evidence has shown that the biomedical model falls short in the treatment of patients with musculoskeletal pain. To understand musculoskeletal pain and a patient's health behavior and beliefs, physical therapists should assess the illness perceptions of their patients. In this quantitative study, we audiotaped the assessments of 19 primary care physical therapists on 27 patients and analyzed if and how illness perceptions were assessed. The Common Sense Model was used as the theoretical framework. We conclude that some of the domains of the Common Sense Model were frequently asked for (identity, causes and consequences), while others (timeline, treatment control, coherence, emotional representation) were used less frequently or seldom mentioned. The overall impression was that the assessments of the physical therapists were still bio-medically oriented in these patients with chronic musculoskeletal pain. PMID:24389339

  2. Cough . 2: Chronic cough in children

    NARCIS (Netherlands)

    J.C. de Jongste (Johan); M.D. Shields

    2003-01-01

    textabstractChronic cough is a common problem in childhood. Viral infections are the most prevalent cause, but other rarer disorders should be excluded whenever cough appears unusually severe and/or frequent, and when there is evidence of failure to thrive and growth retardation. T

  3. “Then She Looked at Me and Said – the Old Age!”: The Impact of Social Representations of Ageing on the Elderly People’s Chronic Illness Experience in Latvia

    Directory of Open Access Journals (Sweden)

    Signe Mezinska

    2010-01-01

    Full Text Available This article discusses the impact of social representations of ageing, such as breakdown, inevitability of illnesses and unfitness, on chronic illness experience of elderly people in Latvia. The qualitative study is based on theoretical framework of symbolic interactionism and uses grounded theory methodology. The results of the study lead to the conclusion that in Latvia certain social representations of ageing have a negative impact on chronic illness experience of elderly people, decreasing health-related quality of life and hampering reception of required medical assistance, adaptation of environment to the needs of elderly people with chronic illnesses and successful incorporation of the chronic illness in the context of biography.

  4. Integrated management of childhood illness (IMCI) strategy for children under five

    Science.gov (United States)

    Gera, Tarun; Shah, Dheeraj; Garner, Paul; Richardson, Marty; Sachdev, Harshpal S

    2016-01-01

    Background More than 7.5 million children younger than age five living in low- and middle-income countries die every year. The World Health Organization (WHO) developed the integrated management of childhood illness (IMCI) strategy to reduce mortality and morbidity and to improve quality of care by improving the delivery of a variety of curative and preventive medical and behavioral interventions at health facilities, at home, and in the community. Objectives To evaluate the effects of programs that implement the IMCI strategy in terms of death, nutritional status, quality of care, coverage with IMCI deliverables, and satisfaction of beneficiaries. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE; EMBASE, Ovid; the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EbscoHost; the Latin American Caribbean Health Sciences Literature (LILACS), Virtual Health Library (VHL); the WHO Library & Information Networks for Knowledge Database (WHOLIS); the Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Science; Population Information Online (POPLINE); the WHO International Clinical Trials Registry Platform (WHO ICTRP); and the Global Health, Ovid and Health Management, ProQuest database. We performed searches until 30 June 2015 and supplemented these by searching revised bibliographies and by contacting experts to identify ongoing and unpublished studies. Selection criteria We sought to include randomised controlled trials (RCTs) and controlled before-after (CBA) studies with at least two intervention and two control sites evaluating the generic IMCI strategy or its adaptation in children younger than age five, and including at minimum efforts to improve health care worker skills for case management. We excluded studies in which IMCI was

  5. Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: I. The scientific basis to a comprehensive approach

    NARCIS (Netherlands)

    Hosman, C.M.H.; Doesum, K.T.M. van; Santvoort, F. van

    2009-01-01

    Children of parents with a mental illness are at significant risk of developing mental disorders and other adverse outcomes at some point in their lives compared to children of healthy parents. During the last 20 years, a comprehensive preventive program for children of parents with a mental illness

  6. Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study

    OpenAIRE

    Kaiser, Daniela; Bolt, Isabel; Hofer, Michael; Relly, Christa; Berthet, Gerald; Bolz, Dieter; Saurenmann, Traudel

    2015-01-01

    Background To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. Methods Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. Result...

  7. Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study

    OpenAIRE

    Kaiser, Daniela; Bolt, Isabel; Hofer, Michael; Relly, Christa; Berthet, Gerald; Bolz, Dieter; Saurenmann, Traudel

    2015-01-01

    BACKGROUND: To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. METHODS: Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. ...

  8. Challenges Surrounding the Education of Children with Chronic Diseases

    Science.gov (United States)

    Gordon, Maria, Ed.

    2016-01-01

    While governing bodies have mandated that all students have the right to an education, with disabled students treated to the same rights and opportunities as non-disabled students, policymakers do not always agree on what all-inclusive education should look like. "Challenges Surrounding the Education of Children with Chronic Diseases"…

  9. [Hypnosis for chronic pain of children].

    Science.gov (United States)

    Célestin-Lhopiteau, Isabelle

    2014-01-01

    A child or adolescent can suffer from chronic pain. Whatever the causes, it can trap the child in a specific process whereby they focus on the pain, fearing that it will appear and experiencing anxiety. Hypno-analgesia and hypnotherapy enable them to escape this process and find within themselves the capacity to face up to the pain. Moreover, these techniques offer them an autonomy which they can use in all areas of their life. PMID:24779171

  10. Use of the Internet for Health Information by the Chronically Ill

    OpenAIRE

    Wagner, Todd H.; Baker, Laurence C.; M. Kate Bundorf; Sara Singer

    2004-01-01

    Introduction Chronic conditions are among the leading causes of death and disability in the United States. The Internet is a source of health information and advice for individuals with chronic conditions and shows promise for helping individuals manage their conditions and improve their quality of life. Methods We assessed Internet use for health information by people who had one or more of five common chronic conditions. We conducted a national survey of adults aged 21 and older, then...

  11. Late effects of cranial irradiation on visual attention in children treated for hematologic illnesses

    Energy Technology Data Exchange (ETDEWEB)

    Hill, D.L.

    1992-01-01

    A cross-sectional design was employed to assess the effects of CNS therapy including cranial irradiation (CRT) on visual attention. Forty one children between the ages of 8 and 16 years, 24 with a history of CRT, were tested. The attentional measure was a set of 14 timed, age-normed visual cancellation tasks that permitted an assessment of task-relevant motor response speed in the measurement of attentional efficiency. CRT doses ranged from 1000 to 4800 rads, administered to whole brain between 1 and 12 years prior to testing. It was found that increasing doses of CRT were associated with slower motor responding. Motor speed accounted for a significant proportion of variance in attentional task performance: slowed motor responding must be controlled by covariation in the measurement of attentional abilities in CRT-treated children. No child receiving CRT before age 4 and more than 5 years prior to testing performed above the mean overall on the attentional task, compared to several children demonstrating above-average performance who received CRT less than 5 years prior to testing. Scores for the CRT group were highly correlated with IQ and achievement results. CRT variables (dose, age at earliest CRT, time since CRT) explained half the variance in attentional task performance. Children who received CRT performed significantly below the mean on subtests with the most complex, symbolic or sequential target stimuli, a pattern that has predicted poor academic achievement in non-medically ill children. It was concluded that children receiving CRT should continue to be evaluated more than five years after treatment to monitor potential late effects of neurotoxic treatment. Longitudinal, prospective, well-controlled dose-effect research using a developmentally sensitive, theoretically grounded battery of attentional measures is needed to best compare neurotoxicity of different treatment regima in children.

  12. Late effects of cranial irradiation on visual attention in children treated for hematologic illnesses

    International Nuclear Information System (INIS)

    A cross-sectional design was employed to assess the effects of CNS therapy including cranial irradiation (CRT) on visual attention. Forty one children between the ages of 8 and 16 years, 24 with a history of CRT, were tested. The attentional measure was a set of 14 timed, age-normed visual cancellation tasks that permitted an assessment of task-relevant motor response speed in the measurement of attentional efficiency. CRT doses ranged from 1000 to 4800 rads, administered to whole brain between 1 and 12 years prior to testing. It was found that increasing doses of CRT were associated with slower motor responding. Motor speed accounted for a significant proportion of variance in attentional task performance: slowed motor responding must be controlled by covariation in the measurement of attentional abilities in CRT-treated children. No child receiving CRT before age 4 and more than 5 years prior to testing performed above the mean overall on the attentional task, compared to several children demonstrating above-average performance who received CRT less than 5 years prior to testing. Scores for the CRT group were highly correlated with IQ and achievement results. CRT variables (dose, age at earliest CRT, time since CRT) explained half the variance in attentional task performance. Children who received CRT performed significantly below the mean on subtests with the most complex, symbolic or sequential target stimuli, a pattern that has predicted poor academic achievement in non-medically ill children. It was concluded that children receiving CRT should continue to be evaluated more than five years after treatment to monitor potential late effects of neurotoxic treatment. Longitudinal, prospective, well-controlled dose-effect research using a developmentally sensitive, theoretically grounded battery of attentional measures is needed to best compare neurotoxicity of different treatment regima in children

  13. Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death.

    OpenAIRE

    Peter Hodkinson; Andrew Argent; Lee Wallis; Steve Reid; Rafael Perera; Sian Harrison; Matthew Thompson; Mike English; Ian Maconochie; Alison Ward

    2016-01-01

    Purpose Critically ill or injured children require prompt identification, rapid referral and quality emergency management. We undertook a study to evaluate the care pathway of critically ill or injured children to identify preventable failures in the care provided. Methods A year-long cohort study of critically ill and injured children was performed in Cape Town, South Africa, from first presentation to healthcare services until paediatric intensive care unit (PICU) admission or emergency dep...

  14. Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review.

    Science.gov (United States)

    Luckett, Tim; Disler, Rebecca; Hosie, Annmarie; Johnson, Miriam; Davidson, Patricia; Currow, David; Sumah, Anthony; Phillips, Jane

    2016-01-01

    Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch-Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade ⩾9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability. PMID:27225898

  15. 'You say treatment, I say hard work': treatment burden among people with chronic illness and their carers in Australia.

    Science.gov (United States)

    Sav, Adem; Kendall, Elizabeth; McMillan, Sara S; Kelly, Fiona; Whitty, Jennifer A; King, Michelle A; Wheeler, Amanda J

    2013-11-01

    The aim of this study was to explore treatment burden among people with a variety of chronic conditions and comorbidities and their unpaid carers. The burden of living with ongoing chronic illness has been well established. However, the burden associated with proactively treating and managing chronic illness, commonly referred to as 'treatment burden', is less understood. This study helps to bridge this gap in our understanding by providing an in-depth analysis of qualitative data collected from a large sample of adults from diverse backgrounds and with various chronic conditions. Using semi-structured in-depth interviews, data were collected with a large sample of 97 participants that included a high representation of people from culturally and linguistically diverse backgrounds and indigenous populations across four regions of Australia. Interviews were conducted during May-October 2012, either face to face (n = 49) or over the telephone (n = 48) depending on the participant's preference and location. Data were analysed using an iterative thematic approach and the constant comparison method. The findings revealed four interrelated components of treatment burden: financial burden, time and travel burden, medication burden and healthcare access burden. However, financial burden was the most problematic component with the cost of treatment being significant for most people. Financial burden had a detrimental impact on a person's use of medication and also exacerbated other types of burden such as access to healthcare services and the time and travel associated with treatment. The four components of treatment burden operated in a cyclical manner and although treatment burden was objective in some ways (number of medications, and time to access treatment), it was also a subjective experience. Overall, this study underscores the urgent need for healthcare professionals to identify patients overwhelmed by their treatment and develop 'individualised' treatment

  16. Comparison of psychological functioning in children and their mothers living through a life-threatening and non life-threatening chronic disease: A pilot study.

    Science.gov (United States)

    Graziano, Sonia; Rossi, Angela; Spano, Barbara; Petrocchi, Michela; Biondi, Gianni; Ammaniti, Massimo

    2016-06-01

    Childhood chronic illness is a potential source of distress and can be a traumatic experience both for the child and for the family. Several studies highlighted the importance of integrating psychosocial care and standard medical practice in the child's care. The current pilot study is the first investigation that compared distress in children and their mothers living through a life-threatening illness (cancer) and a non life-threatening (juvenile rheumatoid arthritis) chronic disease. Findings show that there are differences in the psychological functioning in children with respect to age. Moreover, the presence of posttraumatic stress symptoms in mothers of children with cancer seems to be a possible key to understanding the psychological response in this specific population. PMID:25561695

  17. Prevalence and risk factors of stress-induced gastrointestinal bleeding in critically ill children

    Institute of Scientific and Technical Information of China (English)

    Chookhuan Nithiwathanapong; Sanit Reungrongrat; Nuthapong Ukarapol

    2005-01-01

    AIM: To assess the frequency and the risk factors of stress-induced gastrointestinal (GI) bleeding in children admitted to a pediatric intensive care unit (PICU).METHODS: The medical records of children aged between 1 month and 15 years admitted to the PICU between January 2002 and December 2002 were reviewed.Demographic data, indications for PICU admission, principle diagnosis, and basic laboratory investigations were recorded. Previously described factors for stress ulcer bleeding (mechanical ventilation, sepsis, acute respiratory distress syndrome, renal insufficiency, coagulopathy,thrombocytopenia, and intracranial pathology) were used as independent variables in a multivariate analysis.RESULTS: One hundred and seventy of two hundred and five medical records were eligible for review. The most common indication for PICU admission was respiratory failure (48.8%). Twenty-five children received stress ulcer bleeding prophylaxis with ranitidine. The incidence of stress ulcer bleeding was 43.5%, in which 5.3% were clinically significant bleeding. Only mechanical ventilation and thrombocytopenia were significantly associated with stress ulcer bleeding using the univariate analysis.The odds ratio and 95% confidence intervals were 5.13(1.86-14.12) and 2.26 (1.07-4.74), respectively. However, the logistic regression analysis showed that mechanicai ventilation was the only significant risk factor with the odds ratio of 14.1.CONCLUSION: The incidence of gastrointestinal bleeding was high in critically ill children. Mechanical ventilation was an important risk factor for gastrointestinal bleeding.

  18. Hantavirus infection among children hospitalized for febrile illness suspected to be dengue in Barbados.

    Science.gov (United States)

    Kumar, Alok; Krishnamurthy, Kandamaran; Nielsen, Anders L

    2016-01-01

    Emerging picture of hantavirus infection in the South America is characterized by greater proportion of childhood infection and wider spectrum of disease from mild asymptomatic to lethal cardiopulmonary disease. Barbados is endemic for dengue and leptospirosis, both of which share clinical features with hantavirus infection and in many cases neither of these diagnosis could be confirmed. We investigate whether some of the children hospitalized with suspected dengue could indeed have been hantavirus infections. In this prospective study children hospitalized with suspected dengue were tested for hantavirus infection using ELISA for the IgM antibodies. Thirty-eight children tested positive for hantavirus infection. They presented with fever, headache and mild respiratory and gastrointestinal symptoms and signs. None of them had features suggestive of hantavirus cardiopulmonary syndrome. Blood count values ranged from low to normal to high for their age. There were no deaths. Hantavirus infection is prevalent in this Caribbean country. It predominantly presents with milder disease and is responsible for some of the nonspecific febrile illnesses in children. PMID:26153080

  19. Sex differences in anxiety sensitivity among children with chronic pain and non-clinical children

    OpenAIRE

    Tsao, Jennie C. I.; Evans, Subhadra; Meldrum, Marcia; Zeltzer, Lonnie K

    2009-01-01

    Although sex differences in anxiety sensitivity or the specific tendency to fear anxiety-related sensations have been reported in adults with clinical pain, there is a dearth of relevant research among children. This study examined sex differences in anxiety sensitivity across unselected samples of 187 children with chronic pain (71.7% girls; mean age = 14.5) and 202 non-clinical children (52% girls; mean age = 13.6). Girls in the chronic pain and non-clinical samples reported elevated anxiet...

  20. Religiously integrated cognitive behavioral therapy: a new method of treatment for major depression in patients with chronic medical illness.

    Science.gov (United States)

    Pearce, Michelle J; Koenig, Harold G; Robins, Clive J; Nelson, Bruce; Shaw, Sally F; Cohen, Harvey J; King, Michael B

    2015-03-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients' spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive-behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  1. A questionnaire to evaluate the impact of chronic diseases: validated translation and Illness Effects Questionnaire (IEQ reliability study

    Directory of Open Access Journals (Sweden)

    Patrícia Pinto Fonseca

    2012-01-01

    Full Text Available INTRODUCTION: Patients' perception about their health condition, mainly involving chronic diseases, has been investigated in many studies and it has been associated to depression, compliance with the treatment, quality of life and prognosis. The Illness Effects Questionnaire (IEQ is a tool which makes the standardized evaluation of patients' perception about their illness possible, so that it is brief and accessible to the different clinical settings. This work aims to begin the transcultural adaptation of the IEQ to Brazil through the validated translation and the reliability study. METHODS: The back-translation method and the test-retest reliability study were used in a sample of 30 adult patients under chronic hemodialysis. The reliability indexes were estimated using the Pearson, Spearman, Weighted Kappa and Cronbach's alpha coefficients. RESULTS: The semantic equivalence was reached through the validated translation. In this study, the reliability indexes obtained were respectively: 0.85 and 0.75 (p < 0.001; 0.68 and 0.92 (p < 0.0001. DISCUSSION: The reliability indexes obtained attest to the stability of responses in both evaluations. Additional procedures are necessary for the transcultural adaptation of the IEQ to be complete. CONCLUSION: The results indicate the translation validity and the reliability of the Brazilian version of the IEQ for the sample studied.

  2. [The role of the doctor in the prevention of ill-treatment and punishment of children (author's transl)].

    Science.gov (United States)

    Petri, H

    1980-07-01

    The duty of the doctor in the medical and psychosocial care of families with an environment of ill-treatment should be directed to the basic concepts of a child protection model. Interdisciplinary cooperation with advisory and therapeutic institutions and with family welfare play a decisive role here. A conflict-oriented discussion with the family whose conditions with regard to Balint groups he can learn is particularly important for the doctor in charge of such a case. Ill-treatment of children must be seen in an overlapping connection of violence towards children. In the sense of primary prevention of ill-treatment it would therefore be necessary to forbid all forms of corporal punishment of children because of the considerable psychological effects. PMID:6772948

  3. Acute Childhood Illnesses and Health Seeking Behaviour among under five children in a village of Hooghly district, West Bengal

    Directory of Open Access Journals (Sweden)

    Indira Dey (Pal

    2012-04-01

    Full Text Available Background: – Acute respiratory infections and diarrhoeal diseases are important causes of morbidity in children worldwide. IMNCI component is addressing these two illnesses in a major way and is concentrating on health care practices of community. Objective: – to find out their health seeking behaviour. Methodology: – A community based , cross-sectional study was conducted in the Mollasimla village of Hooghly district of West Bengal using 2 weeks recall for acute illnesses. Results – It was found that 56.8%, 23.8% and 18.9% children suffered from ARI, fever and diarrhea respectively. Overall treatment rate was above 93% and most of the children were treated in hospitals and health centre. Conclusion: – Acute illnesses are still largely prevalent in the rural community. As mothers are the first care givers, they should be made aware of the preventive measures and the need for seeking treatment.

  4. Parental Ease in Asking Others Not to Smoke and Respiratory Symptoms and Illness among Children

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    John Spangler

    2014-02-01

    Full Text Available Objective: Childhood exposure to secondhand tobacco smoke (SHS increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT Department (Budapest, Hungary from July to November, 2010. A consecutive series of children’s caregivers were approached to participate in a survey measuring household smoking bans, upper and lower respiratory tract symptoms and illnesses, and socioeconomic factors. Bivariate and multivariate logistic regression analyses were performed. Results: Of the 215 caregivers recruited for the study, 208 agreed to participate (response rate of 96.7%. More than half of the children were male (54%, and 39% lived in a household with at least one member who smoked. Smoking was frequently banned inside the car (91.3% and home (85.1%. Respondents felt it easiest to ask friends (97.1% and family members not living in the household (98.1% to refrain from smoking inside the home. Respondents also found it easier to ask a stranger (81.7% or a family member (61.1% not to smoke around the child. Logistic regression showed that respondents for children with a history of pneumonia found it less difficult to ask visitors in the home not to smoke compared to children without pneumonia (OR = 0.23, 95% CI = 0.06–0.98. Conversely, respondents for children who had had adenoidectomy found it over three times more difficult to ask strangers not to smoke near the child compared to those of children without adenoidectomy (OR = 3.20, 95% CI = 1.43–6.38. Conclusions: In a population of children visiting an outpatient ENT clinic in Budapest, Hungary, we found a high degree of exposure to SHS. The ease with which caregivers felt towards asking others not to smoke predicted

  5. Rurality and Ethnicity in Adolescent Physical Illness: Are Children of the Growing Rural Latino Population at Excess Health Risk?

    Science.gov (United States)

    Wickrama, K. A. S.; Elder, Glen H.; Abraham, W. Todd

    2007-01-01

    Context and Purpose: This study's objectives are to: investigate potential additive and multiplicative influences of rurality and race/ethnicity on chronic physical illness in a nationally representative sample of youth; and examine intra-Latino processes using a Latino sub-sample. Specifically, we examine how rurality and individual psychosocial…

  6. Clinical aspects of chronic ENT inflammation in children.

    Science.gov (United States)

    Mansbach, A L; Brihaye, P; Casimir, G; Dhooghe, I; Gordts, F; Halewyck, S; Hanssens, L; Lemkens, N; Lemkens, P; Leupe, P; Mulier, S; Van Crombrugge, L; Van Der Veken, P; Van Hoecke, H

    2012-01-01

    In children, all ENT cavities are particularly prone to the development of chronic inflammation. This is due to many predisposing factors, of which the most common are unfavourable anatomy, absence of nasal blowing, day care attendance, allergy, immature immunity, gastro-oesophageal reflux and tobacco smoke exposure. The aim of this paper is to outline the most specific paediatric clinical aspects of chronic pharyngo-tonsillitis, rhinosinusitis, otitis media, adenoiditis and laryngotracheitis and the important influence that some of these pathologies exert on the others. PMID:23431613

  7. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Minal S Kale

    Full Text Available Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD.We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ and Beliefs about Medications Questionnaire (BMQ. Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs.We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001, not be married (p = 0.006, and to have lower income (p<0.001 or education (p<0.001. In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen's d = 0.42, and were more likely to be concerned about their illness ((p = 0.04, Cohen's d = 0.17. In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94. In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37 though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04.In this cohort of urban individuals with COPD, low health literacy was

  8. Do healthy school meals affect illness, allergies and school attendance in 8- to 11-year-old children?

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Lauritzen, Lotte; Ritz, Christian;

    2015-01-01

    -reported occurrence or duration of asthma and allergies or self-reported well-being. The most common symptoms of illness were stomach pain (24%), headache (28%) and cold (24%). A slightly higher number of children experienced headaches in the school meal (27%) compared with the control period (22%) (P=0.02). However......, allergies, illness or well-being in 8- to 11-year-old children. The slight increase in occurrence of headaches seems to be related to the physical eating environment.European Journal of Clinical Nutrition advance online publication, 10 December 2014; doi:10.1038/ejcn.2014.263....

  9. The Burden of Illness in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease in Canada

    Directory of Open Access Journals (Sweden)

    M Reza Maleki-Yazdi

    2012-01-01

    Full Text Available INTRODUCTION: No recent Canadian studies with physician- and spirometry-confirmed diagnosis of chronic obstructive pulmonary disease (COPD that assessed the burden of COPD have been published.

  10. Physicians should increase focus on poor medicine adherence among chronically ill patients

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Topp, Marie; Ingebrigtsen, Truls Sylvan; Lange, Peter

    2014-01-01

    Non-adherence to medicine is common in patients with chronic diseases, contributing to significant worsening of disease, increased mortality and health expenditure. Methods of measuring adherence include self report, prescription refill rates, biomarkers, electronic monitoring and therapeutic...

  11. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis.

    Science.gov (United States)

    Philpott, J; Houghton, K; Luke, A

    2010-04-01

    As a group, children with a chronic disease or disability are less active than their healthy peers. There are many reasons for suboptimal physical activity, including biological, psychological and social factors. Furthermore, the lack of specific guidelines for 'safe' physical activity participation poses a barrier to increasing activity. Physical activity provides significant general health benefits and may improve disease outcomes. Each child with a chronic illness should be evaluated by an experienced physician for activity counselling and for identifing any contraindications to participation. The present statement reviews the benefits and risks of participation in sport and exercise for children with juvenile arthritis, hemophilia, asthma and cystic fibrosis. Guidelines for participation are included. PMID:21455465

  12. Cognitive development in children with chronic protein energy malnutrition

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    Chandramouli B A

    2008-07-01

    Full Text Available Abstract Background Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age. The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures. Methods Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory Results Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children. Conclusion Chronic protein energy malnutrition (stunting affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in

  13. Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Shen, Kunling; Xiong, Tengbin; Tan, Seng Chuen; Wu, Jiuhong

    2016-01-01

    Background Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor—a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China. Objective To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI. Methods We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER). Results In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy

  14. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

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    Masters IB

    2010-11-01

    Full Text Available Abstract Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250 fulfilling inclusion criteria (new patients with chronic cough are randomised (allocation concealed to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks or usual care (existing care until review by specialist at 6 weeks. Cough diary, cough-specific quality of life (QOL and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses. A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years. This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471

  15. Specific features of chronic inflammatory demyelinating polyneuropathy in children

    OpenAIRE

    A. L. Kurenkov; S. S. Nikitin; B. I. Bursagova; Kuzenkova, L.M.

    2012-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune peripheral neuropathy that affects both adults and children. The basis for the paper is the analysis of 5 cases of CIDP in children (3 girls and 2 boys) aged 5 to 17 years, followed up for 3 to 6 years. The types of its clinical picture and electromyographic changes at different disease stages are considered in detail. The course of the disease is traced during therapy with corticosteroids and intravenous human immunogl...

  16. Self-awareness of depression and life events in three groups of patients: Psychotic depression, obsessive–compulsive disorder and chronic medical illness in North India

    OpenAIRE

    Gupta, Anjali; Bahadur, Indu; Gupta, K.R.; Bhugra, Dinesh

    2006-01-01

    Background: Depression is a common experience across cultures although not all languages have words describing depression. Aim: To identify patients' perception and awareness of depression as an illness. Methods: Sixty psychiatric patients (each with depression or obsessive–compulsive disorder [OCD]) were compared with 30 medical patients with chronic physical illness and assessed on levels of awareness of depression in relation to life events. Results: Life events were more in patients with ...

  17. Qigong Exercise Alleviates Fatigue, Anxiety, and Depressive Symptoms, Improves Sleep Quality, and Shortens Sleep Latency in Persons with Chronic Fatigue Syndrome-Like Illness

    OpenAIRE

    2014-01-01

    Objectives. To evaluate the effectiveness of Baduanjin Qigong exercise on sleep, fatigue, anxiety, and depressive symptoms in chronic fatigue syndrome- (CFS-) like illness and to determine the dose-response relationship. Methods. One hundred fifty participants with CFS-like illness (mean age = 39.0, SD = 7.9) were randomly assigned to Qigong and waitlist. Sixteen 1.5-hour Qigong lessons were arranged over 9 consecutive weeks. Pittsburgh Sleep Quality Index (PSQI), Chalder Fatigue Scale (ChFS)...

  18. Qigong Exercise Alleviates Fatigue, Anxiety, and Depressive Symptoms, Improves Sleep Quality, and Shortens Sleep Latency in Persons with Chronic Fatigue Syndrome-Like Illness

    OpenAIRE

    Jessie S. M. Chan; Ho, Rainbow T. H.; Chung, Ka-Fai; Wang, Chong-Wen; Yao, Tzy-Jyun; Ng, Siu-man; Chan, Cecilia L. W.

    2014-01-01

    Objectives:. To evaluate the effectiveness of Baduanjin Qigong exercise on sleep, fatigue, anxiety, and depressive symptoms in chronic fatigue syndrome- (CFS-) like illness and to determine the dose-response relationship. Methods:. One hundred fifty participants with CFS-like illness (mean age = 39.0, SD = 7.9) were randomly assigned to Qigong and waitlist. Sixteen 1.5-hour Qigong lessons were arranged over 9 consecutive weeks. Pittsburgh Sleep Quality Index (PSQI), Chalder Fatigue Scale (ChF...

  19. How do macro-level contexts and policies affect the employment chances of chronically ill and disabled people? Part I: The impact of recession and deindustrialization

    DEFF Research Database (Denmark)

    Holland, Paula; Burström, Bo; Whitehead, Margaret;

    2011-01-01

    on their employment chances, and these influences urgently need to be understood as the current economic crisis intensifies. In Part I of this two-part study, the authors examine employment trends for people who report a chronic illness or disability, by gender and educational level, in Canada......Low employment rates of chronically ill and disabled people are of serious concern. Being out of work increases the risk of poverty and social exclusion, which may further damage the health of these groups, exacerbating health inequalities. Macro-level policies have a potentially tremendous impact......, Denmark, Norway, Sweden, and the United Kingdom in the context of economic booms and busts and deindustrialization. People with the double burden of chronic illness and low education have become increasingly marginalized from the labor market. Deindustrialization may have played a part in this process. In...

  20. The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged children

    Directory of Open Access Journals (Sweden)

    Allen Kelly M

    2008-01-01

    Full Text Available Abstract Background Acute respiratory illnesses (ARIs during childhood are often caused by respiratory viruses, result in significant morbidity, and have associated costs for families and society. Despite their ubiquity, there is a lack of interdisciplinary epidemiologic and economic research that has collected primary impact data, particularly associated with indirect costs, from families during ARIs in children. Methods We conducted a 12-month cohort study in 234 preschool children with impact diary recording and PCR testing of nose-throat swabs for viruses during an ARI. We used applied values to estimate a virus-specific mean cost of ARIs. Results Impact diaries were available for 72% (523/725 of community-managed illnesses between January 2003 and January 2004. The mean cost of ARIs was AU$309 (95% confidence interval $263 to $354. Influenza illnesses had a mean cost of $904, compared with RSV, $304, the next most expensive single-virus illness, although confidence intervals overlapped. Mean carer time away from usual activity per day was two hours for influenza ARIs and between 30 and 45 minutes for all other ARI categories. Conclusion From a societal perspective, community-managed ARIs are a significant cost burden on families and society. The point estimate of the mean cost of community-managed influenza illnesses in healthy preschool aged children is three times greater than those illnesses caused by RSV and other respiratory viruses. Indirect costs, particularly carer time away from usual activity, are the key cost drivers for ARIs in children. The use of parent-collected specimens may enhance ARI surveillance and reduce any potential Hawthorne effect caused by compliance with study procedures. These findings reinforce the need for further integrated epidemiologic and economic research of ARIs in children to allow for comprehensive cost-effectiveness assessments of preventive and therapeutic options.

  1. CHRONIC URTICARIAL IN CHILDHOOD. CLINICAL FEATURES OF CHRONIC URTICARIA IN CHILDREN. DIFFERENTIAL DIAGNOSTICS (PART II

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    N. A. Sinelnikova

    2014-07-01

    Full Text Available Abstract. Clinical structure of urticaria has been changed over last decade, due to discovery of an autoimmune form of the disease. This clinical form of chronic idiopathic urticaria comprises 30 to 52% of total. Incidence of physical urticaria varies from 17 to 20%, whereas other forms, including allergic urticaria, are diagnosed for < 5% of the patients. Different types of chronic urticaria exhibit their typical immunological features and clinical characteristics. A joint study of European Expert Group for Allergology, Clinical Immunology and Dermatology (EAACI/GA2LEN/EDF/UNEV is going on. Appropriate recommendations are aimed for improvement of diagnosis and management of children with this disease.

  2. Gallium-67 scintigraphy in children with chronic granulomatous disease

    International Nuclear Information System (INIS)

    We review our experience with Gallium scintigraphy in three children with chronic granulomatous disease, an entity characterized by defective neutrophils and recurrent infection. Radiogallium was found to localize in inflammation in these patients. Hematologic disordrs with specific structural of biochemical defects in their polymorphonuclear leukocytes may provide important information as to how these cells contribute to the accumulation of Gallium-67 in inflammation. (orig./MG)

  3. Delta sleep instability in children with chronic arthritis

    OpenAIRE

    Lopes, M.C.; Guilleminault, C; de Rosa, A.; Passarelli, C.; S. Roizenblatt; Tufik, S

    2008-01-01

    The objective of the present study was to evaluate the expression of a cyclic alternating pattern (CAP) in slow wave sleep (SWS) in children with the well-defined chronic syndrome juvenile idiopathic arthritis (JIA). Twelve patients (9-17 years of age), 7 girls, with JIA were compared to matched controls by age, pubertal stage and gender. After one night of habituation in the sleep laboratory, sleep measurements were obtained by standard polysomnography with conventional sleep scoring and add...

  4. Degree of muscle fatigue in children with chronic juvenile arthritis

    OpenAIRE

    Sekulić Aleksandra; Stevanović Srbislav; Milićević Saša; Gicić-Skenderi Suada

    2011-01-01

    The aim of our work was to identify gradient of the muscle fatigue of some muscle groups, among children with chronic juvenile arthritis, which are restricted in function by existing limitation in range of motions. Four patients in age of 9,5, with mentioned diagnosis were examined. Healthy subjects, with same ages were control group. Manuel muscle test, range of motion test and EMG examination were performed. Results shown significance difference in degree of muscle fatigue among observed pa...

  5. Transport of critically ill children: how to utilize resources in the developing world.

    Science.gov (United States)

    Khilnani, Praveen; Chhabra, Rajiv

    2008-06-01

    Safe transport of critically ill children remains a globally important issue, particularly in the developing countries such as India and Africa where the high risk mortality and morbidity exists during the transport process that may be less than optimal due to personnel and resource limitation. This article is intended to familiarize the reader with essential components of a good ground pediatric critical care transport program with special reference to developing countries. Essential equipment, medications, training requirement and responsibilities of transport team have been discussed in detail. In addition, recommendations from American (American academy of pediatrics-Transport section) and British pediatric critical care transport systems have been included, keeping in mind the practical feasibility in the Indian scenario where resources are limited. PMID:18759088

  6. Clinical and morphological characteristics of chronic duodenitis in children

    Directory of Open Access Journals (Sweden)

    Tishchenko D.V.

    2012-09-01

    Full Text Available

     

    The research goal is to determine clinical, endoscopic and morphological signs of chronic duodenitis in children. Materials and methods: The diagnostic value of molecular markers has been revealed by immunohistochemical research of biopsy. It has been received from endoscopic examination of 32 children aged from 3 to 17 years old with chronic duodenitis. Morphometric investigation of markers expression has been carried out by means of analyzing system of digital images of Mikrovizor medical uVizo-103. Results: The index of proliferation has been higher in cells of cover epithelium than in glands. The inductor expression of apoptosis Bax has been poorly expressed in both groups of patients. It has been proved that proliferative processes are predominant in this pathology. Conclusion: It has been found out that proliferation of significant activity in the cover epithelium accompanies the development of preatrophic processes in children with chronic duodenitis. The greater degree of regeneration has been marked in crypts.

  7. Two children with chronic progressive radiation myelopathy

    International Nuclear Information System (INIS)

    We report two patients who developed chronic progressive radiation myelopathy (CPRM). Patient 1 was a 16-year-old boy with group IV rhabdomyosarcoma of cervical soft tissue. He underwent partial excision of the tumor and received systemic and intrathecal chemotherapy and 44 Gy of local radiotherapy (C4 through Th3). These therapies were followed by high-dose chemotherapy including thio-TEPA and busulfan with autologous bone marrow rescue. One year after the completion of the therapies, he developed CPRM. Patient 2 was a 15-year-old girl with acute lymphoblastic leukemia on the 3rd complete remission. She received 18 Gy of irradiation to whole brain during the 1st remission and another 18 Gy to whole brain and 9 Gy to spinal cord after her 1st CNS relapse. After successful reinduction therapy for the 2nd relapse in CNS and bone marrow, she underwent an allogeneic bone marrow transplantation (BMT). The preconditioning regimen consisted of 12 Gy total body irradiation, thio-TEPA and cyclophosphamide. Seven months after BMT, she developed CPRM at C0-C1 level, which was included in the area of whole-brain irradiation. In both patients, MR images showed a swelling of the cervical cord and ring-like images by gadolinium enhancement. Their neurological disability transiently responded to the administration of corticosteroid, but they developed progressive quadriplegia. Although it is reported that a dose of 45-50 Gy may be safe, these cases suggest that administration of high-dose chemotherapy combined with intrathecal chemotherapy and radiotherapy to the cord might increase the rink of developing CPRM. (author)

  8. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  9. Management of chronic hepatitis B in children: an unresolved issue.

    Science.gov (United States)

    Della Corte, Claudia; Nobili, Valerio; Comparcola, Donatella; Cainelli, Francesca; Vento, Sandro

    2014-05-01

    Although a rather benign course of chronic hepatitis B virus (HBV) infection during childhood has been described, 3-5% and 0.01-0.03% of chronic carriers develop cirrhosis or hepatocellular carcinoma before adulthood. Considering the whole lifetime, the risk of hepatocellular carcinoma rises to 9-24% and the incidence of cirrhosis to 2-3% per year. The aim of this article is to review the current knowledge regarding the natural history and treatment of chronic hepatitis B in children and to focus on critical aspects and unresolved questions in the management of childhood HBV infection. A literature search was carried out on MEDLINE, EMBASE, and Web of Science for articles published in English in peer-reviewed journals from January 1980 to February 2013. The search terms used included "Hepatitis B virus infection," "children," "HBV," "interferon," "lamivudine," "adefovir," "entecavir," and "tenofovir." Articles resulting from these searches and relevant references cited in the articles retrieved were reviewed. The current goals of therapy are to suppress viral replication, reduce liver inflammation, and reverse liver fibrosis. Therapeutic options for children are currently limited, and the risk for viral resistance to current and future therapies is a particular concern. Based on the data available at this time, it is the consensus of the panel that it is not appropriate to treat children in the immune-tolerant phase or in the inactive carrier state. For children in the immune-active or reactivation phases, liver histology can help guide treatment decisions. Outside of clinical trials, interferon is the agent of choice in most cases; currently, available nucleoside analogs are secondary therapies. PMID:24863185

  10. Incidence of Medically Attended Respiratory Syncytial Virus and Influenza Illnesses in Children 6–59 Months Old During Four Seasons

    Science.gov (United States)

    Simpson, Melissa D.; Kieke, Burney A.; Sundaram, Maria E.; McClure, David L.; Meece, Jennifer K.; Sifakis, Frangiscos; Gasser, Robert A.; Belongia, Edward A.

    2016-01-01

    Background. Respiratory syncytial virus (RSV) and influenza are significant causes of seasonal respiratory illness in children. The incidence of influenza and RSV hospitalization is well documented, but the incidence of medically attended, laboratory-confirmed illness has not been assessed in a well defined community cohort. Methods. Children aged 6–59 months with medically attended acute respiratory illness were prospectively enrolled during the 2006–2007 through 2009–2010 influenza seasons in a Wisconsin community cohort. Nasal swabs were tested for RSV and influenza by multiplex reverse-transcription polymerase chain reaction. The population incidence of medically attended RSV and influenza was estimated separately and standardized to weeks 40 through 18 of each season. Results. The cohort included 2800–3073 children each season. There were 2384 children enrolled with acute respiratory illness; 627 (26%) were positive for RSV and 314 (13%) for influenza. The mean age was 28 months (standard deviation [SD] = 15) for RSV-positive and 38 months (SD = 16) for influenza-positive children. Seasonal incidence (cases per 10 000) was 1718 (95% confidence interval [CI], 1602–1843) for RSV and 768 (95% CI, 696–848) for influenza. Respiratory syncytial virus incidence was highest among children 6–11 (2927) and 12–23 months old (2377). Influenza incidence was highest (850) in children 24–59 months old. The incidence of RSV was higher than influenza across all seasons and age groups. Conclusions. The incidence of medically attended RSV was highest in children 6–23 months old, and it was consistently higher than influenza. The burden of RSV remains high throughout the first 2 years of life. PMID:27419158

  11. Circuit life span in critically ill children on continuous renal replacement treatment: a prospective observational evaluation study

    OpenAIRE

    del Castillo, Jimena; López-Herce, Jesús; Cidoncha, Elena; Urbano, Javier; Mencía, Santiago; Santiago, Maria J; Bellón, Jose M

    2008-01-01

    Introduction One of the greatest problems with continuous renal replacement therapy (CRRT) is early coagulation of the filters. Few studies have monitored circuit function prospectively. The purpose of this study was to determine the variables associated with circuit life in critically ill children with CRRT. Methods A prospective observational study was performed in 122 children treated with CRRT in a pediatric intensive care unit from 1996 to 2006. Patient and filter characteristics were an...

  12. Defining Quality of Life in the Children of Parents with Severe Mental Illness: A Preliminary Stakeholder-Led Model

    OpenAIRE

    Penny Bee; Kathryn Berzins; Rachel Calam; Steven Pryjmachuk; Van Abel, Kathryn M.

    2013-01-01

    Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical ...

  13. The predictive value of the NICE "red traffic lights" in acutely ill children.

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    Evelien Kerkhof

    Full Text Available OBJECTIVE: Early recognition and treatment of febrile children with serious infections (SI improves prognosis, however, early detection can be difficult. We aimed to validate the predictive rule-in value of the National Institute for Health and Clinical Excellence (NICE most severe alarming signs or symptoms to identify SI in children. DESIGN, SETTING AND PARTICIPANTS: The 16 most severe ("red" features of the NICE traffic light system were validated in seven different primary care and emergency department settings, including 6,260 children presenting with acute illness. MAIN OUTCOME MEASURES: We focussed on the individual predictive value of single red features for SI and their combinations. Results were presented as positive likelihood ratios, sensitivities and specificities. We categorised "general" and "disease-specific" red features. Changes in pre-test probability versus post-test probability for SI were visualised in Fagan nomograms. RESULTS: Almost all red features had rule-in value for SI, but only four individual red features substantially raised the probability of SI in more than one dataset: "does not wake/stay awake", "reduced skin turgor", "non-blanching rash", and "focal neurological signs". The presence of ≥ 3 red features improved prediction of SI but still lacked strong rule-in value as likelihood ratios were below 5. CONCLUSIONS: The rule-in value of the most severe alarming signs or symptoms of the NICE traffic light system for identifying children with SI was limited, even when multiple red features were present. Our study highlights the importance of assessing the predictive value of alarming signs in clinical guidelines prior to widespread implementation in routine practice.

  14. Transfusion of leukocyte-depleted red blood cells is not a risk factor for nosocomial infections in critically ill children

    NARCIS (Netherlands)

    van der Wal, Judith; van Heerde, Marc; Markhorst, Dick G.; Kneyber, Martin C. J.

    2011-01-01

    Objectives: Transfusion of red blood cells is increasingly linked with adverse outcomes in critically ill children. We tested the hypothesis that leukocyte-depleted red blood cell transfusions were independently associated with increased development of bloodstream infections, ventilator-associated p

  15. Relationship between Illness Severity, Social/Familial Variables and Adjustment in Children and Adolescents with Sickle Cell Disease.

    Science.gov (United States)

    Hurtig, Anita Landau; Koepke, David

    The study examined the effects of social support and family functioning on illness and adjustment in 70 children and adolescents with sickle cell disease. Four sources of information were used: patient interview and standardized tests; parent interview and standardized tests; teacher interview; and medical records. Results revealed several…

  16. Hospital malnutrition and inflammatory response in critically ill children and adolescents admitted to a tertiary intensive care unit

    Science.gov (United States)

    Critical illness has a major impact on the nutritional status of both children and adults. A retrospective study was conducted to evaluate the incidence of hospital malnutrition at a pediatric tertiary intensive care unit (PICU). Serum concentrations of IL-6 in subgroups of well-nourished and malnou...

  17. [Autoantibodies to glutamate receptors in children with chronic posttraumatic headache].

    Science.gov (United States)

    Goriunova, A V; Bazarnaia, N A; Sorokina, E G; Semenova, N Iu; Globa, O V; Semenova, Zh B; Pinelis, V G; Roshal', L M; Maslova, O I

    2006-01-01

    Autoantibodies (aAB) to AMPA (Glu R1 subunit) and NMDA (NR 2A subunit) glutamate receptors were studied in blood serum of 60 children, aged 7-16 years, with chronic posttraumatic headache after mild skull injury. All the children were divided into 2 groups: group 1 included 48 children with concussion of the brain, group 2--12 children with brain contusion. Group 1 was divided into 2 subgroups: subgroup 1a comprised 34 children with single concussion and subgroup 1b--14 children with repeated concussion. The aAB level was determined 6 months and 1 year after skull injury. The aAB concentration was expressed in percents to the control level being considered significant if the increase was higher than 120%. The increased NMDA aAB level was observed during the first year after skull injury. In the la subgroup, the NR2 aAB level in blood serum was 145 +/- 12,6%, in the 1b one--108 +/- 12,4%, in group 2--165 +/- 34%. The content of aAB to AMPA receptors was elevated only in children of lb subgroup and group 2 (150 +/- 16,8% and 167 +/- 31,3%, respectively). The EEG examination of this group revealed the nonspecific paroxysmal discharges in 18% of cases and epileptiform activity in 6% of children. The results obtained suggest that children with posttraumatic headache have elevated levels of aAB to glutamate receptors, hyperstimulation of which reflects hypoxic processes in the brain, and are in need of metabolic therapy. PMID:16972597

  18. Chronic Disease and Childhood Development: Kidney Disease and Transplantation.

    Science.gov (United States)

    Klein, Susan D.; Simmons, Roberta G.

    As part of a larger study of transplantation and chronic disease and the family, 124 children (10-18 years old) who were chronically ill with kidney disease (n=72) or were a year or more post-transplant (n=52) were included in a study focusing on the effects of chronic kidney disease and transplantation on children's psychosocial development. Ss…

  19. Chronic pain associated with the Chikungunya Fever: long lasting burden of an acute illness

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    Dallel Radhouane

    2010-02-01

    Full Text Available Abstract Background Chikungunya virus (CHIKV is responsible for major epidemics worldwide. Autochthonous cases were recently reported in several European countries. Acute infection is thought to be monophasic. However reports on chronic pain related to CHIKV infection have been made. In particular, the fact that many of these patients do not respond well to usual analgesics suggests that the nature of chronic pain may be not only nociceptive but also neuropathic. Neuropathic pain syndromes require specific treatment and the identification of neuropathic characteristics (NC in a pain syndrome is a major step towards pain control. Methods We carried out a cross-sectional study at the end of the major two-wave outbreak lasting 17 months in Réunion Island. We assessed pain in 106 patients seeking general practitioners with confirmed infection with the CHIK virus, and evaluated its impact on quality of life (QoL. Results The mean intensity of pain on the visual-analogical scale (VAS was 5.8 ± 2.1, and its mean duration was 89 ± 2 days. Fifty-six patients fulfilled the definition of chronic pain. Pain had NC in 18.9% according to the DN4 questionnaire. Conversely, about two thirds (65% of patients with NC had chronic pain. The average pain intensity was similar between patients with or without NC (6.0 ± 1.7 vs 6.1 ± 2.0. However, the total score of the Short Form-McGill Pain Questionnaire (SF-MPQ(15.5 ± 5.2 vs 11.6 ± 5.2; p Conclusions There exists a specific chronic pain condition associated to CHIKV. Pain with NC seems to be associated with more aggressive clinical picture, more intense impact in QoL and more challenging pharmacological treatment.

  20. The Australian Prevention Partnership Centre: systems thinking to prevent lifestyle-related chronic illness.

    Science.gov (United States)

    Wilson, Andrew; Wutzke, Sonia; Overs, Marge

    2014-01-01

    Chronic diseases are the major cause of death in Australia and the biggest contributor to premature death and disability. Although prevention of chronic disease can be effective and cost-effective, it has proven difficult to systematically implement interventions that target important lifestyle-related risk factors for chronic disease such as poor nutrition, physical inactivity and harmful alcohol use. Prevention efforts targeting these lifestyle-related risk factors have had mixed success due to issues around designing and implementing effective interventions that address the complexity of risk factors, and incorporating evidence and implementing interventions at a scale, duration, intensity and quality required to achieve population effects. There is increasing recognition that multilevel, multisector approaches are required for the effective and sustained prevention of complex chronic disease. The Australian Prevention Partnership Centre, one of two National Health and Medical Research Council Partnership Centres established in 2013, is researching and developing systems perspectives to prevent lifestyle-related chronic disease in Australia. The Centre's collaborative approach is providing opportunities for researchers to work with policy makers and practitioners to develop research questions, conduct research, and analyse, interpret and disseminate the findings. As such, it is the model of interaction that is being tested as much as the specific projects. With its funding partners, the Centre has developed plans for more than 30 projects. It has also established four capacity units that will improve the gathering, sharing and use of evidence to build a prevention system in Australia. The Centre is exploring new ways to advance prevention by bringing together researchers, policy makers and practitioners to determine the information and actions needed for an effective prevention system for Australia. PMID:25828440

  1. Reasons for default from treatment of chronic illnesses in a primary healthcare program in rural Tamil Nadu

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    Henry R Jennens

    2013-01-01

    Full Text Available Chronic illnesses are an increasing cause of morbidity and mortality in rural India. Many patients default from treatment, and exploring their reasons for the same may suggest strategies to improve service accessibility and acceptability. A qualitative study was conducted of 22 patient interviews, six key informant interviews, and two patient focus group discussions for investigating the reasons for default at the KC Patty Primary Health Centre and surrounding villages in Kodaikanal Taluk, Dindigul district, Tamil Nadu. The reasons included money or transport difficulties, frequent travel, feeling healthy, focus on work, fear of scolding from clinic staff, medication side effects, preference for alternative therapy, and depression. Some reasons were only divulged after an extended discussion. Support from families and village-level health workers (VLHWs were also identified as important. Recommendations include more open and patient communication between health workers and defaulting patients, in addition to recruitment of more VLHWs.

  2. Medical Transport of Children with Complex Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Carlos F. Lerner

    2012-01-01

    Full Text Available One of the most notable trends in child health has been the increase in the number of children with special health care needs, including those with complex chronic conditions. Care of these children accounts for a growing fraction of health care resources. We examine recent developments in health care, especially with regard to medical transport and prehospital care, that have emerged to adapt to this remarkable demographic trend. One such development is the focus on care coordination, including the dissemination of the patient-centered medical home concept. In the prehospital setting, the need for greater coordination has catalyzed the development of the emergency information form. Training programs for prehospital providers now incorporate specific modules for children with complex conditions. Another notable trend is the shift to a family-centered model of care. We explore efforts toward regionalization of care, including the development of specialized pediatric transport teams, and conclude with recommendations for a research agenda.

  3. Between disruption and continuity: challenges in maintaining the 'biographical we' when caring for a partner with a severe, chronic illness.

    Science.gov (United States)

    Aasbø, Gunvor; Solbraekke, Kari Nyheim; Kristvik, Ellen; Werner, Anne

    2016-06-01

    Chronic obstructive pulmonary disease (COPD) is a progressive illness that changes the lives of patients and their spouses dramatically. The aim of this paper is to show how spouses of COPD patients integrate their tasks as informal carers with their role as spouses and the tensions and challenges involved in this. The study draws on qualitative interviews with spouses of COPD patients, recruited from the patient pool of ambulatory pulmonary services of two hospitals in Oslo, Norway. The spouses described their great efforts to re-establish normality and continuity in their everyday lives. Accomplishing this was a delicate process because they faced several dilemmas in this work. They balanced the need to sustain the independence and integrity of both parties against the need to ensure safety and deal with the progression of the illness. We propose 'biographical we' as a concept that can highlight the great effort spouses put into establishing a sense of continuity in their lives. In times when healthcare policy involves mobilising informal caregiving resources, an awareness of the complexity of caregiving relationships is crucial when developing appropriate support for informal carers. PMID:26852721

  4. Religious versus Conventional Psychotherapy for Major Depression in Patients with Chronic Medical Illness: Rationale, Methods, and Preliminary Results

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    Harold G. Koenig

    2012-01-01

    Full Text Available This paper (1 reviews the physical and religious barriers to CBT that disabled medically ill-depressed patients face, (2 discusses research on the relationship between religion and depression-induced physiological changes, (3 describes an ongoing randomized clinical trial of religious versus secular CBT in chronically ill patients with mild-to-moderate major depression designed to (a overcome physical and religious barriers to CBT and (b compare the efficacy of religious versus secular CBT in relieving depression and improving immune and endocrine functions, and (4 presents preliminary results that illustrate the technical difficulties that have been encountered in implementing this trial. CBT is being delivered remotely via instant messaging, telephone, or Skype, and Christian, Jewish, Muslim, Buddhist, and Hindu versions of religious CBT are being developed. The preliminary results described here are particular to the technologies employed in this study and are not results from the CBT clinical trial whose findings will be published in the future after the study ends and data are analyzed. The ultimate goal is to determine if a psychotherapy delivered remotely that integrates patients’ religious resources improves depression more quickly than a therapy that ignores them, and whether religious CBT is more effective than conventional CBT in reversing depression-induced physiological changes.

  5. From Body to Mind and Spirit: Qigong Exercise for Bereaved Persons with Chronic Fatigue Syndrome-Like Illness

    Directory of Open Access Journals (Sweden)

    Jie Li

    2015-01-01

    Full Text Available Bereavement may bring negative impacts on the mind, body, and spiritual well-being of grieving persons. Some bereaved persons with chronic fatigue syndrome- (CFS- illness experience a dual burden of distress. This study investigated the effects of bereavement on CFS-like illness by comparing bereaved and nonbereaved participants. It also adopted a random group design to investigate the effectiveness of Qigong on improving the well-being of bereaved participants. The Qigong intervention comprised 10 group sessions delivered twice a week for 5 weeks and home-practice for at least three times a week lasting 15–30 minutes each. The participants’ fatigue, anxiety, and depression, quality of life (QoL, and spiritual well-being were measured at baseline and 3 months after treatment. The bereaved participants experienced significantly greater mental fatigue (16.09 versus 14.44, p=0.017 and lower physical QoL (34.02 versus 37.17, p=0.011 than their nonbereaved counterparts. After 3 months, the mental fatigue (−8 versus −4, p=0.010 and physical fatigue (−10 versus −5, p=0.007 experienced by intervention group had declined significantly, and improvements on their spirituality (14 versus −2, p=0.013 and psychological QoL (8.91 versus 0.69, p=0.002 scores exceeded those of the control group.

  6. From Body to Mind and Spirit: Qigong Exercise for Bereaved Persons with Chronic Fatigue Syndrome-Like Illness.

    Science.gov (United States)

    Li, Jie; Chan, Jessie S M; Chow, Amy Y M; Yuen, Lai Ping; Chan, Cecilia L W

    2015-01-01

    Bereavement may bring negative impacts on the mind, body, and spiritual well-being of grieving persons. Some bereaved persons with chronic fatigue syndrome- (CFS-) illness experience a dual burden of distress. This study investigated the effects of bereavement on CFS-like illness by comparing bereaved and nonbereaved participants. It also adopted a random group design to investigate the effectiveness of Qigong on improving the well-being of bereaved participants. The Qigong intervention comprised 10 group sessions delivered twice a week for 5 weeks and home-practice for at least three times a week lasting 15-30 minutes each. The participants' fatigue, anxiety, and depression, quality of life (QoL), and spiritual well-being were measured at baseline and 3 months after treatment. The bereaved participants experienced significantly greater mental fatigue (16.09 versus 14.44, p = 0.017) and lower physical QoL (34.02 versus 37.17, p = 0.011) than their nonbereaved counterparts. After 3 months, the mental fatigue (-8 versus -4, p = 0.010) and physical fatigue (-10 versus -5, p = 0.007) experienced by intervention group had declined significantly, and improvements on their spirituality (14 versus -2, p = 0.013) and psychological QoL (8.91 versus 0.69, p = 0.002) scores exceeded those of the control group. PMID:26504478

  7. Etiology and Outcome of Chronic Kidney Disease in Iranian Children

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    Neamatollah Ataei

    2016-07-01

    Full Text Available Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD, the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 1991 –2014. Children (186 boys, 186 girls with Stage 3 to 5 CKDs, defined as a glomerular filtration rate below 60 ml/min per 1.73 m2body surface area, were identified. Results Etiology was congenital anomalies of the kidney and urinary tract in 125 (33.60%, cystic/ hereditary/ congenital diseases in 91 (24.46%, glomerulopathy in 73(19.62%, and cause unknown in 71 (19.09% patients. Forty-eight (13.22% were on conservative treatment, 174(47.93% had end-stage renal disease (ESRD with chronic hemodialysis, 24 (6.61% were on continuous ambulatory peritoneal dialysis. Sixty-eight (18.74% underwent on renal transplant which was successful in 52 (14.33% patients but was associated with abnormal renal function in 16(4.41% children. Finally, 49 (13.50% patients died. Conclusion A large number of children developed CKD secondary to congenital anomalies of the kidney and urinary tract. Planning for screening, early detection and instituting timely treatment of preventable causes could lead to a lower incidence of CKD in this group of children.

  8. Use of deferred consent for severely ill children in a multi-centre phase III trial

    Directory of Open Access Journals (Sweden)

    Boga Mwamvua

    2011-03-01

    Full Text Available Abstract Background Voluntary participation of a subject in research respects a subject's rights, strengthens its ethical conduct, and is formalized by the informed consent process. Clinical trials of life-saving interventions for medical emergencies often necessitate enrolment of patients where prior written individual informed consent is impossible. Although there are regulations and guidelines on protecting subjects in emergency research, these have been criticised for being limited and unnecessarily restrictive. Across Europe and the United States stringent regulations have resulted in a substantial decline of clinical trials involving emergency interventions. Methods We are conducting a trial of fluid resuscitation in children with hypovolaemic shock in six hospitals across three malaria-endemic African countries. The design is pragmatic as children are enrolled on clinical criteria alone and is being conducted in hospitals with facilities typical of many district hospitals across Africa. The trial aims to inform strategy for managing children with febrile illness and features of shock. In order to develop appropriate consent processes for the trial, we conducted a narrative review of current international recommendations for emergency consent. Results Practical or specific guidance was generally sparse or confusing with few examples in the literature to direct our informed consent process. For a sub-group of children who were critically sick or where parents themselves were otherwise too distressed to consider prior written consent, we opted for a modified form of deferred consent. This included verbal assent from guardians at the point of enrolment, with full written consent obtained after stabilising the child. For children who died prior to full written consent, ethical permission was received to waiver full consent. Conclusions In light of the controversy around guidance and regulations in this area we report how and why we have used a

  9. Mineral Requirements in Children with Chronic Liver Disease

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    A Rezaeian

    2014-04-01

    Full Text Available Introduction: Decreased oral intake or impaired function / structure in the gut, such as hypertension port associated with atrophic changes in the protein nutrition - calories can lead to micronutrient deficiencies.This paper examines the status of micronutrients in chronic liver disease in children.   Materials and Methods: In this review study databases including proquest, pubmedcentral, scincedirect, ovid, medlineplus were been searched with keyword words such as” chronic liver disease"” minerals””children” between 1999 to 2014. Finally, 3 related articles have been found.   Results: In chronic liver disease changes in micronutrient metabolism lead to changes in the daily requirements, such that in certain circumstances intake increasing or decreasing  is needed. Low serum calcium and phosphate concentrations are often the reflection of malabsorption-induced bone disease that is unresponsive to vitamin D store normalization. Iron is usually deficient in children with CLD and supplementation frequently needed. The origin of iron deficiency is multifactorial and includes ongoing losses, inadequate intakes, serial blood draws and malabsorption secondary to hypertensive enteropathy. Zinc plays an important role in cognitive function, appetite and taste, immune function, wound healing, and protein metabolism. Low plasma zinc levels are frequent in children with chronic cholestasis, but unfortunately plasma concentrations are not reflective of total body zinc status. Copper and manganese, unlike other minerals, are increased in CLD, because they are normally excreted through bile. Parenteral nutrition in cholestatic patients can induce manganese intoxication and accumulation in basal ganglia.   Conclusion:  In fants with CLD are prone to multiple nutritional deficiencies. Mineral state should be evaluated, treated and reevaluated, until sufficient daily requirement achieved. Poster  Presentation, N 33  

  10. Evaluation of Children with Chronic Rhinosinusitis after Adenotonsillectomy

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    Fatholah Behnoud

    2011-01-01

    Full Text Available Introduction: Chronic rhinosinusitis (CRS, defined as an inflammatory process involving the paranasal sinuses that continues for at least three months, is a major cause of morbidity in the pediatric population and a difficult entity to treat with a poorly defined pathophysiology. The cornerstone of treatment for children with CRS remains aggressive antibiotic therapy, but many patients fail to improve even after extended courses of broad-spectrum oral antibiotics.  However, good treatment results with adenoidectomy alone have been reported in pediatric patients with CRS. The purpose of this study was to evaluate the effect of adenotonsillectomy on chronic rhinosinusitis in children.   Materials and Methods: In this clinical trial the study population was 40 children under 14 years old who had been selected for adenotonsillectomy. Prior to the procedure, a Waters’ view radiograph was performed on individuals that suffered from CRS and displayed symptoms such as rhinorrhea, halitosis, and chronic cough. Only patients with bilateral clouding of the maxillary sinuses were enrolled in study. A further radiograph was performed on the 28th day following the procedure and the outcome of the treatment evaluated. Results: Of the 40 patients under 14 years old who were evaluated, 22 (55% were female and 18 (45% were male. The mean age of the patients was 7.22 years while the oldest was 14 and the youngest was 4 years old.  Nasal congestion, rhinorrhea, post nasal drip, and chronic cough were present in all of the patients. Following the adenotonsillectomy, these symptoms were significantly reduced and were present in only 15.5%, 0%, 20%, and 20% of the patients, respectively. Multivariate analyses were performed using McNemar’s test. Conclusion: According to the results of this study, where 72.5% of patients showed a complete recovery following treatment, an adenotonsillectomy can be considered as a treatment modality for CRS.

  11. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  12. Effects of preventive family service coordination for parents with mental illnesses and their children, a RCT.

    Science.gov (United States)

    Wansink, Henny J; Janssens, Jan M A M; Hoencamp, Erik; Middelkoop, Barend J C; Hosman, Clemens M H

    2015-06-01

    Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as developed in the Preventive Basic Care Management (PBCM) program, improve parenting and prevent child behavioral problems? This randomized controlled clinical trial (RCT) compared the effectiveness of PBCM with a control condition. Ninety-nine outpatients of a community mental health center were randomized to intervention or control. Primary outcomes included parenting quality (assessed by the HOME instrument), parenting skills (parenting skills subscale of FFQ), and parenting stress (PDH). Secondary outcomes are child behavioral problems (SDQ). Outcomes were assessed at baseline and after 9 and 18 months. Effects were analyzed by Repeated Measures Analysis of Variance. Most families were single-parent families belonging to ethnic minorities. The results of the first RCT on effects of PBCM suggest that this intervention is feasible and has a positive effect on parenting skills. There was no evidence for effects on the quality of parenting and parenting stress, nor preventive effects on child behavioral problems. Replication studies in other sites, with more power, including monitoring of the implementation quality and studying a broader palette of child outcomes are needed to confirm the positive effects of PBCM. Long-term prospective studies are needed to investigate if improved parenting skills lead to positive effects in the children in the long run. PMID:25751176

  13. Examining the Experiences of Fathers of Children with a Life-Limiting Illness.

    Science.gov (United States)

    Nicholas, David B; Beaune, Laura; Barrera, Maru; Blumberg, Jonathan; Belletrutti, Mark

    2016-01-01

    Families who have a child diagnosed with a life-limiting illness (LLI) face substantial challenges resulting from the complexity and devastating impact of the condition and potential closeness of death. The experiences of fathers of a child with LLI have been understudied; therefore, this study explored the stresses, experiences, and strategies of these fathers, including their perceptions about support needs. Based on grounded theory, in-depth semi-structured interviews were conducted with 18 fathers of children with LLI. Six fathers had experienced the death of their child. The overarching themes were stresses, means of coping, and perceived needs for support. Generally, fathers in this study struggled relative to discursive and internalized notions of fathers as providers and protectors for their children, combined with an inability to ease their child's vulnerability to LLI. Participants were engaged in the care of their child with LLI, but several felt marginalized by health care providers in care planning and staff/family communication. Some fathers recognized and valued their support network while others had few supports. Some described personal growth and desired to help other fathers. Practice implications and recommendations include renewed application of family-centered care, overcoming presumptions about fathers' roles, and recognizing the impact of LLI beyond physical health. PMID:27143577

  14. Astronomy for Extremely ill or Traumatically Injured Children and Their Families - IAU OAD Grant

    Science.gov (United States)

    Lubowich, Donald

    2015-08-01

    This grant funded a program for extremely ill or traumatically injured children, their siblings, and family members rlated to the children’s surgery and medical treatments at nearby hospitals. This grant provided an educational family-learning experience and out-of-this world diversion from the stress of being sick or of having a sick family member hospitalized. The families stayed at the four Ronald McDonald Houses (RMHs) of Chicago. The RMHs provide free or low-cost housing in a comfortable, supportive alternative atmosphere where family members sleep, eat, relax and find support from other families in similar situations. Families are kept united when mutual support is as critical as the medical treatment itself. The ill children and their families may stay for a few days or months because of chemotherapy, dialysis, or rehabilitative therapy. Children from 50 states and 50 countries stay the Chicago RMHs and there are 260 RMHs in the US and 65 worldwide.The RMH staff and volunteers were trained to: use optical and solar telescopes; use the Stellarium program to show the night sky, identify objects, and plan observing sessions; use Sky and Telescope or Astronomy Magazine to selected the best nights for observing; conduct simple family oriented demonstrations; demonstrate citizen science/Zooniverse activities; and provide information about science museums and astronomy clubs near their home. The Chicago Astronomical Society (amateur astronomy club) provides ongoing support.I created an Activity Book with demonstrations and participatory hands-on activities including a toilet plunger sundial, making a sundial, creating a scale model of the Solar System (football field or toilet paper), phases and craters of the Moon (Oreo cookie phases, flour/ cocoa crater formation), eclipses, make constellations from chocolate chips in chocolate-chip cookies, crate your own constellation patterns, stellar temperature (images, demonstrations, candy), order images of the stages of

  15. [Defects of neutrophil function in chronic gastroduodenitis in children].

    Science.gov (United States)

    Agafonova, E V; Malanicheva, T G; Denisova, S N

    2013-01-01

    At present, chronic gastroduodenitis (CGD) occupies one ofthe leading places in the structure of diseases of the gastrointestinal tract in children. In the etiology of CGD, along with the leading pathogenic Helicobacterpylori (HP), the role of the fungal flora increased. The aim of the work was to evaluate the functional activity of neutrophils in children with the CGD, associated with HP and Candida albicans. Among 110 children in the age from 7 to 17 years with chronic gastroduodenitis, associated with Helicobacter pylory(HP), as well as the association of HP with Candida albicans and the markers of secondary immune insufficiency, a study of the phagocytic activity and immune phenotype of neutrophils by flow cytofluorimetry was conducted. Differentiated peculiarities of the phagocytic activity of neutrophils in association with bacterial pathogens (HP) and fungal flora were identified. The transformation of the immune phenotype was combined with a significant depression of the phagocytic and microbicidal functions, more pronounced with the association of HP and Candida albicans. Circulating mannano protein antigen of Candida albicans influenced on the surface of phenotype of neutrophils, increasing the expression of protopathic and HLADR-receptors, and decreasing the expression of adhesion receptors and cytolysis. Thus, in case of chronic gastroduodenitis in children, there was a considerable transformation of the phenotype of neutrophil with differentiated characteristics at the association with bacterial (HP) pathogens and fungal flora. The obtained data should be taken into account when carrying out medical activities, and the doctors should include in the composition of complex therapy of CGD, associated with Candida albicans, drugs, aimed at immunocorrection of the identified violations PMID:23951901

  16. A First Step on the Journey to High-Quality Chronic Illness Care.

    Science.gov (United States)

    Wagner, Edward H

    2016-01-01

    The Atlantic Healthcare Collaboration (AHC) conducted a quality improvement initiative to improve chronic disease prevention and management for the four Atlantic provinces and their regional health authorities. Leaders and front-line teams carried out a range of projects, each suited to the needs of that region. This initiative helped build the case for improvement, increased the motivation to change, exposed participants to proven ideas for improvement and supported participating organizations in developing the capacity and culture to test, implement and spread improvements. The AHC also created a politically safe learning community with the potential to support and sustain the work of chronic care improvement over time. In carrying this initiative forward, the greatest challenge will be the magnitude of work to be done. PMID:27009640

  17. Telephone-based health coaching for chronically ill patients: study protocol for a randomized controlled trial

    OpenAIRE

    Dwinger, Sarah; Dirmaier, Jörg; Herbarth, Lutz; König, Hans-Helmut; Eckardt, Matthias; Kriston, Levente; Bermejo, Isaac; Härter, Martin

    2013-01-01

    Background The rising prevalence of chronic conditions constitutes a major burden for patients and healthcare systems and is predicted to increase in the upcoming decades. Improving the self-management skills of patients is a strategy to steer against this burden. This could lead to better outcomes and lower healthcare costs. Health coaching is one method for enhancing the self-management of patients and can be delivered by phone. The effects of telephone-based health coaching are promising, ...

  18. Living with Chronic Kidney Disease : The role of illness perceptions, treatment perceptions and social support

    OpenAIRE

    Jansen, D.L.

    2012-01-01

    Chronic Kidney Disease (CKD) patients, particularly patients on dialysis, often experience difficulties with participating in daily activities, including paid work. Restrictions on the quantity or quality of activities, may impede people’ perceived autonomy and self-esteem. This thesis addressed the question why some patients with CKD succeed in keeping high levels of autonomy and self-esteem, and maintaining paid employment, whereas others do not, and focused on psychological factors conside...

  19. [Is capsule endoscopy useful in children with chronic abdominal pain?].

    Science.gov (United States)

    Argüelles-Arias, F; Argüelles Martín, F; Caunedo Alvarez, A; Sánchez Yagüe, A; Romero Vázquez, J; García Montes, M J; Rodríguez-Téllez, M; Pellicer Bautista, F J; Herrerías Gutiérrez, J M

    2007-10-01

    Chronic abdominal pain is highly prevalent in school-aged children and is one of the most frequent disorders in our environment. The aim of the present study was to evaluate the usefulness of capsule endoscopy (CE) in patients with chronic abdominal pain. Sixteen patients (nine boys and seven girls), aged between 5 and 16 years old, with chronic abdominal pain for at least 12 months were studied. In all patients the results of hemograms, biochemical investigations, urine sediment test, Helicobacter pylori breath test and celiac serology were normal. In all children, gastroscopy, small bowel follow-through, abdominal ultrasound and colonoscopy were normal. All patients received CE by mouth. In 43.75 % of the patients studied (7/16), the capsule showed evidence of nodular lymphoid hyperplasia, mainly located in the ileum. In one girl, oxyuriasis was observed in the cecum and in another girl aphthous lesions were observed in the ileum. These lesions suggested small bowel Crohn's disease. CE mainly showed images compatible with nodular lymphoid hyperplasia, with unknown clinical significance. Consequently, we conclude that CE does not provide useful information in patients with abdominal pain without other symptoms. PMID:17949651

  20. Blood Glucose as a Predictor of Mortality in Children Admitted to the Hospital with Febrile Illness in Tanzania

    OpenAIRE

    Nadjm, Behzad; Mtove, George; Amos, Ben; Hildenwall, Helena; Najjuka, Anne; Mtei, Frank; Todd, Jim; Reyburn, Hugh

    2013-01-01

    Data from a prospective study of 3,319 children ages 2 months to 5 years admitted with febrile illness to a Tanzanian district hospital were analyzed to determine the relationship of blood glucose and mortality. Hypoglycemia (blood sugar < 2.5 mmol/L and < 45 mg/dL) was found in 105 of 3,319 (3.2%) children at admission, and low-normal blood glucose (2.5-5 mmol/L and 45-90 mg/dL) was found in 773 of 3,319 (23.3%) children. Mortality was inversely related to admission blood sugar; compared wit...

  1. Prediction of self-monitoring compliance: application of the theory of planned behaviour to chronic illness sufferers.

    Science.gov (United States)

    McGuckin, Conor; Prentice, Garry R; McLaughlin, Christopher G; Harkin, Emma

    2012-01-01

    Chronic obstructive pulmonary disease (COPD), diabetes and asthma are chronic illnesses that affect a substantial number of people. The continued high cost of clinic- and hospital-based care provision in these areas could be reduced by patients self-monitoring their condition more effectively. Such a move requires an understanding of how to predict self-monitoring compliance. Ajzen's theory of planned behaviour (TPB) makes it possible to predict those clients who will comply with medical guidelines, prescription drug intake and self-monitoring behaviours (peak flow or blood sugar levels). Ninety-seven clients attending a medical centre located in a large urbanised area of Northern Ireland completed TPB questionnaires. Significant amounts of variance explained by the TPB model indicated its usefulness as a predictor of self-monitoring behaviour intentions in the sample. The results also highlighted the importance of subjective norm and perceived behavioural control within the TPB in predicting intentions. The utility of the TPB in this study also provides evidence for health promotion professionals that costly clinic/hospital treatment provision can be reduced, whilst also being satisfied with ongoing client self-monitoring of their condition. PMID:22111866

  2. Mycotoxins and Antifungal Drug Interactions: Implications in the Treatment of Illnesses Due to Indoor Chronic Toxigenic Mold Exposures

    Directory of Open Access Journals (Sweden)

    Ebere C. Anyanwu

    2004-01-01

    Full Text Available Chronic exposure to toxigenic molds in water-damaged buildings is an indoor environmental health problem to which escalating health and property insurance costs are raising a statewide concern in recent times. This paper reviews the structural and functional properties of mycotoxins produced by toxigenic molds and their interactive health implications with antifungal drugs. Fundamental bases of pathophysiological, neurodevelopmental, and cellular mechanisms of mycotoxic effects are evaluated. It is most likely that the interactions of mycotoxins with antifungal drugs may, at least in part, contribute to the observable persistent illnesses, antifungal drug resistance, and allergic reactions in patients exposed to chronic toxigenic molds. Safe dose level of mycotoxin in humans is not clear. Hence, the safety regulations in place at the moment remain inconclusive, precautionary, and arbitrary. Since some of the antifungal drugs are derived from molds, and since they have structural and functional groups similar to those of mycotoxins, the knowledge of their interactions are important in enhancing preventive measures.

  3. Winners and losers in flexible labor markets: the fate of women with chronic illness in contrasting policy environments--Sweden and Britain

    DEFF Research Database (Denmark)

    Burström, Bo; Holland, Paula; Diderichsen, Finn;

    2003-01-01

    This study compares employment rates among men and women with and without chronic illness in the contrasting policy environments of Britain and Sweden, through analysis of household surveys for 1979-1995. Professional and managerial groups were winners in both countries, including during recessio......, would be the winners in a more flexible, less regulated labor market-quite the reverse....

  4. Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: a tale of three studies.

    NARCIS (Netherlands)

    Nes, A.A.G.; Eide, H.; Kristjánsdóttir, O.B.; Dulmen, S. van

    2013-01-01

    Objective: Chronic illness places high demands on patients. Interventions supporting self-management and providing personalized feedback might help patients to gain new perspectives and enhance use of constructive self-management strategies. We developed three comparable web-based CBT-grounded inter

  5. Web-based, self-management enhancing interventions with e-diaries and personalized feedback for persons with chronic illness: A tale of three studies

    NARCIS (Netherlands)

    Nes, A.A.; Eide, H.; Kristjansdottir, O.B.; Dulmen, S. van

    2013-01-01

    OBJECTIVE: Chronic illness places high demands on patients. Interventions supporting self-management and providing personalized feedback might help patients to gain new perspectives and enhance use of constructive self-management strategies. We developed three comparable web-based CBT-grounded inter

  6. Determinants of school performance in children with chronic asthma.

    Science.gov (United States)

    Gutstadt, L B; Gillette, J W; Mrazek, D A; Fukuhara, J T; LaBrecque, J F; Strunk, R C

    1989-04-01

    We have documented performance on standardized academic achievement tests for reading and mathematics in 99 children with moderately severe to severe chronic asthma. Academic performance and intelligence test scores indicated that, overall, the academic capabilities of the children with asthma were average to above average. A stepwise regression analysis was used to examine relationships between the dependent variables of reading and mathematics and the independent variables of socioeconomic status, school attendance, medical factors relating to asthma, age, and emotional and behavioral problems of the children. Factors that were associated significantly with low performance scores were low socioeconomic status, older age, history of continuous oral steroid use (prednisone or methyl prednisolone taken at least every other day for the year prior to evaluation), and presence of emotional and behavioral problems. School absenteeism, use of medical resources, oral steroid dosage, other medications used to treat asthma, and pulmonary functions were not associated with academic performance. Investigation of poor classroom performance of a child with chronic asthma should include investigation of the roles of socioeconomic status, oral steroid therapy, and emotional and behavioral problems. PMID:2929529

  7. Intractable chronic constipation in children: Outcome after anorectal myectomy

    Directory of Open Access Journals (Sweden)

    Seyed Abdollah Mousavi

    2014-01-01

    Full Text Available Background: Many children with constipation fail to respond with conventional medical therapy. Surgery can produce a good result in dysfunction of the colon secondary to aganglionosis. However, its role in treating idiopathic constipation is more controversial. Patients and Methods: A consecutive series of 44 patients with chronic idiopathic intractable constipation were included in this study. All children were investigated by barium enema and anorectal manometry. Due to inadequate response to medical therapy, all of these patients were selected for internal sphincter myomectomy. Patients were followed-up from 3 to 12 months. Results: Short-term (3 months and long-term (6 months follow-up was available for all patients. The histology examinations showed normal ganglion cells in 32, hypoganglionosis in eight and aganglionosis in four patients. In short-term, regular bowel habits, without the need for laxatives or low dose drugs were recorded in 35 patients (79.5%. Overall there was an improvement in 68.2% of the children after 6 months follow-up. There was not any correlation between histopathological findings, duration of symptoms, age and sex of operation and response to myectomy. Conclusion: anorectal myectomy is an effective procedure in patients with intractable idiopathic constipation. It relieves symptoms in 68.2% of patients with chronic refractory constipation.

  8. In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Randall Ellen

    2012-12-01

    Full Text Available Abstract Background Most Canadians receive basic health services from a family physician and these physicians are particularly critical in the management of chronic disease. Canada, however, has an endemic shortage of family physicians. Physician shortages and turnover are particularly acute in rural regions, leaving their residents at risk of needing to transition between family physicians. The knowledge base about how patients manage transitioning in a climate of scarcity remains nascent. The purpose of this study is to explore the experience of transitioning for chronically ill, rurally situated Canadian women to provide insight into if and how the system supports transitioning patients and to identify opportunities for enhancing that support. Methods Chronically ill women managing rheumatic diseases residing in two rural counties in the province of Ontario were recruited to participate in face-to-face, semi-structured interviews. Interview transcripts were analysed thematically to identify emergent themes associated with the transitioning experience. Results Seventeen women participated in this study. Ten had experienced transitioning and four with long-standing family physicians anticipated doing so soon. The remaining three expressed concerns about transitioning. Thematic analysis revealed the presence of a transitioning trajectory with three phases. The detachment phase focused on activities related to the termination of a physician-patient relationship, including haphazard notification tactics and the absence of referrals to replacement physicians. For those unable to immediately find a new doctor, there was a phase of unattachment during which patients had to improvise ways to receive care from alternative providers or walk-in clinics. The final phase, attachment, was characterized by acceptance into the practice of a new family physician. Conclusions Participants often found transitioning challenging, largely due to perceived gaps in

  9. Altered Food-Cue Processing in Chronically Ill and Recovered Women with Anorexia Nervosa

    OpenAIRE

    Nicole eSanders; Smeets, Paul A. M.; van Elburg, Annemarie A.; Danner, Unna N; Floor evan Meer; Hoek, Hans W.; Roger A Adan

    2015-01-01

    Anorexia nervosa (AN) is a severe mental disorder characterized by food restriction and weight loss. This study aimed to test the model posed by Brooks et al. (2012a,b) that women suffering from chronic AN show decreased food-cue processing activity in brain regions associated with energy balance and food reward (bottom-up; BU) and increased activity in brain regions associated with cognitive control (top-down; TD) when compared with long-term recovered AN (REC) and healthy controls (HC). Thr...

  10. Safety and tolerability of levocetirizine dihydrochloride in infants and children with allergic rhinitis or chronic urticaria.

    Science.gov (United States)

    Hampel, Frank; Ratner, Paul; Haeusler, Jean-Marc C

    2010-01-01

    Allergic rhinitis (AR) and chronic idiopathic urticaria (CIU) are common causes of substantial illness and disability in preschool children. Antihistamines are commonly used to treat preschool children with these conditions, but their use is based mostly on extrapolated efficacy from adult populations; it is thus important to characterize the safety of antihistamines in the pediatric population. This study was designed to assess the safety of levocetirizine dihydrochloride oral liquid drops in infants and children with AR or CIU. Two multicenter, double-blind, randomized, parallel-group studies randomized infants aged 6-11 months (study 1, n = 69) and children aged 1-5 years (study 2, n = 173) to levocetirizine, 1.25 mg (q.d. or b.i.d., respectively), or placebo for 2 weeks, using a 2:1 ratio. Safety evaluations included treatment-emergent adverse events (TEAEs), vital signs, electrocardiographic (ECG) assessments, and laboratory tests. The overall incidence of TEAEs was similar between levocetirizine and placebo in both studies. Most TEAEs were mild or moderate in intensity. TEAEs prompted discontinuation of therapy in three patients receiving levocetirizine in study 1. No clinically relevant changes from baseline in vital signs or laboratory parameters were apparent in either study; changes from baseline in these evaluations were similar between groups. No significant changes were observed in ECG parameters, including corrected QT interval. Levocetirizine, 1.25 and 2.5 mg/day, was well tolerated in infants aged 6-11 months and in children aged 1-5 years, respectively, with AR or CIU. PMID:20819318

  11. Treatment Preferences for CAM in children with chronic pain.

    Science.gov (United States)

    Tsao, Jennie C I; Meldrum, Marcia; Kim, Su C; Jacob, Margaret C; Zeltzer, Lonnie K

    2007-09-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities. PMID:17965769

  12. Treatment Preferences for CAM in Children with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2007-01-01

    Full Text Available CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls (mean age = 14.5 years ± 2.4; range = 8–18 years presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80% were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy, pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  13. Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

    OpenAIRE

    Goeppel, Christine; Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

    2016-01-01

    Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or u...

  14. Familia y enfermedad crónica pediátrica Family and chronic paediatric illness

    Directory of Open Access Journals (Sweden)

    C. Grau

    2010-08-01

    Full Text Available La enfermedad pediátrica es siempre un problema familiar. La hospitalización, los tratamientos y las secuelas constituyen un desafío para la familia. En este trabajo describimos las alteraciones estructurales, procesuales y emocionales que se producen en la dinámica familiar. Consideramos que la intervención del niño enfermo debe hacerse siempre en el contexto familiar y proponemos un modelo de intervención multidimensional centrado en la singularidad de las familias y en sus necesidades, en los apoyos disponibles en su entorno natural, en el desarrollo de las competencias y de la resiliencia y en la organización de servicios centrados en el usuario y coordinados con todos los servicios que ofrece la comunidad.Pediatric illnesses are always a family problem. Hospitalization, treatments and their long term consequences constitute a challenge for the family. In this paper, we describe the structural, procedural and emotional alterations that affect the family dynamic. We argue that the child should be treated within the family context and propose a multi-dimensional intervention model centered on the family’s singularities and specific needs, the support available in their environment, the development of capacities and resilience, and also the organization of user-centered services that are coordinated with all the services provided by the community.

  15. The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: Results of a nationwide panel-study in the Netherlands

    OpenAIRE

    Rijken, M.; Spreeuwenberg, P.; Schippers, J.J.; Groenewegen, P.P.

    2013-01-01

    Background Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals’ well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain ins...

  16. The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in the Netherlands

    OpenAIRE

    2013-01-01

    Background Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals’ well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain ins...

  17. The importance of illness duration, age at diagosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in the Netherlands.

    OpenAIRE

    Rijken, M.; Spreeuwenberg, P.; Schippers, J.; Groenewegen, P.P.

    2013-01-01

    Background: Compared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals' well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain in...

  18. X-ray changes of children with chronic renal insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W.; Balzar, E. (Vienna Univ. (Austria). Kinderklinik)

    1983-01-01

    The typical changes of renal osteopathy are shown in the X-rays of 7 children with end-stage renal disease treated with chronic intermittent hemodialysis. The exact evaluation of the granular structural changes of the cranium, the evidence of osteomalacia because of the hazy appearance of the vertebrae and the broadening of the sacroilical joints depend highly on subjective judgement and the technical X-ray procedures used. Unmistakable radiological diagnoses can be made when a broadening of the metalphyseal zones, epiphysioloysis as well as characteristic changes in the finder phalanges (acroosteolyses, spiculae, tunnelation) are present.

  19. [Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome].

    Science.gov (United States)

    Ramberg, Axel; Feldkötter, Sinja

    2015-01-01

    One of the most discussed questions in clinical literature concerns the impact of child abuse by mentally ill parents (cf. Mattejat, 1998). It's obvious that most children cannot understand such a parental behaviour and that this lack of understanding along with the lack of knowledge about their parents' emotional disorder results in childrens' fear, disorientation and uncertainty. The consequences are massive interferences in the relationship between parents and children, who could develop an anxious-resistant insecure or even a disorganized/disoriented attachment. But how does a child react, if the behaviour of its parents is ambivalent itself and alternates from abuse to care? Such a parental behaviour is described as the "Munchausen by Proxy Syndrome". This article regards the effects of a "Munchausen by Proxy Syndrome" on the childrens' attachment development. After discussing the basic assumptions about the "Munchhauen by Proxy Syndrome" and the attachment theory we draw conclusions about the syndrome's effect on childrens' attachment behaviour. PMID:26509970

  20. Specific features of chronic inflammatory demyelinating polyneuropathy in children

    Directory of Open Access Journals (Sweden)

    A. L. Kurenkov

    2012-01-01

    Full Text Available Chronic inflammatory demyelinating polyneuropathy (CIDP is an autoimmune peripheral neuropathy that affects both adults and children. The basis for the paper is the analysis of 5 cases of CIDP in children (3 girls and 2 boys aged 5 to 17 years, followed up for 3 to 6 years. The types of its clinical picture and electromyographic changes at different disease stages are considered in detail. The course of the disease is traced during therapy with corticosteroids and intravenous human immunoglobulin and plasmapheresis. The results of the authors’ observations are compared with those of investigations conducted by other authors. The consideration of the diagnosis of CIDP and its treatment options focuses on that the international standards must be necessarily met to minimize errors in its differential diagnosis and management of these patients, and to make the prognosis for the disease.

  1. Modelling management of chronic illness in everyday life: A common-sense approach

    Directory of Open Access Journals (Sweden)

    Howard Leventhal

    2016-04-01

    Full Text Available The Commonsense Model of Self-Regulation (CSM has a history of over 50 years as a theoretical framework that explicates the processes by which individuals form cognitive, affective, and behavioral representations of health threats. This article summarizes the major components of individuals' "commonsense models", the underlying assumptions of the CSM as a theory of dynamic behavior change, and the major empirical evidence that have developed these aspects of the CSM since its inception. We also discuss ongoing changes to the theory itself as well as its use in medical practice for optimizing patients' self-management of chronic health threats. The final section focuses on future directions for the theory and its application.

  2. Social living mitigates the costs of a chronic illness in a cooperative carnivore.

    Science.gov (United States)

    Almberg, E S; Cross, P C; Dobson, A P; Smith, D W; Metz, M C; Stahler, D R; Hudson, P J

    2015-07-01

    Infection risk is assumed to increase with social group size, and thus be a cost of group living. We assess infection risk and costs with respect to group size using data from an epidemic of sarcoptic mange (Sarcoptes scabiei) among grey wolves (Canis lupus). We demonstrate that group size does not predict infection risk and that individual costs of infection, in terms of reduced survival, can be entirely offset by having sufficient numbers of pack-mates. Infected individuals experience increased mortality hazards with increasing proportions of infected pack-mates, but healthy individuals remain unaffected. The social support of group hunting and territory defence are two possible mechanisms mediating infection costs. This is likely a common phenomenon among other social species and chronic infections, but difficult to detect in systems where infection status cannot be measured continuously over time. PMID:25983011

  3. Metabolic Disturbances in Children with Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    A Rezaeian

    2014-04-01

    Full Text Available Introduction: Liver disease results in complex pathophysiologic disturbances affecting nutrient digestion, absorption, distribution, storage, and use. This article aimed to present a classification of metabolic disturbances in chronic liver disease in children?   Materials and Methods: In this review study databases including proquest, pubmedcentral, scincedirect, ovid, medlineplus were been searched with keyword words such as” chronic liver disease"  ” metabolic disorder””children” between 1999 to 2014. Finally, 8 related articles have been found.   Results: Metabolic disorder in this population could be categorized in four set: 1carbohydrates, 2proteins,3 fats and 4vitamins. 1 Carbohydrates: Children with CLD are at increased risk for fasting hypoglycemia, because the capacity for glycogen storage and gluconeogenesis is reduced as a result of abnormal hepatocyte function and loss of hepatocyte mass. 2 Proteins: The liver’s capacity for plasma protein synthesis is impaired by reduced substrate availability, impaired hepatocyte function, and increased catabolism. This results in hypoalbuminemia, leading to peripheral edema and contributing to ascites. Reduced synthesis of insulin-like growth factor (IGF-1 and its binding protein IGF-BP3 by the chronically diseased liver results in growth hormone resistance and may contribute to the poor growth observed in these children. 3 Fats: There is increased fat oxidation in children with end-stage liver disease in the fed and fasting states compared with controls, which is probably related to reduced carbohydrate availability. The increased lipolysis results in a decrease in fat stores, which may not be easily replenished in the setting of the fat malabsorption that accompanies cholestasis. Reduced bile delivery to the gut results in impaired fat emulsification, and hence digestion. The products of fat digestion are also poorly absorbed, because bile is also required for micelle formation

  4. Psychosocial effects on caregivers for children on chronic peritoneal dialysis.

    Science.gov (United States)

    Tsai, T-C; Liu, S-I; Tsai, J-D; Chou, L-H

    2006-12-01

    The study was designed to explore the psychosocial effects on caretakers of children in Taiwan on chronic peritoneal dialysis (CPD). This is a case-control study, performed with subjects drawn from eight medical centers. The study group consisted of caretakers of 32 children with renal failure being treated with CPD. For comparison, a control group of caretakers of 64 healthy children as well as the regional Taiwanese studies were used. Two instruments were used to explore the presence of probable depression and quality of life (QOL) of the caretakers: the Taiwanese Depression Questionnaire, and the World Health Organization QOL BRIEF-Taiwan Version. In the study group, only 25% of caregivers had full-time jobs, and 66% of families had an annual income of less than US dollar 15,000. Of the 32 families in the study group, 16% had only a single parent. The prevalence of probable depression was significantly more common in the study group compared with control and referent group (28% vs 5% and 9.44%; P = 0.001). QOL scores in four domains were also significantly lower in the study group. In conclusion, even with the advances of peritoneal dialysis techniques, caring for children on CPD in Taiwan has significant adverse psychosocial effects on the primary caregivers. Attention should be paid to the psycho-social status of the caregivers. PMID:16985519

  5. Life expectancy of brain impaired, chronically ventilated children.

    Science.gov (United States)

    Gale, Rena; Namestnic, Julia

    2013-04-01

    We present a 5-year survival profile of 42 children and adolescents between 1 to 21 years of age in an immobile minimally conscious state, chronically dependent on supportive ventilation. Data were collected from a 22-bed pediatric unit dedicated to this unique population, within a 350-bed geriatric hospital, between May 2006 and May 2011. The practice of ventilating children even in minimally conscious state stems from the unique cultural, religious, and ethnic background of the population in Israel. The 5-year survival probability was 48% (52% probability of death within 5 years, 26.5% within 2 years). No significant difference was found in the survival profile of patients admitted following hypoxic accidents (20 children) and those admitted with other problems such as genetic/metabolic diseases or brain anomalies (22). The mortality rate of male patients was higher than that of female patients, but the difference was not statistically significant. No difference in 5-year mortality rates was found between children of different ethnic backgrounds. PMID:23498560

  6. [Chronic interstitial lung disease in children: Diagnostic approach and management].

    Science.gov (United States)

    Fuger, M; Clair, M-P; El Ayoun Ibrahim, N; L'Excellent, S; Nizery, L; O'Neill, C; Tabone, L; Truffinet, O; Yakovleff, C; de Blic, J

    2016-05-01

    Chronic interstitial lung disease (ILD) in children is a heterogeneous group of rare lung disorders characterized by an inflammatory process of the alveolar wall and the pulmonary interstitium that induces gas exchange disorders. The diagnostic approach to an ILD involves three essential steps: recognizing the ILD, appreciating the impact, and identifying the cause. The spectrum of clinical findings depends to a large extent on age. In the newborn, the beginning is often abrupt (neonatal respiratory distress), whereas there is a more gradual onset in infants (failure to thrive, tachypnea, indrawing of the respiratory muscles). In older children, the onset is insidious and the diagnosis can only be made at an advanced stage of the disease. The diagnosis is based on noninvasive methods (clinical history, respiratory function tests, chest X-ray, and high-resolution CT scan) and invasive techniques (bronchoalveolar lavage, transbronchial biopsy, video-assisted thoracoscopic biopsy, and open lung biopsy). The treatment of interstitial lung disease in children depends on the nature of the underlying pathology. The most common therapeutic approach involves the use of corticosteroids and immunosuppressive agents for their anti-inflammatory and antifibrotic effects. Children with ILD also need support therapy (oxygen therapy, nutritional support, treatment of pulmonary arterial hypertension, vaccination). Lung transplantation is discussed in patients with severe respiratory failure. PMID:27021883

  7. Plasma homocysteine concentration in children with chronic renal failure.

    Science.gov (United States)

    Merouani, A; Lambert, M; Delvin, E E; Genest, J; Robitaille, P; Rozen, R

    2001-10-01

    Hyperhomocysteinemia, a risk factor for vascular disease, is commonly found in adult patients with end-stage renal disease. Major determinants of elevated plasma homocysteine levels in these patients include deficiencies in folate and vitamin B12, methylenetetrahydrofolate reductase (MTHFR) genotype and renal function. Little information is available for children with chronic renal failure (CRF). The prevalence and the factors that affect plasma homocysteine concentration were determined in children. Twenty-nine children with various degrees of CRF (15 were dialyzed, 14 were not dialyzed) were compared with 57 age- and sex-matched healthy children. Homocysteine concentrations were higher in patients than controls (17.3 micromol/l vs 6.8 micromol/l, P95th percentile for controls: 14.0 micromol/l) was seen in 62.0% of patients and 5.2% of controls. Folate concentrations were lower in patients (9.9 nmol/l) than controls (13.5 nmol/l), P<0.01. Vitamin B12 was similar in patients (322 pmol/l) and controls (284 pmol/l). Dialyzed patients have a higher prevalence of hyperhomocysteinemia than nondialyzed patients (87% vs 35%). Dialyzed patients with MTHFR mutation have higher plasma homocysteine (28.5 micromol/l) than nondialyzed patients with the mutation (10.7 micromol/l), P<0.002. In our study, differences between controls and patients in plasma homocysteine concentrations are observed when age is greater then 92 months, folate less than 21.6 nmol/l and vitamin B12 less than 522 pmol/l. Our study shows that hyperhomocysteinemia is common in children with CRF and is associated with low folate and normal vitamin B12 status, compared to normal children. Among the patients, the dialyzed patients with the MTHFR mutation are particularly at risk for hyperhomocysteinemia. Further studies are needed to investigate therapeutic interventions and the potential link with vascular complications in these patients. PMID:11605787

  8. Costs of illness analysis in Italian patients with chronic obstructive pulmonary disease (COPD: an update

    Directory of Open Access Journals (Sweden)

    Dal Negro RW

    2015-03-01

    Full Text Available Roberto W Dal Negro,1,2 Luca Bonadiman,1 Paola Turco,2 Silvia Tognella,3 Sergio Iannazzo41National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology, Verona, Italy; 2Research and Clinical Governance, Verona, Italy; 3General Hospital, ULSS 22 Regione Veneto, Bussolengo, Italy; 4SIHS Health Economics Consulting, Torino, ItalyBackground: Chronic obstructive pulmonary disease (COPD is a major cause of chronic morbidity and mortality worldwide, and its epidemiological, clinical, and socioeconomic impact is progressively increasing. A first estimate of the economic burden of COPD in Italy was conducted in 2008 (the SIRIO [Social Impact of Respiratory Integrated Outcomes] study. The aim of the present study is to provide an updated picture of the COPD economic burden in Italy.Methods: Sequential patients presenting at the specialist center for the first time during the period 2008–2012 and with record file complete (demographic, clinical, lung function, and therapeutic data; health care resources consumed in the 12 months before the enrollment and for the 3 subsequent years were selected from the institutional database.Results: Two hundred and seventy-five COPD patients fitting the inclusion criteria were selected (226 males; mean age: 70.9 years [standard deviation: ±8.4 years]; 45.8% were from the north, 25.1% from central Italy, and 29.1% from south Italy. COPD-related average costs per patient in the 12 months before enrollment were as follows: hospitalization: €1,970; outpatient care: €463; pharmaceutical: €499; and indirect costs: €358. Average direct costs and total societal costs were €2,932 and €3,291, respectively. Direct cost was €2,461 (hospitalization: €1,570; outpatient: €344; and pharmaceutical: €547 in the first year of follow-up, while total societal cost was €2,707. No significant difference was reported in any cost category between sexes.Conclusion: The therapeutic approach followed in a

  9. Correlation of end tidal and arterial carbon dioxide levels in critically Ill neonates and children

    Directory of Open Access Journals (Sweden)

    Hiren Mehta

    2014-01-01

    Full Text Available Aim of the Study: End tidal carbon dioxide (EtCO 2 monitoring is considered to reflect real-time estimation of partial pressure of carbon dioxide in arterial blood (PaCO 2 noninvasively. However, knowledge about its relationship with PaCO 2 in critically ill pediatric and neonatal patients is limited. The primary objective was to evaluate predictive capability of end tidal carbon dioxide monitoring and secondary objective was to determine the influence of severity of lung disease on EtCO 2 and PaCO 2 relationship. Materials and Methods: This was a prospective, nonrandomized, consecutive enrollment study carried out in neonatal and pediatric intensive care units of a tertiary care children hospital. It was conducted in 66 neonates and 35 children receiving mechanical ventilation. Severity of lung disease was estimated by ventilation index and PaO 2 /FiO 2 (P/F ratio. Simultaneous recording of EtCO 2 and PaCO 2 levels was done and data were analyzed for correlation and agreement. Results: In neonates, 150 EtCO 2 and PaCO 2 pairs were recorded. The mean weight ± SD of patients was 2.1 ± 0.63 kg. PaCO 2 had a positive correlation with EtCO 2 (r = 0.836, 95% CI = 0.78-0.88. P/F ratio <200 adversely affected relationship. In infants and children, 96 pairs were recorded. Mean age ± SD of patients was 4.20 ± 4.92 years and mean weight ± SD was 13.1 ± 9.49 kg. PaCO 2 had an excellent correlation with EtCO 2 (r = 0.914, 95% CI = 0.87 and 0.94. P/F ratio <200 adversely affected relationship. Conclusion: EtCO 2 monitoring displayed a good validity to predict PaCO 2 . Correlation was affected by low P/F ratio (<200; hence, it is recommended that blood gases be measured in these patients until such time that a good relation can be established between end tidal and arterial CO 2 values.

  10. Delta sleep instability in children with chronic arthritis

    Directory of Open Access Journals (Sweden)

    M.C. Lopes

    2008-10-01

    Full Text Available The objective of the present study was to evaluate the expression of a cyclic alternating pattern (CAP in slow wave sleep (SWS in children with the well-defined chronic syndrome juvenile idiopathic arthritis (JIA. Twelve patients (9-17 years of age, 7 girls, with JIA were compared to matched controls by age, pubertal stage and gender. After one night of habituation in the sleep laboratory, sleep measurements were obtained by standard polysomnography with conventional sleep scoring and additional CAP analyses. The sleep parameters of the JIA and control groups were similar for sleep efficiency (91.1 ± 6.7 vs 95.8 ± 4.0, sleep stage in minutes: stage 1 (16.8 ± 8.5 vs 17.8 ± 4.0, stage 2 (251.9 ± 41 vs 262.8 ± 38.1, stage 3 (17.0 ± 6.0 vs 15.1 ± 5.7, stage 4 (61.0 ± 21.7 vs 77.1 ± 20.4, and rapid eye movement sleep (82.0 ± 27.6 vs 99.0 ± 23.9, respectively. JIA patients presented nocturnal disrupted sleep, with an increase in short awakenings, but CAP analyses showed that sleep disruption was present even during SWS, showing an increase in the overall CAP rate (P < 0.01. Overall CAP rate during non-rapid eye movement sleep was significantly higher in pediatric patients who were in chronic pain. This is the first study of CAP in pediatric patients with chronic arthritis showing that CAP analyses can be a powerful tool for the investigation of disturbance of SWS in children, based on sleep EEG visual analysis.

  11. Modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliotic illness for children

    Directory of Open Access Journals (Sweden)

    Olga Peshkova

    2015-12-01

    Full Text Available Authors in the article are consider the basic going near setting of medical physical culture at scoliostic illness of І–ІІ degree for children taking into account a type, form, etiology, degree and clinical displays. Purpose: to describe the modern going near setting of medical physical culture taking into account etiology, type, form, degree and clinical displays of scoliostic illness for children. Material and Methods: analysis of the modern special literature on issue of physical rehabilitation of children at scoliostic illness; analysis of medical cards. Results: description of scoliosis is given on an etiologic sign, form, type, degrees and clinical displays. The features of methods of medical physical culture are presented taking into account the afore-named signs of scoliotic illness. Conclusions: setting of facilities and forms of medical physical culture at scoliotic illness depends on etiology, form and type of scoliosis, degree and clinical displays of disease

  12. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model.

    Science.gov (United States)

    Bee, Penny; Berzins, Kathryn; Calam, Rachel; Pryjmachuk, Steven; Abel, Kathryn M

    2013-01-01

    Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13-18 yrs) with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key 'meta-themes'. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i) the alleviation of parental mental health symptoms, ii) improved problem-based coping skills and iii) increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third sector providers to

  13. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model.

    Directory of Open Access Journals (Sweden)

    Penny Bee

    Full Text Available Severe parental mental illness poses a challenge to quality of life (QoL in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13-18 yrs with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key 'meta-themes'. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i the alleviation of parental mental health symptoms, ii improved problem-based coping skills and iii increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third

  14. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis

    OpenAIRE

    Mayo-Wilson, Evan; Imdad, Aamer; Herzer, Kurt; Yakoob, Mohammad Yawar; Zulfiqar A Bhutta

    2011-01-01

    Objective To determine if vitamin A supplementation is associated with reductions in mortality and morbidity in children aged 6 months to 5 years. Design Systematic review and meta-analysis. Two reviewers independently assessed studies for inclusion. Data were double extracted; discrepancies were resolved by discussion. Meta-analyses were performed for mortality, illness, vision, and side effects. Data sources Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, M...

  15. Parents’ communication to primary school-aged children about mental health and ill-health: a grounded theory study

    OpenAIRE

    J. Mueller; Greenwood, K.; Callanan, M.

    2014-01-01

    Purpose – Stigma around mental health problems is known to emerge in middle childhood and persist into adulthood, yet almost nothing is known about the role of parents in this process. This paper aims to develop a model of parental communication to primary school-aged children around mental health and ill-health, to increase understanding about how stigma develops. Design/methodology/approach – Semi-structured interviews were performed with ten UK-based parents of children aged 7-11 years...

  16. Detection of human bocavirus from children and adults with acute respiratory tract illness in Guangzhou, southern China

    Directory of Open Access Journals (Sweden)

    Liu Wen-Kuan

    2011-12-01

    Full Text Available Abstract Background Human bocavirus (HBoV is a newly discovered parvovirus associated with acute respiratory tract illness (ARTI and gastrointestinal illness. Our study is the first to analyze the characteristics of HBoV-positive samples from ARTI patients with a wide age distribution from Guangzhou, southern China. Methods Throat swabs (n=2811 were collected and analyzed from children and adults with ARTI over a 13-month period. The HBoV complete genome from a 60 year-old female patient isolate was also determined. Results HBoV DNA was detected in 65/2811 (2.3% samples, of which 61/1797 were from children (Mycoplasma pneumoniae had the highest frequency of 16.9% (11/65. Upper and lower respiratory tract illness were common symptoms, with 19/65 (29.2% patients diagnosed with pneumonia by chest radiography. All four adult patients had systemic influenza-like symptoms. Phylogenetic analysis of the complete genome revealed a close relationship with other HBoVs, and a more distant relationship with HBoV2 and HBoV3. Conclusions HBoV was detected from children and adults with ARTI from Guangzhou, southern China. Elderly people were also susceptive to HBoV. A single lineage of HBoV was detected among a wide age distribution of patients with ARTI.

  17. Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study.

    Directory of Open Access Journals (Sweden)

    Anna Wikman

    Full Text Available BACKGROUND: There has been considerable research into the impact of chronic illness on health-related quality of life. However, few studies have assessed the impact of different chronic conditions on general quality of life (QOL. The objective of this paper was to compare general (rather than health-related QOL and affective well-being in middle aged and older people across eight chronic illnesses. METHODS AND FINDINGS: This population-based, cross-sectional study involved 11,523 individuals aged 50 years and older, taking part in wave 1 of the English Longitudinal Study of Ageing. General QOL was assessed using the CASP-19, happiness was evaluated using two items drawn from the GHQ-12, and depression was measured with the CES-D. Analysis of covariance and logistic regression, adjusting for age, gender and wealth, were performed. General QOL was most impaired in people with stroke (mean 37.56, CI 36.73-38.39, and least in those reporting cancer (mean 41.78, CI 41.12-42.44, respectively, compared with no illness (mean 44.15, CI 43.92-44.39. Stroke (mean 3.65, CI 3.58-3.73 was also associated with the greatest reduction in positive well-being whereas diabetes (mean 3.81, CI 3.76-3.86 and cancer were least affected (3.85, CI 3.79-3.91, compared with no illness (mean 3.97, CI 3.95-4.00. Depression was significantly elevated in all conditions, but was most common in chronic lung disease (OR 3.04, CI 2.56-3.61, with more modest elevations in those with osteoarthritis (OR 2.08, CI 1.84-2.34 or cancer (OR 2.07, CI 1.69-2.54. Multiple co-morbidities were associated with greater decrements in QOL and affective well-being. CONCLUSION: The presence of chronic illness is associated with impairments in broader aspects of QOL and affective well-being, but different conditions vary in their impact. Further longitudinal work is needed to establish the temporal links between chronic illness and impairments in QOL and affective well-being.

  18. Goal Setting and Treatment Adherence among Patients with Chronic Illness and Depressive Symptoms: Applying a Patient-Centered Approach

    Science.gov (United States)

    Houston, Eric; Tatum, Alexander K.; Guy, Arryn; Mikrut, Cassandra; Yoder, Wren

    2016-01-01

    Objective: Poor treatment adherence is a major problem among individuals with chronic illness. Research indicates that adherence is worsened when accompanied by depressive symptoms. In this preliminary study, we aimed to describe how a patient-centered approach could be employed to aid patients with depressive symptoms in following their treatment regimens. Methods: The sample consisted of 14 patients undergoing antiretroviral therapy (ART) for HIV who reported clinically-significant depressive symptoms. Participant ratings of 23 treatment-related statements were examined using two assessment and analytic techniques. Interviews were conducted with participants to determine their views of information based on the technique. Results: Results indicate that while participants with optimal adherence focused on views of treatment associated with side effects to a greater extent than participants with poor adherence, they tended to relate these side effects to sources of intrinsic motivation. Conclusion: The study provides examples of how practitioners could employ the assessment techniques outlined to better understand how patients think about treatment and aid them in effectively framing their health-related goals. PMID:26755463

  19. Systematic Review of the Impact of Transition Interventions for Adolescents With Chronic Illness on Transfer From Pediatric to Adult Healthcare.

    Science.gov (United States)

    Chu, Patricia Y; Maslow, Gary R; von Isenburg, Megan; Chung, Richard J

    2015-01-01

    Transfer from pediatric to adult care is a critical component of a high-quality transition experience for adolescents and young adults (AYA) with chronic illness. To examine the current evidence regarding the effect of transition interventions on care transfer, we performed a systematic review of studies that evaluated the effect of transition interventions on the specific health services outcome of transfer. The Medline, CINAHL, and PsycINFO databases were searched for studies that evaluated 1) a discrete transition intervention for AYA, 2) included a comparison group, and 3) reported on the outcome of transfer from pediatric to adult healthcare. References were screened and reviewed separately by authors, and relevant study details were abstracted during the review process. Five studies from five different countries were included in the final analysis. All five studies were conducted in specialty care clinics, with three interventions involving a nurse practitioner or systems navigator and two interventions involving physicians. Four studies were retrospective observational studies, and one was a pilot randomized controlled trial. Three of the five studies found that the transition intervention was associated with increased rates of transfer while the other two showed no statistically significant effects. Overall, evaluation of transfer appears to be hindered by methodological challenges. Establishing clearer definitions and metrics of transfer and creating the infrastructure needed to monitor the transfer of patients more consistently are important goals. PMID:26209872

  20. Children with chronic renal failure have reduced numbers of memory B cells.

    NARCIS (Netherlands)

    Bouts, A.H.M.; Davin, J.C.; Krediet, R.T.; Monnens, L.A.H.; Nauta, J.; Schröder, C.H.; Lier, R.A.W. van; Out, T.A.

    2004-01-01

    Reduced serum IgG and subclass levels have been demonstrated in children with chronic renal failure. To study possible causes of this reduction, we analysed B cell subset composition, T helper cell frequencies and immunoglobulin (Ig) production capacity in vitro in children with chronic renal failur

  1. Hypophosphatemia in critically ill children Hipofosfatemia em crianças gravemente doentes

    Directory of Open Access Journals (Sweden)

    Fernanda Souza de Menezes

    2004-01-01

    Full Text Available The purpose of this paper is to review clinical studies on hypophosphatemia in pediatric intensive care unit patients with a view to verifying prevalence and risk factors associated with this disorder. We searched the computerized bibliographic databases Medline, Embase, Cochrane Library, and LILACS to identify eligible studies. Search terms included critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. The search period covered those clinical trials published from January 1990 to January 2004. Studies concerning endocrinological disorders, genetic syndromes, rickets, renal diseases, anorexia nervosa, alcohol abuse, and prematurity were not included in this review. Out of 27 studies retrieved, only 8 involved pediatric patients, and most of these were case reports. One clinical trial and one retrospective study were identified. The prevalence of hypophosphatemia exceeded 50%. The commonly associated factors in most patients with hypophosphatemia were refeeding syndrome, malnutrition, sepsis, trauma, and diuretic and steroid therapy. Given the high prevalence, clinical manifestations, and multiple risk factors, the early identification of this disorder in critically ill children is crucial for adequate replacement therapy and also to avoid complications.Este estudo objetivou realizar revisão da literatura para verificar prevalência, fatores de risco e condições clínicas associadas à hipofosfatemia em crianças gravemente doentes. Para a pesquisa foram utilizadas as bases de dados Medline, Embase, Cochrane Library, Lilacs abrangendo estudos clínicos publicados de janeiro de 1990 a janeiro de 2004. Os termos utilizados para pesquisa foram: critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation

  2. Health implications of chronic hepatosplenomegaly in Kenyan school-aged children chronically exposed to malarial infections and Schistosoma mansoni

    DEFF Research Database (Denmark)

    Wilson, Shona; Vennervald, Birgitte J; Kadzo, Hilda; Ireri, Edmund; Amaganga, Clifford; Booth, Mark; Kariuki, H. Curtis; Mwatha, Joseph K.; Kimani, Gachuhi; Ouma, John H.; Muchiri, Eric; Dunne, David W.

    2010-01-01

    investigated in a study area where children were chronically exposed to malaria throughout while S. mansoni transmission was geographically restricted. Hepatosplenomegaly was associated with increased portal vein diameters, with enlargement of the spleen rather than the liver being more closely associated with...... hepatosplenomegaly. Children who presented with hepatosplenomegaly had the lowest height-for-age Z-scores. This study shows that hepatosplenomegaly associated with chronic exposure to malaria and schistosomiasis is not a benign symptom amongst school-aged children but has potential long-term health consequences.......Hepatosplenomegaly among school-aged children in sub-Saharan Africa is highly prevalent. Two of the more common aetiological agents of hepatosplenomegaly, namely chronic exposure to malaria and Schistosoma mansoni infection, can result in similar clinical presentation, with the liver and spleen...

  3. The aetiology of non-malarial febrile illness in children in the malaria-endemic Niger Delta Region of Nigeria

    Science.gov (United States)

    Pondei, Kemebradikumo; Kunle-Olowu, Onyaye E.; Peterside, Oliemen

    2013-01-01

    Objective Febrile illnesses are common in childhood and differentiating the causes could be challenging in areas of perennial malaria transmission. To determine the proportion of non-malarial febrile illness in children, the aetiological agents and their antimicrobial sensitivity pattern. Methods Blood, urine, throat swab and ear swab samples were obtained from 190 febrile children aged 6 months to 11 years. Malaria parasite was detected by microscopic examination of thick and thin Giemsa-stained films. Smears from ear and throat swabs and urine specimen were cultured on appropriate media. Bacterial isolates were identified by Gram staining, morphology and biochemical tests. Antibiotic susceptibility was tested using the Kirby-Bauer disc diffusion method. Results The prevalence of non-malarial febrile illnesses was 45.26% (95% CI: 38.21-52.31). Twenty-four patients (12.6%) had at least one sample that was bacterial culture positive. Samples from 62 patients (32.6%) were negative for both malaria parasite and bacterial culture. Urinary tract infection was responsible for 8.42%, otitis media 7.89% and pharyngitis 5.78% of the fevers. E.coli, S. aureus and S. pneumoniae were the commonest isolates from urine, ear swab and throat swab samples respectively. S. pneumoniae was responsible for all the positive throat cultures. Bacterial isolates exhibited different degrees of susceptibility to the antibiotics tested, but susceptibility of most of the isolates to oxacillin and cloxacillin was generally poor. Conclusions Bacterial infections are responsible for a significant proportion of non-malarial febrile illnesses, and diagnostic facilities should be strengthened to detect other causes of febrile illness outside malaria.

  4. [Chronic diseases in children and adolescents: a review of the literature].

    Science.gov (United States)

    Moreira, Martha Cristina Nunes; Gomes, Romeu; Calheiros de Sá, Miriam Ribeiro

    2014-07-01

    The scope of this article is to analyze papers published between 2003 and 2011 that focus on discussions regarding chronic conditions or chronic diseases in children and adolescents. It combines a methodological review of the literature and thematic analysis of content in order to identify the elements that characterize chronic diseases in children and adolescents and the specificities generated by these chronic conditions. The review of the literature resulted in a description of the series of articles identified by year of publication, country of origin, type of study, population and the chronic condition addressed. Thematic content analysis generated two core themes: Definition of chronic disease and Ways of handling chronic disease in children and teenagers. The main conclusion reached is that the age transitions when a disease is diagnosed and treated since childhood involve transformations that include changes in health facilities, discharge processes, decision making and networking that include family, hospital, school and institutions that guarantee the child's rights. PMID:25014288

  5. Alternative hybrid and staged interventional treatment of congenital heart defects in critically ill children with complex and non-cardiac problems

    OpenAIRE

    Haponiuk, Ireneusz; Chojnicki, Maciej; Jaworski, Radosław; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Paczkowski, Konrad; Kwaśniak, Ewelina; Zieliński, Jacek; Gierat-Haponiuk, Katarzyna; Leszczyńska, Katarzyna

    2015-01-01

    Introduction An individually designed strategy of comprehensive alternative hybrid and staged interventional treatment (AHASIT) can be a reasonable alternative to conventional treatment of congenital heart defects, reduce the risk of cardiac surgery or interventions performed separately, and give an additional chance for critically ill children. Aim To present our experience and the results of AHASIT of severely ill or borderline children referred for surgery with the diagnosis of congenital ...

  6. Improving Communication About Serious Illness

    Science.gov (United States)

    2016-07-12

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  7. Household illness, poverty and physical and emotional child abuse victimisation: findings from South Africa’s first prospective cohort study

    OpenAIRE

    Meinck, F.; Cluver, LD; Boyes, ME

    2015-01-01

    Background Physical and emotional abuse of children is a large scale problem in South Africa, with severe negative outcomes for survivors. Although chronic household illness has shown to be a predictor for physical and emotional abuse, no research has thus far investigated the different pathways from household chronic illness to child abuse victimisation in South Africa. Methods Confidential self-report questionnaires using internationally utilised measures were completed by children aged 10-...

  8. The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions

    Directory of Open Access Journals (Sweden)

    E. Sgnaolin

    2012-07-01

    Full Text Available Objective: Fibromyalgia syndrome (FMs is a chronic widespread pain condition that can negatively impact on all aspects of patient’s life. The purpose of this study was: first, to evaluate illness perception (IP, quality of life (QoL and affective-emotive variables (EAV of patients with FM; and second, to compare these variables to different pain conditions. Methods: Consecutive 34 women (mean age 47.4±8.3 years affected by FM were enrolled for the study from December 2009 to May 2011. IP was evaluated by means of the Revised Illness Perception Questionnaire, QoL through Nottigham Health Profile and EAV through the Beck Depression Inventory. Scores were compared with rheumatoid arthritis (RA (n=20; mean age 53±12.8 years and low back pain (LBP (n=20; 51.3±7.8 years groups. Results: FM patients scored higher than RA and LBP groups on IP (Identity scale mean: FM=8.8±2.3, AR=5.5±3.3, LBP=4.1±2.9; Kruskal-Wallis=24.42. Moreover FM patients show higher EAV (mean FM=21±9.6, AR=8.9±5.6, LBP=14.9±6.5; Kolmogorov-Smirnov Z=2.17 and QoL (Pain scale mean: FM=74.2±24.1; AR=35.7±19.9; LBP=56.5±20.4; Kolmogorov-Smirnov Z=2.27; Energy scale mean: FM=86.2±28.5; AR=46.8±35.4; LBP=61.6 ±63.7; Kolmogorov-Smirnov Z=1.98 than RA group. Conclusions: Our study highlighted dysfunctional IP, low QoL, high EAV scores in FM patients and the significant relations between these variables. Research results provided support for relevance of a multidisciplinary approach to the management of FM, including psychological interventions, according to a biopsychosocial perspective.Objective: Fibromyalgia syndrome (FMs is a chronic widespread pain condition that can negatively impact on all aspects of patient’s life. The purposes of this study were: i to evaluate illness perception (IP, quality of life (QoL and affective-emotive variables (EAV of patients with FM; and ii to compare these variables to different pain conditions. Methods: Consecutive 34 women (mean age

  9. The Shared Decision Making Frontier: a Feasibility and Usability Study for Managing Non-Critical Chronic Illness by Combining Behavioural & Decision Theory with Online Technology.

    Science.gov (United States)

    Russell, Amina; Van Woensel, William; Abidi, Samina Raza

    2015-01-01

    The objective of this study is to determine if shared decisions for managing non-critical chronic illness, made through an online biomedical technology intervention, us feasible and usable. The technology intervention incorporates behavioural and decision theories to increase patient engagement, and ultimately long term adherence to health behaviour change. We devised the iheart web intervention as a "proof of concept" in five phases. The implementation incorporates the Vaadin web application framework, Drools, EclipseLink and a MySQL database. Two-thirds of the study participants favoured the technology intervention, based on Likert-scale questions from a post-study questionnaire. Qualitative analysis of think aloud feedback, video screen captures and open-ended questions from the post-study questionnaire uncovered six main areas or themes for improvement. We conclude that online shared decisions for managing a non-critical chronic illness are feasible and usable through the iheart web intervention. PMID:26262028

  10. Degree of muscle fatigue in children with chronic juvenile arthritis

    Directory of Open Access Journals (Sweden)

    Sekulić Aleksandra

    2011-01-01

    Full Text Available The aim of our work was to identify gradient of the muscle fatigue of some muscle groups, among children with chronic juvenile arthritis, which are restricted in function by existing limitation in range of motions. Four patients in age of 9,5, with mentioned diagnosis were examined. Healthy subjects, with same ages were control group. Manuel muscle test, range of motion test and EMG examination were performed. Results shown significance difference in degree of muscle fatigue among observed patients, which explain decrease of muscle efficiency and must be taken when intensity of kinesitherapic treatment has to be done. It is concluded that structural changes on locomotory system induce secondary hypertrophy or atrophy of the muscle system and increase of muscle fatigue when activity of certain muscles is performed.

  11. Assessment of Iron Status in Anemic Children with Chronic Kidney Disease

    OpenAIRE

    Ali K Alzahrani1, 2, Abdrahman Alzahrani3, Nihad A Al Nashar4 , Hala A Mohamed4

    2013-01-01

    Background: Iron deficiency is the commonest cause of resistance to erythropoiesis stimulating agents (ESAs) in dialyzed children treated from anemia of chronic kidney disease (CKD). Aim of the work: This study was conducted in order to evaluate the significance of different biomarkers in assessment of iron status during management of anemic children with CKD. Patients and method: Twenty five children with diagnosis of anemia of chronic kidney disease were enrolled for the study. They were cl...

  12. Anxiety and Functional Disability in a Large Sample of Children and Adolescents with Chronic Pain

    OpenAIRE

    Simons, Laura E; Sieberg, Christine B.; Robyn Lewis Claar

    2012-01-01

    BACKGROUND: Anxiety is the most common psychiatric condition in children and adolescents, and is linked to significant disruptions across domains of function. Due to the avoidant nature of anxiety and pain-related disability, studying anxiety symptoms in children with chronic and recurrent pain conditions is important.OBJECTIVES: To examine anxiety symptoms in a large cohort of children and adolescents evaluated for complex chronic and recurrent pain conditions.METHODS: Through retrospective ...

  13. Clinical Peculiarities of Recurrent and Chronic Bronchitis in Children (Part 1)

    OpenAIRE

    Makian, M. V.; Harhaun, V. A.; Maidannyk, V. H.

    2015-01-01

    Subjective manifestations in children with recurrent and chronic bronchitis were the subject of the research.The objective of the research was to evaluate the main clinical manifestations of recurrent and chronic bronchitis, analyze risk factors and preconditions for their occurence in children.Materials and methods of research. The comprehensive clinical and anamnestic examination of 120 children with bronchopulmonary pathology at the age of 3 to 18 (average age was 10.5±1.1 years) was condu...

  14. If diabetes is a public health problem, why not treat it as one? A population-based approach to chronic illness.

    Science.gov (United States)

    Glasgow, R E; Wagner, E H; Kaplan, R M; Vinicor, F; Smith, L; Norman, J

    1999-01-01

    It is increasingly acknowledged that diabetes and other chronic illnesses are major public health problems. Medicare and many managed health care organizations have recognized the enormous personal and societal costs of uncontrolled diabetes in terms of complications, patient quality of life, and health care system resources. However, the current system of reactive acute-episode focused disease care practiced in many settings does not adequately address this public health problem. An alternative proactive, population-based approach to chronic illnesses such as diabetes is proposed and illustrated. This multilevel systems approach addresses supportive and inhibitory social-environmental factors at multiple levels (personal, family, health care team, work, neighborhood, community). Key disciplines contributing to a population-based approach to diabetes include epidemiology, behavioral science, health care services, public health, health economics, and quality of life professions. Current and potential contributions of each of these disciplines are illustrated and an integrative, population-based systems approach to diabetes management and prevention of complications is proposed. This approach is also seen as applicable to other chronic illnesses. PMID:10499137

  15. PATHOPHYSIOLOGY, CLINICAL FEATURES, AND MANAGEMENT OF CHILDREN WITH CHRONIC INFECTIOUS DISEASES

    OpenAIRE

    Giannattasio, Antonietta

    2009-01-01

    Children with chronic diseases Chronic viral hepatitis Among human hepatitis viruses, hepatitis B (HBV) and C (HCV) viruses are able to persist in the host for years and thereby causing chronic hepatitis. Three hundred and seventy and 130 million people is estimated to be infected with HBV and HCV, respectively, worldwide (1). In endemic areas, HBV infection is often acquired perinatally or early in childhood and becomes chronic in a high proportion of cases. Universal vaccination of...

  16. Oxidative Stress in Children with Chronic Spontaneous Urticaria

    Directory of Open Access Journals (Sweden)

    Fatih Dilek

    2016-01-01

    Full Text Available The pathogenesis of chronic spontaneous urticaria (CSU has not been fully understood; nevertheless, significant progress has been achieved in recent years. The aim of this study was to investigate the possible role of reactive oxygen species (ROS in the pathogenesis of CSU. Sixty-two children with CSU and 41 healthy control subjects were enrolled in the study. An extensive evaluation of demographic and clinical features was done, and serum oxidative stress was evaluated by plasma total oxidant status (TOS and total antioxidant status (TAS measurements. The median value of plasma TOS was found to be 10.49 μmol H2O2 equiv./L (interquartile range, 7.29–17.65 in CSU patients and 7.68 μmol H2O2 equiv./L (5.95–10.39 in the control group. The difference between the groups was statistically significant (p=0.003. Likewise, the median plasma TAS level in the CSU group was decreased significantly compared to that of the control group (2.64 [2.30–2.74] versus 2.76 [2.65–2.86] mmol Trolox equiv./L, resp., p = 0,001. Our results indicated that plasma oxidative stress is increased in children with CSU when compared to healthy subjects, and plasma oxidative stress markers are positively correlated with disease activity.

  17. Causes of chronic kidney disease in Egyptian children

    Directory of Open Access Journals (Sweden)

    Hesham Safouh

    2015-01-01

    Full Text Available There are very few published reports on the causes of chronic kidney disease (CKD in Egyptian children. We reviewed the records of 1018 (males 56.7%, age ranged from 1 to 19 years Egyptian patients suffering from CKD and followed-up at the pediatric nephrology units (outpatient clinics and dialysis units of 11 universities over a period of two years. The mean of the estimated glomerular filtration rate was 12.5 mL/min/1.73 m 2 . Children with CKD stage I and stage II comprised 4.4% of the studied group, while those with stage III, IV and V comprised 19.7%, 18.3% and 57.6%, respectively. The most common single cause of CKD was obstructive uropathy (21.7%, followed by primary glomerulonephritis (15.3%, reflux/urinary tract infection (14.6%, aplasia/hypoplasia (9.8% and familial/metabolic diseases (6.8%; unknown causes accounted for 20.6% of the cases. Of the 587 patients who had reached end-stage renal disease, 93.5% was treated with hemodialysis and only 6.5% were treated with peritoneal dialysis.

  18. MRI and ultrasound in children with juvenile chronic arthritis

    International Nuclear Information System (INIS)

    In this era of advancing imaging technology, a knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with juvenile chronic arthritis (JCA). After clinical examination, plain films remain the initial investigation. The need for radiation protection must be a priority in children with JCA. Conventional radiographs allow grouping of the various arthritides (on the base of the distribution and pattern of joint space changes) and staging of disease progression. Ultrasound (US) is very sensitive in the detection of joint effusions, especially in the hip, and guides fluid aspiration. US and Doppler can be used for the evaluation of synovial hypertrophy and activity. Arthrography and to a certain extent nuclear studies have been replaced by magnetic resonance imaging (MRI). MRI can demonstrate articular cartilage, joint effusion, synovial hypertrophy, cortical and medullary bone, cartilage and bone perfusion, and fibrocartilaginous structures (menisci and ligaments). Contrast enhanced MRI is the most sensitive modality to determine whether an arthritic condition is present. However, it does not assist in establishing a specific diagnosis. MRI determines accurately the activity and the extent of the disease and is particularly useful in the early detection of articular damage. Finally, MRI is of major importance in the evaluation of response to local therapy (especially steroids) and the detection of complications

  19. MRI and ultrasound in children with juvenile chronic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Lamer, S.; Sebag, G.H

    2000-02-01

    In this era of advancing imaging technology, a knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with juvenile chronic arthritis (JCA). After clinical examination, plain films remain the initial investigation. The need for radiation protection must be a priority in children with JCA. Conventional radiographs allow grouping of the various arthritides (on the base of the distribution and pattern of joint space changes) and staging of disease progression. Ultrasound (US) is very sensitive in the detection of joint effusions, especially in the hip, and guides fluid aspiration. US and Doppler can be used for the evaluation of synovial hypertrophy and activity. Arthrography and to a certain extent nuclear studies have been replaced by magnetic resonance imaging (MRI). MRI can demonstrate articular cartilage, joint effusion, synovial hypertrophy, cortical and medullary bone, cartilage and bone perfusion, and fibrocartilaginous structures (menisci and ligaments). Contrast enhanced MRI is the most sensitive modality to determine whether an arthritic condition is present. However, it does not assist in establishing a specific diagnosis. MRI determines accurately the activity and the extent of the disease and is particularly useful in the early detection of articular damage. Finally, MRI is of major importance in the evaluation of response to local therapy (especially steroids) and the detection of complications.

  20. Monitoring physical functioning as the sixth vital sign: evaluating patient and practice engagement in chronic illness care in a primary care setting--a quasi-experimental design

    Directory of Open Access Journals (Sweden)

    Richardson Julie

    2012-04-01

    Full Text Available Abstract Background In Canada, one in three adults or almost 9 million people report having a chronic condition. Over two thirds of total deaths result from cardiovascular disease, diabetes, cancer and respiratory illness and 77% of persons ≥65 years have at least one chronic condition. Persons with chronic disease are at risk for functional decline; as a result, there is an increased awareness of the significance of functional status as an important health outcome. The purpose of this study was to determine whether patients who receive a multi-component rehabilitation intervention, including online monitoring of function with feedback and self-management workshops, showed less functional decline than case matched controls who did not receive this intervention. In addition, we wanted to determine whether capacity building initiatives within the Family Health Team promote a collaborative approach to Chronic Disease Management. Methods A population-based multi-component rehabilitation intervention delivered to persons with chronic illnesses (≥ 44 yrs (n = 60 was compared to a group of age and sex matched controls (n = 60 with chronic illnesses receiving usual care within a primary healthcare setting. The population-based intervention consisted of four main components: (1 function-based individual assessment and action planning, (2 rehabilitation self-management workshops, (3 on-line self-assessment of function and (4 organizational capacity building. T-tests and chi-square tests were used for continuous and categorical variables respectively in baseline comparison between groups. Results Two MANOVA showed significant between group differences in patient reported physical functioning (Λ = 0.88, F = (2.86 = 5.97. p = 0.004 and for the physical performance measures collectively as the dependent variable (Λ = 0.80, F = (6.93 = 3.68. p = 0.0025. There were no within group differences for the capacity measures. Conclusion It is feasible to monitor

  1. Dry Eye in Children with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Pınar Yüksekkaya

    2014-05-01

    Full Text Available Objectives: To evaluate the dry eye symptoms based on objective test and subjective findings in children with chronic renal failure (CRF and to compare the results with those in healthy subjects. Materials and Methods: Thirty-four children with CRF and 89 age- and sex-matched healthy subjects were included in this prospective study. Tear break-up time (TBUT and Schirmer test, subjective symptoms (burning, foreign-body sensation, hyperemia, itching, tearing, calcification of the conjunctiva, and corneal staining were evaluated. In the study group, relation between TBUT and Schirmer test results and duration of disease, duration of dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were recorded. For statistical analysis, t-test, chi-square test, and Pearson’s correlation test were used. Results: In the study group, burning sensation was statistically higher than in the control group. Except this, according to the other subjective tests and corneal staining, there were no significant differences between the two groups (p>0.05. Conjunctival calcification was seen in 3 patients in the study group. The mean Schirmer test result was 21.1±8.0 and 23.7±8.0 mm in the study and control groups, respectively (p=0.101. The mean TBUT was 12.5±5.2 seconds (s in the study and 16.0±5.5 s in the control groups (p=0.002. None of the disease-related variables (the mean duration of disease and dialysis, serum calcium, phosphorus, urea, creatinine, and total protein levels were associated with dry eye syndrome (p>0.05. Conclusion: TBUT was statistically significantly lower, but Schirmet test result was not significantly different between children with CRF and age- and sex-matched healthy subjects. The disease-related variables have no effect in the development of dry eyes. (Turk J Ophthalmol 2014; 44: 196-200

  2. How do macro-level contexts and policies affect the employment chances of chronically ill and disabled people? Part II: The impact of active and passive labor market policies

    DEFF Research Database (Denmark)

    Holland, Paula; Nylén, Lotta; Thielen, Karsten;

    2011-01-01

    The authors investigate three hypotheses on the influence of labor market deregulation, decommodification, and investment in active labor market policies on the employment of chronically ill and disabled people. The study explores the interaction between employment, chronic illness, and educational...... level for men and women in Canada, Denmark, Norway, Sweden, and the United Kingdom, countries with advanced social welfare systems and universal health care but with varying types of active and passive labor market policies. People with chronic illness were found to fare better in employment terms in......, Norwegian men, and Danish women. Hypotheses on the disincentive effects of tighter employment regulation or more generous welfare benefits were not supported. The hypothesis that greater investments in active labor market policies may improve the employment of chronically ill people was partially supported...

  3. Latino Caregiver Coping With Children's Chronic Health Conditions: An Integrative Literature Review.

    Science.gov (United States)

    Desai, Priti P; Rivera, Abigail Torres; Backes, Emily M

    2016-01-01

    In this study we examined research pertaining to how Latino caregivers cope with their children's chronic health conditions. An understanding of this topic could facilitate appropriate interventions by health care staff to promote optimal child health outcomes. In this integrative review we categorized 21 studies by publication characteristics, methodology, findings, and their focus on emotion-focused and/or problem-focused coping. Thirteen studies used a qualitative design. Five studies included fathers in the sample. Twelve studies investigated coping with child's asthma, primarily in Mexican or Puerto Rican families. Coping strategies utilizing religion/spirituality, alternate healing practices, family support, and education about the child's illness were identified. Language, cultural dissimilarities, receiving inadequate information about the child's health care, differences in health beliefs, and feeling disrespected by providers were frequently cited coping challenges. Addressing these barriers is imperative to enhance coping of caregivers. Inconsistencies in research samples regarding income, education, immigration, and acculturation histories make findings difficult to generalize; recommendations for further research are suggested. PMID:26188357

  4. The power of food: mediating social relationships in the care of chronically ill elderly people in urban Indonesia

    Directory of Open Access Journals (Sweden)

    Peter van Eeuwijk

    2008-03-01

    . However, many of the chronically ill elderly patients in this study have to comply with certain dietary restrictions. Chronic disease such as hypertension, diabetes and rheumatism thus change the nature of the patient-carer relationship by introducing the notions of trust and control. The patient has to trust the special, “healthy” treatment, that is to say, the healthy diet that is provided by his/her caregiver. On the other hand, the caregiver exerts power by controlling dietary intake, thus monitoring the elderly patient’s compliance with prescribed therapy.

  5. EFFECTS OF ETIOLOGICALLY DEFINED RESPIRATORY INFECTIONS ON LUNG FUNCTION AND ITS GROWTH IN AN AREA OF LOW AIR POLLUTION - SPIROMETRY IN YOUNG CHILDREN WHEN ILLNESS-FREE

    Science.gov (United States)

    This longitudinal study was performed in a group of 3-12 year old children to document normal lung growth patterns as measured by spirometry. By clinical and laboratory parameters, these children were free of illness at the time of study and had been for the preceding 21 days. Sp...

  6. Relationship Between Beta Cell Dysfunction and Severity of Disease Among Critically Ill Children: A STROBE-Compliant Prospective Observational Study.

    Science.gov (United States)

    Liu, Ping-Ping; Lu, Xiu-Lan; Xiao, Zheng-Hui; Qiu, Jun; Zhu, Yi-Min

    2016-05-01

    Although beta cell dysfunction has been proved to predict prognosis among humans and animals, its prediction on severity of disease remains unclear among children. The present study was aimed to examine the relationship between beta cell dysfunction and severity of disease among critically ill children.This prospective study included 1146 critically ill children, who were admitted to Pediatric Intensive Care Unit (PICU) of Hunan Children's Hospital from November 2011 to August 2013. Information on characteristics, laboratory tests, and prognostic outcomes was collected. Homeostasis model assessment (HOMA)-β, evaluating beta cell function, was used to divide all participants into 4 groups: HOMA-β = 100% (group I, n = 339), 80% ≤ HOMA-β ventilation (MV) and mortality. Logistic regression analysis was used to evaluate the risk of developing poor outcomes among patients in different HOMA-β groups, with group I as the reference group.Among 1146 children, incidence of HOMA-β < 100% was 70.41%. C-peptide and insulin declined with the decrement of HOMA-β (P < 0.01). C-reactive protein and procalcitonin levels, rather than white blood cell, were significantly different among 4 groups (P < 0.01). In addition, the worst SOFA score and the worst PRISMIII score increased with declined HOMA-β. For example, the worst SOFA score in group I, II, III, and IV was 1.55 ± 1.85, 1.71 ± 1.93, 1.92 ± 1.63, and 2.18 ± 1.77, respectively. Furthermore, patients with declined HOMA-β had higher risk of developing septic shock, MODS, MV, and mortality, even after adjusting age, gender, myocardial injury, and lung injury. For instance, compared with group I, the multivariate-adjusted odds ratio (95% confidence interval) for developing septic shock was 2.17 (0.59, 8.02), 2.94 (2.18, 6.46), and 2.76 (1.18, 6.46) among patients in group II, III, and IV, respectively.Beta cell dysfunction reflected the severity of disease among critically ill children

  7. Fatigue, depression, and social adjustment in chronic fatigue syndrome.

    OpenAIRE

    Walford, G.A.; Nelson, W. M.; McCluskey, D R

    1993-01-01

    The aims of this study were to determine the characteristics and perceived levels of fatigue and the prevalence of depression in children with chronic fatigue syndrome and to assess the effects of illness on schooling and social functioning. Twelve children with chronic fatigue syndrome were compared with a matched group of children with cystic fibrosis and matched healthy controls. Levels of fatigue (fatigue questionnaire), depression (children's depression inventory), and social adjustment ...

  8. Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries.

    Science.gov (United States)

    Iroh Tam, Pui-Ying; Obaro, Stephen K; Storch, Gregory

    2016-06-01

    Acute febrile illness is a common cause of hospital admission, and its associated infectious causes contribute to substantial morbidity and death among children worldwide, especially in low- and middle-income countries. Declining transmission of malaria in many regions, combined with the increasing use of rapid diagnostic tests for malaria, has led to the increasing recognition of leptospirosis, rickettsioses, respiratory viruses, and arboviruses as etiologic agents of fevers. However, clinical discrimination between these etiologies can be difficult. Overtreatment with antimalarial drugs is common, even in the setting of a negative test result, as is overtreatment with empiric antibacterial drugs. Viral etiologies remain underrecognized and poorly investigated. More-sensitive diagnostics have led to additional dilemmas in discriminating whether a positive test result reflects a causative pathogen. Here, we review and summarize the current epidemiology and focus particularly on children and the challenges for future research. PMID:27059657

  9. Hypnosis for the management of chronic and cancer procedure-related pain in children.

    Science.gov (United States)

    Tomé-Pires, Catarina; Miró, Jordi

    2012-01-01

    The aim of this study was to review published controlled trials of hypnotic treatments for chronic and cancer procedure-related pain in children. Trials were included if participants were 18 years of age or below, were randomized and had populations with chronic pain or cancer procedure-related pain. After the studies were assessed, 12 were selected for review. Although the evidence is limited, the findings indicate that hypnosis is an effective pain-control technique when used with children suffering from cancer procedure-related pain or chronic pain. Further research into the use of hypnosis to manage chronic pain in children should be a priority so that empirically based conclusions can be drawn about the effects of hypnosis on children. PMID:22917107

  10. Ultrasound diagnosis of pulmonary hypertension in children with chronic bronchopulmonary diseases

    International Nuclear Information System (INIS)

    Ultrasound criteria of diagnosis of pulmonary hypertension and study this complication frequency in children with chronic bronchopulmonary diseases was determined. As diagnostic criteria of pulmonary hypertension Doppler echocardiographic indices of circulation in the pulmonary arteries are suggested

  11. Media and technology use predicts ill-being among children, preteens and teenagers independent of the negative health impacts of exercise and eating habits

    OpenAIRE

    Rosen, L.D.; Lim, A.F.; Felt, J.; Carrier, L.M.; Cheever, N.A.; Lara-Ruiz, J.M.; Mendoza, J.S.; Rokkum, J.

    2014-01-01

    The American Academy of Pediatrics recommends no screen time for children under the age of 2 and limited screen time for all children. However, no such guidelines have been proposed for preteens and teenagers. Further, research shows that children, preteens, and teenagers are using massive amounts of media and those with more screen time have been shown to have increased obesity, reduced physical activity, and decreased health. This study examined the impact of technology on four areas of ill...

  12. Value of impulse oscillometry in evaluating the illness in children with asthma and analysis of its correlation with serum indicators

    Institute of Scientific and Technical Information of China (English)

    Cui-Fen Bai

    2016-01-01

    Objective:To Value of impulse oscillometry in evaluating the illness in children with asthma and its correlation with serum indicators.Methods:Children with asthma attack, children with asthma remission and healthy children were selected for study, impulse oscillometry was conducted to obtain related parameters, and serum and peripheral blood were collected to detect related indicators.Results:Zrs, R5, R20, R5-R20, absolute value of X5 and Fres of asthma attack group and asthma remission group were higher than those of control group, eosinophil, YKL-40, Hes-1, Cyr61, Eotaxin, IgE, IgG4, LT-B4, LT-C4, LT-D4 and Cys-LT contents in peripheral blood were higher than those of control group, positive proportion of Th2, Th17, cTfh and Th19 in peripheral blood were higher than those of control group, and positive proportion of Th1 and Treg in peripheral blood were lower than those of control group; the changes of above indicators of asthma attack group were more significant than those of asthma remission group; Zrs, R5, R20, R5-R20, absolute value of X5 and Fres were positively correlated with eosinophil, YKL-40, Hes-1, Cyr61, Eotaxin, IgE, IgG4, LT-B4, LT-C4, LT-D4 and Cys-LT contents in peripheral blood as well as positive proportion of Th2, Th17, cTfh and Th19 in peripheral blood, and negatively correlated with positive proportion of Th1 and Treg in peripheral blood.Conclusion:Impulse oscillometry detection can provide evidence for diagnosis of bronchial asthma and judgment of its illness, and IOS-related parameters can judge the abnormal degree of inflammatory response and immune response.

  13. A prospective assessment of the effect of aminophylline therapy on urine output and inflammation in critically ill children

    Directory of Open Access Journals (Sweden)

    Robert F Tamburro

    2014-06-01

    Full Text Available Background: Aminophylline, an established bronchodilator, is also purported to be an effective diuretic and anti-inflammatory agent. However, the data to support these contentions are scant. We conducted a prospective, open-label, single arm, single center study to assess the hypothesis that aminophylline increases urine output and decreases inflammation in critically ill children. Methods: Children less than 18 years of age admitted to the pediatric intensive care unit who were prescribed aminophylline over a 24-hour period were eligible for study. The use and dosing of aminophylline was independent of the study and was at the discretion of the clinical team. Data analyzed consisted of demographics, diagnoses, medications, and markers of pulmonary function, renal function and inflammation. Data were collected at baseline and at 24-hours after aminophylline initiation with primary outcomes of change in urine output and inflammatory cytokine concentrations. Results: Thirty-five patients were studied. Urine output increased significantly with aminophylline use (median increase 0.5 mL/kg/hour ([IQR:-0.3,1.3], p=0.05 while BUN and creatinine concentrations remained unchanged. Among patients with elevated C-reactive protein concentrations, levels of both interleukin-6 (IL-6 and IL-10 decreased at 24-hours of aminophylline therapy. There were no significant differences in pulmonary compliance or resistance among patients invasively ventilated at both time points. Side effects of aminophylline were detected in 7 of 35 patients. Conclusions: Although no definitive conclusions can be drawn from this study, aminophylline may be a useful diuretic and effective anti-inflammatory medication in critically ill children. Given the incidence of side effects, the small sample size and the uncontrolled study design, further study is needed to inform the appropriate use of aminophylline in these children.

  14. [Obesity in children and its relationship with chronic kidney disease].

    Science.gov (United States)

    Zurita-Cruz, Jessie Nallely; Villasís-Keever, Miguel Ángel

    2016-01-01

    In the last decades, obesity and chronic kidney disease (CKD) have increased worldwide, in parallel. This article focuses on the current issues of obesity on renal damage, with special emphasis on what happens at pediatric ages. While obesity has been linked closely with type 2 diabetes mellitus and hypertension, reduced insulin sensitivity is a direct mechanism for renal damage. The pathophysiologic mechanisms on renal damage include glomerular hyperfiltration and hypertrophy, hypercellularity and broadening of the mesangial regions, while the lack of sensitivity to insulin increases the effects of angiotensin II, exacerbates proteinuria and induces the production of inflammatory cytokines. Many epidemiological studies have documented the relationship of increased BMI with the development of ERC, but most of these studies have been conducted in adults. In children, the information is scarce, but is consistent with findings in adults. In contrast, there are studies which show that interventions aimed to improve weight loss and limit renal damage and proteinuria is reduced, the blood pressure and glomerular filtration rate. Allthe above make us think on the need to improve efforts to reduce the prevalence of obesity from the early stages of life, which could reduce the number of patients with CKD in the future. PMID:27197109

  15. Protein Anabolism in Critically Ill Children: Pathophysiological aspects and interventional challenges

    NARCIS (Netherlands)

    C.T. de Betue (Carlijn)

    2012-01-01

    textabstractCritical illness can be defi ned as “a life threatening medical or surgical condition usually requiring intensive care unit (ICU) level care“ [1]. It mostly results from infection, sepsis and trauma (including surgery and burns). Th ese conditions are accompanied by similar physiological

  16. Chronic inflammatory demyelinating polyneuropathy in children: a report of four patients with variable relapsing courses

    OpenAIRE

    Chang, Soo Jin; Lee, Ji Hyun; Kim, Shin Hye; Lee, Joon Soo; Kim, Heung Dong; Kang, Joon Won; Lee, Young Mock; Kang, Hoon-Chul

    2015-01-01

    Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospita...

  17. Uraemic vascular damage and calcification in children with chronic kidney disease

    OpenAIRE

    Shroff, R

    2009-01-01

    Summary of thesis: Cardiovascular disease is the most common cause of death in patients with chronic kidney disease. Structural and functional vascular abnormalities and arterial calcification begins early in the course of renal decline and can be found even in children, contributing to their high mortality risk. Through clinical and laboratory studies, this thesis sought to investigate the causes of uraemic vascular damage and calcification in children with chronic kidney dise...

  18. Challenges for nephrology nurses in the management of children with chronic kidney disease.

    Science.gov (United States)

    Miller, Deborah; Macdonald, Dina; Kolnacki, Ken; Simek, Teresa

    2004-01-01

    An important treatment goal for pediatric nephrology caregivers is the optimization of a child's capacity for normal growth and development. However, the physiologic and metabolic derangements associated with chronic kidney disease (CKD) significantly alter these processes, creating important challenges in the care of affected children. Evidence-based clinical practice guidelines support early recognition and treatment of CKD-related complications to improve growth and development and, ultimately, quality of life for children with this chronic condition. PMID:15303424

  19. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Directory of Open Access Journals (Sweden)

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  20. What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature.

    Science.gov (United States)

    Goldberg, Rachel E; Short, Susan E

    2016-03-01

    Millions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being. This review confirms that this population of children is substantial in size, and that the vulnerabilities they experience are multi-faceted, spanning physical and emotional health and schooling. Mechanisms were examined empirically in only a small number of studies, but encompass poverty, transmission of opportunistic infections, care for unwell adults, adult distress, AIDS stigma, lack of social support, maternal breastfeeding issues, and vertical HIV transmission. Some evidence is provided that infants, adolescents, children with infected or ill mothers, and children living with severely ill adults are particularly vulnerable. Future research would benefit from more attention to causal inference and further characterization of processes and circumstances related to vulnerability and resilience. It would also benefit from further study of variation in observed associations between adult HIV/AIDS and child well-being based on characteristics such as age, sex, kinship, severity of illness, TB co-infection, disclosure, and serostatus awareness. Almost one-quarter of the studies reviewed did not investigate variation based on any of these factors. More nuanced understanding of the short- and long

  1. Pathways to Care for Critically Ill or Injured Children: A Cohort Study from First Presentation to Healthcare Services through to Admission to Intensive Care or Death.

    Directory of Open Access Journals (Sweden)

    Peter Hodkinson

    Full Text Available Critically ill or injured children require prompt identification, rapid referral and quality emergency management. We undertook a study to evaluate the care pathway of critically ill or injured children to identify preventable failures in the care provided.A year-long cohort study of critically ill and injured children was performed in Cape Town, South Africa, from first presentation to healthcare services until paediatric intensive care unit (PICU admission or emergency department death, using expert panel review of medical records and caregiver interview. Main outcomes were expert assessment of overall quality of care; avoidability of severity of illness and PICU admission or death and the identification of modifiable factors.The study enrolled 282 children, 252 emergency PICU admissions, and 30 deaths. Global quality of care was graded good in 10% of cases, with half having at least one major impact modifiable factor. Key modifiable factors related to access to care and identification of the critically ill, assessment of severity, inadequate resuscitation, and delays in decision making and referral. Children were transferred with median time from first presentation to PICU admission of 12.3 hours. There was potentially avoidable severity of illness in 185 (74% of children, and death prior to PICU admission was avoidable in 17/30 (56.7% of children.The study presents a novel methodology, examining quality of care across an entire system, and highlighting the complexity of the pathway and the modifiable events amenable to interventions, that could reduce mortality and morbidity, and optimize utilization of scarce critical care resources; as well as demonstrating the importance of continuity and quality of care.

  2. Chronic Inflammatory Demyelinating Polyneuropathy in Children: A Review of Clinical Characteristics and Recommendations for Treatment

    OpenAIRE

    Narges Karimi; Athena Sharifi; Ashraf Zarvani; Hamed Cheraghmakani

    2015-01-01

    Context: Chronic inflammatory demyelinating polyradiculopathy (CIDP) is an acquired and autoimmune neuropathy, characterized by a chronic, rapidly progressive, symmetric weakness. In children, abnormal gait is as a first symptom of muscle weakness. Evidence Acquisition: The diagnosis of CIDP is on the basis of clinical characteristics, electrodiagnostic that shows the severity of the disease, lumbar puncture and spine magnetic res...

  3. Community health centers and primary care access and quality for chronically-ill patients – a case-comparison study of urban Guangdong Province, China

    OpenAIRE

    Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong

    2015-01-01

    Objective Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the ‘gate-keeper’ CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. Methods The case-comparison design was used to study nine health care organizations in Guan...

  4. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs for physical activity in chronically ill and elderly people

    Directory of Open Access Journals (Sweden)

    Frei Anja

    2011-12-01

    Full Text Available Abstract Background Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. Methods We conducted a systematic literature search of electronic databases (Medline, Embase, Psychinfo, Cinahl and hand searches. We included studies describing the original development of fully structured instruments measuring dimensions of physical activity or related constructs in chronically ills or elderly. We broadened the population to elderly because they are likely to share physical activity limitations. At least two reviewers independently conducted title and abstract screening and full text assessment. We evaluated instruments in terms of their aim, items identification and selection, domain development, test-retest reliability, internal consistency, validity and responsiveness. Results Of the 2542 references from the database search and 89 from the hand search, 103 full texts which covered 104 instruments met our inclusion criteria. For almost half of the instruments the authors clearly described the aim of the instruments before the scales were developed. For item identification, patient input was used in 38% of the instruments and in 32% adaptation of existing scales and/or unsystematic literature searches were the only sources for the generation of items. For item reduction, in 56% of the instruments patient input was used and in 33% the item reduction process was not clearly described. Test-retest reliability was assessed for 61%, validity for 85% and responsiveness to change for 19% of the instruments. Conclusions Many PRO instruments exist to measure

  5. Effect of passive smoking on frequency of respiratory illnesses and serum immunoglobulin-E (IgE) and interleukin-4 (IL-4) concentrations in exposed children.

    Science.gov (United States)

    el-Nawawy, A; Soliman, A T; el-Azzouni, O; Amer el-S; Demian, S; el-Sayed, M

    1996-06-01

    We studied the relationship of serum immunoglobulin-E (Ig-E) and interleukin-4 (IL-4) concentrations, eosinophil counts, and frequency of respiratory illness with passive smoking in 70 randomly selected children of smoking parents. Fifty randomly selected age-matched children of non-smoking parents served as controls. Children of smoking parents had higher frequency of respiratory illnesses per year (P < 0.01), significantly higher total leucocytic and eosinophil counts, higher percentage of eosinophils (P < 0.01), and higher serum IgE and IL-4 concentrations (P < 0.05) compared to the control group. Serum IgE level was correlated positively with the average number of smoked cigarettes/day, number of siblings, and total leucocytic count. Interleukin-4 concentrations were significantly correlated with the number of smoked cigarettes and IgE levels. Although IgE levels were higher in children of smoking parents (587 +/- 359 IU/ml) compared to controls (189 +/- 21 IU/ml), they did not differ significantly between children with and those without frequent respiratory illness (605 +/- 365 and 557 +/- 354 IU/ml, respectively). Interleukin-4 concentrations were significantly higher in children of smoking parents with frequent respiratory illness (1.8 +/- 0.5 pg/ml) v. those without frequent respiratory illness (1.3 +/- 0.45 pg/ml). Multiple logistic regression analysis revealed that the overall positivity of the risk factors predisposing to respiratory diseases in the study children was 79 percent, and the highest odds ratio was that for IL-4 (OR = 5.15). In conclusion, there is a significant increase in IL-4 and Ig-E concentrations, high eosinophil count and frequent respiratory symptoms in children of smoking parents. It remains that the current state of knowledge on health risks associated with passive smoking warrants that strong preventive action be promoted. PMID:8699585

  6. Parental Ease in Asking Others Not to Smoke and Respiratory Symptoms and Illness among Children

    OpenAIRE

    John Spangler; Zsuzsanna Csákányi; Todd Rogers; Gábor Katona

    2014-01-01

    Objective: Childhood exposure to secondhand tobacco smoke (SHS) increases a child’s burden of respiratory conditions, but parental smoking bans may reduce such morbidity. This study evaluated household smoking bans and their relationship to respiratory illness in an outpatient otolaryngology clinic. Methods: The study was performed at the Heim Pal National Children’s Hospital, Ear, Nose and Throat (ENT) Department (Budapest, Hungary) from July to November, 2010. A consecutive series of childr...

  7. Protein Anabolism in Critically Ill Children: Pathophysiological aspects and interventional challenges

    OpenAIRE

    Betue, Carlijn

    2012-01-01

    textabstractCritical illness can be defi ned as “a life threatening medical or surgical condition usually requiring intensive care unit (ICU) level care“ [1]. It mostly results from infection, sepsis and trauma (including surgery and burns). Th ese conditions are accompanied by similar physiological and biochemical responses, which have been termed the systemic infl ammatory response syndrome (SIRS) [2]. Th e associated major metabolic changes are also known as the acute stress response. From...

  8. America's Children and the Environment: Measures of Contaminants, Body Burdens, and Illnesses. Second Edition.

    Science.gov (United States)

    Woodruff, Tracey J.; Axelrad, Daniel A.; Kyle, Amy D.; Nweke, Onyemaechi; Miller, Gregory G.

    Noting that children may be affected by environmental contaminants in ways quite different from the way adults are affected, this report is the second on trends in measures reflecting environmental factors that may affect the U.S. children's health and well-being. A list of measures and key findings begins the report, followed by five main…

  9. Parents' and Coaches' Guide to Dehydration and Other Heat Illnesses in Children

    Science.gov (United States)

    ... help parents and coaches increase the safety and performance of children who play sports in hot weather. Children who play sports or ... of body weight can cause a decrease in performance. Because scientists have ... offer a flavored sports drink to increase the amount of fluid your ...

  10. Comparison of Hypnosis and Distraction in Severely Ill Children Undergoing Painful Medical Procedures.

    Science.gov (United States)

    Smith, Julien T.; And Others

    1996-01-01

    An ethnically diverse sample of high and low hypnotizable children (N=27) suffering from cancer or blood disorders were trained along with their parents to use both distraction and hypnosis to reduce pain and anxiety. Distraction produced significant positive effects for observer-rated distress scores for the low hypnotizable children. Discusses…

  11. Transmission and Prevention of Mood Disorders among Children of Affectively Ill Parents: A Review

    Science.gov (United States)

    Beardslee, William R.; Gladstone, Tracy R. G.; O'Connor, Erin E.

    2011-01-01

    Objective: To provide a conceptual review of the literature on children of depressed parents over the past 12 years. Method: This selective review focused on published studies that delineate the diagnosis of depression in parents, have large samples, describe children 6 to 17 years old, and are methodologically rigorous. The review emphasized…

  12. A enfermidade sob o olhar da criança hospitalizada The children's sense of illness in the hospital

    Directory of Open Access Journals (Sweden)

    Helena de Oliveira

    1993-09-01

    Full Text Available No presente estudo, partimos dos pressupostos de que existe uma dimensão vivencial da enfermidade na infância e de que a criança doente é capaz de falar sobre ela, de alguma forma. O nosso objetivo é conhecer suas representações da doença, do tratamento médico, da hospitalização e da equipe de saúde. Para isso, durante o mês de julho de 1990, foram entrevistadas 15 crianças entre 5 e 11 anos de idade, hospitalizadas em três hospitais pediátricos da cidade do Rio de Janeiro. Utilizamos a metodologia qualitativa como forma de análise do material coletado, segundo recomendações de Minayo (1988 e Bardin (1977. Falando sobre sua doença, as crianças nos falam sobre a prática médica, a organização da família moderna e de si próprias, enquanto sujeitos do brincar.In this study, we assume that illness has a meaning during childhood, and that children are capable of speaking about it. Our objective is to unveil their representations concerning disease, medical treatment, hospitalization, and health personnel. This study was carried out in three pediatric hospitals in the city of Rio de Janeiro during the month of July 1990. Fifteen hospitalized children from five to eleven years of age were interviewed and asked to talk about the questions described above. The methodological approach was qualitative, in accordance with Bardin (1977 and Minayo (1988. In speaking about their illnesses, the children refer to medical practice, contemporary family arrangements, and themselves as players or subjects.

  13. Prevalence and genotypic characterization of Human Parvovirus B19 in children with measles- and rubella-like illness in Iran.

    Science.gov (United States)

    Rezaei, Farhad; Sarshari, Behrang; Ghavami, Nastaran; Meysami, Parisa; Shadab, Azadeh; Salimi, Hamid; Mokhtari-Azad, Talat

    2016-06-01

    Human Parvovirus B19 (B19V) is a prototype of the Erythroparvovirus genus in Parvoviridae family. B19V infections are often associated with fever and rash, and can be mistakenly reported as measles or rubella. Differential diagnosis of B19V illness is necessary for case management and also for public health control activities, particularly in outbreak situations in which measles or rubella is suspected. To investigate the causative role of B19V infection in children with measles- and rubella-like illness, a total of 583 sera from children with exanthema were tested for presence of B19V by determining anti-B19V IgG and IgM antibodies by ELISA as well as B19V DNA detection by nested PCR. DNA positive samples were assessed further for determination of viral load and sequence analysis by Real-Time PCR and Sanger sequencing method, respectively. Out of 583 patients, 112 (19.21%) patients were positive for B19V-IgM antibody, 110 (18.87%) were positive for B19V-IgG antibody, and 63 (10.81%) were positive for B19V viral DNA. The frequency of B19V-IgG antibodies were increased with age; that is children under 6 year old showed 7.11% seroprevalence for B19V-IgG as compared to 18.39% and 28.91% for age groups 6 to >11 and 11-14 years old, respectively. Phylogenetic analysis of the NS1-VPu1 overlapping region revealed that all sequenced B19V-DNA belonged to genotype 1. The results of this study may aid the surveillance programs aiming at eradicating measles/rubella virus in Iran, as infections with B19V can be mistakenly reported as measles or rubella if laboratory testing is not conducted. PMID:26538067

  14. Sculpting the Illness Experience

    Directory of Open Access Journals (Sweden)

    Molly Bathje MS, OTR/L

    2014-10-01

    Full Text Available Otto Kamensek provided the cover art for the Fall 2014 issue of the Open Journal of Occupational Therapy. “Glimmer of Hope” is part of Otto’s collection “Shard’s, Bone Deep,” which includes hand-built ceramic sculptures that portray his experiences with a lifelong chronic illness. Engaging in ceramic sculpture helps him process the experiences associated with Juvenile Rheumatoid Arthritis and provides a means to support others experiencing chronic illness.

  15. Sculpting the Illness Experience

    OpenAIRE

    Molly Bathje MS, OTR/L

    2014-01-01

    Otto Kamensek provided the cover art for the Fall 2014 issue of the Open Journal of Occupational Therapy. “Glimmer of Hope” is part of Otto’s collection “Shard’s, Bone Deep,” which includes hand-built ceramic sculptures that portray his experiences with a lifelong chronic illness. Engaging in ceramic sculpture helps him process the experiences associated with Juvenile Rheumatoid Arthritis and provides a means to support others experiencing chronic illness.

  16. The forgotten ones: challenges and needs of children living with disabling parental chronic pain.

    Science.gov (United States)

    Umberger, Wendy A; Risko, Judy; Covington, Edward

    2015-01-01

    A qualitative study explored the challenges and needs of children living with parental chronic pain. Young adult children (n=30) of parents with chronic pain were interviewed. Parents (n=20) with chronic pain participated in four focus groups. Content analysis yielded five categories of child challenges: (a) understanding the big picture; (b) enduring hardships; (c) grieving losses; (d) communicating with parent, and; (e) isolating self from peers. Three categories of child needs emerged: (a) knowledge; (b) skills, and; (c) supervised interaction. Understanding these challenges and needs is a vital step in the process of developing evidence-based interventions for this at-risk group. PMID:25557986

  17. [Contribution to the treatment of acute haematogenous anc chronic secondary osteomyelitis in children (author's transl)].

    Science.gov (United States)

    Pillich, J; Továrek, J; Fait, M

    1978-02-01

    The possibility of utilizing antistaphylococcal vaccine and local phage lysate for complex therapy of chronic and acute haematogenous osteomyelitis in children is demonstrated on three clinical cases. The study reassurmes good experience with this therapy in adult patients with chronic osteomyelitis. The results obtained so far in children suggest that the application of antistaphylococcal vaccine and of local phage lysate positively influences the course of the osteomyelitic disease and reduces the number of relpases. In order to specify and intensify the clinical effect of the above mentioned preparations, this method is being employed in other cases of chronic and acute haematogenous osteomyelitis. PMID:148797

  18. Psychiatric morbidity in children with medically unexplained chronic pain: Diagnosis from the pediatrician's perspective

    NARCIS (Netherlands)

    Konijnenberg, Antoinette Y.; De Graeff-Meeder, Elisabeth R.; Van Der Hoeven, Joost; Kimpen, Jan L. L.; Buitelaar, Jan K.; Uiterwaal, Cuno S.P.M.; Van Dijken, Pieter J.; Dijkman-Neerincx, Regina H.M.; Essink, Alphons H.P.M.; Flapper, Boudien C.T.; Fliers, Ellen A.; Ten Haaf, Jeanette K.; Hofkamp, Marchinus; Van Der Meer, Syb B.; Moens, Marijn; Pelleboer, Rolf A.A.; Van Rhijn, Aart; Russel, Ingrid M.B.; Thunnissen, Bernadien T.M.J.; Vlieger, Arine M.; Wennink, Johanna M.B.; Van Wieringen, Hester; Zwart, Pieter

    2006-01-01

    CONTEXT. There is very little general evidence to support the clinical management, particularly diagnosis, of medically unexplained chronic pain (UCP) in children. OBJECTIVE. We sought to assess in children with UCP if clinical characteristics held important by general pediatricians help to accurate

  19. Methylphenidate and Comorbid Anxiety Disorder in Children with both Chronic Multiple Tic Disorder and ADHD

    Science.gov (United States)

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

    Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial…

  20. 慢重症防治刍议%Opinions on the prevention and treatment of chronic ;critical illness

    Institute of Scientific and Technical Information of China (English)

    安友仲

    2016-01-01

    慢重症是全球人口数量过度增加、人口老化以及医学科学技术进步的必然结果。慢重症患者的数量必定会持续增加,势必大大加重全球、特别是经济发达和人均寿命较高国家的政府、社会、家庭的经济与人力负担。防治慢重症须多方并举:首先,医师、特别是重症医师必须“知症懂病”,在对症多器官功能支持的同时,尽早了解导致器官损伤的病因并联合专科医师积极展开病因治疗;其次,积极且准确地了解疾病本身以及机体的不当反应对于机体所造成的损伤,评估机体各器官的储备功能及可能的预后和生活质量;第三,在加强医护人员人文修养的同时,应更加积极地在全社会宣传一切生物都是“向死而生”的正确死亡观,明确医疗服务的有限性和“永远是安慰”的实质。%Chronic critical illness (CCI) is an inevitable result of overpopulation and aging, as well as the development of medicine. The number of CCI patients will constantly increase and become an unaffordable economic burden for families, societies and countries. CCI could be prevented by multiple measures. Firstly, doctors must know about the pathophysiology and etiology of the disease. When providing organ function support for CCI patient, we have to know and treat the cause of the disease as early as possible. Secondly, we need to precisely monitor the insults caused by the disease and/or improper host response to the disease, evaluate the organ reserve function, and predict the outcomes and life quality after discharging from hospital. In addition, it is necessary to strengthen the humanity training of health care workers, publicize the correct thanatopsis in the whole society that every life is “born to die”, and define the core role of medicine as“to comfort always”.