Self-care in pediatric patients with chronic conditions: A systematic review of theoretical models

Background: To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support. Aims: (1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework. Methods: A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All peer-reviewed papers describing a theory or a conceptual model of self-care in CYAs (0-24 years) with chronic conditions were included. Results: Of 2674 records, 17 met the inclusion criteria. Six papers included a theory or a model of self-care, self-management, or a similar concept. Six papers developed or revised pre-existing models or theories, while five papers did not directly focus on a specific model or a theory. Patients were CYAs, mainly with type 1 diabetes mellitus and asthma. Some relevant findings about self-care in CYAs with neurocognitive impairment and in those living with cancer may have been missed. Conclusions: By aggregating the key elements of the 13 self-care conceptual models identified in the review, we developed a new overarching model emphasizing the shift of self-care agency from family to patients as main actors of their self-management process. The model describes influencing factors, self-care behaviors, and outcomes; the more patients engaged in self-care behaviors, the more the outcomes were favorable

Self-care in children and young people with complex chronic conditions: a qualitative study using Emotional Text Mining

Objectives: To explore: (1) self-care behaviors in children and young people (range: 6 months–24 years) with complex chronic conditions, characterized by the diagnosis of a severe chronic condition, substantial family-identified needs, functional limitations associated with technology dependence, and intensive use of healthcare services; (2) the contribution to self-care of family members and other persons involved in the child's health and daily life context (e.g., health professionals and teachers), and (3) the principal factors that might have influenced the self-care process associated with developmental age. Methods: A qualitative descriptive study was conducted in an Italian academic tertiary pediatric hospital between September 2020 and May 2021. Overall, 25 focus groups and 7 online interviews were conducted via videoconferencing. Textual data were analyzed using Emotional Text Mining to identify three levels of communication: the factors, the main themes (clusters), and the sub-themes. Results: A total of 104 participants were enrolled, including 27 patients with complex chronic conditions (12 males, mean age = 11.1 ± 4.40), 33 parents, 6 siblings, 33 health professionals, and 5 teachers. Participants described the process of self-care through four main factors: “self-care”, “external settings”, “family”, and “management”. Five clusters (themes) were identified: (1) Self-care management (device; consulting); (2) Shift of agency (influencing factors; parents; school); (3) Self-care support (normal life and personal development; multidisciplinary support); (4) Daily self-care maintenance/monitoring; (5) Treatment adherence. Self-care management was mostly relevant for parents of children aged between 6 months and 3 years. Conclusion: The self-care process varies according to the needs related to the specific developmental age and the evolution of the clinical condition over time. The contribution of the family, health professionals, and social networks is fundamental for adequate self-care. To help families manage the unstable condition of their children at home, it is necessary to strengthen support networks implement home care, and ensure continuity of care

Compass: An upper limit on cosmic microwave background polarization at an angular scale of 20′

COMPASS is an on-axis 2.6 meter telescope coupled to a correlation polarimeter operating at a wavelength of 1 cm. The entire instrument was built specifically for CMB polarization studies. We report here on observations of February 2001 - April 2001 using this system. We set an upper limit on E-mode polarized anisotropies of 33.5 uK (95% confidence limit) in the l-range 200-600.Comment: Submitted to ApJ 8/19/200

Anatrophic nephrotomy as nephron-sparing approach for complete removal of intraparenchymal renal tumors

OBJECTIVE: Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy. PATIENTS AND METHODS: A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identified. Patient demographics, perioperative outcomes and oncological results were evaluated. RESULTS: Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no significant creatinine changes or local or systemic recurrences were observed. CONCLUSION: The operative technique described is a safe and effective nephron-sparing option for complete removal of endophytic renal tumors

Atlantic rainforest remnant harbors greater biotic diversity but reduced lepidopteran populations compared to a eucalyptus plantation

Study of the dynamics and distribution of lepidopteran defoliators is important because some of them are major pests of eucalyptus. More than 3,000,000 ha of eucalyptus are now planted in Brazil even though the genus is not native there. The goal of this study was to document the frequency and constancy indexes of lepidopteran pests of Eucalyptus grandis Hill ex Maiden (Myrtaceae) collected with Slight traps (replicates) in different habitats. The first and second traps were installed in a eucalyptus plantation at 400 and 200 m, respectively, from the interface with a native vegetation area (Atlantic Rainforest); the third in the interface and the fourth and the fifth in native vegetation at 200 and 400 in, respectively, from the interface zone. The most frequent primary pest species were Stenalcidia grosica Schaus, 1901 (Geometridae) and Thyrinteina leucoceraea Rindge, 1961 (Geometridae) with greater frequencies in the eucalyptus plantation at 400 and 200 in from the interface with the native vegetation. In the native vegetation at 200 m from the interface Oxydia vesulia Cramer, 1779 (Geometridae) (33.33%) was the most frequently collected primary pest species, and in the interface zone, Eupseudosoma involuta Sepp, 1855 (16.27%), and Eupseudosoma aberrans Schaus, 1905 (Arctiidae) (15.22%) were the most frequently collected primary pest species. Native vegetation areas of Atlantic Rainforest are more spatially heterogeneous and abundant in host plant species than eucalypt plantations and the high level of species diversity within native vegetation helps to provide natural biological control of herbivorous insects in nearby areas reforested with eucalyptus species.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES