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

Attitudes and practices towards vital signs monitoring on paediatric wards: Cross-validation of the Ped-V scale

Purpose: To develop and psychometrically test an instrument measuring the attitudes and practices towards vital signs (VS) monitoring in nurses caring for children on paediatric wards (Ped-V scale).Design and methods: This is a multicentre cross-validation study with a cross-sectional design. The Ped-V scale was developed by adapting the V-scale to the paediatric context and administered to a convenience sample of clinical nurses working in paediatric wards from January to May 2020. The content validity of the Ped-V scale was evaluated by a group of 10 experts. The psychometric properties of the scale were tested through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).Results: Overall, 10 Italian hospitals participated in the study, and 640 questionnaires were completed (87% female). At EFA a 30-item version of the scale and four factors emerged. This solution was confirmed at CFA: F1) 'Inaccuracy of VS monitoring and workload'; F2) 'Clinical competence and communication'; F3) 'Standardization and protocol adherence'; F4) 'Misconceptions about key indicators'. Cronbach's alpha ranged between 0.63 and 0.85.Conclusions: The Ped-V scale is valid and reliable for use in the paediatric context to identify barriers concerning nurses' self-efficacy, competences, and knowledge of clinical indicators of paediatric critical deterioration, attitudes towards accuracy, standardization, communication to senior team members and the appropriate use of technology in paediatric VS monitoring.Practice implications: The Ped-V scalemay assist in identifying gaps in nurses' attitudes and devising strategies to change nurses' beliefs, knowledge, skills and decreasing individual, local cultural or organizational barriers towards VS monitoring.(C) 2022 Elsevier Inc. All rights reserved

Assessing a measure for Quality of Life in patients with severe Alopecia Areata: a multicentric Italian study

objective the prevalence of anxiety and depression in patients diagnosed with alopecia areata (AA) is very high and this significant burden of psychological symptoms threatens the health-related quality of Life (HRQoL) of affected patients. Indeed, AA often does not produce significant physical symptoms, but it nonetheless disrupts many areas of mental health. clinical assessment of disease severity may not reliably predict patient's HRQoL, nor may it predict the patient's perception of illness. for this reason, considerable effort has been made to apply and develop measures that consider patient's perception and assess the HRQoL of individuals affected by AA. the aim of this multicentric study was to provide the Italian version of the Skindex-16AA and to evaluate its psychometric properties in a clinical sample of consecutive patients with moderate-to-severe AA. methods this is a longitudinal, multicenter, observational study. patients returned for follow-up visits at 4-, 12-, and 24-weeks. the analyses of the current work aimed to confirm the factorial structure of the skindex-16AA. in the case of non-fit, an alternative structure for the model was proposed, using an exploratory graph analysis and the bayesian approach. results the sample was composed of 106 patients with AA. alopecia universalis was the most frequently diagnosed type of alopecia at all time points. the analyses on the skindex-16AA revealed that a two-factor structure with eight items fit the data best (bayesian posterior predictive checking using 95% confidence Interval for the difference between the observed and the replicated chi-square values = -6.246/56.395, posterior predictive P-value = 0.06), and reported satisfactory psychometric properties (i.e., internal consistency and convergent validity).conclusion the skindex-8AA demonstrated optimal psychometric properties (i.e., convergent and construct validity, and test-retest reliability) measured in a sample of patients with AA, that may suggest that it is an appropriate tool to measure the HRQoL in AA patients. however, further studies are needed in order to confirm and tested other psychometric features of this tool

Ant assemblage (Hymenoptera: Formicidae) in forest fragment in Mato Grosso Amazonian

Ant community studies provide a wealth of information, making reliable estimates of local and regional species richness, biology, behavior and fauna morphology data. This work consists of a survey of litter - associated ant fauna in a forest fragment in the municipality of Sinop - MT, Brazil. The mirmecofauna was sampled using pitfall traps from September 2015 to February 2016, with 10 traps spaced 25 m apart along a transect in each of the collections. A total of 5,066 specimens were collected from 7 subfamilies, 23 genera and 35 morphospecies. Myrmicinae was the richest subfamily, accounting for most of the species collected (51.43%), followed by Ponerinae (17.14%) and Formicinae (14.28%). Pheidole (Westwood, 1839) was the most diverse genus, being represented by 6 morphospecies, followed by the genus Neoponera (Emery, 1901) with 3. Regarding the number of individuals, the most abundant species in the studied environment were one species of Pheidole sp.1. , a species of Trachymyrmex sp.1 and Crematogaster arcuata with 1,343, 1,144 and 897 individuals, respectively. As for the eating habits and biology of the species it was verified the great variety of resources that can be exploited by the studied species, with predominance of omnivorous ants.</jats:p

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