Factors Affecting Quality of Life for Children with Asthma

BACKGROUND: In the U.S., asthma is the most common chronic illness in children under 18 years. An exploration of asthma admission rates in emergency departments indicated this was also the case for Southeast Georgia. Despite the availability of effective asthma treatments and interventions, asthma continues to severely impact children’s health-related QOL. PURPOSE: This exploratory study sought to assess quality of life (QOL) issues facing children with asthma and their caregivers. Specifically, this study aimed to 1) Determine the baseline QOL in children with asthma and their parents/caregivers, & 2) Determine what factors affect QOL for children with asthma and their caregivers. METHODS: This exploratory study employed a mixed-model design. Participants were recruited for a convenience sample from a large children’s hospital outpatient clinic in Southeast Georgia. Participants included children aged 7-17 with a diagnosis of asthma or reactive airway disease (N=104) and their parents/caregivers (N=104). Child participants completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), a reliable and validated QOL questionnaire for childhood asthma focusing on the domains of activity limitations, emotional function, and an exploration of symptoms. Caregiver participants completed a demographics questionnaire and the Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ), a reliable and validated QOL questionnaire for caregivers of children with childhood asthma focusing on two domains, activity limitations and emotional function. Items in both the PAQLQ and PACQLQ questionnaires are rated on a 7-point scale, with higher scores indicating less impairment and lower scores indicating greater impairment to the domain under consideration. RESULTS & CLINICAL IMPLICATIONS: In addressing the first aim of this study, the results revealed that the baseline QOL for children with asthma and their caregivers was relatively high. In addressing the second aim of this study, the results of both the PAQLQ and the PACQLQ revealed that the most significant factor that affects the QOL of children with asthma is ED visits. The more ED visits reported, the greater the impairment to emotional function and physical activity. While the findings of this study demonstrate a positive baseline QOL, it is important to further investigate the specific impact of ED visits on QOL of children with asthma and their caregivers. An important clinical implication is that education on controlling asthma symptoms to prevent ED visits for both children and their caregivers may be of value to improve their QOL

Urokinase Plasminogen Activator Inhibits HIV Virion Release from Macrophage-Differentiated Chronically Infected Cells via Activation of RhoA and PKCε

HIV replication in mononuclear phagocytes is a multi-step process regulated by viral and cellular proteins with the peculiar feature of virion budding and accumulation in intra-cytoplasmic vesicles. Interaction of urokinase-type plasminogen activator (uPA) with its cell surface receptor (uPAR) has been shown to favor virion accumulation in such sub-cellular compartment in primary monocyte-derived macrophages and chronically infected promonocytic U1 cells differentiated into macrophage-like cells by stimulation with phorbol myristate acetate (PMA). By adopting this latter model system, we have here investigated which intracellular signaling pathways were triggered by uPA/uPAR interaction leading the redirection of virion accumulation in intra-cytoplasmic vesicles.uPA induced activation of RhoA, PKCδ and PKCε in PMA-differentiated U1 cells. In the same conditions, RhoA, PKCδ and PKCε modulated uPA-induced cell adhesion and polarization, whereas only RhoA and PKCε were also responsible for the redirection of virions in intracellular vesicles. Distribution of G and F actin revealed that uPA reorganized the cytoskeleton in both adherent and polarized cells. The role of G and F actin isoforms was unveiled by the use of cytochalasin D, a cell-permeable fungal toxin that prevents F actin polymerization. Receptor-independent cytoskeleton remodeling by Cytochalasin D resulted in cell adhesion, polarization and intracellular accumulation of HIV virions similar to the effects gained with uPA.These findings illustrate the potential contribution of the uPA/uPAR system in the generation and/or maintenance of intra-cytoplasmic vesicles that actively accumulate virions, thus sustaining the presence of HIV reservoirs of macrophage origin. In addition, our observations also provide evidences that pathways controlling cytoskeleton remodeling and activation of PKCε bear relevance for the design of new antiviral strategies aimed at interfering with the partitioning of virion budding between intra-cytoplasmic vesicles and plasma membrane in infected human macrophages

Parks, people, and conservation: A review of management issues in nepal's protected areas

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43480/1/11111_2005_Article_BF01254607.pd