118 research outputs found

    Control, Care, and Stress: Parenting\u27s Effect on Child Internalizing Symptoms

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    Theoretical models of childhood psychopathology suggest that the parent-child relationship serves an influential role in the development and maintenance of internalizing disorders such as anxiety and depression. However, there is a great deal of inconsistency in the research literature on the predictive power of parenting variables such as parental control and parental care. Furthermore, these parenting variables are often poorly defined and inconsistently operationalized across studies, hampering interpretation of results and limiting conclusions on the strength of the effect. Additionally, few studies have examined the role of parenting with careful attention to moderators. In order to investigate these problems, 189 mother-child dyads (children between the ages of 8 and 16) from an existing database were analyzed. The relationships between maternal care, maternal control, child anxiety, and child depression were examined with maternal stress, child age, child gender, and child ethnicity as moderators. In summary, child age emerged as a nonspecific predictor of child anxiety (B=-.218, t(187)= -3.054, p=.003) and a significant moderator of the relationship between child anxiety and maternal care (ΔR2 = .045, F(3, 185) = 6.627, p \u3c.001); less maternal care was associated with higher anxiety for younger children. Additionally, child gender trended significance as a nonspecific predictor of child anxiety (B=.140, t(187)= 1.930, p=.054) and of child depression (B=.140, t(187)= 1.940, p=.054), with females exhibiting higher anxiety and depression than males. This research may inform future evidence-based assessments and treatments through identification of potential pathways to child psychopathology

    Iron sucrose causes greater proteinuria than ferric gluconate in non-dialysis chronic kidney disease

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    Non-dextran intravenous (i.v.) iron preparations seem to differentially affect proteinuria in patients with chronic kidney disease. To study effects of ferric gluconate and iron sucrose on proteinuria, we conducted a crossover trial in 12 patients with stage 3–4 chronic kidney disease. These patients were randomized to receive the same dose of either drug 1 week apart. Urine samples were obtained immediately before and at frequent intervals after the drug. The urine total protein/creatinine ratio was significantly greater after iron sucrose than ferric gluconate treatment with the effect noted within 15 min post-infusion. Furthermore, when iron sucrose was given first, a significantly greater protein/creatinine ratio was seen subsequently with ferric gluconate than with the reverse order of treatment. The urine albumin/creatinine ratio was also significantly greater with iron sucrose than with ferric gluconate. There was no significant difference, however, between the two i.v. irons in the measured urine N-acetyl-ÎČ-D-glucosaminidase/creatinine ratio. Although our study showed that acutely, iron sucrose increased proteinuria, the long-term effects of repeated i.v. non-dextran iron on kidney function requires further study

    Oxygen tension, H2S, and NO bioavailability:is there an interaction?

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    Molecular oxygen (O2) is an essential component for survival and development. Variation in O2 levels leads to changes in molecular signaling and ultimately affects the physiological functions of many organisms. Nitric oxide (NO) and hydrogen sulfide (H2S) are two gaseous cellular signaling molecules that play key roles in several physiological functions involved in maintaining vascular homeostasis including vasodilation, anti-inflammation, and vascular growth. Apart from the aforementioned functions, NO and H2S are believed to mediate hypoxic responses and serve as O2 chemosensors in biological systems. In this literature review, we briefly discuss NO and H2S and their roles during hypoxia

    Teledermatology in Medical Student, Postgraduate Trainee, and Global Dermatology Education: A Systematic Review

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    BACKGROUND: In the aftermath of the COVID-19 pandemic, medical students and residents in the U.S. and globally have gained more exposure to teledermatology, both for the purposes of clinical practice and education. OBJECTIVE: We conducted a systematic review to assess outcomes from teledermatology interventions for dermatology trainees in the U.S. and globally in accordance with Preferred Reporting Items for Systematic Reviews (PRISMA). METHODS: We searched MEDLINE, EMBASE, Web of Science, and Cochrane CENTRAL for articles written in English and published database inception to November 20, 2022. RESULTS: In total, 15 studies met the inclusion criteria. Outcomes reported ranged broadly from resident-provider concordance rates, diagnostic accuracy in comparison to control groups, number of patients seen, and self-reported satisfaction and improvement. Generally, studies indicated high satisfaction rates and improvement in educational outcomes among medical students, residents, and other trainees in the global health setting. LIMITATIONS: Because of the heterogeneity of study design and outcomes reported, meta-analysis could not be performed. CONCLUSION: Teledermatology can be successfully deployed for clinical care and education domestically and in the global health setting

    Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review

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    Postpartum depression (PPD) is one of the three major categories on the spectrum of postpartum psychiatric syndromes. Postpartum psychiatric syndromes are classified as either postpartum blues, postpartum depression, or postpartum psychosis. Postpartum depression is important to recognize clinically because of the effect it can have on the mother-child bond. The neurosteroid allopregnanolone, a progesterone derivative, is important for its role in positively modulating GABAA receptors. GABA-mediated signaling has been previously implicated in major depressive disorder. Allopregnanolone-mediated signaling has been identified as an important therapeutic target. Treatment with an allopregnanolone-analog, brexanolone, has been shown to improve depression scores in trials for the treatment of PPD. Brexanolone is a positive allosteric modulator of GABAA and is the first drug approved by the FDA to treat postpartum depression. Brexanolone enhances the inhibitory effects of GABAA, restores dysfunctional GABAA transmembrane channels, and mimics a naturally produced progesterone metabolite that fluctuates during pregnancy and postpartum. One open-label study and two phase two studies have some significant reduction in HAM-D scores after treatment and that the effect was still there 30 days post-treatment. Per the data reported, intravenous infusion of brexanolone could be efficacious and safe for the treatment of women suffering from postpartum depression

    The Role of Cognitive Vulnerabilities in the Severity of Internalizing Symptoms in Children and Adolescents

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    Contemporary theories of psychopathology suggest that cognitive vulnerabilities play a key role in the development, severity, and maintenance of internalizing symptomology across the lifespan. The two primary cognitive vulnerabilities assessed in children and adolescents are anxiety sensitivity (i.e., negative beliefs about the consequences of physiological arousal; AS) and negative self-cognitions (i.e., negative self-referential thoughts; NS-C). These cognitive vulnerabilities are theorized to have transdiagnostic qualities, as both have been evaluated as predictors of symptoms of anxiety and depression. However, existing research in youth has largely examined AS in relation to anxiety alone and NS-C primarily in relation to depression. Additionally, the relationship between AS and NS-C has not yet been explored, and although subconstructs of these factors have been evaluated in adults, no empirical studies with these subconstructs have been conducted in youth. In the current study, the relationships between AS, NS-C, anxiety symptoms, and depressive symptoms were evaluated in 187 youth (ages 8-16 years), with age and gender serving as moderators. In summary, strong relationships between cognitive vulnerabilities (i.e., AS and NS-C) and their subscales and internalizing symptoms (i.e., anxiety and depression) emerged. After accounting for the relationship between the internalizing symptoms, the relationship between AS and anxiety symptoms was significantly stronger than the relationship between AS and depressive symptoms. Examinations of the subscales of AS and NS-C yielded further insights into the specificity of subfactors in predicting internalizing symptomology. Results and implications of this study may be used to expand transdiagnostic understanding of internalizing problems in youth and to inform clinical assessment and treatment practices

    Sjuksköterskors erfarenheter av omvÄrdnaden kring barn med cancer ur ett psykosocialt perspektiv : en litteraturstudie

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    Bakgrund: Cancer Àr en sjukdom som drabbar mÄnga och varje dag drabbas ett barn av cancer i Sverige. NÀr ett barn fÄr cancer drabbas inte bara barnet utan alla i omgivningen vilket komplicerar omvÄrdanden för sjuksköterskan. Syfte: Syftet Àr att beskriva sjuksköterskors erfarenheter av omvÄrdnaden kring barn med cancer ur ett psykosocialt perspektiv pÄ en pediatrisk onkologavdelning. Syftet Àr Àven att granska de valda artiklarnas urvalsgrupper. Metod: Litteraturstudien bygger pÄ en deskriptiv design dÀr resultatet grundar pÄ 10 artiklar med bÄde kvantitativ och kvalitativ ansats som Àr sökta frÄn Pubmed och Cinahl. Resultat: PÄ en pediatrisk onkologavdelning möter sjuksköterskan mÄnga svÄrigheter vilket gör att det krÀvs en individuell strategi för att klara av utmaningarna. KommunikationssvÄrigheter, ett barn under palliativ vÄrd eller stress pÄ avdelningen var olika svÄrigheter som kunde uppstÄ. För sjuksköterskan var det en utmaning att hÄlla en balans mellan det kÀnslomÀssiga bandet till barnet och familjen och att vara professionell i sin yrkesroll. Ett bra stöd frÄn kollegor, familj och vÀnner krÀvdes för att sjuksköterskan skulle klara av svÄrigheterna inom yrket. Slutsats: Att arbeta pÄ en pediatrisk onkologavdelning ansÄgs vara psykiskt och fysiskt pÄfrestande pÄ grund av det svÄra etiska situationerna som kunde uppstÄ, olika beslut i vÄrden och barnens prognoser. För att sjuksköterskorna skulle klara av det tunga arbetet krÀvdes det ett bra stöd frÄn kollegorna och en individuell strategi. En god kommunikation krÀvdes för att en god omvÄrdnad skulle kunna fortlöpa pÄ avdelningen och sjuksköterskorna ansÄg att erfarenheter alltid var nÄgot som skulle tas vara pÄ

    Kostrelaterade riskfaktorer : En litteraturstudie gÀllande IGF-1 och ökad risk för prostatacancer

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    Bakgrund: Den dominerande cancerformen hos mÀn över 75 Är Àr prostatacancer. Kosten har en pÄverkan pÄ mÄnga sjukdomstillstÄnd och pÄ senare tid har man undersökt misstankarna kring om höga nivÄer av IGF-1 kan öka risken för att utveckla prostatacancer. IGF-1 finns naturligt i kroppen men hormonet finns bland annat ocksÄ i vissa livsmedel sÄ som mejeriprodukter. Syfte: Att granska tillgÀnglig evidens gÀllande samband mellan höga nivÄer av IGF-1 och prostatacancer, samt att om ett samband gÄr att finna, undersöka om en kostrekommendation kan göras för att sÀnka nivÄerna av detta hormon i kroppen och pÄ sÄ vis minska risken för utveckling av prostatacancer. Metod: Systematisk litteraturstudie. Resultat: Det finns studier som talar för och emot ett samband mellan höga nivÄer av IGF-1 och ökad risk för att drabbas av prostatacancer. Dock belyser samtliga studierna vikten av fortsatt granskning inom omrÄdet för att helt kunna faststÀlla ett eventuellt samband. Slutsats: Det krÀvs fler studier för att faststÀlla ett samband mellan höga nivÄer av IGF-1 och ökad risk för prostatacancer. I nulÀget anser författarna att det inte gÄr att göra en kostrekommendation dÀr man har för avsikt att sÀnka nivÄerna av IGF-1 i serum pÄ grund av olika presenterade studieresultat

    ”AlltsĂ„, det var ju ganska lĂ€tt. Det Ă€r det som gör det roligt.” : En studie om hur flersprĂ„kiga elever i Ă„rskurs 5 upplever och fullgör olika typer av matematikuppgifter.

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    Studier visar att resultaten i matematik för flersprĂ„kiga elever Ă€r sĂ€mre Ă€n de för elever med svensk bakgrund. DĂ€rför syftar studien till att ge exempel pĂ„ hur nĂ„gra flersprĂ„kiga elever i Ă„rskurs 5 fullgör och upplever olika typer av matematikuppgifter. Tre fallstudier utförs ur barns perspektiv med 12 elever frĂ„n tre skolor. Genom att kombinera intervjuer, observationer och ett experimentellt inslag sĂ„ blir det möjligt att urskilja eventuella likheter och skillnader mellan de olika skolorna. I studien framkommer inga skillnader mellan skolorna. Eleverna arbetar till övervĂ€gande del i sin matematikbok under lektionerna. Eleverna efterfrĂ„gar mer variation i undervisningen och i samtliga tre skolor uttrycker eleverna att matematik Ă€r roligt nĂ€r de förstĂ„r och trĂ„kigt nĂ€r det Ă€r nĂ„got de inte kan. NĂ„gra slutsatser för studien Ă€r att eleverna blir mer motiverade av variation av matematikuppgifter och arbetssĂ€tt samt att det Ă€r viktigt med förstĂ„else av matematikuppgifterna för att eleverna ska tycka det Ă€r roligt. Är dessutom uppgiften verklighetsnĂ€ra för eleven sĂ„ kan eleven ta sig an en svĂ„rare uppgift.Kritiska hĂ€ndelser för sprĂ„k- och kunskapsutvecklande matematikundervisnin
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