Living with mentally ill parents during adolescence: a risk factor for future welfare dependence? A longitudinal, population-based study

Background Living with parents suffering from mental illness can influence adolescents’ health and well-being, and adverse effects may persist into adulthood. The aim of this study was to investigate the relationship between parents’ mental health problems reported by their 15–16-year-old adolescents, the potential protective effect of social support and long-term dependence on public welfare assistance in young adulthood. Methods The study linked data from a youth health survey conducted during 1999–2004 among approximately 14 000 15–16-year-olds to data from high-quality, compulsory Norwegian registries that followed each participant through February 2010. Cox regression was used to compute hazard ratios for long-term welfare dependence in young adulthood based on several risk factors in 15–16-year-olds, including their parents’ mental health problems. Results Of the total study population, 10% (1397) reported having parents who suffered from some level of mental health problems during the 12 months prior to the baseline survey; 3% (420) reported that their parents had frequent mental health problems. Adolescent report of their parents’ mental health problems was associated with the adolescents’ long-term welfare dependence during follow-up, with hazard ratios (HRs) of 1.49 (CI 1.29–1.71), 1.82 (1.44–2.31) and 2.13 (CI 1.59–2.85) for some trouble, moderate trouble and frequent trouble, respectively, compared with report of no trouble with mental health problems. The associations remained significant after adjusting for socio-demographic factors, although additionally correcting for the adolescents’ own health status accounted for most of the effect. Perceived support from family, friends, classmates and teachers was analysed separately and each was associated with a lower risk of later welfare dependence. Family and classmate support remained a protective factor for welfare dependence after correcting for all study covariates (HR 0.84, CI 0.78–0.90 and 0.80, 0.75–0.85). We did not find evidence supporting a hypothesized buffering effect of social support. Conclusions Exposure to a parent’s mental health problem during adolescence may represent a risk for future welfare dependence in young adulthood. Perceived social support, from family and classmates in particular, may be a protective factor against future long-term welfare dependence

Musculoskeletal extremity pain in Danish school children – how often and for how long? The CHAMPS study-DK

Abstract Background Musculoskeletal pain is common in childhood and adolescence, and may be long-lasting and recurrent. Musculoskeletal problems tend to follow adolescents into adulthood, and therefore it is important to design better prevention strategies and early effective treatment. To this end, we need in-depth knowledge about the epidemiology of musculoskeletal extremity problems in this age group, and therefore, the aim of this study was to determine the prevalence, frequency and course of musculoskeletal pain in the upper and lower extremities in a cohort of Danish school children aged 8–14 years at baseline. Methods This was a prospective 3-year school-based cohort study, with information about musculoskeletal pain collected in two ways. Parents answered weekly mobile phone text messages about the presence or absence of musculoskeletal pain in their children, and a clinical consultation was performed in a subset of the children. Results We found that approximately half the children had lower extremity pain every study year. This pain lasted on average for 8 weeks out of a study year, and the children had on average two and a half episodes per study year. Approximately one quarter of the children had upper extremity pain every study year that lasted on average 3 weeks during a study year, with one and a half episodes being the average. In general, there were more non-traumatic pain episodes compared with traumatic episodes in the lower extremities, whereas the opposite was true in the upper extremities. The most common anatomical pain sites were ‘knee’ and ‘ankle/ft’. Conclusion Lower extremity pain among children and adolescents is common, recurrent and most often of non-traumatic origin. Upper extremity pain is less common, with fewer and shorter episodes, and usually with a traumatic onset. Girls more frequently reported upper extremity pain, whereas there was no sex-related difference in the lower extremities. The most frequently reported locations were ‘knee’ and ‘ankle/ft’

Structure and dynamics of a nanodisc by integrating NMR, SAXS and SANS experiments with molecular dynamics simulations

Nanodiscs are membrane mimetics that consist of a protein belt surrounding a lipid bilayer, and are broadly used for characterization of membrane proteins. Here, we investigate the structure, dynamics and biophysical properties of two small nanodiscs, MSP1D1ΔH5 and ΔH4H5. We combine our SAXS and SANS experiments with molecular dynamics simulations and previously obtained NMR and EPR data to derive and validate a conformational ensemble that represents the structure and dynamics of the nanodisc. We find that it displays conformational heterogeneity with various elliptical shapes, and with substantial differences in lipid ordering in the centre and rim of the discs. Together, our results reconcile previous apparently conflicting observations about the shape of nanodiscs, and pave the way for future integrative studies of larger complex systems such as membrane proteins embedded in nanodiscs

Working with patients suffering from chronic diseases can be a balancing act for health care professionals - a meta-synthesis of qualitative studies

Background The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Method A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes. Results Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 sub-categories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions. Conclusion Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support. Trial registration PROSPERO number: CRD42019119052