326 research outputs found

    The relationship between quality of life and coping strategies of children with EB and their parents

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    BackgroundEpidermolysis bullosa (EB) is a group of rare genetic skin disorders that primarily manifest as blisters and erosions following mild mechanical trauma. Despite the crucial role of the parents of children with EB in managing the disease, studies focusing on the parent-child relationship remain a gap in the literature. To address this gap, the current quantitative study, involving 55 children with all types of EB and 48 parents, assessed the relationship between their quality of life and coping strategies. Quality of life was measured with the Pediatric Quality of Life Inventory and TNO-AZL Questionnaire for Adult's Health- related Quality of Life, and coping strategies were assessed with the Coping with a Disease Questionnaire. The majority of the analyses were descriptive and the results were interpreted qualitatively because of the small sample size.ResultsOverall, the quality of life of children with EB and that of their parents was somewhat lower compared with the quality of life of healthy children and adults. Children with EB who more frequently used emotional reactions and cognitive-palliative strategies to cope with the disease demonstrated lower levels of emotional and social functioning, while children who showed more acceptance and distancing showed higher levels of functioning on all domains. Parents who frequently demonstrated emotional reactions reported lower levels of social functioning and experienced more depressive emotions and anger. Parents who used more avoidance showed higher levels of positive emotions. Within parent-child dyads, acceptance, cognitive-palliative strategies and distancing were positively related. Children's emotional and social functioning were negatively associated with their parents' depressive emotions. Parents' acceptance was linked to higher physical functioning in children, whereas children's avoidance was linked to a lower level of anger in parents.ConclusionChildren who are able to accept the disease or distance themselves from it appear to be better off in contrast to those who tend to engage in the cognitive-palliative strategies and expressing emotional reactions. Parents seem to be better off when they are able to use avoidance in contrast to those who tend to show emotional reactions. Further research is needed to substantiate these findings

    Patients' and parents' experiences during wound care of epidermolysis bullosa from a dyadic perspective:a survey study

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    Background Epidermolysis bullosa is a rare, often severe, genetic disorder characterized by fragility of the skin and mucous membranes. Despite the important role of parents during wound care, an essential factor in adapting to this disease, studies focusing on the parent-child relationship during wound care are scarce. The current study is aimed at addressing this gap. Methods A quantitative study among 31 children (n = 2

    Rotavirus genetic diversity, disease association, and temporal change in hospitalized rural Kenyan children

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    Background. The effectiveness of rotavirus vaccines will be dependent on the immunity conferred against prevalent and emergent variants causing severe diarrheal disease. Longitudinal surveillance of disease-causing strains is a prerequisite to intervention. Methods. Molecular characterization was conducted on rotavirus-positive stool samples from children admitted with diarrhea to a rural district hospital during 2002-2004. Extracted viral RNA was separated by polyacrylamide gel electrophoresis, and rotavirus VP4 (P types) and VP7 (G types) specificities were determined. Results. Among 558 investigated cases, the predominant genotype was P[8]G1 (42%), followed by P[8]G9 (15%), P[4]G8 (7%), P[6]G8 (6%), and P[8]G8 (4%), with 10% mixed strains. Overall, there were 6 different P types and 7 G types. No association was identified between genotype and child age, sex, or severity of diarrhea. The P and G genotypes and polyacrylamide gel electropherotypes showed significant temporal variation in frequency: P[8]G1 decreased from 51% (95% confidence interval [CI], 43%-58%) in 2002 to 30% (95% CI, 24%-37%) in 2004, and P[4]G8 increased from 2% (95% CI, 0%-5%) in 2002 to 13% (95% CI, 9%-19%). Quarterly data revealed seasonally endemic and emergence and/or decay patterns. Conclusions. Our study of rotavirus strains causing severe diarrhea in rural Kenyan children showed a predominance of P[8]G1 and confirms the importance of G8 and G9 strains in sub-Saharan Africa. Considerable genetic diversity of rotavirus strains was observed, including substantial mixed and unusual types, coupled with significant temporal strain variation and emergence. These results warn of variable vaccine efficacy and the need for long-term surveillance of circulating rotavirus genotypes

    Partner support and distress in women with breast cancer:The role of patients' awareness of support and level of mastery

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    The aim of the present study was to investigate the associations between partners' ways of providing support (both active engagement and protective buffering) and distress in women with breast cancer as a function of patients' awareness of the support received and their sense of mastery. These associations were investigated both cross-sectionally and longitudinally (i.e. changes in distress over time). At 3 months (T1) after diagnosis, women with breast cancer and their partners (n = 82 couples) were assessed regarding partners' supportive behaviour. Women also indicated their sense of mastery. At both 3 and 9 months (T2) after diagnosis, women reported their level of distress. Cross-sectional as well as longitudinal analyses showed that active engagement was unrelated to distress, regardless of patients' awareness of the support received and their feelings of mastery. In contrast, perceived protective buffering was found to be associated with more concurrent distress (i.e. cross-sectionally). Moreover, protective buffering that was reported by partners but remained unnoticed by patients was associated with higher levels of concurrent distress, but only for patients who were low in mastery. Over time, protective buffering that remained unnoticed by patients was associated with more distress, regardless of women's sense of mastery

    Mise en place de l'extraction liquide-liquide en microsystèmes établir des écoulements segmentés à façon pour optimiser le transfert de masse

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    National audienceLiquid-liquid extraction is commonly used for radiochemical analysis. When miniaturized, it can benefitfrom the advantages of microfluidic tools i.e. possible coupling, precise control of the interfacial areabetween the aqueous and organic phases, and contact time. A first study, dedicated to liquid-liquidextraction with parallel flows of europium diluted in nitric acid by the N,N′-dimethyl-N,N′-dibutyltetradecylmalonic diamide [1, 2], allowed us to highlight the limitations of parallel flows for aslow chemical system. One way to optimize yields of extraction of the kinetically slow systems is toincrease the specific interfacial area. For this reason, segmented flows formation and characteristicswere investigated, as a function of the physicochemical properties of a biphasic system, flow rates andthe dimensions of a focalized flux junction. In the following, two multiphase models of the droplets sizecorresponding to the transition and dripping regimes were validated and will be used for theoptimization of the specific interfacial area.L’extraction liquide-liquide est couramment utilisée pour les analyses radiochimiques. Miniaturisée,elle peut bénéficier des avantages des outils microfluidiques qui sont la possibilité de réaliser descouplages, le contrôle précis de l’aire interfaciale entre les phases aqueuse et organique en présence,et des temps de contact. Une première étude, dédiée à l’extraction liquide-liquide en flux parallèlesd’europium en milieu nitrique par le N,N’-dimethyl N,N’-dibutyl tetradecylmalonamide [1, 2], a permisde mettre en évidence les limitations des flux parallèles pour un système chimique lent. Une façond’optimiser les rendements d’extraction des systèmes cinétiquement lents est de mettre en œuvre desécoulements permettant d’augmenter l’aire interfaciale spécifique. C’est pourquoi nous étudions laformation d’écoulements segmentés à façon en fonction des propriétés physico-chimiques d’un systèmechimique biphasique, des débits et des dimensions d’une jonction en flux focalisé. L’utilisation de deuxmodèles de calcul des tailles de gouttes en régimes d’écoulements transitoire

    A multicenter, prospective cohort study

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    Organ transplant recipients (OTRs) have a 100‐fold increased risk of cutaneous squamous cell carcinoma (cSCC). We prospectively evaluated the association between β genus human papillomaviruses (βPV) and keratinocyte carcinoma in OTRs. Two OTR cohorts without cSCC were assembled: cohort 1 was transplanted in 2003‐2006 (n = 274) and cohort 2 was transplanted in 1986‐2002 (n = 352). Participants were followed until death or cessation of follow‐up in 2016. βPV infection was assessed in eyebrow hair by using polymerase chain reaction–based methods. βPV IgG seroresponses were determined with multiplex serology. A competing risk model with delayed entry was used to estimate cumulative incidence of histologically proven cSCC and the effect of βPV by using a multivariable Cox regression model. Results are reported as adjusted hazard ratios (HRs). OTRs with 5 or more different βPV types in eyebrow hair had 1.7 times the risk of cSCC vs OTRs with 0 to 4 different types (HR 1.7, 95% confidence interval 1.1‐2.6). A similar risk was seen with high βPV loads (HR 1.8, 95% confidence interval 1.2‐2.8). No significant associations were seen between serum antibodies and cSCC or between βPV and basal cell carcinoma. The diversity and load of βPV types in eyebrow hair are associated with cSCC risk in OTRs, providing evidence that βPV is associated with cSCC carcinogenesis and may present a target for future preventive strategies

    \u3cem\u3eTrichodysplasia Spinulosa\u3c/em\u3e-Associated Polyomavirus Uses a Displaced Binding Site on VP1 to Engage Sialylated Glycolipids

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    Trichodysplasia spinulosa-associated Polyomavirus (TSPyV) was isolated from a patient suffering from trichodysplasia spinulosa, a skin disease that can appear in severely immunocompromised patients. While TSPyV is one of the five members of the polyomavirus family that are directly linked to a human disease, details about molecular recognition events, the viral entry pathway, and intracellular trafficking events during TSPyV infection remain unknown. Here we have used a structure-function approach to shed light on the first steps of TSPyV infection. We established by cell binding and pseudovirus infection studies that TSPyV interacts with sialic acids during attachment and/or entry. Subsequently, we solved high-resolution X-ray structures of the major capsid protein VP1 of TSPyV in complex with three different glycans, the branched GM1 glycan, and the linear trisaccharides α2,3- and α2,6-sialyllactose. The terminal sialic acid of all three glycans is engaged in a unique binding site on TSPyV VP1, which is positioned about 18 Å from established sialic acid binding sites of other polyomaviruses. Structure-based mutagenesis of sialic acid-binding residues leads to reduction in cell attachment and pseudovirus infection, demonstrating the physiological relevance of the TSPyV VP1-glycan interaction. Furthermore, treatments of cells with inhibitors of N-, O-linked glycosylation, and glycosphingolipid synthesis suggest that glycolipids play an important role during TSPyV infection. Our findings elucidate the first molecular recognition events of cellular infection with TSPyV and demonstrate that receptor recognition by polyomaviruses is highly variable not only in interactions with sialic acid itself, but also in the location of the binding site

    Intent to use a web-based psychological intervention for partners of cancer patients:Associated factors and preferences

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    This study examined partners of cancer patients intention to use a web-based psychological intervention, their preferences regarding its preconditions, functionalities and topics, and factors related to their intention. One hundred and sixty-eight partners completed a questionnaire about these aspects. Forty-eight percent of the partners would (maybe) make use of a web-based intervention. Partners who intended to participate were significantly younger, used the Internet more often, and perceived more caregiver strain. Most partners preferred an intervention that takes less than 1 hour/week, lasts five weeks or more, and contains information and peer support. Half of the partners would like to receive online guidance

    Web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion training:a randomized controlled trial with automated versus personal feedback

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    Purpose: To evaluate the effectiveness of two versions (personal or automated feedback) of a psychological Web-based self-help intervention targeting partners of cancer patients. The intervention was based on acceptance and commitment therapy (ACT) and self-compassion training. Participants’ adherence and their satisfaction were also studied. Methods: Two hundred three partners of patients with heterogeneous entities of cancer were randomized into three conditions: personal feedback (PF) (n = 67), automated feedback (AF) (n = 70), or waiting list (WL) control (n = 66). Participants completed measures at baseline (T0) and post-intervention (T1; 3 months after baseline) to assess psychological distress (HADS; primary outcome), positive mental health, caregiver strain, general health (secondary outcomes), posttraumatic growth, resilience, self-compassion, psychological flexibility, sense of mastery, and relational communication style (process measures). Participants in the two experimental conditions also completed these measures at follow-up (T2; 6 months after baseline). Results: There was no significant difference in change in psychological distress, positive mental health, caregiver strain and general health from T0 to T1 for either of the experimental conditions compared with the WL-condition. However, when compared to a WL-condition, the PF-condition was effective in increasing psychological flexibility (effect size d = 0.49) and resilience (d = 0.12) and decreasing overprotection (d = 0.25), and the AF-condition was effective in reducing overprotection (d = 0.36) and improving protective buffering (d = 0.36). At follow-up, the PF-condition was more effective than the AF-condition for improving mental health (d = 0.36), psychological flexibility (d = 0.60), mastery (d = 0.48), and protective buffering (d = 0.24). Participants positively appreciated the intervention and 69% participants were adherent. Conclusion: This study demonstrates that a Web-based intervention based on ACT and self-compassion training with automated or personal feedback does not seem to improve psychological distress; however, it may have the potential to support partners of cancer patients to cope with the difficult situation they are facing. The condition with personal feedback seemed to be more beneficial
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