Children and adolescents’ preferences for support when living with a dying parent – An integrative review

Aim To identify and synthesize the evidence base regarding children and adolescents’ preferences for support when living with a dying parent. Design Integrative literature review study. Methods Searches were conducted in PubMed, CINAHL, PsycINFO, the Cochrane Library, Sociological Abstracts and Scopus, between 1 October 2019 and May 2021. Data were analysed and synthesized using integrative thematic analysis according to the analysis stages specified by Whittermore and Knafl. Results Twenty-two articles were identified. Children and adolescents’ preferences for support were described through one overarching theme, Striving to achieve control and balance, together with six subthemes; “Involvement in the sick parent's care and treatment”; “Wanting to be with the sick parent but needing respite”; “Information must be continuous and individually adapted”; “emotional and communicative support from parents and family members”; “professional, compassionate and informative support”; and “support in friendships and opportunities to maintain normality.”publishedVersio

Children and adolescents’ preferences for support when living with a dying parent – An integrative review

Aim: To identify and synthesize the evidence base regarding children and adolescents’ preferences for support when living with a dying parent. Design: Integrative literature review study. Methods: Searches were conducted in PubMed, CINAHL, PsycINFO, the Cochrane Library, Sociological Abstracts and Scopus, between 1 October 2019 and May 2021. Data were analysed and synthesized using integrative thematic analysis according to the analysis stages specified by Whittermore and Knafl. Results: Twenty-two articles were identified. Children and adolescents’ preferences for support were described through one overarching theme, Striving to achieve control and balance, together with six subthemes; “Involvement in the sick parent's care and treatment”; “Wanting to be with the sick parent but needing respite”; “Information must be continuous and individually adapted”; “emotional and communicative support from parents and family members”; “professional, compassionate and informative support”; and “support in friendships and opportunities to maintain normality.”publishedVersio

Adolescents’ and young people’s needs and preferences for support when living with a parent with life-threatening cancer: a grounded theory study

Background: Living with a parent facing life-threatening illness and losing a mom or dad at a young age can cause both short- and long-term health problems. Without satisfactory support, adolescents’ and young people are at risk of developing low self-esteem, behavioural difficulties (e.g., anger and aggression), long-term illness or premature death caused by severe mental illness, substance abuse, self-harm and suicide attempts. The aim of this study was to explore adolescents’ and young people’s needs and preferences for support as they live with a parent with life-threatening cancer. Methods: Qualitative interviews were conducted with 10 respondents (17–24 years) in Norway and Sweden. Data were analysed through grounded theory according to Charmaz. Results: Adolescents’ and young peoples’ needs and preferences for support were described through the main category ‘To feel safe and secure and to be prepared’ and further broken down into five subcategories ‘Relationships in the immediate family—balancing support and protection’; ‘The social network—support and normalcy in a carefully selected group’; ‘Maintaining everyday life—challenges in school and working life’; ‘The right support at the right time—competence, trust and continuity in meeting health care professionals’; and ‘Support outside the home—an opportunity for full transparency’. Conclusion: Adolescents’ and young peoples’ preferences for support when living with a parent facing life-threatening illness are individual and unique, but they share a common need to feel safe and secure and to be prepared. Adolescents and young people express that they primarily want support from parents and friends, but they also want support from health care professionals, especially in situations when the ill parent becomes worse. Therefore, it is of the utmost importance for health care professionals to identify the most vulnerable adolescents and young people by mapping their social networks and paying extra attention to their needs for support when there is deterioration in the parent’s illness state. This study also highlights the importance for health care professionals to establish a good relationship with adolescents and young people to meet their needs and preferences for support. In addition, information and support are needed in a timely manner and adapted to the life-threatening ill parent’s illness state and individual’s needs and preferences to optimise preparedness.publishedVersio

Adolescents’ and young people’s needs and preferences for support when living with a parent with life-threatening cancer: a grounded theory study

Background Living with a parent facing life-threatening illness and losing a mom or dad at a young age can cause both short- and long-term health problems. Without satisfactory support, adolescents’ and young people are at risk of developing low self-esteem, behavioural difficulties (e.g., anger and aggression), long-term illness or premature death caused by severe mental illness, substance abuse, self-harm and suicide attempts. The aim of this study was to explore adolescents’ and young people’s needs and preferences for support as they live with a parent with life-threatening cancer. Methods Qualitative interviews were conducted with 10 respondents (17–24 years) in Norway and Sweden. Data were analysed through grounded theory according to Charmaz. Results Adolescents’ and young peoples’ needs and preferences for support were described through the main category ‘To feel safe and secure and to be prepared’ and further broken down into five subcategories ‘Relationships in the immediate family—balancing support and protection’; ‘The social network—support and normalcy in a carefully selected group’; ‘Maintaining everyday life—challenges in school and working life’; ‘The right support at the right time—competence, trust and continuity in meeting health care professionals’; and ‘Support outside the home—an opportunity for full transparency’. Conclusion Adolescents’ and young peoples’ preferences for support when living with a parent facing life-threatening illness are individual and unique, but they share a common need to feel safe and secure and to be prepared. Adolescents and young people express that they primarily want support from parents and friends, but they also want support from health care professionals, especially in situations when the ill parent becomes worse. Therefore, it is of the utmost importance for health care professionals to identify the most vulnerable adolescents and young people by mapping their social networks and paying extra attention to their needs for support when there is deterioration in the parent’s illness state. This study also highlights the importance for health care professionals to establish a good relationship with adolescents and young people to meet their needs and preferences for support. In addition, information and support are needed in a timely manner and adapted to the life-threatening ill parent’s illness state and individual’s needs and preferences to optimise preparedness.publishedVersio

Examination of Several Physiological and Psychosocial Factors Potentially Associated With Masked Hypertension Among Low-Risk Adults

We examined the association of factors in addition to prehypertensive office blood pressure (BP) level that might improve detection of masked hypertension (MH, defined as non-elevated office BP with elevated out-of-office BP average) among those otherwise at low-risk. This sample of 340 untreated adults 30 years and older with office BP average <140/90 mmHg all had two sets of paired office BP measurements and 24-hour ambulatory BP monitoring (ABPM) sessions one week apart. Other than BP levels, the only factors that were associated (at P<0.10) with MH at both sets were male sex (75% vs 66%) and working outside the home (72% vs 59% first set; 71% vs 45% second set). Adding these variables to BP level in the model did not appreciably improve detection of MH. We found no demographic, clinical, or psychosocial measures that improved upon prehypertension as a potential predictor of MH in this sample

Plasma enterolactone and risk of prostate cancer in middle-aged Swedish men

Enterolactone (ENL) is formed in the human gut after consumption of lignans, has estrogenic properties, and has been associated with risk of prostate cancer. We examined the association between plasma ENL levels and prostate cancer in a nested case-control study within the population-based Malmo Diet and Cancer cohort. We also examined the association between plasma ENL and dietary and lifestyle factors. The study population consisted of 1010 cases occurring during a mean follow-up of 14.6 years, and 1817 controls matched on age and study entry date. We used national registers (95%) and hospital records (5%) to ascertain cases. Diet was estimated by a modified diet history method. Plasma ENL concentrations were determined by a time-resolved fluoroimmunoassay. Odds ratios were calculated by unconditional logistic regression. There were no significant associations between plasma ENL and incidence of all prostate cancer (odds ratio 0.99 [95% confidence interval 0.77-1.280] for the highest ENL quintile versus lowest, p for trend 0.66). However, in certain subgroups of men, including men with abdominal obesity (p for interaction = 0.012), we observed associations between high ENL levels and lower odds of high-risk prostate cancer. Plasma ENL was positively associated with consumption of high-fibre bread, fruit, tea, and coffee; with age, and with height, while it was negatively associated with smoking and waist circumference; however, although significant, all associations were rather weak (r ae |0.14|). ENL concentration was not consistently associated with lower prostate cancer risk, although it was weakly associated with a healthy lifestyle.Peer reviewe

Levels of Office Blood Pressure and Their Operating Characteristics for Detecting Masked Hypertension Based on Ambulatory Blood Pressure Monitoring

BACKGROUND Masked hypertension (MH)—nonelevated office blood pressure (BP) with elevated out-of-office BP average—conveys cardiovascular risk similar to or approaching sustained hypertension, making its detection of potential clinical importance. However, it may not be feasible or cost-effective to perform ambulatory BP monitoring (ABPM) on all patients with a nonelevated office BP. There likely exists a level of office BP below which ABPM is not warranted because the probability of MH is low. METHODS We analyzed data from 294 adults aged ≥30 years not on BP-lowering medication with office BP <140/90mm Hg, all of whom underwent 24-hour ABPM. We calculated sensitivity, false-positive rate, and likelihood ratios (LRs) for the range of office BP cutoffs from 110 to 138mm Hg systolic and from 68 to 88mm Hg diastolic for detecting MH. RESULTS The systolic BP cutoff with the highest +LR for detecting MH (1.8) was 120mm Hg, and the diastolic cutoff with the highest +LR (2.4) was 82mm Hg. However, the systolic level of 120mm Hg had a false-positive rate of 42%, and the diastolic level of 82mm Hg had a sensitivity of only 39%. CONCLUSIONS The cutoff of office BP with the best overall operating characteristics for diagnosing MH is approximately 120/82mm Hg. However, this cutoff may have an unacceptably high false-positive rate. Clinical risk tools to identify patients with nonelevated office BP for whom ABPM should be considered will likely need to include factors in addition to office BP

Comparison of patients’ confidence in office, ambulatory, and home blood pressure measurements as methods of assessing for hypertension

Uncertainty exists when relying on office (clinic) blood pressure (BP) measurements to diagnose hypertension. Home BP monitoring and ambulatory BP monitoring (ABPM) provide measurements that are more strongly associated with cardiovascular disease. The degree to which patients exhibit uncertainty about office BP measurements is unknown, as is whether they would have less uncertainty about other BP measurement methods. We therefore assessed people's confidence in methods of BP measurement, comparing perceptions about office BP, home BP, and ABPM techniques

Understory 2014

“Art is the struggle to be, in a particular sort of way, virtuous.” —Iris Murdoch Indeed, when we embark on any creative adventure it is with the purpose of conveying a certain truth; an emotion, an idea that brings us together and reminds us of the innate consciousness that dwells within. Understory is emblematic of this; where individuals intent on honing their craft can join others to become a part of something greater, their work immortalized to become a time capsule. Decades from now a volume of Understory may be discovered on a dusty bookshelf in some forgotten corner and the lucky explorer who finds it shall be enlightened by pages of gold. We, as editors of Understory 2014, have worked very hard this year to put together a journal that showcases the very best of the University of Alaska Anchorage undergraduate student work. We hope you enjoy your journey through this issue as much as we have enjoyed ours. Thank you to the English and Art Departments, for the staff and faculty’s unerring support of our club; to Provost Baker, for seeing and believing in the vision of Understory; and to our club’s faculty advisor, Douglass Bourne, for his guidance and tireless assistance. Finally, thank you to the wonderful students who submit such excellent work each year. Without your passion for the arts, we would not be here.Staff / Letter from the Editors / Glass Blower / Writing / Obsolete Evolution / Permafrost / Phoenix / Untitled / Ratio / Tripping / Abiogenesis / My Heart Beats for You / Meeting of the Fingerprint Lines / You Are No Stranger / Nightmare Fuel / Cane-Sugar / Gossamer Strands / Panthera Gold / Butterfly / A Mantis Too Far / Long and Winding Road / Chasing Shadows / Merisunas / Chequer Grove / Modzilla / Beans / Little Red and Mr. Wolf / In Memoriam, Joel Fletcher Armstrong / Glance / Courage / Uranium Waltz / Danger / Journey to the West / Antumbra / Roaring Like a Lion / Pre-boarding / Untitled / How Do You Say a Word / Fishing for Doom/ Contributor

Neurofascin as a novel target for autoantibody-mediated axonal injury

Axonal injury is considered the major cause of disability in patients with multiple sclerosis (MS), but the underlying effector mechanisms are poorly understood. Starting with a proteomics-based approach, we identified neurofascin-specific autoantibodies in patients with MS. These autoantibodies recognize the native form of the extracellular domains of both neurofascin 186 (NF186), a neuronal protein concentrated in myelinated fibers at nodes of Ranvier, and NF155, the oligodendrocyte-specific isoform of neurofascin. Our in vitro studies with hippocampal slice cultures indicate that neurofascin antibodies inhibit axonal conduction in a complement-dependent manner. To evaluate whether circulating antineurofascin antibodies mediate a pathogenic effect in vivo, we cotransferred these antibodies with myelin oligodendrocyte glycoprotein–specific encephalitogenic T cells to mimic the inflammatory pathology of MS and breach the blood–brain barrier. In this animal model, antibodies to neurofascin selectively targeted nodes of Ranvier, resulting in deposition of complement, axonal injury, and disease exacerbation. Collectively, these results identify a novel mechanism of immune-mediated axonal injury that can contribute to axonal pathology in MS