Prediction of posttraumatic stress in fathers of children with chronic diseases or unintentional injuries: a six-months follow-up study

<p>Abstract</p> <p>Background</p> <p>While fathers were neglected for a long time in research investigating families of pediatric patients, there are now a few studies available on fathers' posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD). However, little is known about the course of PTSS and PTSD in fathers of pediatric patients. The present study aimed to compare the prevalence and course of PTSS and PTSD in fathers of children with different chronic and acute conditions and to identify factors that contribute to fathers' PTSS.</p> <p>Methods</p> <p>Sixty-nine fathers of children newly diagnosed with either cancer, type I diabetes mellitus, or epilepsy and 70 fathers of children suffering from an unintentional injury completed questionnaires at 4–6 weeks (Time 1) and six months (Time 2) after diagnosis or injury.</p> <p>Results</p> <p>Noticeable PTSD rates were found in fathers of children with a chronic disease (26% at Time 1 and 21% at Time 2, respectively). These rates were significantly higher than rates found in fathers of children with unintentional injuries (12% at Time 1 and 6% at Time 2, respectively). Within six months after the child's diagnosis or accident a decrease in severity of PTSS was observed in both groups. Significant predictors of PTSS at Time 2 were the father's initial level of PTSS, the child's medical condition (injuries vs. chronic diseases) and functional status, the father's use of dysfunctional coping strategies, and father's level of neuroticism.</p> <p>Conclusion</p> <p>Our findings suggest that fathers with initially high PTSS levels are at greater risk to experience PTSS at follow-up, particularly fathers of children with a chronic disease. Sensitizing health care professionals to the identification of PTSS symptoms but also to indicators of neuroticism and the use of specific coping strategies early in the treatment course is essential for the planning and implementation of adequate intervention strategies.</p

Churg-Strauss syndrome with cardiac involvement: case illustration and contribution of CMR in the diagnosis and clinical follow-up.

This report summarises three cases of Churg-Strauss syndrome (CSS) illustrating the diagnostic challenges associated with the cardiac manifestation of this disease. Here, we illustrate the role of cardiac magnetic resonance (CMR) for diagnosis and follow-up of CSS with a focus on new non-contrast T &lt;sub&gt;2&lt;/sub&gt; -weighted imaging sequences for quantification of myocardial scar tissue and quantitative T &lt;sub&gt;2&lt;/sub&gt; mapping techniques, which allow the detection of myocardial edema

PHYSICAL ASPECTS OF REVERSIBLE INACTIVATION OF ENDOTOXIN *

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74729/1/j.1749-6632.1966.tb52394.x.pd

Characterization of soft x-ray echo-enabled harmonic generation free-electron laser pulses in the presence of incoherent electron beam energy modulations

Echo-enabled harmonic generation free-electron lasers (EEHG FELs) are promising candidates to produce fully coherent soft x-ray pulses by virtue of efficient high-harmonic frequency up-conversion from ultraviolet lasers. The ultimate spectral limit of EEHG, however, remains unclear, because of the broadening and distortions induced in the output spectrum by residual broadband energy modulations in the electron beam. We present a mathematical description of the impact of incoherent (broadband) energy modulations on the bunching spectrum produced by the microbunching instability through both the accelerator and the EEHG line. The model is in agreement with a systematic experimental characterization of the FERMI EEHG FEL in the photon energy range 130\u2013210 eV. We find that amplification of electron beam energy distortions primarily in the EEHG dispersive sections explains an observed reduction of the FEL spectral brightness proportional to the EEHG harmonic number. Local maxima of the FEL spectral brightness and of the spectral stability are found for a suitable balance of the dispersive sections\u2019 strength and the first seed laser pulse energy. Such characterization provides a benchmark for user experiments and future EEHG implementations designed to reach shorter wavelengths

The Swiss Systemic lupus erythematosus Cohort Study (SSCS) - cross-sectional analysis of clinical characteristics and treatments across different medical disciplines in Switzerland.

OBJECTIVES: To describe disease characteristics and treatment modalities in a multidisciplinary cohort of systemic lupus erythematosus (SLE) patients in Switzerland. METHODS: Cross-sectional analysis of 255 patients included in the Swiss SLE Cohort and coming from centres specialised in Clinical Immunology, Internal Medicine, Nephrology and Rheumatology. Clinical data were collected with a standardised form. Disease activity was assessed using the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI), an integer physician's global assessment score (PGA) ranging from 0 (inactive) to 3 (very active disease) and the erythrocyte sedimentation rate (ESR). The relationship between SLE treatment and activity was assessed by propensity score methods using a mixed-effect logistic regression with a random effect on the contributing centre. RESULTS: Of the 255 patients, 82% were women and 82% were of European ancestry. The mean age at enrolment was 44.8 years and the median SLE duration was 5.2 years. Patients from Rheumatology had a significantly later disease onset. Renal disease was reported in 44% of patients. PGA showed active disease in 49% of patients, median SLEDAI was 4 and median ESR was 14 millimetre/first hour. Prescription rates of anti-malarial drugs ranged from 3% by nephrologists to 76% by rheumatologists. Patients regularly using anti-malarial drugs had significantly lower SELENA-SLEDAI scores and ESR values. CONCLUSION: In our cohort, patients in Rheumatology had a significantly later SLE onset than those in Nephrology. Anti-malarial drugs were mostly prescribed by rheumatologists and internists and less frequently by nephrologists, and appeared to be associated with less active SLE

Does it bite? The role of stimuli characteristics on preschoolers’ interactions with robots, insects and a dog

While there is increasing interest in the impact of animal interactions upon children’s wellbeing and attitudes, there has been less attention paid to the specific characteristics of the animals which attract and engage children. We used a within-subjects design to explore how differences in animal features (such as their animacy, size, and texture) impacted upon pre-school children’s social and emotional responses. This study examined pre-schoolers’ interactions with two animal-like robots (Teksta and Scoozie), two insect types (stick insects and hissing cockroaches) and a dog (Teasel, a West Highland Terrier). Nineteen preschool participants aged 35-57 months were videoed while interacting with the experimenter, a peer and each stimulus (presented individually). We used both verbal and nonverbal behaviours to evaluate interactions and emotional responses to the stimuli and found that these two measures could be incongruent, highlighting the need for systematic approaches to evaluating children’s interactions with animals. We categorised the content of children’s dialogues in relation to psychological and biological attributes of each stimulus and their distinctions between living and non-living stimuli; the majority of comments were biological, with psychological terms largely reserved for the dog and mammal-like robot only. Comments relating to living qualities revealed ambiguity towards attributes that denote differences between living and non-living creatures. We used a range of nonverbal measures, including willingness to approach and touch stimuli, rates of self-touching, facial expressions of emotion, and touch to others. Insects (hissing cockroaches and stick insects) received the most negative verbal and nonverbal responses. The mammal-like robot (rounded, fluffy body shape, large eyes, and sympathetic sounds) was viewed much more positively than its metallic counterpart, as was the real dog. We propose that these interactions provide information on how children perceive animals and a platform for the examination of human socio-emotional and cognitive development more generally. The children engaged in social referencing to the adult experimenter rather than familiar peers when uncertain about the stimuli presented, suggesting that caregivers have a primary role in shaping children’s responses to animals

Sexual dysfunction and fertility-related distress in young adults with cancer over 5 years following diagnosis: study protocol of the Fex-Can Cohort study

BACKGROUND: There is a lack of firm knowledge regarding sexual problems and fertility-related distress in young adults following a diagnosis with cancer. Establishing such understanding is essential to identify patients in need of specific support and to develop cancer care accordingly. This study protocol describes the Fex-Can Cohort study, a population-based prospective cohort study investigating sexual dysfunction and fertility-related distress in young adults diagnosed with cancer in Sweden. The primary objective of the study is to determine the prevalence and predictors of sexual dysfunction and fertility-related distress following a cancer diagnosis in young adulthood compared to prevalence rates for the general population. Further aims are to investigate the trajectories of these issues over time, the co-existence between sexual dysfunction and fertility-related distress, and the relation between these issues and body image, anxiety and depression, health-related quality of life, self-efficacy related to sexuality and fertility, and fertility-related knowledge. METHODS: Participants in the Fex-Can Cohort will be identified via the Swedish National Quality Registries for Brain Tumors, Breast Cancer, Gynecological Oncology, Lymphoma, and Testicular Cancer. All patients diagnosed at the ages of 18-39, during a period of 18 months, will be invited to participate. Established instruments will be used to measure sexual function (PROMIS SexFS), fertility-related distress (RCAC), body image (BIS), anxiety and depression (HADS), and health-related quality of life (QLQ-C30); Self-efficacy and fertility-related knowledge will be assessed by study-specific measures. The survey will be administered to participants at baseline (approximately 1.5 year after diagnosis) and at 3 and 5 years post-diagnosis. Registry data will be used to collect clinical variables. A comparison group of 2000 young adults will be drawn from the Swedish population register (SPAR) and subsequently approached with the same measures as the cancer group. DISCUSSION: The study will determine the prevalence and predictors of sexual dysfunction and fertility-related distress in young men and women with cancer. The findings will form a basis for developing interventions to alleviate sexual problems and fertility-related distress in young adults with cancer in the short and long term. TRIAL REGISTRATION: This is an observational cohort study and clinical trial registration was therefore not obtained

Pneumococcal polysaccharide vaccination in adults undergoing immunosuppressive treatment for inflammatory diseases - a longitudinal study.

INTRODUCTION: Patients undergoing immunosuppressive therapy are at increased risk of infection. Community-acquired pneumonia and invasive pneumococcal disease account for substantial morbidity and mortality in this population and may be prevented by vaccination. Ideally, immunization to pneumococcal antigens should take place before the start of immunosuppressive treatment. Often, however, the treatment cannot be delayed. Little is known about the efficacy of pneumococcal vaccines during immunosuppressive treatment. The objectives of this study were to determine the percentage of vaccine-naïve, immunosuppressed adults with inflammatory diseases seroprotected against Streptococcus pneumoniae and to assess factors associated with the immunogenicity, clinical impact and safety of 23-valent pneumococcal polysaccharide vaccine (PPV) in seronegative subjects. METHODS: This observational study included patients 18 years of age and older who were receiving prednisone ≥20 mg/day or other immunosuppressive drugs. Exclusion criteria were PPV administration in the previous 5 years, intravenous immunoglobulins and pregnancy. Serum immunoglobulin G (IgG) antibody levels against six pneumococcal serotypes were measured. Seropositivity was defined as IgG of 0.5 μg/ml or greater for at least four of six serotypes. Seronegative patients received PPV, and seropositive patients were included as a comparison group. Vaccine response and tolerance were assessed after 4-8 weeks. Disease activity was evaluated on the basis of the Physician Global Assessment scores. Serology was repeated after 1 year, and information on any kind of infection needing medical attention was collected. Outcomes were the proportion of seropositivity and infections between vaccinated and unvaccinated patients. RESULTS: Of 201 included patients, 35 received high-dose corticosteroids and 181 were given immunosuppressive drugs. Baseline seronegativity in 60 (30 %) patients was associated with corticotherapy and lower total IgG. After PPV, disease activity remained unchanged or decreased in 81 % of patients, and 87 % became seropositive. After 1 year, 67 % of vaccinated compared with 90 % of observed patients were seropositive (p &lt; 0.001), whereas the rate of infections did not differ between groups. Those still taking prednisone ≥10 mg/day tended to have poorer serological responses and had significantly more infections. CONCLUSIONS: PPV was safe and moderately effective based on serological response. Seropositivity to pneumococcal antigens significantly reduced the risk of infections. Sustained high-dose corticosteroids were associated with poor vaccine response and more infections