9 research outputs found
Antioxidant intake in paediatric oncology patients
Thesis (MNutr)--Stellenbosch University, 2011.ENGLISH ABSTRACT: Background: The role of antioxidants and adequate nutrition in the prevention and course of
cancer treatment is globally recognised in nullifying the effects of free radicals and increasing the
nutritional status of children during treatment.
Objective: To investigate whether children with cancer meet their Dietary Reference Values and
Safe Intakes for antioxidants, energy and protein.
Design: Single centre prospective study.
Setting: Children were recruited from the East of England Primary Treatment Centre using
convenience sampling over 8 months. Forty-two children and adolescents diagnosed with a Solid
tumour, Lymphoma or Leukaemia were eligible for data analysis (n=20 male; n=22 female).
Method: Data was collected with an Estimated Food Record (EFR) in the 1st (EFR1) and 3rd month
(EFR2) post-diagnosis. In the week following EFR completion, parents and/or children were
contacted to complete four non-consecutive days of 24-hr food recalls. Data was categorised into
diet alone, diet + food supplement (FS), tube feeding (tube) or diet + multi-vitamin-mineral
supplementation (VMS). Malnutrition was determined by weight-for-age z-scores. Nutrient intake
was compared to the Recommended Nutrient Intake (RNI), the Estimated Average Requirements
(EAR) and the Lower Recommended Nutrient Intake (LRNI).
Result: The sample consisted of 33% (n=14) diagnosed with Leukaemia, 24% (n=10) with
Lymphoma and 43% (n=18) with Solid tumours. Sixty seven percent (n=28) underwent
chemotherapy and 33% (n=14) a combination of therapies. Significant correlations were seen
between the assessment tools in the diet alone category for both months for; vitamins A, C, E,
selenium and protein and for EFR1 for zinc and energy. In both months greater numbers of
children achieved ≥100% of requirements for diet + VMS (EFR 1; p<0.05; EFR2 p<0.05) than for
other feeding modes. Vitamin C achieved the highest intakes compared to the RNI at 773%
(EFR1) and 829% (EFR2). Intakes above 200% of the RNI were seen for vitamins A, C, E,
selenium and zinc. No significant differences were seen between modes of feeding in either month
for selenium or zinc. Vitamin A (EFR1≤ 100% diet alone p<0.05) and zinc (EFR1≤ 100% diet alone
p=0.02) met the least of the LRNI in the 1st month compared to other antioxidants. No statistical
significant difference was observed between the number of children attaining their EAR’s between
the 3 modes of feeding in the 1st month and 3rd month. In the 1st month 27% (n=8) of participants
consumed vitamin and/or mineral supplements, 18% in the 3rd month (n=4). In the 1st month 5%
(n=2) of children were moderately malnourished and 10% (n=4) in 3rd month. Conversely in the 1st
month 3% (n=1) were overweight and 3% (n=1) obese; the leukaemia group predominant.
Conclusion: The research tools showed good correlation. Children using vitamin and/or mineral
supplements mostly achieved their RNI’s compared to other feeding modes. Across feeding modes
some children achieved antioxidant intakes above 200% RNI. LRNI’s on diet alone were not achieved for vitamin A and zinc. The study showed Leukaemics as having a higher prevalence of
obesity. More research is required to determine the clinical implications of these findings.AFRIKAANSE OPSOMMING: Agtergrond: Die rol van anti-oksidante en voldoende voeding in die voorkoming en verloop van
kanker behandeling word wêreldwyd erken vir vernietiging van die effek van vry radikale en die
verbetering van voedingstatus van kinders tydens behandeling.
Doelwit: Om ondersoek in te stel of kinders met kanker hul Dieet Verwysingswaardes en Veilige
Innames vir anti-oksidante, energie en proteïen bereik.
Ontwerp: Enkel sentrum prospektiewe studie.
Omgewing: Kinders was gewerf deur middel van gerieflikheidsteekproefneming oor 8 maande
vanaf die “East of England Primary Treatment Centre”. Twee-en-veertig kinders en adolessente
gediagnoseer met 'n Soliede tumor, Limfoom of Leukemie het in aanmerking gekom vir dataanalise
(n=20 manlik, n=22 vroulik).
Metode: Data was ingesamel met ‘n Geskatte Voedsel Rekord (GVR) in die eerste (GVR1) en
derde maand (GVR2) na diagnose. In die week na voltooiing van die GVR is ouers en/of kinders
gekontak om vier onopeenvolgende dae van 24-uur herroepe te voltooi. Data was verdeel in dieet
alleen, dieet + voedsel supplement (VS), buisvoeding (buis) of dieet + multi-vitamien-mineraal
supplementasie (VMS). Wanvoeding was bepaal deur middel van gewig-vir-ouderdom z-tellings.
Nutriënt inname was vergelyk met die Aanbevole Nutriënt Inname (ANI), die Geskatte Gemiddelde
Behoeftes (GGB) en die Laer Aanbevole Nutriënt Inname (LANI).
Resultate: Die steekproef het bestaan uit 33% (n=14) gediagnoseer met Leukemie, 24% (n=10)
Limfoom en 43% (n=18) Soliede tumore. Sewe-en-sestig persent (n=28) het chemoterapie ontvang
en 33% (n=14) ‘n kombinasie van terapieë. Betekenisvolle korrelasies was waargeneem tussen
die assesseringsinstrumente in die dieet alleen kategorie vir beide maande vir vitamiene A, C, E,
selenium en proteïen en vir GVR1 ook vir sink en energie. In beide maande het ‘n groter aantal
kinders ≥100% van hul behoeftes bereik vr dieet+VMS (GVR1; p<0.05; GVR2 p<0.05) as vir ander
modi van voeding. Vitamien C het die hoogste innames bereik vergeleke met die ANI teen 773%
(GVR1) en 829% (GVR2). Innames bo 200% van die ANI was waargeneem vir vitamiene A, C, E,
selenium en sink. Geen betekenisvolle verskille was waargeneem tussen modi van voeding in
enige maand vir selenium en sink nie. Vitamien A (GVR1≤100% dieet alleen p<0.05) en sink
(GVR1≤100% dieet alleen p=0.02) het die minste van die LANI bereik in die eerste maand
vergeleke met ander anti-oksidante. Geen statisties beduidende verskil was waargeneem tussen
die aantal kinders wat hul GGB’s bereik het tussen die 3 voedingswyses in die eerste en derde
maande nie. In die eerste maand het 27% (n=8) van deelnemers vitamien en/of mineraal
supplemente ingeneem, en 18% (n=4) in die derde maand. In die eerste maand was 5% (n=2) van
kinders matig wangevoed en 10% (n=4) in die derde maand. In die eerste maand was 3% (n=1)
van kinders oorgewig en 3% (n=1) vetsugtig, die leukemie groep spesifiek.
Gevolgtrekking: Die navorsingsinstrumente het goeie korrelasie getoon. Kinders wat vitamien
en/of mineraal supplemente gebruik het het meestal hul ANI’s bereik vergeleke met ander modi van voeding. Oor voeding modi het sommige kinders anti-oksidant innames bo 200% ANI bereik.
LANI’s op dieet alleen was nie bereik vir Vitamien A en sink nie. Hierdie studie het aangetoon dat
dié met Leukemia ‘n hoër prevalensie van oorgewig/vetsug getoon het. Meer navorsing is nodig
om die kliniese implikasies van die bevindinge te bepaal
Recruitment of trimeric eIF2 by phosphatase non-catalytic subunit PPP1R15B
Regulated protein phosphorylation controls most cellular processes. The protein phosphatase PP1 is the catalytic subunit of many holoenzymes that dephosphorylate serine/threonine residues. How these enzymes recruit their substrates is largely unknown. Here, we integrated diverse approaches to elucidate how the PP1 non-catalytic subunit PPP1R15B (R15B) captures its full trimeric eIF2 substrate. We found that the substrate-recruitment module of R15B is largely disordered with three short helical elements, H1, H2, and H3. H1 and H2 form a clamp that grasps the substrate in a region remote from the phosphorylated residue. A homozygous N423D variant, adjacent to H1, reducing substrate binding and dephosphorylation was discovered in a rare syndrome with microcephaly, developmental delay, and intellectual disability. These findings explain how R15B captures its 125 kDa substrate by binding the far end of the complex relative to the phosphosite to present it for dephosphorylation by PP1, a paradigm of broad relevance.</p
Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment
Background: Type 1 diabetes in young children is a heavy parental burden. As part of
pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to
study the association between hypoglycemia fear, parental well-being and child behavior.
Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear
survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties
Questionnaire (SDQ).
Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes
duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found
a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia
worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two
parents. Median daytime sleepiness score was high in five parents (>10). For six children a
high total behavioral difficulty score (>16) was reported. Pro social behavior score was
lower than normal in six children (<6). Parental well-being was negatively associated with
HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and
HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and
diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime
sleepiness are associated with the HbA1c.
Conclusion: Regular screening of parental well-being, hypoglycemia fear and child
behavior should be part of routine care to target early intervention
Recommended from our members
Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment
Background: Type 1 diabetes in young children is a heavy parental burden. As part of pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to study the association between hypoglycemia fear, parental well-being and child behavior. Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties Questionnaire (SDQ). Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two parents. Median daytime sleepiness score was high in five parents (>10). For six children a high total behavioral difficulty score (>16) was reported. Pro social behavior score was lower than normal in six children (<6). Parental well-being was negatively associated with HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime sleepiness are associated with the HbA1c. Conclusion: Regular screening of parental well-being, hypoglycemia fear and child behavior should be part of routine care to target early intervention
Antioxidant intake in paediatric oncology patients
Background & aims: Antioxidant intake can affect both free radical and the nutritional status of children receiving cancer treatment. The aim of this study was to investigate whether children with cancer met their antioxidant requirements. Methods: A prospective observational study was performed at a single hospital in England from June 2008 to February 2010.Children with a solid tumour, lymphoma or leukaemia were included. Dietary intakes including 3 modes of feeding ('diet alone', 'diet + tube' feeding or 'diet + vitamin-mineral supplementation' (VMS)) were collected with an estimated food record (EFR) 1 and 3 month post-diagnosis. Four and 24-hr food recalls were performed to validate the food records. Results: Forty two children were included: 57% leukaemia or lymphoma and 43% solid tumours. Sixty seven percent underwent chemotherapy and 33% a combination of therapies. In months 1 and 3, greater numbers of children achieved ≥100% of requirements for 'diet + VMS' (p < 0.05) than for other feeding modes. However, considerable proportions of all feeding groups did not achieve 100% of the Recommended Nutrient Intake (RNI) for vitamin A, C, E, selenium and zinc. This was most marked in the 'diet alone' group. Significant proportions did not achieve the Lower Recommended Nutrient Intake (LRNI) for some antioxidants. The 'diet alone' group had the highest proportion not meeting LRNI for vitamin A (p << 0.001; 1st month) and zinc (p < 0.02; 3rd month). Conclusion: Inadequate antioxidant intake was observed in a significant proportion of cancer patients when feeding was not augmented in any way. More research is required to determine the clinical implications of these findings.</p
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Home Use of Day-and-Night Hybrid Closed-Loop Insulin Delivery in Very Young Children: A Multicenter, 3-Week, Randomized Trial.
OBJECTIVE: We aimed to assess the feasibility and safety of hybrid closed-loop insulin delivery in children with type 1 diabetes aged 1-7 years as well as evaluate the role of diluted insulin on glucose control. RESEARCH DESIGN AND METHODS: In an open-label, multicenter, multinational, randomized crossover study, 24 children with type 1 diabetes on insulin pump therapy (median age 5 years [interquartile range 3-6] and mean ± SD HbA1c 7.4 ± 0.7% [57 ± 8 mmol/mol] and total insulin 13.2 ± 4.8 units/day) underwent two 21-day periods of unrestricted living and we compared hybrid closed-loop with diluted insulin (U20) and hybrid closed-loop with standard strength insulin (U100) in random order. During both interventions, the Cambridge model predictive control algorithm was used. RESULTS: The proportion of time that sensor glucose was in the target range between 3.9 and 10 mmol/L (primary end point) was not different between interventions (mean ± SD 72 ± 8% vs. 70 ± 7% for closed-loop with diluted insulin vs. closed-loop with standard insulin, respectively; P = 0.16). There was no difference in mean glucose levels (8.0 ± 0.8 vs. 8.2 ± 0.6 mmol/L; P = 0.14), glucose variability (SD of sensor glucose 3.1 ± 0.5 vs. 3.2 ± 0.4 mmol/L; P = 0.16), or the proportion of time spent with sensor glucose 0.99). Total daily insulin delivery did not differ (17.3 ± 5.6 vs. 18.9 ± 6.9 units/day; P = 0.07). No closed-loop-related severe hypoglycemia or ketoacidosis occurred. CONCLUSIONS: Unrestricted home use of day-and-night closed-loop in very young children with type 1 diabetes is feasible and safe. The use of diluted insulin during closed-loop does not provide additional benefits compared with standard strength insulin.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the grant agreement No 731560. This material reflects only the author’s views and the Commission is not liable for any use that may be made of the information contained therein. The Jaeb Center for Health Research is funded by JDRF under the grant 3-SRA-2016-297-M-N. Additional support for the artificial pancreas work was from National Institute for Health Research Cambridge Biomedical Research Centre, and Wellcome Trust Strategic Award (100574/Z/12/Z)
Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment
Background: Type 1 diabetes in young children is a heavy parental burden. As part of
pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to
study the association between hypoglycemia fear, parental well-being and child behavior.
Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear
survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties
Questionnaire (SDQ).
Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes
duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found
a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia
worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two
parents. Median daytime sleepiness score was high in five parents (>10). For six children a
high total behavioral difficulty score (>16) was reported. Pro social behavior score was
lower than normal in six children (<6). Parental well-being was negatively associated with
HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and
HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and
diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime
sleepiness are associated with the HbA1c.
Conclusion: Regular screening of parental well-being, hypoglycemia fear and child
behavior should be part of routine care to target early intervention
Recommended from our members
Reduced burden of diabetes and improved quality of life: Experiences from unrestricted day-and-night hybrid closed-loop use in very young children with type 1 diabetes.
OBJECTIVE: To evaluate the experiences of families with very young children aged 1 to 7 years (inclusive) with type 1 diabetes using day-and-night hybrid closed-loop insulin delivery. METHODS: Parents/caregivers of 20 children aged 1 to 7 years with type 1 diabetes completed a closed-loop experience survey following two 3-week periods of unrestricted day-and-night hybrid closed-loop insulin therapy using Cambridge FlorenceM system at home. Benefits, limitations, and improvements of closed-loop technology were explored. RESULTS: Responders reported reduced burden of diabetes management, less time spent managing diabetes, and improved quality of sleep with closed-loop. Ninety percent of the responders felt less worried about their child's glucose control using closed-loop. Size of study devices, battery performance and connectivity issues were identified as areas for improvement. Parents/caregivers wished for more options to input information to the system such as temporary glucose targets. CONCLUSIONS: Parents/caregivers of very young children reported important quality of life benefits associated with using closed-loop, supporting adoption of this technology in this population
Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment
Background: Type 1 diabetes in young children is a heavy parental burden. As part of
pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to
study the association between hypoglycemia fear, parental well-being and child behavior.
Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear
survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties
Questionnaire (SDQ).
Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes
duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found
a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia
worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two
parents. Median daytime sleepiness score was high in five parents (>10). For six children a
high total behavioral difficulty score (>16) was reported. Pro social behavior score was
lower than normal in six children (<6). Parental well-being was negatively associated with
HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and
HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and
diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime
sleepiness are associated with the HbA1c.
Conclusion: Regular screening of parental well-being, hypoglycemia fear and child
behavior should be part of routine care to target early intervention