The Relationship between Family Functioning and Adolescent Substance Use

This study utilized an explanatory correlational design to examine the relationship which exists between the predictor variables of adolescent\u27s perception of family adaptation, cohesion, and communication, parental use of substances, adolescent age and gender and the criterion variables of adolescent behavioral intention and self-reported use of alcohol, tobacco, and illicit drugs. The theoretical perspectives of the study, derived from developmental theory and the Circumplex Model of Marital and Family Systems viewed the adolescent stage as a period in which the entire family is challenged to balance levels of adaptation and cohesion in order to facilitate individuation and autonomy of adolescent members. Use of controlled substances by adolescents are considered behaviors which may be influenced by patterns of interaction within the family system. The sample consisted of 306 male and female high school students. Following consent from the student and at least one parent the adolescent was asked to complete four paper and pencil questionnaires. These questionnaires included the Demographic Survey; the Primary Prevention Awareness, Attitude and Usage Scale; the FACES III; and the Parent-Adolescent Communication Scale. Utilizing measures of central tendency and canonical correlation, the data analysis statistically addressed the relationships between the two variables sets. The findings indicated that balanced levels of family functioning and low usage of substances by parents has a strong relationship with decreased substance use by adolescents. Conversely, non-balanced families and those in which parents use substances more often, are families in which the adolescents are more likely to use substances. Age and gender had no significant relation to adolescent substance use or levels of family functioning. Family adaptation, cohesion and communication, and parental role modeling are variables that appear to have a significant impact upon the decisions adolescents make concerning use of alcohol, tobacco products and illicit drugs

Transcriptional dynamics driving MAMP-triggered immunity and pathogen effector-mediated immunosuppression in Arabidopsis leaves following infection with Pseudomonas syringae pv tomato DC3000

Transcriptional reprogramming is integral to effective plant defense. Pathogen effectors act transcriptionally and posttranscriptionally to suppress defense responses. A major challenge to understanding disease and defense responses is discriminating between transcriptional reprogramming associated with microbial-associated molecular pattern (MAMP)-triggered immunity (MTI) and that orchestrated by effectors. A high-resolution time course of genome-wide expression changes following challenge with Pseudomonas syringae pv tomato DC3000 and the nonpathogenic mutant strain DC3000hrpA- allowed us to establish causal links between the activities of pathogen effectors and suppression of MTI and infer with high confidence a range of processes specifically targeted by effectors. Analysis of this information-rich data set with a range of computational tools provided insights into the earliest transcriptional events triggered by effector delivery, regulatory mechanisms recruited, and biological processes targeted. We show that the majority of genes contributing to disease or defense are induced within 6 h postinfection, significantly before pathogen multiplication. Suppression of chloroplast-associated genes is a rapid MAMP-triggered defense response, and suppression of genes involved in chromatin assembly and induction of ubiquitin-related genes coincide with pathogen-induced abscisic acid accumulation. Specific combinations of promoter motifs are engaged in fine-tuning the MTI response and active transcriptional suppression at specific promoter configurations by P. syringae

SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (<380 AU ml−1). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies

Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648

Pediatric nursing procedures, 2 nd ed./ Bowden

xxi, 823 hal.: ill, tab.; 28 cm

Pediatric nursing procedures, 2 nd ed./ Bowden

xxi, 823 hal.: ill, tab.; 28 cm

Children and their families:the continuum of nursing care 2

The thirt edition of children and their families:the continuum of nursing care provides a unique interdisciplinary perspective that anderscores the nurse's role in plaining, coordinating, and working with all members of a pediatric health care team.xxx, 1722 hl.L ilus.; 28 c

Children and their families:the contiuum of nursing care 1

The thirt edition of children and their families:the continuum of nursing care provides a unique interdisciplinary perspective that anderscores the nurse's role in plaining, coordinating, and working with all members of a pediatric health care team.xxx, 874 hlm.: ilus.; 28 c

Buku Ajar Keperawatan Keluarga Riset, dan Praktik Teori,

xxii, 664 hlm, 21 x 27 cm ilu