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PubMed1999

Maternal stress in caring for children with feeding disabilities: implications for health care providers.

The purposes of this study were to compare the stress experienced by mothers of children with feeding disorders to the stress experienced by mothers of children with other childhood disabilities, to compare the stress experienced by mothers of children who are tube-fed with that of mothers of children with disabilities who do not require tube feeding, to ascertain the types of stressors that mothers in both groups experience, and to determine their coping resources. Subjects were mothers of children with disabilities who had recently been discharged or were receiving outpatient care from a private rehabilitation facility in a Midwestern city. The Short Form of the Questionnaire on Resources and Stress instrument and open-ended questions developed by the researchers were used. Results were analyzed using analysis of variance. Results indicate that mothers of children requiring tube feeding experienced significantly greater stress than mothers of children with disabilities who do not require tube feedings. Mothers of children requiring tube feeding also receive less support from family and friends. To assist dietitians, other health care professionals, and university instructors in developing family-centered treatment programs, we recommend including fathers, friends, or relatives in the care and feeding process; discovering ways to include the tube-fed child in family mealtime activities; increasing public awareness of tube-feeding issues; organizing support groups; and educating dietetics students about the unique stresses experienced by mothers of children who are tube-fed.

Adolescent↗

PubMed2000

The effect of age on the attentional demands of postural control.

A dual-task paradigm was used to determine the attentional demands of several postural control tasks in 16 older women (age, 71.5+/-3.4 years) and 14 young women (age, 25.5+/-2.4 years). Older women had slower verbal reaction times (VRT) compared with the younger women and increased reaction time more from a sitting to standing posture. Compared with the younger women, older women required more cognitive resources to maintain a simple eyes open standing posture versus an eyes open seated posture. Further, older women had significantly greater VRT during the dual-task conditions compared with younger women. However, VRT did not significantly change as the difficulty of the primary task increased in either group. These data have implications for older adults who may be at risk for falls in situations where they may be engaged in concurrent tasks, even when those tasks are considered automated and/or lower order operations.

Accidental Falls↗

PubMed2006

Secondary syringe exchange as a model for HIV prevention programs in the Russian Federation.

Effective prevention of syringe-borne transmission of HIV and the hepatitis viruses can be undermined if contact between injection drug users and the staff of prevention programs is impeded by police harassment, limited program resources, and the absence of an open "drug scene." All these are commonplace in the Russian Federation. In response, "Project Renewal," the harm reduction program of the AIDS Prevention and Control Center of the Tatarstan Ministry of Health in Kazan, has created a hybrid syringe exchange program that as its primary focus recruited and trained volunteers to provide secondary syringe exchange. To compensate for operational barriers, the program staff identified private venues and trained responsible individuals to work through their own and related networks of injectors to provide clean syringes, other harm reduction supplies, and educational materials, while facilitating the collection and removal of used and potentially contaminated syringes. Program staff developed a detailed set of tracking instruments to monitor, on a daily and weekly basis, the locations and types of contacts and the dissemination of trainings and materials to ensure that the secondary distribution network reaches its target audience. Data show that these secondary exchange sites have proven more productive than the primary mobile and fixed-site syringe exchanges in Kazan. Beginning in 2001, Project Renewal has trained other harm reduction programs in the Russian Federation to use this model of reaching injectors, identifying and training volunteers, and monitoring results of secondary syringe exchange.

Adult↗

PubMed2004

HGVbase: a curated resource describing human DNA variation and phenotype relationships.

The Human Genome Variation Database (HGVbase; http://hgvbase.cgb.ki.se) has provided a curated summary of human DNA variation for more than 5 years, thus facilitating research into DNA sequence variation and human phenotypes. The database has undergone many changes and improvements to accommodate increasing volumes and new types of data. The focus of HGVbase has recently shifted towards information on haplotypes and phenotypes, relationships between phenotypes and DNA variation, and collaborative efforts to provide a global resource for genome-phenome data. Open sharing and precise phenotype definitions are necessary to advance the current understanding of common diseases that are typified by complex aetiologies, small genetic effect sizes and multiple confounding factors that obscure positive study results. Association data will increasingly be collected as part of this new project thrust. This report describes the evolving features of HGVbase, and covers in detail the technological choices we have made to enable efficient storage and data mining of increasingly large and complex data sets.

Computational Biology↗

PubMedDate not supplied

Strategic partnerships: bridging the collaboration gap.

"Teambuilding," "partnering," "outreach," and "collaboration" all are terms of the new millennium. Such terms suggest a continuing trend in healthcare. Partnering and collaboration are the hallmark of many successful models implemented by practice and academic healthcare settings worldwide. Strategic partnering, within and beyond institutions, provides opportunities for personal and professional growth, outreach, and collaboration. Within the global nursing community, cross-national partnerships represent a vehicle for extending knowledge sharing, and for using on-site visits, tele- and videoconferencing, electronic mail, and other resources. The World Wide Web has opened doors to distance learning programs that were once a dream, and that now represent reality. The author addresses the partnering concept and applications within the local healthcare community, within the country, and worldwide.

Attitude of Health Personnel↗

PubMed2004

A study of the empowerment process for cancer patients using Freire's dialogical interviewing.

The aim of this study was to illustrate the empowering process for cancer patients through Freire ' s dialogical interviewing. Fifteen interviewees participated in interviews over a period of three months. Five themes of dialogical interviewing for the empowering process were adopted including building rapport, assessing disempowerment issues, facilitating critical thinking, joint creation, resource connecting and positive feedback. Open-ended questions and participatory observation with reflective notes written by participants were used for data collecting. Constant comparison and content analysis were used for data analysis. The empowered outcomes at a personal level included redefining health, being confident, active involvement, revitalizing the sense of self, and the desire to live for themselves, negotiating the goals of one ' s care plan and having the strength to help others. On the basis of the empowered outcomes achieved through dialogical interviewing in this study, health professionals should apply this process to build partnerships with patients and help them to overcome the suffering caused by cancer.

Adaptation, Psychological↗

PubMed2026

Association of gestational diabetes with other lactation-related disorders: A 2-sample Mendelian randomization analysis of causal effects.

Gestational diabetes mellitus (GDM) is associated with adverse metabolic outcomes and may also be related to postpartum breast and lactation disorders. Observational studies are susceptible to confounding and reverse causation. We used a 2-sample Mendelian randomization design to examine the association between genetic liability to GDM and other disorders of the breast and lactation associated with childbirth. Genetic liability to GDM was associated with higher odds of a composite phenotype of breast and lactation disorders associated with childbirth. Replication using independent samples and more specific clinical outcomes is required. Summary statistics for GDM and the FinnGen outcome "other disorders of breast and lactation associated with childbirth" were obtained from the Integrative Epidemiology Unit open genome-wide association study resource. single nucleotide polymorphisms associated with GDM (P < 5 × 10-6) were clumped (R2 < 0.001) within 10,000 kb. The inverse-variance weighted method was the primary analysis; Mendelian randomization-Egger, weighted median, simple mode, and weighted mode analyses were complementary methods. Heterogeneity, directional horizontal pleiotropy, leave-one-out, and Steiger directionality analyses were performed. Nineteen single nucleotide polymorphisms were retained; F statistics ranged from 21.08 to 288.04. Genetic liability to GDM was associated with higher odds of the outcome in the inverse-variance weighted analysis (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.08-2.09; P = .0165). The weighted median (OR, 1.76; 95% CI, 1.09-2.84; P = .0216) and weighted mode estimates (OR, 1.98; 95% CI, 1.21-3.26; P = .0148) were directionally consistent. There was no statistical evidence of heterogeneity or directional horizontal pleiotropy. The Steiger test supported the direction from GDM to the outcome (P = 1.30 × 10-11).

Diabetes, Gestational↗

PubMed2002

Maternal predictors of children's social cognition: an attachment perspective.

BACKGROUND: This paper assumes that the capacities to (1) openly acknowledge, and (2) elaborate a resourceful plan for coping with distress in the self and others are central features of social cognition. METHOD: These capacities were assessed in a sample (N = 51) of 11-year-old children whose mothers and fathers had previously provided Adult Attachment Interviews (AAIs) before their children were born. The children were shown six line-drawn sequences of child(ren), with peer(s) and/or family in diverse situations involving some moderate distress. The experimenter described the adversity shown in the sequence (e.g., bully pushing over another school-aged child in the presence of onlookers) and then invited the child to attribute thoughts and feelings to the characters, and comment upon what might happen next. RESULTS: Children whose responses scored highly for acknowledgement of the distress, and elaborating a resolution, were significantly more likely to have had mothers (but not fathers) whose AAIs were judged autonomous-secure as opposed to insecure (i.e., dismissing, preoccupied and/or unresolved). The significant influence of maternal representations of attachment upon the 11-year outcome remained even after taking account of concurrent parenting attitudes, children's verbal intelligence, as well as the previously assessed infant-parent attachment patterns. CONCLUSIONS: Discussion concerns the differential predictive power of maternal responses to the Adult Attachment Interview as related to the domain of children's social and emotional understanding.

Adaptation, Psychological↗

PubMed1990

Relationships between support and adjustment among children of divorce.

In a sample of 102 4th-6th grade urban children of divorce, low to moderate relationships were found between perceived support and child adjustment. This relationship held for several sources of support and across several types of adjustment measures. It was strongest when adjustment was assessed through child self-ratings. Thus, children of divorce who perceived themselves as having more overall support had lower scores on measures of post-divorce difficulties, anxiety, and worry, and higher scores on measures of openness about the divorce and positive resources. The relationships found between support and adjustment among children of divorce suggest a potentially useful role for support in developing preventive interventions for such youngsters.

Adaptation, Psychological↗

PubMed1996

Identification, diagnosis and treatment of heart failure: could we do better?

Numerous studies have shown that it is very difficult to diagnose mild heart failure accurately on clinical grounds alone. Routine echocardiography would help to solve this problem but studies have shown that this technique is greatly underused. Providing open access echocardiography, and/or targeting this resource to the most deserving cases by measuring plasma natriuretic peptides may help to optimize the use of this technique while improving the diagnosis of heart failure patients. Studies have also demonstrated the value, but apparent underuse, of angiotensin-converting enzyme (ACE) inhibitor therapy. Further questions for the management of heart failure patients have been presented by these investigations. Uncertainty remains over the appropriate timing of ACE inhibitor therapy and whether low or high doses are more effective. The ongoing ATLAS study aims to answer these questions and promotes an improvement in the treatment of heart failure patients.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2026

A guide to selecting high-performing renewable antibodies for KIF5A (Q12840) across western blot, immunoprecipitation, and immunofluorescence.

Kinesin Family Member 5A (KIF5A) is an important protein for anterograde cellular transport. We characterized ten commercially available research antibodies against KIF5A for use in western blot, immunoprecipitation, and immunofluorescence using a standardized workflow. Antibody performance was assessed by comparing signal in a wild-type cell line and its corresponding knockout derivative. This work is part of a broader collaborative public-good initiative to improve biomedical research by systematically evaluating commercial antibodies against human proteins and openly sharing the data as a resource for the scientific community. We encourage readers to use this report as a guide for selecting antibodies best suited to their specific applications.

Kinesins↗

PubMed2002

Quality, mainstream services with proactive and targeted outreach: a model of contraceptive service provision for young people.

INTRODUCTION: High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service. METHODS: Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service. RESULTS: The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold. CONCLUSION: This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.

Adolescent↗

PubMed2005

Caring for family with Alzheimer's disease and Parkinson's disease: needs, challenges and satisfaction.

A convenience sample of 40 family members caring for an individual with either Alzheimer's disease (AD) or Parkinson's disease (PD) completed the Caregiver Assistance Measure (CAM) to identify the types of assistance that would be most helpful in caring for a family member at home. The CAM measures three categories or types of assistance: care knowledge and skills, self-care, and resource acquisition. Caregivers also completed open-ended questions about the difficulties and the satisfactions of caregiving. The PD and AD caregivers agreed on the importance of 75% of the assistance items on the CAM. In addition, both groups of caregivers identified issues related to care knowledge and skills and selfcare as the most difficult aspects of caregiving. These findings suggest many caregiver needs may be common across chronic illness populations and provide initial support for the development and testing of standardized interventions for caregivers.

Adult↗

PubMed2001

Hand-assisted gastroesophageal surgery.

Hand-assisted laparoscopic surgery (HALS) has been shown to be an effective tool when performing advanced laparoscopic procedures. The hand-assist device restores tactile feedback, facilitates retraction and dissection, and can be a successful alternative to open conversion. HALS is a valuable resource when performing complex gastroesophageal operations, including gastrectomy, esophagectomy, and bariatric surgery. The aim of this review is to familiarize the laparoscopic surgeon with the use of HALS when performing these technically demanding procedures.

Dissection↗

PubMed2004

Triaging patients with post-abortion complications: a prospective study in Nepal.

The first manual vacuum aspiration (MVA) services unit in Nepal was established in 1995 at the country's largest national maternity hospital in Kathmandu. This research sought to assess and evaluate the safety, acceptability, and effectiveness of MVA services. This prospective study was conducted during 12 months in 1998, and follow-up was made at six weeks. Two groups of patients were compared: 529 patients treated in the MVA unit and 236 patients who were clinically eligible for treatment in the MVA unit but were treated instead in the main operation theatre (OT) owing to the unavailability of services in the MVA unit during the hours of their admission. The two groups differed with respect to some of their background characteristics but were similar in their clinical characteristics. The MVA group received contraceptive counselling and services and had significantly shorter stays in hospital. However, the direct cost incurred by the patients, regardless of the type of facility they used, was about the same. Follow-up at six weeks revealed that the MVA patients had significantly fewer complaints and were generally more satisfied with the services they had received than their counterparts. Slightly more than half of the women in the MVA group were using contraception at the time of follow-up compared to no women in the OT group. It is concluded that the MVA unit provided safe, effective, and efficient services to about 50% of all the patients admitted to the hospital with post-abortion complications. An additional 25% of the post-abortion patients could be served if the unit were kept open 24 hours a day, saving resources and time for patients and hospital staff. As a parallel development, both MVA and main OT services would need to be more effectively integrated with outside antenatal and family-planning clinics to address the reproductive health needs of women, thereby reducing the number of patients requiring post-abortion care.

Abortion, Induced↗

PubMed2026

Computational metabolomics at scale: from open data to insight.

Metabolomics data are currently generated at scale thanks to the evolution of technologies that have led to marked improvements in the number of metabolites detected, spanning all chemical classes. These data are increasingly submitted to public repositories for data reuse, integration, and interpretation. Despite the availability of public resources and associated computational tools, the field still lacks a widely adopted, consistent data and analytics infrastructure capable of transforming this wealth of information into scientific insight. Indeed, the metabolomics field is just now scratching the surface of being able to harness the power of new computational technologies. In this review, we summarize discussions from the "Dagstuhl-Seminar 24181 Computational Metabolomics: Towards Molecules, Models, and their Meaning" with a focus on public data availability, open data standards, data and knowledge integration, and education. Our goal is to raise awareness and adoption of the latest open science resources while highlighting key areas needing further development.

Metabolomics↗

PubMed2005

Neural approximation of open-loop feedback rate control in satellite networks.

A resource allocation problem for a satellite network is considered, where variations of fading conditions are added to those of traffic load. Since the capacity of the system is finite and divided in finite discrete portions, the resource allocation problem reveals to be a discrete stochastic programming one, which is typically NP-Hard. In practice, a good approximation of the optimal solution could be obtained through the adoption of a closed-form expression of the performance measure in steady-state conditions. Once we have summarized the drawbacks of such optimization strategy, we address two novel optimization approaches. The first one derives from Gokbayrak and Cassandras and is based on the minimization over the discrete constraint set using an estimate of the gradient, obtained through a "relaxed continuous extension" of the performance measure. The computation of the gradient estimation is based on infinitesimal perturbation analysis (IPA). Neither closed forms of the performance measures, nor additional feedbacks concerning the state of the system and very mild assumptions about the stochastic environment are requested. The second one is the main contribution of the present work, and is based on an open-loop feedback control (OLFC) strategy, aimed at providing optimal reallocation strategies as functions of the state of the network. The optimization approach leads us to a functional optimization problem, and we investigate the adoption of a neural network-based technique, in order to approximate its solution. As is shown in the simulation results, we obtain near-optimal reallocation strategies with a small real time computational effort and avoid the suboptimal transient periods introduced by the IPA gradient descent algorithm.

Algorithms↗

PubMed2000

The ASGE guidelines for the appropriate use of colonoscopy in an open access system.

BACKGROUND: Appropriateness of indications is essential to the rational utilization of resources. The aim of this study was to evaluate the appropriate use of colonoscopy in an open access system and to assess whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are useful in clinical practice. METHODS: The indication for colonoscopy was assessed on 3000 consecutive examinations performed at 7 institutions. RESULTS: The rate of colonoscopies "generally not indicated" according to the ASGE guidelines was 24.5% for outpatients and 15.5% for inpatients; the rates of examinations performed for an indication not listed in the ASGE guidelines were 12% and 20.1%, respectively. Generally not indicated colonoscopies were significantly less frequent for procedures requested by gastroenterologists or family physicians than those requested by other specialists, but were similar. Most generally not indicated examinations requested by gastroenterologists were for routine follow-up of patients with inflammatory bowel disease; when these patients were excluded, the rate of generally not indicated endoscopies requested by gastroenterologists was also lower than the corresponding rate for examinations requested by family physicians. CONCLUSIONS: In Italy, the rate of colonoscopies performed for generally not indicated reasons is high, particularly among examinations not requested by a gastroenterologist. Many colonoscopies are performed for indications not listed in the ASGE guidelines.

Adolescent↗