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Arias D, So E, Chen TF, Moles RJ. The information seeking behaviors of caregivers in the management of childhood fever - A systematic literature review. Res Social Adm Pharm 2024; 20:559-575. [PMID: 38609816 DOI: 10.1016/j.sapharm.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/05/2023] [Accepted: 02/23/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Parents' and caregivers' non-evidence-based childhood fever management 'fever phobic' practices have remained relatively stable over more than 34 years despite successful educational interventions. This systematic review aimed to assess the information seeking behavior of caregivers managing fever in their children, as well as to compile the fever management practices undertaken by caregivers by investigating underlying factors influencing them. METHODS The electronic databases Pubmed, CINAHL, Medline, and International Pharmaceutical Abstracts were searched using key terms including, fever, child, caregiver, and management. Studies were included if they were written in English, published between January 1980 and January 2021, explored generalized childhood fever management practices of caregivers, and factors which influence fever management. Data extracted included study year and design, location, dimensions of fever management explored (i.e., knowledge, beliefs, detection, and/or treatment of fever), factors influencing management, and information sources used by caregivers. RESULTS In total, 36 studies were eligible for inclusion in the study. Twenty-nine of the studies were designed as a cross-sectional survey, six studies were interviews and the remainder were pre-post studies. The review of studies found that parents and caregivers sourced childhood fever management information most commonly from friends and family or their own personal experiences, however, participants most commonly sourced doctors/general practitioners as their first line of information when required. Over the years, trends showed that doctors as well as the internet were more frequently being used as a first line source of information by caregivers. CONCLUSIONS Despite decades of research, education and development of evidence-based guidelines caregivers continue to exhibit 'fever phobia' when caring for febrile children. This is demonstrated by their continued use of non-evidence-based methods and increasing reliance on, and incorrect use of antipyretics, alternating antipyretics if fever is not sufficiently reduced or returns. There is an increasing need for the development of easy to access digital resources for caregiver as internet use is rising which mirrors best practice taught to professionals.
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Affiliation(s)
- Daniel Arias
- School of Pharmacy, The University of Sydney, Australia
| | - Esther So
- School of Pharmacy, The University of Sydney, Australia
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2
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Rogachev S, Hashavya S, Rekhtman D, Schiesel G, Benenson-Weinberg T, Weiser G, Gordon O, Gross I. Return Visits in Infants Younger Than 90 Days Presenting to the Pediatric Emergency Department for Fever. Clin Pediatr (Phila) 2024:99228241234963. [PMID: 38415681 DOI: 10.1177/00099228241234963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Fever in infants presenting to pediatric emergency departments (PEDs) often results in significant return visits (RVs). This retrospective study aimed to identify factors associated with RVs in febrile infants aged 0 to 90 days. Data from infants presenting to PED between 2018 and 2021 and returning within 7 days (RV group) were compared to age-matched febrile infants without RVs (control group). Each group had 95 infants with similar demographics and medical history. RVs were primarily due to positive cultures and persistent fever. The control group had higher initial hospitalization rates, longer PED stays, and increased antibiotic treatment. Prevalence of serious bacterial infections (SBIs) did not significantly differ. Higher hospitalization, prolonged PED stays, and initial antibiotic treatment were associated with reduced RV incidence despite similar SBI rates. Return visits in infants <90 days were primarily driven by persistent fever and positive cultures. Addressing these factors through targeted parental education and improved care protocols may reduce RVs.
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Affiliation(s)
- Sonia Rogachev
- Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Saar Hashavya
- Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - David Rekhtman
- Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Gali Schiesel
- Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel
| | | | - Giora Weiser
- Department of Pediatric Emergency Medicine, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Oren Gordon
- Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itai Gross
- Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel
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Milani GP, Corsello A, Schulz PJ, Fadda M, Giannì ML, Alberti I, Comotti A, Marchisio P, Chiappini E, Peroni D. Childhood fever and medical students: A multicentre, educational intervention. Acta Paediatr 2023; 112:1954-1961. [PMID: 37059701 DOI: 10.1111/apa.16790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/16/2023]
Abstract
AIM Misconceptions and non-evidence-based practices toward childhood fever are reported worldwide. Medical students might be ideal candidates to introduce long-lasting changes in clinical practice. However, no study has gauged the effectiveness of an educational intervention to improve fever management in this population. We conducted an educational, interventional study on childhood fever among final-year medical students. METHODS We conducted a prospective, multicentre interventional study employing a pre/post-test design. Participants from three Italian Universities filled in a questionnaire just before the intervention (T0), immediately after (T1) and 6 months later (T2) in 2022. The intervention was a two-hour lecture focused on the pathophysiology of fever, recommendations for its treatment and risks associated with improper management. RESULTS 188 final-year medical students (median age of 26 years, 67% females) were enrolled. Relevant improvements in the criterion for treating fever and conceptions about the beneficial effects of fever were observed at T1 and T2. Similar data were found for the reduction of physical methods advice to decrease body temperature and concerns for brain damage from fever. CONCLUSION This study shows for the first time that an educational intervention is effective in changing students' conceptions and attitudes toward fever both in the short and medium term.
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Affiliation(s)
- Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Antonio Corsello
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Department of Communication & Media, Ewha Womans University, Seoul, South Korea
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ilaria Alberti
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Comotti
- Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elena Chiappini
- Paediatric Infectious Disease Unit, Meyer Children's University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
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Himbert C, Jenetzky E, Wagenpfeil G, Kerdar SH, Schwarz S, Martin D. [Educating Parents about Fever in Childhood Evaluation of the Effect of an Information Leaflet]. KLINISCHE PADIATRIE 2023; 235:284-289. [PMID: 36603824 PMCID: PMC10477019 DOI: 10.1055/a-1988-1033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Fever is an important immune reaction of the body in infections and plays a major role in childhood. Fear and uncertainty in dealing with fever are still widespread among parents. Information leaflets on the knowledge and handling of fever in childhood can serve as an educational tool for parents. It has not yet been investigated whether this type of information transfer is a suitable tool for educating parents. METHODS 16 kindergartens in Saarland were visited. 481 parents of at least one child between the ages of 1 and 7 years answered a questionnaire on knowledge, approach and handling of fever in infections. Subsequently, an information leaflet on fever was handed out. On the following day, the questionnaire was answered again by the 190 parents who had read the information leaflet. The change due to reading the information leaflet was analyzed. RESULTS 40% of the participants read the information leaflet. 87% mothers and 13% fathers participated in the follow-up survey. 10% of the post-survey respondents had a secondary school diploma and 34% had a university degree. After reading, fever was considered useful significantly more often and febrile convulsions and consequential damage were mentioned significantly less often as a reason for fever reduction. CONCLUSION Information leaflets on fever can be a complementary tool for education, the short-term effect is confirmed, the sustainability needs to be further evaluated. There is also a need to reach the majority.
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Affiliation(s)
- Christina Himbert
- Faculty of Health, School of Medicine, Witten/Herdecke
University, Witten, Germany
| | - Ekkehart Jenetzky
- Faculty of Health, School of Medicine, Witten/Herdecke
University, Witten, Germany
- Department for Child and Adolescent Psychiatry and Psychotherapy,
University Medical Centre of the Johannes Gutenberg University Mainz, Mainz,
Germany
| | - Gudrun Wagenpfeil
- Medical Biometrics, Epidemiology and Health Informatics, Saarland
University, Homburg, Germany
| | - Sara Hamideh Kerdar
- Faculty of Health, School of Medicine, Witten/Herdecke
University, Witten, Germany
| | - Silke Schwarz
- Faculty of Health, School of Medicine, Witten/Herdecke
University, Witten, Germany
| | - David Martin
- Faculty of Health, School of Medicine, Witten/Herdecke
University, Witten, Germany
- Clinic for Paediatrics and Adolescent Medicine, University of
Tübingen, Tübingen, Germany
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Ogunyinka IA, Oshikoya KA, Yusuff KB, Tahir Y, Yahaya M, Adeniye SB, Oforkansi IE. Determinants of caregiver's knowledge and practices regarding childhood fever management in a developing setting: a multi-centre cross-sectional assessment. Front Pediatr 2023; 11:1119067. [PMID: 37675390 PMCID: PMC10477664 DOI: 10.3389/fped.2023.1119067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/04/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Fever is both a sign of various diseases (chief of which are infectious in nature) and an adverse effect of certain interventions (e.g. vaccines, drugs) in the pediatric population. It elicits anxiety among caregivers and healthcare professionals alike resulting in non-evidence based practices, adverse medication administration events, waste of scarce resources and overutilization of health facilities. The determinants of these practices among caregivers in the domiciliary contexts have not been well characterized in developing settings. Methods We assessed the knowledge and practices of childhood fever and their determinants among caregivers in domiciliary settings in Northern Nigeria using a 41-item questionnaire between August 2020 and February 2021. Results The questionnaire is reliable (knowledge: Cronbach's Alpha = 0.689; practice: Cronbach's Alpha = 0.814) and collected data on a total of 2,400 caregiver-child pairs, who participated in the study. Over two-third (68.3%; 1,640) of the caregivers expressed fever phobic tendencies. Paracetamol was the most commonly used medication and constituted 31.3% of medication administration adverse events reported by the caregivers. Only one out of every six knowledgeable caregivers engaged in evidence-based home childhood fever management practices (7% vs. 41.6%) with being a primary caregiver [Knowledge: odd ratio (OR): 2.81, 95% CI: 0.38; 5.68; p value: 0.04; Practice: OR: 1.65, 95% CI: 0.09; 7.33; 0.02] and having a child/children aged ≤3 years (knowledge: OR: 7.03, 95% CI: 4.89; 9.67, p value: 0.003; practice OR: 3.11, 95% CI: 1.27; 8.59, 0.007) determining both the knowledge and practices of childhood fever management in a household. Conclusions The knowledge and practice of childhood fever management among caregivers were sub-optimal with being a primary caregiver and having a child/children aged ≤3 years being the significant determinants of each domain. These gaps underscore the dire need for targeted strategies aimed at improving childhood fever management by educating caregivers.
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Affiliation(s)
- Ibrahim A. Ogunyinka
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Kazeem A. Oshikoya
- Department of Pharmacology, Therapeutics and Toxicology, College of Medicine, Lagos State University, Ikeja, Nigeria
| | - Kazeem B. Yusuff
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Yusuf Tahir
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Mohammed Yahaya
- Department of Medical Microbiology and Parasitology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Sulaiman B. Adeniye
- Department of Research, Innovation and Development, MaributhGlobal Resources Limited, Sagamu, Nigeria
| | - Innocent E. Oforkansi
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
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Milani GP, Corsello A, Fadda M, Falvo I, Giannì ML, Marseglia GL, Cuppari C, Bruzzese E, Bianchetti MG, Schulz PJ, Peroni D, Marchisio P, Chiappini E. Perception, knowledge and attitude towards childhood fever: A survey among final-year medical students. Br J Clin Pharmacol 2023; 89:261-267. [PMID: 35982532 PMCID: PMC10087473 DOI: 10.1111/bcp.15493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS Undue concerns about the consequences of fever and its inappropriate management have been documented worldwide among physicians. However, no data exist on medical students. We investigated the perception, knowledge and attitude towards childhood fever among final-year medical students. METHODS Between June and September 2021, final-year medical students of six Italian universities were invited to complete an online survey on their conceptions and attitude towards pharmacological and non-pharmacological management of childhood fever. History of relevant personal or second-hand experience with childhood fever was also addressed. Both quantitative and qualitative approaches were used. RESULTS Of 1095 (69%) final-year medical students, 756 completed the survey. Many students believe that high fever might cause brain damage, would recommend physical methods and alternate two drugs for fever. Most students do not think that fever has mainly beneficial effects. In Northern Italy, students are less likely to believe that fever might lead to brain damage (OR 0.55, 95% CI 0.33-0.94), and in Southern Italy students are more likely to advise physical methods (OR 1.77, 95% CI 1.22-2.57) and less likely to believe that fever has mainly beneficial effects (OR 0.55, 95% CI 0.39-0.77). History of a relevant personal episode of fever during childhood was not associated with these outcomes. CONCLUSIONS Misconceptions about fever are common among final-year medical students in Italy. Cultural factors rather than individually learned traits might underlie these beliefs. Medical students are a promising target for educational interventions to improve childhood fever management.
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Affiliation(s)
- Gregorio P Milani
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Antonio Corsello
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy.,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Marta Fadda
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Institute of Public Health, Switzerland
| | - Ilaria Falvo
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Institute of Public Health, Switzerland
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milan, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, Fondazione IRCSS-Policlinico San Matteo, University of Pavia, Italy
| | - Caterina Cuppari
- Department of Human Pathology of Adulthood and Childhood, Pediatric Emergency Unit, University of Messina, Messina, Italy
| | - Eugenia Bruzzese
- Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università di Napoli Federico II, Naples, Italy
| | - Mario G Bianchetti
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Switzerland.,Department of Communication & Media, Ewha Womans University, Seoul, South Korea
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elena Chiappini
- Pediatric Infectious Disease Unit, Meyer Children's University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
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Merlo F, Falvo I, Caiata-Zufferey M, Schulz PJ, Milani GP, Simonetti GD, Bianchetti MG, Fadda M. New insights into fever phobia: a pilot qualitative study with caregivers and their healthcare providers. Eur J Pediatr 2023; 182:651-659. [PMID: 36443503 PMCID: PMC9899170 DOI: 10.1007/s00431-022-04704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED Despite the availability of clinical guidelines on the correct symptomatic management of fever in children, several studies have reported inaccurate knowledge about this symptom and inappropriate management behaviours among caregivers. There is evidence that caregivers' management of fever is largely influenced by unrealistic and unwarranted concerns about the potential harm that elevated body temperature can cause, a phenomenon commonly referred to as fever phobia. Research on fever phobia has predominantly focused on the role of fever misconceptions in triggering anxiety and impeding a proper fever management, in terms of both concept and operationalization, with little attention to the influence of the relationship between caregivers and the healthcare team. The aim of this pilot study was to explore and describe fever-related knowledge, experience and behaviour among a sample of caregivers, paediatricians and their medical assistants in the Canton of Ticino, Switzerland. We used a qualitative study design with semi-structured, one-to-one interviews with paediatricians employed in private healthcare facilities, their medical assistants and caregivers with at least one child between the ages of 0 and 3 years. We conducted individual interviews either in person or by phone, according to participants' preferences, between October 2020 and February 2021. We performed an inductive-deductive analysis of the transcripts to identify the most meaningful themes from participants' reports. The analysis of the transcripts yielded three main themes. The first theme refers to participants' awareness of the emotional component in managing the child's fever and the challenges this component presents. The second theme refers to the risk of overtreating when the child's right to be sick is not recognized and respected. The third theme refers to the importance of the relational component, showing how a solid therapeutic alliance with the healthcare team helps caregivers develop self-confidence in managing the child's fever. This study contributes to advance our understanding of fever phobia and to a better conceptualization and operationalization of this phenomenon. CONCLUSION Our results point out to the importance of going beyond a knowledge gap paradigm and recognizing both the emotional and the relational component of fever phobia, the former being entrenched in latter, that is, the unique relationship caregivers establish with their child's paediatrician and the medical assistant. WHAT IS KNOWN • Research on fever phobia has predominantly focused on the role of fever misconceptions in triggering anxiety and impeding a proper fever management, in terms of both concept and operationalization, with little attention to the relational component of this phenomenon. WHAT IS NEW • Our results point out to the importance of recognizing the emotional component of fever phobia, beyond its declarative and procedural knowledge dimensions. They also suggest that overtreating is not necessarily and not only the result of a phobia but also of a particular conception of health and the relational component of this phenomenon, which is entrenched in the unique relationship caregivers establish with their child's paediatrician and the medical assistant.
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Affiliation(s)
- Federica Merlo
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland ,Sasso Corbaro Foundation, Bellinzona, Switzerland
| | - Ilaria Falvo
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maria Caiata-Zufferey
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Peter J. Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera Italiana, Lugano, Switzerland ,Department of Communication & Media, Ewha Womans University, Seoul, Korea
| | - Gregorio P. Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Giacomo D. Simonetti
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale, EOC, Bellinzona, Switzerland ,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Mario G. Bianchetti
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
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Henrik SZŐKE, István BÓKKON, David M, Jan V, Ágnes K, Zoltán K, Ferenc F, Tibor K, László SL, Ádám D, Odilia M, Andrea K. The innate immune system and fever under redox control: A Narrative Review. Curr Med Chem 2022; 29:4324-4362. [DOI: 10.2174/0929867329666220203122239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/21/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022]
Abstract
ABSTRACT:
In living cells, redox potential is vitally important for normal physiological processes that are closely regulated by antioxidants, free amino acids and proteins that either have reactive oxygen and nitrogen species capture capability or can be compartmentalized. Although hundreds of experiments support the regulatory role of free radicals and their derivatives, several authors continue to claim that these perform only harmful and non-regulatory functions. In this paper we show that countless intracellular and extracellular signal pathways are directly or indirectly linked to regulated redox processes. We also briefly discuss how artificial oxidative stress can have important therapeutic potential and the possible negative effects of popular antioxidant supplements.
Next, we present the argument supported by a large number of studies that several major components of innate immunity, as well as fever, is also essentially associated with regulated redox processes. Our goal is to point out that the production of excess or unregulated free radicals and reactive species can be secondary processes due to the perturbed cellular signal pathways. However, researchers on pharmacology should consider the important role of redox mechanisms in the innate immune system and fever.
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Affiliation(s)
- SZŐKE Henrik
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - BÓKKON István
- Neuroscience and Consciousness Research Department, Vision Research Institute,
Lowell, MA, USA
| | - martin David
- Department of Human Medicine, University Witten/Herdecke, Witten, Germany
| | - Vagedes Jan
- University Children’s Hospital, Tuebingen University, Tuebingen, Germany
| | - kiss Ágnes
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - kovács Zoltán
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - fekete Ferenc
- Department of Nyerges Gábor Pediatric Infectology, Heim Pál National Pediatric Institute, Budapest, Hungary
| | - kocsis Tibor
- Department of Clinical Governance, Hungarian National Ambulance Service, Budapest, Hungary
| | | | | | | | - kisbenedek Andrea
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
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10
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Arias D, Carter SR, Chen TF, Moles RJ. Australian care givers' knowledge of and attitudes towards paediatric fever management. J Paediatr Child Health 2022; 58:54-62. [PMID: 34191367 DOI: 10.1111/jpc.15625] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/20/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Abstract
AIM Non-evidence-based practice and inappropriate paediatric fever management by care givers is common. The aim of this study was to survey a large sample of Australian parents and care givers utilising a validated Fever Management Tool, to determine the current knowledge, beliefs and attitudes of Australian care givers regarding fever management. METHODS This study employed a cross-sectional survey conducted via a third-party market research company. Univariate analysis of demographic factors and their influence on knowledge scores were tested. A multivariate linear regression model was specified using all available independent univariate predicators to determine the demographic factors influencing care givers fever knowledge. RESULTS Data from 1000 questionnaires were analysed. The participants' total knowledge scores were evenly distributed with a mean score of 15.4/29 correct answers in the True/False questionnaire, a median score of 16 and a standard deviation of 4.27. It highlighted that Australian care givers had poor knowledge in questions related to 'teething', 'physical cooling methods' and 'medication dosing'. In the multivariate analysis, 28.9% of the total variance was explained (R2 value = 0.289, P < 0.001) with 5 of 11 factors contributing. CONCLUSION Overall, this cross-sectional survey has provided a strong understanding of the current knowledge, attitude and beliefs of Australian care givers in regards to fever management in their children. Total knowledge of fever management was generally poor in Australia with many participants harbouring misconceptions and non-evidence-based practices. Future interventions improving fever management practices should be tailored to the specific weaknesses faced by Australian care givers in order to promote long term change.
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Affiliation(s)
- Daniel Arias
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen R Carter
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Timothy F Chen
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
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Sociodemographic Characteristics and Interests of FeverApp Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063121. [PMID: 33803541 PMCID: PMC8002853 DOI: 10.3390/ijerph18063121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022]
Abstract
The FeverApp Registry is a model registry focusing on pediatric fever using a mobile app to collect data and present recommendations. The recorded interactions can clarify the relationship between user documentation and user information. This initial evaluation regarding features of participants and usage intensity of educational video, information library, and documentation of fever events covers the runtime of FeverApp for the first 14 months. Of the 1592 users, the educational opening video was viewed by 41.5%, the Info Library was viewed by 37.5%, and fever events were documented by 55.5%. In the current sample, the role of a mother (p < 0.0090), having a higher level of education (p = 0.0013), or being registered at an earlier date appear to be cues to take note of the training video, Info Library, and to document. The FeverApp was used slightly less by people with a lower level of education or who had a migration background, but at the current stage of recruitment no conclusion can be made. The user analyses presented here are plausible and should be verified with further dissemination of the registry. Ecological momentary assessment is used more than the information option, in line with the task of a registry. Data collection via app seems feasible.
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Effective Communication Strategies of Sustainable Hospitality: A Qualitative Exploration. SUSTAINABILITY 2020. [DOI: 10.3390/su12176920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sustainability is a pivotal issue for the development of hospitality. The industry has attempted multiple ways to achieve this goal, with effective communication being one of the most prevalent ones. However, the communication effect which hospitality has obtained in terms of persuading customers to practice sustainability is imperfect. This study draws upon the communication literature and textually analyzes hospitality professionals’ perception worldwide to generate a typology for hospitality practitioners to follow while conducting communication with customers on sustainability. The findings suggest two strategies and seven tactics that are of value to help hospitality achieve better communication. Thus, this study can extend the current communication theories on how to undertake sustainable hospitality communication and elucidate its operation in the industry.
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