Coping and parental role competence of mothers of preterm infant

AIM

The study was aimed at obtaining knowledge about mothers' experiences of preterm birth. The objective of the study is to explore coping strategies and self- perceived parental competence, in mothers of infant born moderately and severely preterm and admitted to the Neonatal Intensive Care Unit (NICU).

METHODS

The study involved a group of 16 mothers of moderately preterm children (weeks' gestational age: mean=34, SD=2 and birth weight: mean=2000 g, SD=200 g) and a group of 14 mothers of severely preterm children (weeks' gestational age: mean=29, SD=2 and birth weight: mean=1700 g, SD=350 g). The following instruments were used with mothers to investigate focus areas of research: Coping Orientation to the Problems Experienced-New Italian Version (COPE-NVI), to analyse coping strategies of mothers, and a Q-sort, a self report on maternal competence.

RESULTS

Data did not show statistically significant differences between the two groups of mothers, both in regard to considered coping strategies (social support, avoidance, problem focused orientation, transcendent orientation, positive aptitude), and the indicators of maternal self-perceived competence (coping, scaffolding, caregiving) (Mann-Whitney U test(n1=16 and n2=14)>0.05).

CONCLUSION

This study, highlighting the lack of differences between the two groups of mothers involved, seems to point out that, beyond the levels of prematurity, the condition of preterm birth itself is precisely the main stressor factor for mothers.

Combined antidiabetic benefits of exenatide and dapagliflozin in diabetic mice

The combined glucose-lowering effect of exenatide and dapagliflozin has not yet been studied. We investigated this combination (single-dose or 4-week dosing) in diabetic ob/ob mice. Vehicle-corrected basal glucose showed greater reduction 1 h following exenatide + dapagliflozin than with exenatide or dapagliflozin alone, and stayed significantly lower for all groups versus vehicle over 3 h. During an oral glucose tolerance test, glucose excursion (30 min post-dose) was significantly lower for exenatide + dapagliflozin versus exenatide or dapagliflozin, or vehicle. Exenatide + dapagliflozin and exenatide, but not dapagliflozin alone, reduced glucose excretion over 24 h versus vehicle. After dosing for 4 weeks, exenatide, dapagliflozin and exenatide + dapagliflozin similarly decreased haemoglobin A1c (HbA1c). Body weight was reduced only with exenatide or exenatide + dapagliflozin. The glomerular filtration rate was similar with exenatide, dapagliflozin and vehicle, and increased with exenatide + dapagliflozin. Optimized combinatorial dosing of these antidiabetic agents may provide additive glucose lowering in type 2 diabetes mellitus.

[Narrative inquiries representations and self-esteem in the child affected by tumor: a pre-test pilot study]

AIM

The contribution reports on a pre-test pilot study, based on the single-case method (N>1 and N=1 one by one), aimed to investigate whether resilience factors regards self-narrative representation, self-esteem and their likely correlations in child suffering from tumour.

METHODS

The administration of specific investigation instruments (TMA - multidimensional self-esteem test, and a narrative inquiry framed on purpose) has been planned by the survey. The participating subjects set up a group of 7 children, 10 year olds, suffering from tumour. The individuation of such subjects has been carried out in terms of some "drawing variables" such as the existence of tumour, its diagnosis (12 months before commencing the research), the continuity of medical treatment and the lack of terminal stage of disease.

RESULTS

The study has highlighted the lack of a statistically remarkable impairment of self-narrative and self-esteem in children suffering from tumour belonging to the reference group. These levels of self-narrative and self-esteem are possible resilience factors in children suffering from tumour.

CONCLUSION

The acquired data about specific resilience elements in child suffering from tumor directs to research with national and international sample.

Health-related quality of life outcomes in HIV-infected patients starting different combination regimens in a randomized multinational trial: the INITIO-QoL substudy

The health-related quality of life (HRQoL) outcomes in HIV-infected, treatment-naive patients starting different HAART regimens in a 3-year, randomized, multinational trial were compared. HRQoL was measured in a subgroup of patients enrolled in the INITIO study (153/911), using a modified version of the MOS-HIV questionnaire. The regimens compared in the INITIO trial were composed by two NRTIs (didanosine + stavudine) plus either an NNRTI (efavirenz) or a PI (nelfinavir), or both (efavirenz + nelfinavir). Primary HRQoL outcomes were Physical and Mental Health Summary scores (PHS and MHS, respectively). During follow-up, an increase of PHS score was observed in all treatment arms. The MHS score remained substantially unchanged with the four-drug combination and showed with both NNRTI- and PI-based three-drug regimens a marked trend toward improvement, which became statistically significant when a multiple imputation method was used to adjust for missing data. Overall, starting all the combination regimens compared in the INITIO study was associated with a maintained or slightly improved HRQOL status, consistently with the positive immunological and virological changes observed in the main study. The observed differences in the MHS indicate a possible HRQoL benefit associated to the use of three-drug, two-class regimens and no additional benefit for the use of four-drug, three-class regimens, confirming that three-drug, two-class regimens that include two NRTIs plus either an NNRTI or a PI should be preferred as initial treatment of HIV infection.

Lipodystrophy is an independent predictor of hypertriglyceridemia during pregnancy in HIV-infected women

Lipid values were measured during pregnancy in HIV-infected, treatment-experienced women. A previous history of lipodystrophy was associated with significantly higher triglyceride values at all pregnancy trimesters. In multivariate analyses lipodystrophy independently increased the risk of hypertriglyceridemia by threefold at the first trimester, and by eightfold at the second and third trimesters. Protease inhibitor treatment was also independently associated with hypertriglyceridemia.

[School in hospital: an opportunity for the hospitalized child to overcome the illness risk]

AIM

The paper reports research on the subject of "Overcoming the illness risk in the School in Hospital service" the aim of which was to monitor this particular service so as to assess whether or not the activities proposed are directed by the model of overcoming inherent risks as defined and reported here. Four research directions were taken to verify the hypothesis whereby the service takes on a supportive-transformative value which enables the hospitalized child to study through his/her illness and is thus able to develop by activating support, protection and diagnosis functions.

METHODS

The investigation was carried out using the single case methodology which provided for continuous observation lasting for the entire hospital period in the paediatric wards of 2 hospital in Sicily. The research involved 58 children aged between 7 and 12; chronically ill or long-stay patients, and 100 mothers of hospitalized children. The research also observed the effects of the intervention activated by "School in Hospital" on the child and on his reference models. Various instruments of an observational, projective and psycho-social investigation type were utilized in relation to the 2 main subjects of the research, the development outcomes on the subjects involved and the activities proposed by the service.

RESULTS

The overall results confirm the supportive-transformative value of the "School in Hospital" service.

CONCLUSIONS

The data obtained suggest that the service should be promoted within hospital structures as a specific form of the caring approach.

The chromatin structure of centromeres from fission yeast: differentiation of the central core that correlates with function

We have examined the chromatin structure of centromere regions from the fission yeast Schizosaccharomyces pombe. The large and complex centromere regions of the S. pombe chromosomes encompass many kilobase pairs of DNA and contain several classes of tandemly repeated DNA sequences. The repeated sequences are further organized into a large inverted repeat flanking a central core, a conserved structural feature among all three centromeres in S. pombe. The nucleosomal configuration of the centromere regions is nonuniform and highly varied. Most of the centromere-specific repeated DNA sequences are packaged into nucleosomes typical of bulk chromatin. However, the central core and core-associated repeated sequences from the centromere regions of chromosomes I (cen1) and II (cen2), when present in S. pombe, show an altered chromatin structure, with little or no evidence of regular nucleosomal packaging. The atypical chromatin organization of the cen2 central core is not due to transcription, as no transcripts from this region were detected. These same DNA sequences, however, are packaged into nucleosomes typical of bulk chromatin when present in a nonfunctional environment on a minichromosome in the budding yeast Saccharomyces cerevisiae. Because the cen2 central core sequences themselves do not preclude regular nucleosomal packaging, we speculate that in S. pombe they constitute a specialized site of kinetochore protein assembly. The atypical nucleosomal pattern of the cen2 central core remains constant during the cell cycle, with only minor differences observed for some sequences. We propose that the unusual chromatin organization of the core region forms the basis of a higher order structural differentiation that distinguishes the centromere from the chromosome arms and specifies the essential structure for centromere function.

Use of defibrotide in the treatment of acute myocardial infarction

The results of this preliminary clinical trial confirm the thrombolytic effect of defibrotide demonstrated in preclinical models; demonstrate the positive influence of the product on the natural history of early AMI; suggest that the optimal dosage range should include not less than 1.6 gm of defibrotide during the first hour of treatment; and justify further commitment in the study of defibrotide also beyond the scope of treating AMI.

[Combinations of some anti-arrhythmia drugs]

The need to treat severe and repetitive arrhythmias which are often resistant to treatment with single different drugs has led to an increasing interest towards associations of antiarrhythmic drugs. The advantages of this associations could be: enhancing effect of different pharmacological properties, synergism, reduction of doses and side-effects. The risks are: induction or aggravation of excitability and conduction disturbances, impairment of contractility, hypotension, interaction with digoxin. This study describes our experience in using associations of antiarrhythmic drugs of different classes (IA + II, IA + III, IB + III) or of the same class (IA). We also report our preliminary results with the use of Propafenon-Amiodarone association in the acute treatment of electrophysiologically induced ventricular tachycardias and in the chronic treatment of repetitive and symptomatic ventricular tachycardias. Our experience demonstrates that the association of antiarrhythmic drugs is effective in the treatment of severe and repetitive arrhythmias only if the patients are carefully selected and the risks of unwelcome electrophysiological actions and side-effects are taken into account.

Infarct as a stress agent: life history and personality characteristics in improved versus not-improved patients after severe heart attack

Fifty-eight male subjects admitted to an intensive coronary care unit were interviewed and underwent psychometric testing on the second--third day after a severe heart attack (infarct). Seven-ten days following admission, the clinical condition of the patients was evaluated by the attending cardiological staff and rated on a three point scale. The patients were divided, on the basis of the clinical rating, into two groups: improved (N = 25) and non-improved (N = 33). Life history characteristics, MMPI personality profiles, and State-Trait anxiety scores were then compared for the two groups. The not-improved group showed the higher scores on almost all the MMPI scales, higher anxiety scores and more work-related problems than the improved group. Such data give some empirical support to the hypothesis that the physiological and hemodynamical conditon of the cardiac patient is in some way correlated with the patient's style of coping with stress, and his history of previous life stress situations.