A Child with Crohn's Disease: Problems and Stress Level of Parents-Caregivers-A Cross-Sectional Study

Crohn's disease (CD) is a chronic inflammatory bowel disease. The perception of the disease, its troublesome symptoms and the highly involved treatment mean that living with CD requires not only the affected child having to learn to cope with it, but also their parents. The aim of the study was to examine the problems and levels of stress in parents-caregivers of children with CD. The study was cross-sectional and conducted using the diagnostic survey method. An original questionnaire was used to assess the socio-demographic situation and problems of caring for a child with CD, and the standardised PSS-10 questionnaire was added. The study group consisted of 60 parents who accompanied their children during hospitalization. The surveyed caregivers of children with CD found it difficult to maintain a specialised diet and deal with the need for hospitalization and the chronic use of medications. Access to the necessary knowledge about the disease posed the least difficulty in everyday life for a child with CD. The vast majority of parents (50, 83.34%) felt a high level of stress related to caring for a child with CD and, simultaneously, a lack of acceptance of the child's disease (39, 65%). The age of the respondents did not have a statistically significant effect on the occurrence of problems related to everyday functioning. The acceptance of the child's disease by the parents and informal caregivers of children with CD reduced their stress level. Parents could count on support from their relatives but, unfortunately, institutional support was not properly provided.

Quality of Life of Polish Patients with Lymphoma Treated Systemically

Research on the quality of life has become of great importance. It is used by clinical researchers to compare the impact of treatment regimens on patients. The choice of treatment method may significantly depend on the patient's opinion. A cross-sectional study was conducted using the method of a diagnostic questionnaire survey. The research tools were the authors' questionnaire and the standardized WHOQOL-BREF. The study was conducted among patients with lymphoma, treated systemically. More than half of the surveyed patients assessed their overall quality of life as good (50%) and very good (6%), while the expressed satisfaction with health most often ranged from neutral (38%-neither good nor bad) to dissatisfactory (30%) and very dissatisfactory (6%). As regards the detailed domains, the area of physical functioning was rated the lowest, while for the remaining domains-psychological, social, environmental-values above average (60.38-64.30) were observed. Social support, particularly from the immediate family, resulted in a higher assessment of the quality of life. The occurrence of side effects related to anticancer treatment and the disease had a statistically significant impact on the decrease in the quality of life, particularly in the physical domain.

Self at Risk: Self-Esteem and Quality of Life in Cancer Patients Undergoing Surgical Treatment and Experiencing Bodily Deformities

Self-esteem is an important factor determining QoL after surgical procedures leading to bodily deformities associated with cancer treatment. However, there are few data on which components of self-esteem are most closely related to QoL. The article presents two studies that aim to fill this gap. Study 1 concerns changes in global self-esteem and QoL in patients treated surgically for oral cancer (n = 35); Study 2 concerns changes in explicit and implicit self-esteem and QoL in women with breast cancer undergoing mastectomy (n = 96). The study was longitudinal with two measurements: before and after surgery. Both studies used the EORTC QLQ-C30 and Rosenberg's SES questionnaires. In Study 2, the Implicit Association Test (IAT) was additionally performed. The patients' global QoL and self-esteem deteriorated after surgery. In Study 1, patients with higher initial self-esteem showed a greater range of decreased self-esteem and QoL than patients with initially low self-esteem. In Study 2, the largest decreases in various dimensions of QoL and explicit self-esteem were observed in women with fragile self-esteem. A group of women with high explicit and implicit self-esteem showed the best QoL after mastectomy. Cancer patients with high, fragile self-esteem are at risk of the greatest deterioration in QoL and self-image after cancer surgery. These people should be given special psycho-oncological care.

Assessment by Women on Selected Aspects of Quality of Life and on Disease Acceptance after Undergoing Urogynecological Procedures for Urinary Incontinence

Urinary incontinence is a common social and health problem that affects both men and women. Women, however, are twice as likely as men to experience unintentional and involuntary bladder emptying due to their anatomical structure and biological functions. Urinary incontinence is associated with great discomfort, a sense of shame, and a significant reduction in self-esteem, often resulting in the limiting of, or withdrawing from, professional, social, and community life. The aim of this study was to evaluate selected aspects of the quality of life and disease acceptance by women who had undergone urogynecological procedures for urinary incontinence. The study encompassed 77 women. The diagnostic tools used in the study were the Polish versions of the King's Health Questionnaire (KHQ), the Acceptance of Illness Scale (AIS), and the authors' own survey questionnaire. From the undertaken research, we found that women with urinary incontinence who underwent urogynecological procedures rated their overall health well. What worsened the most regarding the quality of life of women post-procedure for urinary incontinence was the impact of bladder problems on their lives and the discomfort they felt due to bladder problems. The relationship between the time elapsed since the procedure and the quality of life of the respondents with regard to the emotions they experienced was also found to be significant. The longer the time since the procedure, the lower the intensity of negative emotions, and thus the higher the quality of life. Despite the varied opinions of the respondents about the impact of bladder dysfunction on various areas of their lives, acceptance of the disease, as measured by the AIS scale, appeared to be high.

Mapping the literature on decision regret in patients with non-communicable diseases (NCDs): a scoping review protocol

INTRODUCTION

Decision regret refers to feelings of remorse or dissatisfaction with a decision made regarding the treatment. Mapping the meaningful aspects of decision regret in patients with non-communicable diseases (NCDs) is necessary to provide a comprehensive understanding of the phenomenon and inform the development of effective interventions to address it. For this reason, this protocol aimed to describe the methodological aspects of a scoping review focused on mapping all the meaningful aspects of decision regret in patients with NCDs and provide a conceptual and comprehensive framework of the phenomenon.

METHODS AND ANALYSIS

The study described in this protocol will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews. The anticipated starting time is July/August 2023 and the anticipated end of the review is June 2024. This scoping review will include quantitative, qualitative, primary and secondary literature, as well as grey literature on decision regret in patients with NCDs. The systematic search will be performed by consulting PubMed, Embase, Scopus, CINAHL, the Cochrane Library and Google Scholar. English-language articles from any context will be eligible for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers and extracting data. Disagreements among reviewers will be solved through consensus meetings. Results will be presented in relation to the review question by employing tables, figures and narrative summaries.

ETHICS AND DISSEMINATION

This scoping review did not require ethical approval since it involves a literature review and does not include new data collection from human participants. The results of the review will provide a summary of the available literature on decision regret experienced by patients with NCDs, which is crucial for developing preventive educational interventions in situations where multiple therapeutic options are available.

AStudy on Selected Aspects of the Quality of Life of People in Remission after Cancer Treatment with the use of the Individual in-depth Interview Technique

Background: Acharacteristic feature of cancer is, among other things, that even after successful oncological treatment, the patient cannot close this chapter of life and the experience of being acancer patient. In oncology there is no unambiguous definition of apatient as ahealthy person. Methods: The study covered agroup of 20 people. In the con- ducted tests the diagnostic survey method was introduced. The technique of individual in-depth interviews was used. The re- spondent could fully express his or her own feelings, emotions, thoughts and experiences. Results. The respondents stated that positive emotions ap- peared with the completion of treatment, but indicated that the feelings were not related to the sense of healing but only to the completion of tiring therapeutic procedures. Some respondents complained about the feeling of chronic fatigue. Fatigue was not only related to the physical sphere, although everyone con- firmed that the side effects of the therapy persisted for some time. The respondents paid more attention to mental fatigue, which had various forms, e.g.: anxiety about possible relapse; functional losses; feeling of loss caused by radical treatment. Out of 20 respondents, 4 persons indicated aloss of health, es- pecially the sense of joy and happiness, self-esteem, self-con- fidence, social contacts, family and time. Conclusions: The research group consisted of 20 respondents, which limits the possibility of formulating generalized con- clusions, but indicates various directions of possible improve- ment and, most importantly, shows how the thinking about can- cer can be changed.

Longitudinal Health-Related Quality of Life Study among Cervical Cancer Patients Treated with Radiotherapy

Quality of life studies in medicine, particularly in oncology, have become a basic tool used to assess patient's performance in different types of cancer and different modalities of treatment. The aim of this study was a subjective evaluation of the quality of life in cervical cancer patients treated with radiotherapy. The study has a longitudinal character and comprises four stages: before treatment, at the end of treatment, 5 months and 5 years after treatment. Standardized questionnaires such as EORTC QoL C30, HADS (European Organisation for Research and Treatment of Cancer Quality of life C30 Hospital Anxiety and Depression Scale) and the authors demographic-clinical assessment survey were the study tools. Physical functioning was assessed as the highest before treatment and depreciated to the lowest value 5 years after treatment. Emotional functioning was the lowest before treatment and then decreased again in the fourth stage of the assessment. Global quality of life was the lowest in the fourth stage of the study. Memory and concentration were fairly good at every stage of the study, with the highest score at the end of the treatment. At stages 3 and 4, the respondent's social functioning was the best, followed by the ability to fulfil their social role. General health and quality of life were assessed by the respondents on a level slightly above average, though five years after treatment the score was slightly below average.

The mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses

AIMS

The purpose of this study was to determine the mediational effect of coherence on the relationship between mental load and job burnout among oncology nurses.

BACKGROUND

Working stress and strain cause high mental load and can lead to job burnout among oncology nurses. Sense of coherence protects against the negative consequences of occupational mental load and may prevent professional burnout.

MATERIALS AND METHODS

The study was carried out with 165 oncology nurses from chemotherapy departments. The data were collected from April to September 2013 using the Antonovsky Sense of Coherence Scale, Meister questionnaire, and Maslach Burnout Inventory.

RESULTS

Manageability mediated the relations between Mental Load and both Emotional Exhaustion and Depersonalization. Meaningfulness exerted significant mediational effect on the relationship between Mental Load and Depersonalization. Manageability and Meaningfulness attenuate the unfavourable effect of Monotony and Unspecific load on motional Exhaustion and Depersonalization.

CONCLUSIONS

Sense of coherence, especially Manageability and Meaningfulness, seems to be an important resource for oncology nurses, buffering the negative impact of mental load on well-being of nurses. Strengthening the sense of coherence can be helpful in preventing or dealing with professional burnout.

Perceived social support and the sense of coherence in patient-caregiver dyad versus acceptance of illness in cancer patients

BACKGROUND

Acceptance of illness is a significant determinant of further coping with a disease. Development of illness acceptance may be associated with the sense of coherence and perception of social support. Cancer is an example of a crisis situation, which affects both the patient and his/her close relatives. Consequently, acceptance of illness may be influenced by factors originating from both sides of caregiver-patient dyad. The aim of this study was to analyse direct and indirect interrelationships between perceived support and the sense of coherence in patient-caregiver dyad, and acceptance of illness in cancer patients.

DESIGN

Cross-sectional study.

METHODS

The study included 80 dyads composed of cancer patients and their caregivers. Only cancer patients undergoing oncological treatment at the time of the study, for at least 3 months but no longer than 12 months, were enrolled. All subjects completed perceived support subscale included in the Berlin Social Support Scales, sense of coherence-29 questionnaire to determine the sense of coherence and Acceptance of Illness Scale.

RESULTS

Compared to cancer patients, their caregivers presented with significantly lower levels of perceived social support and weaker sense of coherence. The sense of coherence in caregivers and patients was determined by their perceived support levels. The sense of coherence in caregivers turned out to be a key resource influencing acceptance of illness in cancer patients, both directly and indirectly, via their perceived social support and their sense of coherence.

CONCLUSIONS

The sense of coherence, an intrinsic psychological factor determined by social support, is an important determinant of illness acceptance. Functioning of cancer patients is also modulated by psychosocial characteristics of their caregivers.

RELEVANCE TO CLINICAL PRACTICE

Greater support offered to caregivers may substantially strengthen the sense of coherence in caregivers and cancer patients and, therefore, may improve the functioning of patient-caregiver dyad in a situation of neoplastic disease.

Sense of Coherence vs. Mental Load in Nurses Working at a Chemotherapy Ward

OBJECTIVE

The aim of this study was to analyze the relationship between the sense of coherence and the level of mental load among nurses working at a chemotherapy ward.

METHODS

The study, conducted in 2013, included 164 nurses working at inpatient chemotherapy wards in Krakow, Poznan, Kielce, and Gliwice (Poland). The mean age of the study participants was 43.07±7.99 years. The study was based on a diagnostic survey with Antonovsky's Sense of Coherence Scale (SOC-29) and Meister questionnaire.

RESULTS

The levels of Mental Load, Monotony and Unspecific Load, correlated inversely with the levels of Coherence, Manageability, Meaningfulness, and Comprehensibility. Longer work experience was associated with lower levels of Coherence, Manageability and Comprehensibility and higher levels of Mental Load, Overload and Monotony. Age of nurses correlated inversely with the Manageability level. Heavy mental and physical workload turned out to be the main factor causing dissatisfaction of the study participants.

CONCLUSIONS

Longer work experience and lower levels of Coherence are associated with higher risk for mental overload.

Effect of ethanol and acetaldehyde at clinically relevant concentrations on atrial inward rectifier potassium current IK1: separate and combined effect

Atrial fibrillation is the most common arrhythmia at alcohol consumption. Its pathogenesis is complex, at least partly related to changes of cardiac inward rectifier potassium currents including IK1. Both ethanol and acetaldehyde have been demonstrated to considerably modify IK1 in rat ventricular myocytes. However, analogical data on the atrial IK1 are lacking. The present study aimed to analyse IK1 changes induced by ethanol and acetyldehyde in atrial myocytes. The experiments were performed by the whole cell patch-clamp technique at 23 ± 1°C on enzymatically isolated rat and guinea-pig atrial myocytes as well as on expressed human Kir2.3 channels. Ethanol (8 - 80 mM) caused a dual effect on the atrial IK1 showing the steady-state activation in some cells but inhibition in others in agreement with the ventricular data; on average, the activation was observed (at 20 mM by 4.3 and 4.5% in rat and guinea-pig atrial myocytes, respectively). The effect slightly increased with depolarization above -60 mV. In contrast, the current through human Kir2.3 channels (prevailing atrial IK1 subunit) was inhibited in all measured cells. Unlike ethanol, acetaldehyde (3 μM) markedly inhibited the rat atrial IK1 (by 15.1%) in a voltage-independent manner, comparably to the rat ventricular IK1. The concurrent application of ethanol (20 mM) and acetaldehyde (3 μM) resulted in the steady-state IK1 activation by 2.1% on average. We conclude that ethanol and even more acetaldehyde affected IK1 at clinically relevant concentrations if applied separately. Their combined effect did not significantly differ from the effect of ethanol alone.

Prevalence of generalised joint hypermobility in school-aged children from east-central European region

BACKGROUND

There is no literature regarding joint mobility in children of the Central and Eastern Europe. Studies describing clinical characteristics and functional outcomes are still needed. The aim of this study was to assess the prevalence of generalised joint hypermobility (GJH) in the group of school-aged children from Vilnius, the capital city of Lithuania, in relation to different cut-off values of the Beighton score (BS), and to identify possible patients with joint hypermobility syndrome.

MATERIALS AND METHODS

The representative sample of this study was calculated to be 760 subjects. A total of 778 children from different schools were screened for the mobility of joints. The medical examination included an assessment of joints' hypermobility according to the BS. The presence of specific signs (marfanoid habitus, antimongoloid slant and drooping eyelids) was assessed additionally. Parents of all involved children were asked to answer the questions developed based on the Brighton criteria regarding the medical history of children.

RESULTS

The prevalence of GJH in school-aged children from Vilnius, depending on the BS cut-off value, was 19.2% (BS ≥ 4), 9.5% (BS ≥ 5) or 5.7% (BS ≥ 6). The increased range of mobility was most frequently detected in thumbs of school- -aged children. The frequency of hyperextension > 10o in knees was 7- to 8-fold lower than the frequency of hyperextension > 10o in a passive opposition of the thumb. The evaluation results were similar on the left and right sides in 87.4% cases of thumb opposition, 90.1% cases of hyperextension of 5th finger, 87.9% cases of elbow manoeuvres, and 94.8% attempts to hyperextend knee.

CONCLUSIONS

The prevalence of GJH in school-aged children from Vilnius depends on the BS cut-off value and ranges from 5.7% to 19.2%.

Dual effect of ethanol on inward rectifier potassium current IK1 in rat ventricular myocytes

Alcohol consumption may result in electrocardiographic changes and arrhythmias. Important role of modifications of the inward rectifier potassium current I(K1) in arrhythmogenesis is well established. Considering lack of relevant data, we aimed at studying the effect of 0.2-200 mM ethanol on I(K1) in enzymatically isolated rat right ventricular myocytes using the whole cell patch-clamp technique at 23±1°C. Ethanol reversibly affected I(K1) in a dual way. At a very low concentration of 0.8 mM (≈~0.004%), ethanol significantly decreased IK1 by 6.9±2.7%. However, at concentrations of ethanol ≥20 mM (≈0.09%), I(K1) was conversely significantly increased (by 16.6±4.0% at 20 mM and 24.5±2.4% at 80 mM). The steady-state I(K1) increase was regularly preceded by its transient decrease at the beginning of ethanol application. Under 2 and 8 mM ethanol, I(K1) was decreased at the steady-state in some cells but increased in others. Both effects were voltage-independent. In agreement with the observed effects of ethanol on I(K1), a transient action potential (AP) prolongation followed by its final shortening were observed after the application of ethanol in a low concentration of 8 mM (≈0.04%). Under the effect of 0.8 mM ethanol, only AP prolongation was apparent which agreed well with the above described I(K1) decrease. Other AP characteristics remained unaltered in both concentrations. These observations corresponded with the results of mathematical simulations in a model of the rat ventricular myocyte. To summarize, changes of the cardiac I(K1) under ethanol at concentrations relevant to the current alcohol consumption were first demonstrated in ventricular myocytes in this study. The observed dual ethanol effect suggests at least two underlying mechanisms that remain to be clarified. The ethanol-induced I(K1) changes might contribute to the reported alterations of cardiac electrophysiology related to alcohol consumption.

Quality of life in cervical cancer patients treated with radiation therapy

AIMS AND OBJECTIVES

To evaluate the quality of life in hospitalised patients with cervical cancer treated by radiation therapy.

BACKGROUND

Aside from clinical variables, the quality of life should be considered in the planning and monitoring of the therapeutic process in patients with cancer. Although it is widely known that this parameter can have a considerable impact on the therapeutic outcome, it is not routinely screened in oncological patients.

DESIGN

Survey.

METHODS

The study was performed in six cancer centres in Poland between June 2004-December 2005, and included 205 women hospitalised for any stage of cervical cancer. The EORTC QLQ-C30 questionnaire (v.3) was used to evaluate the patients' quality of life. The survey was conducted three times: (1) stage 1 - before treatment, on admission, (2) stage 2 - after treatment, at discharge, and (3) stage 3 - five to six months after treatment.

RESULTS

Physical functioning was assessed the worst before the radiation treatment and increased gradually throughout further stages; all interstage differences proved to be significant. In contrast, emotional functioning was scored the highest before the initiation of the treatment and was the lowest at stage 2, a difference that proved to be significant. Role functioning was highest immediately after the treatment and the lowest prior to the treatment. Differences between stages proved to be significant. Financial problems increased their negative impact on the quality of patients' lives significantly throughout consecutive stages of this study. Age and cancer stage did not significantly influence the way participants perceived their global health, physical, cognitive, emotional and social functioning, nor their financial difficulties. Overall, the quality of life was evaluated as highest immediately after the end of radiotherapy.

CONCLUSION

Although this study revealed that patients with cervical cancer subjected to radiotherapy are satisfied with their global quality of life, attention should be paid to certain dimensions of the latter (i.e. emotional functioning and role functioning) during post-treatment period.

RELEVANCE TO CLINICAL PRACTICE

The ability to performing everyday activities independently is perceived as the most important during all stages of the cervical cancer treatment, and therefore, appropriate support in this matter is necessary on the part of the nursing personnel.

Muscle FBPase in a complex with muscle aldolase is insensitive to AMP inhibition

Real-time interaction analysis, using the BIAcore biosensor, of rabbit muscle FBPase-aldolase complex revealed apparent binding constant [K(Aapp)] values of about 4.4x10(8) M(-1). The stability of the complex was down-regulated by the glycolytic intermediates dihydroxyacetone phosphate and fructose 6-phosphate, and by the regulator of glycolysis and glyconeogenesis--fructose 2,6-bisphosphate. FBPase in a complex with aldolase was entirely insensitive to inhibition by physiological concentrations of AMP (I(0.5) was 1.35 mM) and the cooperativity of the inhibition was not observed. The existence of an FBPase-aldolase complex that is insensitive to AMP inhibition explains the possibility of glycogen synthesis from carbohydrate precursors in vertebrates' myocytes.

Endothelial leukocyte adhesion molecule 1: direct expression cloning and functional interactions

A cDNA for endothelial leukocyte adhesion molecule 1 (ELAM-1) was isolated by transient expression in COS-7 cells of a subtracted cDNA library from cytokine-treated human umbilical vein endothelial cells (HUVECs), with selection of ELAM-1-expressing clones by adhesion of transfected cells to the human promyelocytic cell line HL-60. This cloning method requires neither antibody nor purified ligand. ELAM-1-expressing COS cells bind the promyelocytic cell line HL-60 by a Ca2(+)-dependent but temperature-independent mechanism. Although ELAM-1 is homologous to mammalian lectins, its interaction with HL-60 cells is not inhibited by simple carbohydrate structures. ELAM-1-expressing COS cells also bind human neutrophils and the human colon carcinoma cell line HT-29, but not the B-cell line Ramos. However, Ramos cells adhere to cytokine-treated HUVECs but not control HUVECs, confirming the existence of other inducible adhesion molecules. In addition, the binding of HL-60 cells or neutrophils to ELAM-1-expressing COS cells is not inhibited by a monoclonal antibody (60.3) directed to an inhibitory epitope on CD18, indicating that the ELAM-1 ligand, although uncharacterized, is not a member of the CD11/CD18 family.

Structural relationship of human interferon alpha genes and pseudogenes

We have isolated and characterized DNA segments containing IFN-alpha-related sequences from human lambda and cosmid clone banks. We describe six linkage groups comprising 18 distinct IFN-alpha-related loci, and report the nucleotide sequences of nine chromosomal IFN-alpha-genes with intact reading frames, as well as of five pseudogenes. Taking into account as yet unsequenced genes as well as clones described by others, there are now seven linkage groups and 23 loci, of which 15 correspond to potentially functional genes and six to non-functional genes; two loci remain unsequenced. Eighteen additional sequences are likely to be allelic to the above. The finding that at least two IFN-alpha genes appear to be natural hybrids of other IFN-alpha genes, and that two distinct IFN-alpha loci have completely identical coding sequences, although their flanking regions are different, is evidence for information exchange between the individual genes.

Production of immunologically active surface antigens of hepatitis B virus by Escherichia coli

Several plasmids have been constructed which direct the synthesis of hepatitis B virus surface antigens in Escherichia coli either as the native polypeptide or fused to other plasmid encoded polypeptides. When injected into rabbits, extracts from bacteria carrying some of these plasmids induced the synthesis of antibodies to the antigens even though the extracts did not give satisfactory positive results in radioimmunoassay for them. Either the NH2-terminal segment or the COOH-terminal segment of the surface antigens alone was sufficient to elicit the immune response, but antibodies against the two segments showed different specificities. The results emphasize the value of an in vivo assay for the presence of antigens in crude cell extracts and illustrate the feasibility of this type of screening with laboratory animals.

Hepatitis B virus genes and their expression in E. coli

A composite DNA sequence of regions of hepatitis B virus, determined from a series of recombinant plasmids, reveals the genes for the surface antigen and the core antigen of the virus. The sequence of the core antigen shows it to be a DNA binding protein. The core antigen gene is expressed in Escherichia coli and when injected into rabbits the bacterial product induces antibodies which react with core antigen isolated from human sources.