Weight status,diet quality,perceived stress,and functional health of caregivers of children with autism spectrum disorder

1 Purpose

Caring for children with autism spectrum disorder (ASD) can be highly demanding and can put significant strain on caregivers. To date, little is known about the extent to which caregivers of children with ASD experience increased levels of stress which may adversely affect health outcomes. The purpose of this secondary analysis was to compare caregivers of children with ASD and caregivers of typically developing children (TDC) in weight status, diet quality, perceived stress related to the parenting role, and functional health and well‐being.

2 Design and methods

Caregivers of 25 children with ASD and 30 TDC completed the 2005 Block Food Frequency Questionnaire, the 36‐item Short Form of the Parenting Stress Index (PSI/SF), and the Short Form Health Survey (SF‐36) and had their heights and weights measured during an onsite visit. Diet quality was assessed using the Healthy Eating Index (HEI)‐2010 and its dietary components and conformance to the 2010 Dietary Guidelines for Americans.

3 Results

ASD caregivers did not differ significantly from TDC caregivers in body mass index or overweight/obesity prevalence (p ≥ .28), even when controlling for covariates. In univariate analyses, ASD caregivers consumed significantly fewer empty calories from solid fats, alcohol, and added sugars than TDC caregivers (p = .03), but they did not differ significantly in any other dietary outcomes including nutrient adequacy (p ≥ .10) and mean total HEI scores (p = .20). ASD caregivers, when compared to TDC caregivers, reported significantly greater parenting stress for the subscales difficult child and parent–child dysfunctional interaction as well as total stress (p < .001). In addition, 56% of ASD caregivers compared with 6.7% of TDC caregivers showed clinically significant levels of stress (p < .0001); a finding which remained statistically significant when controlling for covariates. ASD and TDC caregivers did not differ significantly in any SF‐36 health domains related to functional health and well‐being (p ≥ .10).

4 Practice implications

Despite higher reported levels of stress, ASD caregivers did not differ significantly from TDC caregivers in diet‐ and health‐related outcomes. Nurses and other health professionals should use comprehensive screening tools to assess overall caregiver stress and levels of resilience.     

超声引导经皮双极射频消融治疗良性甲状腺结节的局部疗效观察

正甲状腺良性结节通常无需处理,但随着结节增大可能影响美观或有压迫不适感,此时多需要治疗。射频消融(radiofrequency ablation,RFA)作为一种微创治疗方式,目前临床已广泛用于甲状腺结节的治疗~([1])。本组旨在对行超声引导经皮双极RFA治疗的良性甲状腺结节的局部疗效进行分析。     

康复护理路径应用在脑卒中患者吞咽障碍中的临床研究

目的 探讨康复护理路径(RCNP)应用在脑卒中吞咽障碍患者中的效果。方法 选取2014年5月~2017年6月在上海市松江区泗泾医院神经内科实施RCNP护理的脑卒中吞咽障碍患者600例作为观察组,选取2014年5月~2017年6月在我院接受常规护理的脑卒中吞咽障碍患者600例作为对照组。统计两组患者护理后洼田吞咽能力评分、口腔期评分、咽期评分、护理效果、住院天数、住院费用、健康知识知晓率、满意度。结果 观察组口腔期评分、咽期评分、洼田吞咽能力评分分别为(2.6±0.6)、(2.5±0.5)分、(4.3±1.1),对照组为(1.8±0.5)、(1.9±0.5)、(3.5±0.7)分,两组比较差异有统计学意义(P ＜ 0.01);观察组总有效率为90.0%(540/600),对照组总有效率为73.0%(438/600),差异有统计学意义(P ＜ 0.05);观察组住院费用、住院天数均明显少于对照组(Ｐ＜0.01);观察组患者满意度(98.67％)和健康知晓率(96.5％)均高于对照组(71.0％,73.67％,Ｐ＜0.01)。结论 RCNP的应用,明显改善吞咽障碍患者的吞咽功能,降低住院费用及住院天数,提高患者的生活质量,减轻患者的经济和心理负担。值得推广应用。     

A new manometry device for evaluating the sphincter of Oddi using a fiber-optic pressure sensor

Introduction: Although measuring the pressure of the sphincter of Oddi and the bile duct is considered to be an important examination, called Sphincter of Oddi manometry (SOM), some complications related to the SOM device remain unsolved.

Material and methods: To decrease adverse complications, we developed a 0.46?mm manometry and we performed some in vitro studies.

Results: We successfully developed a 0.46?mm SOM. The diameter is the thinnest size used in endoscopic examinations. The results of in vitro studies show the suitability as SOM.

Conclusion: This device will decrease the risks related to SOM examination. To confirm the safety and feasibility, further studies including in vivo studies will be needed.     

Flibanserin toxicity in a toddler following ingestion

Introduction: Flibanserin is a medication recently approved by the FDA for treatment of generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Its mechanism of action is not fully understood but is thought to modulate serotonin receptors and increase levels of norepinephrine and dopamine. While much is known about toxicity of other drugs which affect these systems, there is little information about toxicity of flibanserin at this time.

Case: We present a case of a 2-year-old boy who ingested an estimated 600?mg of his mother’s flibanserin. Following ingestion, the child developed facial twitching and unresponsiveness to pain, concerning for seizure-like activity. In the emergency department (ED) he was found to have hypertension, mydriasis, slurred speech, and normal labs. He responded well to supportive care including administration of benzodiazepines. Shortly after admission to the hospital, his temperature increased to 38.4?°C. Toxicology testing revealed the presence of 1-(3-trifluoromethylphenyl)-piperazine (TFMPP), a flibanserin metabolite. TFMPP is a recreational drug used as an alternative to 3,4-methylenedioxymethamphetamine (more commonly known as “MDMA” or “ecstasy”).

Discussion: This case highlights potential toxicity associated with ingestion of flibanserin.