Health-related quality of life in children with immunoglobulin A nephropathy – results of a multicentre national study

IntroductionImmunoglobulin A nephropathy (IgAN) may lead to end stage renal disease and severely affect patient functioning and wellbeing. The aim of the study was to evaluate health-related quality of life (HRQoL) in children and adolescents with IgAN, and compare HRQoL in relation to the disease course, social status and psychological factors, such as expressing anger and perceived personal competence.Material and methodsThe multicentre cross-sectional study included 51 patients ≥ 8 years from 7 paediatric nephrology centres in Poland. Psychometric analysis was performed using the Kidscreen-52 questionnaire to evaluate HRQoL, the Anger Expression Scale to evaluate the severity of anger and the Personal Competence Scale to measure general perception of personal competence.ResultsMean age of patients was 14.54 ±3.69 years; duration since the diagnosis of IgAN was 4.98 ±3.9 years. Patients with IgAN rated their psychological wellbeing as significantly worse compared to healthy peers (p < 0.05). The presence of proteinuria was associated with significantly worse physical wellbeing (58.72 ±18.45 vs. 74.44 ±22.97; p < 0.05). Current therapy (steroids/immunosuppressive drugs) had no effect on HRQoL in the study group. Perceived personal competence was rated high by 49% of children in the study group. Children with IgAN were characterized by lower intensity of expressed anger (p < 0.001) and significantly higher intensity of suppressed anger (p < 0.01) compared to reference ranges. Severity of expressed anger correlated positively with the parent relations and school environment dimensions of HRQoL.ConclusionsWe found lower HRQoL in regard to physical and psychological wellbeing in a group of Polish children with IgAN compared to healthy peers. HRQoL should be monitored in this patient group.     

FGF23 contributes to insulin sensitivity in obese adolescents - preliminary results

Fibroblast growth factor‐23 (FGF23) is a hormonal regulator of circulating phosphate and vitamin D levels. Recent investigations revealed that besides a key role in the pathogenesis of calcium–phosphorus disorders, in some patients FGF23 may be an indicator of cardiovascular complications. As a ‘hormone‐like’ factor, it may also be involved in some metabolic processes, especially in the metabolism of glucose and fat. Its potential contribution to metabolic syndrome (MS) development has not been confirmed yet. Objective The study was to examine the possible correlations between FGF23 serum levels and body composition, blood pressure and selected parameters of glucose, insulin and fat metabolism in adolescents with simple obesity. Patients and design In 68 (35 female) adolescents (mean age 13·9 years) with simple obesity [mean BMI SDS 4·9 (95% CI 4·4–5·4)], the levels of FGF23, total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol and triglycerides were measured. Standard oral glucose tolerance tests were performed with the assessment of fasting and after 120′ postload glucose and insulin levels; the insulin resistance index HOMA‐IR was calculated. Results Regardless of gender, there was a significant inverse correlation between FGF23 and fasting insulin level (r = ?0·3), as well as HOMA‐IR (r = ?0·29). Multiple regression model showed the independent association between FGF23 and HOMA‐IR. Conclusion FGF23 seems to be a novel factor contributing to insulin sensitivity. Further investigations are needed to define its role in the development of MS.     

Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories

Background: Behaviour change interventions are effective in supporting individuals in achieving temporary behaviour change. Behaviour change maintenance, however, is rarely attained. The aim of this review was to identify and synthesise current theoretical explanations for behaviour change maintenance to inform future research and practice.

Methods: Potentially relevant theories were identified through systematic searches of electronic databases (Ovid MEDLINE, Embase, PsycINFO). In addition, an existing database of 80 theories was searched, and 25 theory experts were consulted. Theories were included if they formulated hypotheses about behaviour change maintenance. Included theories were synthesised thematically to ascertain overarching explanations for behaviour change maintenance. Initial theoretical themes were cross-validated.

Findings: One hundred and seventeen behaviour theories were identified, of which 100 met the inclusion criteria. Five overarching, interconnected themes representing theoretical explanations for behaviour change maintenance emerged. Theoretical explanations of behaviour change maintenance focus on the differential nature and role of motives, self-regulation, resources (psychological and physical), habits, and environmental and social influences from initiation to maintenance.

Discussion: There are distinct patterns of theoretical explanations for behaviour change and for behaviour change maintenance. The findings from this review can guide the development and evaluation of interventions promoting maintenance of health behaviours and help in the development of an integrated theory of behaviour change maintenance.     

Occupational allergic and irritant contact dermatitis in workers exposed to polyurethane foam

Objectives

To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4′-diphenylmethane diisocyanate (MDI).

Material and Methods

From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent.

Results

Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers.

Conclusions

In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.     

Cell surface IL-1α trafficking is specifically inhibited by interferon-γ, and associates with the membrane via IL-1R2 and GPI anchors

IL-1 is a powerful cytokine that drives inflammation and modulates adaptive immunity. Both IL-1α and IL-1β are translated as proforms that require cleavage for full cytokine activity and release, while IL-1α is reported to occur as an alternative plasma membrane-associated form on many cell types. However, the existence of cell surface IL-1α (csIL-1α) is contested, how IL-1α tethers to the membrane is unknown, and signaling pathways controlling trafficking are not specified. Using a robust and fully validated system, we show that macrophages present bona fide csIL-1α after ligation of TLRs. Pro-IL-1α tethers to the plasma membrane in part through IL-1R2 or via association with a glycosylphosphatidylinositol-anchored protein, and can be cleaved, activated, and released by proteases. csIL-1α requires de novo protein synthesis and its trafficking to the plasma membrane is exquisitely sensitive to inhibition by IFN-γ, independent of expression level. We also reveal how prior csIL-1α detection could occur through inadvertent cell permeabilisation, and that senescent cells do not drive the senescent-associated secretory phenotype via csIL-1α, but rather via soluble IL-1α. We believe these data are important for determining the local or systemic context in which IL-1α can contribute to disease and/or physiological processes.     

Technological Competency As Caring in Nursing: a Description,Analysis and Evaluation of The Theory

IntroductionWhen introducing and using technology in nursing, there is a danger that too much focus is placed on technology over caring for patients. The ‘Technological competency as caring in nursing’ theory can facilitate technology in caring, but the theory needs to be described, analysed and evaluated before it is used. The purpose of the literature review was to determine the possibility of applying the theory in education, research and practice, and whether the theory could be used to guide research into the use of electronic nursing record systems.MethodsA literature search was conducted in PubMed, CINAHL, ScienceDirect, Google Scholar and Google Books, and supplemented with manual searching using the keywords ‘Locsin’, ‘technology’, ‘caring’ and ‘nursing theory’. The criteria for inclusion were fully accessible articles and books in English on the relevant topics. The review process is shown in a PRISMA diagram. A hierarchy of evidence was used to evaluate the relative strength of the results. Pajnkihar’s model was used to describe, analyse and evaluate the theory.ResultsA total of 26 hits were included in the final analysis. The theory in question meets the criteria of clarity, simplicity and complexity, adequacy, importance and significance; it can be tested; and it is useful in patient care that employs technology.Discussion and conclusionThe theory is useful in nursing education, research and practice. The theory will be used to guide research on the perception of technological competency and care of internal medicine patients by nurses when using the electronic nursing record system in three Slovenian hospitals.     

Food Neophobia,Familiarity with French Cuisine,Body Mass,and Restaurant Food Choices in a Sample of Polish Women

Food neophobia, a condition characterized by a reluctance or avoidance of unknown foods and meals, may influence food choice, and is also associated with body mass and familiarity with food items. This study aimed to analyze the associations between food neophobia, familiarity with French cuisine, body mass, and French restaurant menu food choices in a sample of 203 young Polish women. The Computer-Assisted Web Interview (CAWI) method was used in the study. The food choice questionnaire used for assessment was based on a model French restaurant menu, with dishes planned using a 2 × 2 factorial design for the components of neophobic potential (unfamiliar to Polish consumers) and animal-based components. Food neophobia, familiarity with French cuisine, and body mass were considered independent variables. The food neophobia scale (FNS) developed by Pliner and Hobden was used to assess food neophobia among respondents. The results showed an association between food neophobia and familiarity with French cuisine and French restaurant menu food choices (p ≤ 0.05), but no association with body mass was observed (p > 0.05). The respondents with a high level of food neophobia chose dishes with neophobic components (for soups and desserts) less often compared to those with a low neophobia level, and in the absence of such an association, they chose dishes with animal-based components (for starters and main courses) less often (p ≤ 0.05). The respondents who declared that they were familiar with French cuisine chose dishes with animal-based components (for starters and desserts) more often than those with no familiarity, but a reverse association was observed for soups (p ≤ 0.05). Based on the findings of the study, it may be concluded that food neophobia and familiarity with French cuisine may be important determinants of food choice within a French restaurant menu. The study did not show any association between body mass and the choice of dishes from the model French restaurant menu. The findings suggest that the presence of unfamiliar and animal-based ingredients may reduce the frequency of choosing specific dishes within a French restaurant menu, which may reduce the diversity of individuals’ diets.