Social Impact of Dialysis on Children and Their Families

Objectives

To evaluate the social consequences of dialysis on children and their parents.

Methods

From January through June 2012 short structured interviews with parents or caregivers of children on peritoneal dialysis (PD) or hemodialysis (HD) who were followed up at King Abdulaziz University Hospital, King Faisal Specialty Hospital and Research Center, or the Kidney Center at King Fahad Hospital were conducted. Data were analyzed using the Statistical Package for the Social Sciences.

Results

Thirty six children (22 boys and 16 girls) and their families were included. The mean (SD) age of the children was 11.5?±?6.87 y, and the mean (SD) duration of dialysis was 28?±?11.32 mo. Only one third of the families had the opportunity to choose the modality of dialysis. Both modalities of dialysis had a negative effect on fathers’ jobs in over 50 % of the cases. Similarly, both modalities of treatment had a considerable impact on the quality of care provided by the mothers to other family members. There was no difference between the two modalities on the frequency of admissions.

Conclusions

Both PD and HD had a negative impact on fathers’ jobs and on the level of care provided by mothers to the rest of the family.     

Replication of the effect of SLC2A9 genetic variation on serum uric acid levels in American Indians

Increased serum uric acid (SUA) or hyperuricemia, a risk factor for gout, renal and cardiovascular diseases, is caused by either increased production or decreased excretion of uric acid or a mix of both. The solute carrier protein 2 family, member 9 (SLC2A9) gene encodes a transporter that mediates urate flux across the renal proximal tubule. Genome-wide association studies have consistently shown the association of single-nucleotide polymorphisms in this gene with SUA in majority populations. American Indian participants of the Strong Heart Family Study, belonging to multigenerational families, have high prevalence of hyperuricemia. We conducted measured genotype analyses, based on variance components decomposition method and accounting for family relationships, to assess whether the association between SUA and SLC2A9 gene polymorphisms generalized to American Indians (n=3604) of this study. Seven polymorphisms were selected for genotyping based on their association with SUA levels in other populations. A strong association was found between SLC2A9 gene polymorphisms and SUA in all centers combined (P-values: 1.3 × 10⁻³¹–5.1 × 10⁻²³) and also when stratified by recruitment center; P-values: 1.2 × 10⁻¹⁴–1.0 × 10⁻⁵. These polymorphisms were also associated with the estimated glomerular filtration rate and serum creatinine but not albumin–creatinine ratio. In summary, the association of polymorphisms in the uric acid transporter gene with SUA levels extends to a new population of American Indians.     

Age‐time risk patterns of solid cancers in 60 901 non‐Hodgkin lymphoma survivors from Finland,Norway and Sweden

Survival after non‐Hodgkin lymphoma (NHL) has increased thanks to improved treatment but NHL survivors have an increased risk of second neoplasms. The assessment of cancer risk patterns after NHL may help to quantify the late side‐effects of therapy. Poisson regression was used to estimate relative risks (RRs) and absolute incidence rates for nine solid tumours based on a nationwide cohort of 60 901 NHL survivors from Finland, Norway and Sweden. Patients were diagnosed between 1980 and 2006 and developed 6815 s neoplasms. NHL patients showed an increased risk of each of the nine investigated cancer sites: prostate and pancreas (both RRs 1·28), breast (1·37), colorectum (1·48), urinary bladder (1·52), stomach and lung (both RRs 1·87), skin (melanoma 2·27) and kidney (2·56). The RRs showed a U‐shaped relationship with time after NHL for all nine‐second cancer types. NHL diagnosis early in life was a risk factor for the development of second cancers with the exception of melanoma, but a risk excess was even observed in patients diagnosed with NHL at age 80+ years. The present study provides accurate estimates on the adverse late effects of NHL therapy, which should guide the establishment of cancer prevention strategies in NHL survivors.     

Reactions and Attitudes to Postpartal Mental Symptoms in a Rural Community

We examined the reactions of population, social and health care professionals and local politicians in the context of a narrative case of a newborn and her mother evincing postpartal mental symptoms. The results of this postal questionnaire study indicated that in assessing the urgent need for support, a significant positive association prevailed in the resident cohort with female gender, age over 50 years or being a parent. Professionals and politicians estimated that appropriate care and access to care would be obtained in the maternity and child health clinic in the local health centre. Residents would contact relatives rather than social and health care professionals. A future challenge is to promote the knowledge and sensitivity of the general population in recognizing mental symptoms in mothers with small children. Adequate information is also called for regarding local services and means of access to care.     

Perceived Maternal and Paternal Psychological Control: Relations to Adolescent Anxiety Through Deficits in Emotion Regulation

The current study compared the differential effects of early adolescents’ perceived maternal and paternal psychological control (as well as their discrepancy) on adolescent anxiety. It also tested whether psychological control leads to deficits in youths’ ability to regulate their negative emotions, and if, in turn, such deficits lead to anxiety. Sixth- and seventh-grade students (n = 214; 59 % girls; 60 % Caucasian) completed measures of perceived psychological control, regulation of negative emotions, and anxiety symptoms. The discrepancy between perceived mothers’ and fathers’ control was also calculated. Although perceptions of mothers’ control, fathers’ control, and their discrepancy were each bivariately related to adolescent anxiety, when considered together, only a larger discrepancy in parents’ psychological control was uniquely associated with higher self-reported anxiety. Further, adolescents’ dysregulation of negative emotions partially explained the relation of both maternal psychological control and the discrepancy in parental control to anxiety. Implications for understanding family-based etiological correlates of anxiety are discussed.     

Kv7.2 regulates the function of peripheral sensory neurons

The Kv7 (KCNQ) family of voltage‐gated K⁺ channels regulates cellular excitability. The functional role of Kv7.2 has been hampered by the lack of a viable Kcnq2‐null animal model. In this study, we generated homozygous Kcnq2‐null sensory neurons using the Cre‐Lox system; in these mice, Kv7.2 expression is absent in the peripheral sensory neurons, whereas the expression of other molecular components of nodes (including Kv7.3), paranodes, and juxtaparanodes is not altered. The conditional Kcnq2‐null animals exhibit normal motor performance but have increased thermal hyperalgesia and mechanical allodynia. Whole‐cell patch recording technique demonstrates that Kcnq2‐null sensory neurons have increased excitability and reduced spike frequency adaptation. Taken together, our results suggest that the loss of Kv7.2 activity increases the excitability of primary sensory neurons. J. Comp. Neurol. 522:3262–3280, 2014. © 2014 Wiley Periodicals, Inc.     

Trends in maternal BMI, glycaemic control and perinatal outcome among type 1 diabetic pregnant women in 1989–2008

Aims/hypothesis  

Our objective was to examine the trends in prepregnancy BMI and glycaemic control among Finnish type 1 diabetic patients and their relation to delivery mode and perinatal outcome.     

Social factors of sickness absences and ways of coping: a qualitative study of men and women with mental and musculoskeletal diagnoses,Norway

The rate of sickness absence is a serious problem in Norway and Scandinavia as a whole. Musculoskeletal problems are a heterogeneous category, covering a spectrum from a broken back and diffuse muscle pains. Mental diagnoses constitute generally about 25–30% of the total number of the long-term sickness absences. It is thus important to document scientifically how and why participation in nature–culture–health (NaCuHeal) activities may prove beneficial for individuals with long-term illnesses. The purpose of our project is to focus on and to discuss how social factors influence sickness absence. There were two aims of this study: (a) to explore and reveal the absentees' own experiences and perceptions of sickness absence in daily life and (b) to explore and reveal the absentees' own perceptions and experiences of various coping strategies while being on sickness absence. Qualitative method through a pragmatic synthesis of elements of ethnography and grounded theory were used. The sample from the county of Oppland, Norway (n = 30), had a mental or a musculoskeletal diagnosis in accordance with the ICPC-2 medical classification system. In this study, men and women understand and interpret their health situation differently; most men in this sample have become ill due to work-related factors, and for women it seems to be the combined impact of domestic responsibilities and job strain, the so-called double exposure. Health-promoting nature and culture activities refuel their energy levels, which in turn help them to sustain their social network. A combination of various social activities seemed also to be beneficial as long as these activities could be personally chosen within their own time and space. This notion highlights the importance of a lay perspective on the illness experience and its connections to coping strategies. Combined with discussion of sickness absence as a phenomenon, we believe that our findings can contribute to a wider understanding of sickness absence, the complexity behind the outbreak of long-term illnesses and ways of coping in everyday life. This research may add important knowledge and insight, hence increase awareness and understanding of NaCuHeal benefits among health personnel and rehabilitation.