Adaptation to Chronic Dialysis

While dialysis is a medical advance that enables people to live who would otherwise die, it is often experienced as an ordeal by those who must live with it. Patients and staff experience difficulties in their adaptation to chronic dialysis. A program that excepts all patients, regardless of motivation and stability, carries with it the responsibility of offering care in a way the patient can tolerate and of providing a regimen within the context of his personality structure and social adaptation.     

Providing Feedback on Adherence Increases Use of Preventive Medication by Asthmatic Children

This study investigates the impact of measuring adherence and providing feedback on medication usage by children with unstable asthma. Adherence was measured using an electronic monitoring device. Subjects were randomized to either being told of their adherence during review consultations or for their adherence to remain undisclosed to their parents and treating physician. Subjects were reviewed monthly for 4 months. Twenty-six children aged between 6 and 14 years were recruited. Adherence was significantly higher in the intervention group (79% versus 58%, p <.01). There were significant improvements in clinical measures of disease control compared with baseline in both groups. The change in forced expiratory volume in 1 s (FEV₁) (% predicted) was greater in those subjects receiving feedback (13.8% versus 9.8%). However, lung function values were lower in the intervention group at baseline and the relative improvement failed to reach statistical significance. Measuring adherence and providing feedback increases the use of preventive medication. A larger study is required to explore implications for disease control.     

Is the “farm effect” hypothesis still current? Atopy and allergic diseases in rural and urban children in Poland

Objective: The prevalence of allergic diseases has reached epidemic proportions in the Western world. Although farm-living has been associated with a lower prevalence of asthma and atopy, a marked increase in atopy among rural populations after accession to the European Union has been recently reported in Poland. Here, we aimed to investigate the effect of living environment on the prevalence of atopy and allergic diseases in Polish children. Methods: 400 schoolchildren aged 10–14 years from the capital city (223) and from traditional rural part of the country (177) were recruited from June to November 2011. Data on allergic diseases and symptoms were collected by means of questionnaire and physical examination. Atopy was assessed based on skin prick tests (SPTs) reactivity to inhalant allergens in 350 children. Results: A high discrepancy between the prevalence of allergic symptoms (46.7%) and doctor-diagnosed allergic diseases (25%) was demonstrated (p < 0.0001). Urban children had a higher overall prevalence of allergic diseases and atopy than children living in rural areas, 29.3% versus 17.1% (p = 0.007) and 33.5% versus 20% (p = 0.0045), respectively. However, no significant differences in the rates of particular allergic diseases were noted (p > 0.05). There was higher SPT positivity to trees, grass, corn, weeds, animal dander, and molds in urban children (p < 0.05). Conclusions: Our data support the protective effect of farm-living on the prevalence of atopy and overall allergic diseases, albeit not on particular allergic diseases, in children in Poland. The underlying mechanisms are not identified, but current socioeconomic changes may be responsible.     

The Perceived Efficacy and Goal Setting System (PEGS), Part I: Translation and cross-cultural adaptation to a Swedish context

Abstract

Objective: To translate, adapt, and evaluate the applicability of the Perceived Efficacy and Goal Setting System (PEGS) for use in Sweden. Method: Based on guidelines for cross-cultural adaptation of self-reports, the study was performed in several phases involving (i) translation and back-translation, (ii) pre-testing of the translated version, (iii) development of adjusted items and, finally, (iv) field testing of the proposed Swedish version. Participants were 63 parent–child dyads recruited through convenience sampling by 19 therapists. Results: Overall, five items in the original PEGS required adaptation, and one new item was added. Using the Swedish version of the PEGS, both children and parents were able to identify individual strengths and weaknesses in the child's performance of daily tasks as well as to select goals for intervention. Conclusions: The Swedish version of the PEGS thus showed evidence of validity based on test content and was applicable for use with children enrolled in paediatric rehabilitation who had a variety of disabilities and who were between five and 12 years of age.     

Cancer prognosis by general practitioners

Background: General practitioners are probably asked regularly about the prognosis for patients with cancer. There is no readily available source of information on the accuracy of their estimates.

Objective: To discover studies that have reported general practitioners estimates of prognosis.

Methods: A search for studies of estimates of prognosis in terminal cancer by general practitioners.

Results: Three papers were discovered, reporting on 836 patients. In only a quarter of patients was prognosis accurately estimated by general practitioners, even within broad limits. Hospital doctors and nurses performed similarly. We suggest considerable scope for further studies in general practice, which should not require sophisticated procedures.

Conclusion: Evidence of GP's limited performance in cancer prognostication should push us to do better.     

Socio-economic risk factors for injuries in Swedish children and adolescents: A national study over 15 years

Abstract

Few studies have assessed if Sweden's injury prevention work has been equally effective for children of different socio-economic backgrounds. The goal of this paper is to review the country's injury rates for children over time, stratified by socio-economic status (SES), to see if the effects are similar across SES levels. This study employs a retrospective case-control study design, using data from the hospitalisation records of 51,225 children, which were linked to family socio-economic data. Children and adolescents in families receiving social welfare benefits, and those living with single parents and mothers with less education had higher risks of injuries leading to hospitalisation. The population-based safety work over the past decades seems to have had only minor effects on reducing the impact of socio-economic based difference in injury risks to younger Swedes.     

When life is “difficult”: A comparison of street children's and non-street children's priorities

Research on street children has typically described the phenomenon and examined the risks of street life to healthy development. Thus far, research has not contextualized street children's psychosocial lives by comparing them with non-street children or street children undergoing rehabilitation. The purpose of this study was to assess how the life priorities of Tanzanian street children, former street children and school-going children (n?=?183) differ according to their living environment. The “Importance scale” was designed and validated for this study. It includes 29 four-level Likert items about relationships, activities and family, encompassing two subscales: current well-being (Cronbach's α?=?0.65) and preparing for the future (Cronbach's α?=?0.72). Data were analyzed using analysis of variance and contingency tables to determine group-level differences. Post-hoc Bonferroni tests determined pairwise differences. The analyses demonstrate significant differences in 14 of 29 priorities according to living context. With only three differences, former street children were more similar to school-going children than they were to street children. Street children and school-going children differed on 12 items, while street children and former street children differed on nine items. Street children considered that obtaining good advice from adults, having a dependable place to sleep and having time for enjoyable activities are most important, while former street children and school-going children pointed to education-related ambitions as most important. Findings show that after just 1 year of rehabilitative care, former street children's priorities are more similar to school-going children's, and thus rehabilitative care may be instrumental in enabling children to prioritize preparing for the future. Street children's emphasis on a safe place to sleep and adult support may reflect unmet basic needs. Former street children's high priorities on education and protecting themselves may represent healthy adaptation and a hopeful orientation to the future. High-quality rehabilitation for homeless youth can fulfill essential needs that may promote positive shifts in street children's priorities.     

Media experiences in community-driven rural areas: exploring children’s media cultures in rural Gujarat,India

ABSTRACT

In this paper, we examine how social structures of gender, caste, and religion, within which children in India operate, inform their engagements with media technologies/narratives. We demonstrate our approach using the case of three villages in the Ahmedabad district of Gujarat, India. We examine children’s media cultures using ethnographic methods which occasion long-term immersion and paying attention to children’s narratives. We also argue that children experience and enact their agency while engaging with media from within the limitations or norms imposed by the social structures. This is evident in the simple negotiation strategies they have developed to challenge social structures and norms prevalent in their societies. Based on empirical evidence we conclude that the children’s exposure to and consumption of media narratives under adult management allow the families and communities to reinforce the dominant rationality of patriarchy, caste hierarchy, and religious prejudice.     

CHILDREN,YOUTH, AND MOBILE COMMUNICATION

Exposure to online risks does not necessarily result in harm, but some groups of children prove to be less resilient than others when facing a potentially harmful situation online. The aim of this article is to better understand and explain which children under which social conditions are more likely to be more or less resilient. Children with low self-efficacy and more psychological difficulties are more vulnerable online as they experience stronger negative feelings and are more likely to go offline for a while or simply hope the problem would go away. A higher level of digital literacy is related to the use of online coping strategies aimed at solving the problem and protecting the child from further harm. Girls and younger children are more susceptible to sexual risks. Parental mediation and monitoring do not result in more online resilience. Mediation from peers and teachers has rather ambigous outcomes.     

Parents' Perceptions of Preschool Television

Preschool television in the United States has received acclaim from parents and communication researchers for its high quality. Some of the most popular programs in this genre are those that feature Latino themes, such as Dora the Explorer, prompting inquiry into whether there are differences between Spanish- and English-speaking families in the frequency of viewing these shows. An analysis was conducted to determine the programs available to children prior to the distribution of a survey to parents of preschool-age children to assess viewing habits focusing on shows that have Latino themes. The data reveal that Spanish-speaking families have more favorable perceptions toward television in general and desire more Latino-themed programming, whereas English-speakers are more complacent about additional shows. Further, it was found that primary language is a stronger predictor than ethnicity in determining differences in overall perceptions of the influence of television and the desire for more Latino programming.