Depressive Symptoms and Associated Factors in Children With Attention Deficit Hyperactivity Disorder

PROBLEM: To compare depressive symptoms in children with attention deficit hyperactivity disorder (ADHD) to those in healthy children, and to explore the influence of individual and family factors on level of depression. METHODS: Individual interviews with 68 children, ages 7 to 12 years, in order to complete the Children's Depression Inventory. FINDINGS: Children with ADHD reported significantly more depressive symptoms than did children without ADHD; 14.7% of children with ADHD reached the threshold of a 19 point score, which suggests clinical depression. No significant effects of individual and family factors on level of depression were found. CONCLUSIONS: Children with ADHD are more inclined to experience depressive symptoms than are healthy children. To plan appropriate interventions, nurses evaluating and working with children with ADHD should always consider a possible coexistence of depressive symptoms.     

No evidence for an altered mRNA expression or protein level of haematopoietic cell phosphatase in CD34+ bone marrow progenitor cells or mature peripheral blood cells in polycythaemia vera

Abstract: Polycythaemia vera (PV) is a myeloproliferative disorder characterized by haematopoietic progenitor cells being hypersensitive to cytokines such as erythropoietin, interleukin-3, stem cell factor and insulin-like growth factor 1, which results in an increased production of mature blood cells. The pathogenetic cellular mechanism(s) behind this hypersensitivity to cytokines is unknown, but the number of cytokine receptors and the interaction between ligand and receptor are normal in PV. Interest has therefore focused on post-receptor mechanism(s). Haematopoietic cell phosphatase (HCP) is an intracellular tyrosine phosphatase that has been demonstrated to regulate proliferative signals negatively induced by the cytokines mentioned above. Moreover, motheaten mice that genetically lack HCP have an increased amount of erythroid progenitors that are hypersensitive to Epo, and patients with familial polycythaemia have been shown to exhibit a mutation of the Epo receptor gene that includes the docking site for HCP. We therefore studied mRNA expression of HCP in pure populations of CD34⁺ cells, granulocytes, platelets and lymphocytes from patients with PV, chronic myeloid leukaemia (CML) or essential thrombocythemia (ET), as well as healthy controls. Using a polymerase chain reaction analysis employing specific primers for HCP, we failed to detect any abnormalities of HCP expression in PV in any of the cell populations that were examined. Moreover, HCP mRNA expression was similar in ET and CML compared to controls. Finally, Western blot analysis revealed a normal HCP protein content in PV granulocytes and platelets. We therefore conclude that neither an impaired expression of the HCP gene nor a defect in HCP protein synthesis is present in PV, and does not seem to play a role in the aetiology of this disorder.     

The influence of lung volume reduction surgery on exercise in patients with COPD.

Although the influence of lung volume reduction surgery (LVRS) on incremental- and constant-power exercise is important in the evaluation of this procedure for patients with chronic obstructive pulmonary disease (COPD), it is rarely reported even in large randomised controlled trials. This report describes 39 patients with severe COPD ((mean +/- SE) forced expiratory volume in one second 32 +/- 2% pred, functional residual capacity 195 +/- 6% pred) who participated in a randomised controlled trial of LVRS and who completed incremental exercise tests at 6 months as well as endurance tests (constant power of 25 +/- 1 W) at 3, 9 and 12 months. Peak oxygen uptake (V'O2,pk) was similar between the treatment (n = 19) and control groups (n = 20) at baseline. After LVRS, the treatment group had a significantly greater V'O2,pk (mean difference (95% CI) 1.28 (0.07-2.50) mL x kg x min(-1)) and power (13 (6-20) W). The treatment group achieved a significantly greater minute ventilation (7.1 (2.9-11.3) L x min(-1)) with a greater tidal volume (0.16 (0.04-0.28) L). Baseline endurance was similar between groups. After surgery, there were significant between-group differences in endurance time, which were maintained at 12 months (7.3 (3.9-10.8) min). Lung volume reduction surgery is associated with an increase in exercise capacity and endurance, as compared with conventional medical treatment.     

The value of indices in the central and peripheral visual fields for the detection of glaucoma

We assessed 81 patients in four groups (normal, low- and high-risk ocular hypertension, and early glaucoma) with the standard Octopus G1 central visual field program in addition to two quantitative programs, PFN (peripheral field-nasal) and PFT (peripheral field-temporal), designed for this study to test the nasal and temporal periphery, respectively. Indices were calculated for each program for each subject in all groups. We then examined the behavior of the indices across the separate visual field areas within each group as well as the behavior of the indices of each field area among the different groups. We found that quantitative testing of the peripheral nasal visual field provided valuable information in the detection of glaucomatous visual dysfunction additional to that provided by quantitative testing of the central visual field. Quantitative testing of the temporal periphery was less valuable.     

Definitions of oppression

Definitions of oppression
How we begin to serve others as healthcare professionals and how it is we define underserved and oppressed peoples is important in understanding issues in the organization and allocation of health care. This exploration, based on feminist post-structuralist theory, explores how nurses formulate definitions of 'underserved' and 'vulnerable'. This study goes beyond prescribed definitions to locate meanings used to identify oppression. I present, through an analysis of a literature search, the context and construction of the terms 'vulnerable population' and 'medically underserved'. Professional nursing journals are the source of relevant text. The implications of working with particular understandings of the terms 'vulnerable' and 'underserved' is based on my assumption that healthcare providers need to critically focus on the personal and political meanings they attribute to the labels used to define the clients and communities with whom they work. The presentation of this material supports that the way we define 'vulnerable' and 'underserved' is related to how our work fighting racism, ageism, AIDS, poverty, homophobia, addiction, domestic violence, sexism and colonization is realized.