Mediating effects of coping styles on the relationship between family resilience and self-care status of adolescents with epilepsy transitioning to adult healthcare: A cross-sectional study in China

PURPOSE

This study aimed to explore the relationship between family resilience, coping styles, and self-care among Chinese adolescents with epilepsy.

DESIGN AND METHODS

A total of 1238 adolescents with epilepsy in nine tertiary hospitals in China participated in a cross-sectional survey conducted from May 2018 to March 2020. Structural equation modeling was used to analyze the mediating effect.

RESULTS

The total scores for family resilience and coping styles were positively correlated with the total self-care status score of adolescents with epilepsy during their transition (r = 0.209, 0.202, P < 0.01). Family resilience was positively correlated with coping style (r = 0.450, P < 0.01). The modified model's fit index included χ²/df = 1.970, P = 0.001, RMSEA = 0.054, TLI = 0.973, CFI = 0.978, GFI = 0.941, AGFI = 0.917, NFI = 0.956, and IFI = 0.978. The confidence interval (CI) was 0.004-0.140 for the indirect effect and 0.033-0.306 for the direct effect.

CONCLUSIONS

The self-care status of adolescents with epilepsy during the transitional period is closely related to coping style and family resilience. Coping style mediates family resilience and self-care status.

PRACTICE IMPLICATIONS

Healthcare teams should pay attention to the coping ability of adolescents with epilepsy to help them transition smoothly and to improve family functioning. This study provides a theoretical basis for establishing transitional care programs for adolescents with chronic illnesses. The significant mediating effect of coping style should be emphasized in modalities of healthcare that include patient participation.

Participation in healthcare behavior by adolescents with epilepsy and factors that influence it during the transition period: A cross-sectional study in China

PURPOSE

Given the importance of adolescents' participation in the care of their chronic diseases during their transitional period in the healthcare system, the present study investigated the degree of participation in healthcare behavior by Chinese adolescents with chronic epilepsy and identified factors that should be addressed by health interventions.

METHODS

The study used a convenience sample of 1238 adolescent patients with epilepsy, who were hospitalized in 17 tertiary A-level children or maternal and child specialty hospitals in China between January 2017 and March 2020. Several scales were used to measure their degree of participation in healthcare behavior and the factors that influence it. Data collection was conducted after uniform training of the investigators. The adolescents who met the inclusion and exclusion criteria could scan the QR code of the questionnaire via a mobile phone.

RESULTS

The age of the participants ranged from 12.2 to 17.8 years (mean 14.2 years), and the sample had a male-to-female ratio of 1.25:1. The patients' average total score of participation in healthcare behavior was 125.58 (SD = 12.25), which was lower than the norm for China. Their scores on the six dimensions of participation were highest for information interaction, followed in descending order by medical decision-making, treatment and care, appeal, diagnosis and treatment decision-making, and questioning supervision. Multiple linear regression found significant associations between health-care participation and five personal and disease variables (gender, age, course of disease, number of comorbid diseases, type of family structure), self-efficacy, and coping styles (cognitive-palliative and acceptance), which explained 52.1% of the variance in patients' total scores on participating in healthcare behavior.

CONCLUSIONS

The participation of young Chinese patients with epilepsy in transitional healthcare behavior needs to be improved. Participation was positively associated with being female, a longer course of disease, fewer comorbidities, and living in a nuclear family. Patients who used cognitive-palliative and acceptance coping styles and those who had higher self-efficacy also had significantly higher levels of participation in healthcare behavior. The study provides useful reference points for adolescents with chronic disease to participate in healthcare programs, in order to achieve a smooth transition from childhood to adulthood.

Health Assessment of Chinese Adolescents with Epilepsy in the Preparatory Phase of Transition Process from Pediatric to Adulthood:A Single-Center Study Using the Omaha System

OBJECTIVE

Epilepsy is one of the most common childhood-onset neurological disorder characterized by both seizures and the related comorbidities. The preparatory phase in transition refers to a dynamic process of identifying and resolving health issues to ensure seamless continuing care from childhood to adulthood. This study identifies the health issues of the preparatory phase in transition from children to adulthood using the Omaha System.

METHODS

This prospective, single-center study enrolled 86 adolescents with epilepsy in China. The Problem Classification Scheme and Problem Rating Scale for Outcomes of Omaha System were used to evaluate transition-induced health problems.

RESULTS

These health problems cover all four domains of the problem classification scheme of the Omaha System, and the specific distribution is related to the type of epilepsy. The results of the four-category classification evaluation showed that the most common health problem is health-related behavioral problems (46.1%), followed by psychosocial problems (23.0%), physiological problems (20.6%), and environmental problems (10.3%). The distribution of these health problems in generalized seizures, focal seizures, and generalized-focal seizures are significantly different (P < 0.01). The results of the outcome rating scale showed that 83.4% of the children had minimal knowledge, 84.2% had inconsistently appropriate behaviors, and 86.7% had moderate symptoms.

CONCLUSIONS

The health problems of patients with epilepsy during the preparatory phase of transition process from pediatric to adulthood should be emphasized. Identification of health problems though the Omaha System can improve management for adolescents with epilepsy, including prevention, nursing care, social support, and therapeutic interventions.

[Advances in researches of exosomes and other extracellular vesicles in parasites and parasitic diseases]

Exosomes are tiny vesicles secreted by most endogenous cells, and the extracellular vesicles (EVs) are specifically secreted by cells. Recently, it was found that exosomes contain a large quantity of important substances such as proteins, nucleic acids, and lipids, which play important roles in material exchange and information transmission in cell-cell communication, and in modulating the immune response, metabolism, and expansion, metastasis, and drug resistance of tumors. This paper summarizes the recent researches on exosomes in parasites and parasitic diseases and hopes to be helpful for improving the researches of parasites and parasitic diseases.

Meta-analysis of association between IL-6 -634C/G polymorphism and osteoporosis

Osteoporosis is a common disease in the aging population and studies have shown that interleukin-6 (IL-6) is potentially implicated in its pathogenesis. This study was designed to assess the association between the IL-6 gene -634C/G polymorphism and osteoporosis. PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched for eligible studies published up to and including December 2014 in English or Chinese. Meta-analysis was conducted by the RevMan5.2 software. Weighted mean difference and 95% confidence interval (95%CI) were calculated by a fixed-effect or random-effect model. Bone mineral density (BMD) was regarded as the assessment index. As a result, a total of four articles with 3068 subjects were included. Differences in BMD between the CC and GG genotypes were 0.03 g/cm(2) (95%CI = 0.01 to 0.05) at total body, 0.01 g/cm(2) (95%CI = 0.00 to 0.03) at femoral neck, and 0.03 g/cm(2) (95%CI = 0.00 to 0.06) at the lumbar spine (P < 0.05). For the CG versus GG genotypes, the differences in BMD were 0.03 g/cm(2) (95%CI = 0.02 to 0.05) at total body and 0.02 g/cm(2) (95%CI = 0.00 to 0.03 at the femoral neck (P < 0.05). For the CC versus CG genotypes, the differences in BMD were not significant (P > 0.05). In conclusion, the GG genotype of the -634C/G polymorphism in IL-6 appears to play a role in reducing BMD, which affects normal bone metabolism and leads to osteoporosis.

A polymorphism in the 3' untranslated region of Hypoxia-Inducible Factor-1 alpha confers an increased risk of cervical cancer in a Chinese population

Cervical cancer is a multifactorial disease involving a complex interplay between genetic and environmental factors. An important role of HIF-1α in cervical cancer carcinogenesis has been studied by multiple researches. We hypothesized that there is a possible association between HIF-1α gene polymorphisms and the risk of cervical cancer in Chinese women. In a case-control study of 518 cervical cancer patients and 553 cancer-free controls, we genotyped three single-nucleotide polymorphisms (SNPs) (rs11549465, rs11549467 and rs2057482) of HIF-1α using the TaqMan SNP Genotyping Assays and assessed its associations with the cervical cancer risk. Besides, 17 cervical cancer tissues were used to assess the expression of the mature mRNA expression of HIF-1α by real-time quantitative reverse transcription PCR. We found that a significantly increased risk of cervical cancer was associated with the CC genotype of rs2057482 in the 3´-untranslated region (3'-UTR) of HIF-1α (odds ratio (OR), 1.44; 95% confidence interval (CI), 1.11-1.88), compared with the CT/TT genotypes. Moreover, the carriers of CT/TT genotypes had significantly decreased HIF-1α mRNA expression levels compared to those with CC genotype. No association was observed between the two polymorphisms (rs11549465, rs11549467) and cervical cancer risk. So that, our results provided the first insight into rs2057482 polymorphism of in the 3´-untranslated region of HIF-1α contributed to the risk of cervical cancer in a Chinese population and thus may serve as a reliable predictive factor of cervical cancer.

[Clinical observation on treatment of ulcerative colitis by soothing liver and activating spleen]

OBJECTIVE

To observe the effect of soothing Liver and activating Spleen method (SLAS) of TCM in treating ulcerative colitis (UC).

METHODS

Patients were randomly divided into 2 groups, the 33 cases in the treated group were treated with Ningxie Powder (NXP) and the 30 cases in the control group were treated with salicylazosulfapyridine (SASP). The improvement in clinical symptoms scoring, therapeutic effect in various treatment courses, changes in immune indexes as well as the condition in 1-year follow-up were observed.

RESULTS

The initial therapeutic effect after 3 months treatment showed insignificant difference between the two groups. However, the effect in the treated group was better than that in the control group both short-term (after 9 months treatment) and long-term (for 1-year follow-up study) (P < 0.05).

CONCLUSION

NXP, a Chinese herbal drug for soothing Liver and activating Spleen, shows good and persistent effect in treating ulcerative colitis and has favorable prospect in application.

The thermoregulation of halothane versus isoflurane in humans receiving ophthalmological surgery

Although suppression of thermoregulatory mechanisms during anaesthesia is generally assumed, the extent to which thermoregulation may be inactive is unknown. Twenty unpremedicated, ASA physical status class I patients (17 men and 3 women) scheduled for retinal detachment surgery were studied to evaluate the different changes of core and two skin-surface temperatures during halothane or isoflurane anaesthesia. Anaesthesia was induced by mask inhalation of halothane or isoflurane in nitrous oxide 70% and oxygen and was maintained by mechanical ventilation during surgery with halothane or isoflurane in nitrous oxide 50% and oxygen only. Core temperature (rectus) and skin-surface temperatures (forearm and fingertip) were measured during surgery using three separate thermometers (Y.S.I.: Yellow springs instrument Co., Inc. G541-211-Y01-33A0). Operating room temperatures were recorded in every case. Significant vasoconstriction was prospectively defined by a skin-surface temperature gradient between two sampling sites > or = 4 degrees C. The result indicated that there was no significant difference between core temperatures and skin-surface temperature gradients during halothane anaesthesia and isoflurane anaesthesia. However, three of the ten patients had their skin-surface temperature gradients > or = 4 degrees C in the halothane group. None of the ten patients had their skin-surface temperature gradients > or = 4 degrees C in the isoflurane group.

Rapid sequence induction and tracheal intubation with vecuronium--with or without a priming dose

The purpose of this study was to determine whether prior administration of a small, sub-paralytic dose of nondepolarizing muscle relaxant, vecuronium, would have a better intubating condition than a single bolus dose when vecuronium was used as the muscle relaxant during rapid sequence induction and tracheal intubation. Six groups of 15 patients each (ASA class I or II) were involved in this study. Anesthesia was induced with fentanyl 2-3 micrograms/kg and thiopental 4-5 mg/kg. In group 1, 2 and 3, the patients were given the same priming dose of 0.1 mg/kg. Four min later, different doses of vecuronium were given to each group: 0.09 mg/kg (Gp1), 0.14 mg/kg (Gp2), and 0.19 mg/kg (Gp3). In group 4, 5 and 6, no priming vecuronium was given and the intubating doses given to each group were as follow: 0.1 mg/kg (Gp4), 0.15 mg/kg (Gp5) and 0.2 mg/kg (Gp6). At the end of a 60 sec, the percentage of patient with excellent intubating condition were 46.6%, 66.6%, 86.6%, 20%, 40% and 80% respectively for group 1, 2, 3, 4, 5 and 6 respectively. The percentage with good intubating condition were 46.6%, 33.4%, 13.4%, 46.6%, 53.2%, and 20% for group 1, 2, 3, 4, 5 and 6 respectively. The percentage of poor intubating condition were 6.8% in group 1, 33.4% in group 4, 6.8% in group 5 and 0% in group 2, 3, 6. All patients receiving a priming dose could sustain head lift for 5 sec and did not complain any respiratory discomfort 3 min after the priming dose.(ABSTRACT TRUNCATED AT 250 WORDS)