QUALIDADE DE VIDA E STRESS DE CRIANÇAS E ADOLESCENTES COM CÂNCER EM ESTÁGIO DE REMISSÃO E RECIDIVA

O câncer em crianças até cerca de duas décadas, era considerado uma doença crônica, com prognóstico desfavorável, resultando na maioria dos casos, em morte. Atualmente, tem-se apresentado como uma doença com melhores perspectivas, onde 70% das crianças acometidas por essa doença podem ser curadas, quando diagnosticadas precocemente, e tratadas em centros especializados¹. Este estudo teve como objetivo, avaliar a qualidade de vida e o stress de crianças e adolescentes com câncer, em remissão e recidiva. Trata-se de um estudo correlacional, quali-quantitativo, transversal. Foi desenvolvido no ambulatório de oncologia pediátrica da Faculdade de Medicina do ABC, e na enfermaria do Hospital Mário Covas. Contou com a colaboração de 40 sujeitos, com idades entre 06 a 14 anos, de ambos os sexos. Como instrumento para medir a qualidade de vida, foi utilizado o Child Health Questionnaire (CHQ-PF50), que possui 15 conceitos em saúde, abrangendo aspectos físicos e psicossociais e para medir o stress, a Escala de Stress Infantil (ESI), que tem como objetivo, avaliar o stress da criança, através de reações físicas e psicológicas. Os resultados indicaram que no domínio físico (PhS), as crianças em situação clínica de recidiva e remissão não apresentam diferenças significativas em relação às variáveis: qualidade de vida e stress, porém, no domínio psicossocial (PsS), houve diferença estatisticamente significante, indicando que os meninos apresentam melhor qualidade de vida e menor stress, se comparados com as meninas, mostrando que o emocional interfere nesse resultado.(AU)

Learning for life:educational provision at Cadbury, 1831-1981

Cadbury showed concern for the welfare of its labour force in a variety of ways and not least in the provision of educational and educative-recreational facilities. The firm regarded the education of employees as having a positive effect on the efficiency of the business at the same time as being of benefit to the individual, the local community and the nation. The life-long education of people was seen as essential for personal fulfilament, social improvement, economic competitiveness and the proper functioning of democratic procedures. The educational system built up at Cadbury, and the philosophy on which it was founded, acquired both a domestic and international reputation. Its main components were the day continuation education of juniors; the Bournville Works Evening Institute; vocational and non-vocational scholarships; emphasis on the primary importance of general education as a basis for life, work and technical training; stress on equality of educational opportunity for females; and leisure and sporting amenities which the firm felt to be educative in the sense that they contributed to personal psychological and physical development and social skills. The system was primarily shaped and constructed in the first three decades of the twentieth century and went into decline and eventual demise in the 1960's and 1970's as a result of economic pressures, social changes, enhanced state arrangements for education, shifts in Cadbury management thinking and the merger with Schweppes in 1969.

Management of nut allergy influences quality of life and anxiety in children and their mothers

Nut allergy is known to impact on the quality of life (QoL) and anxiety of both the allergic child and their parents, but little is known about how the management of food allergy is associated with these variables. To investigate the impact of nut allergy on QoL and anxiety in mothers and children with nut allergy in order to identify management strategies that may influence these factors. Forty-one nut allergic children (age 6–16 yrs) and their mothers completed questionnaires to assess maternal and children’s QoL (PedsQL™, WHOQOL-BREF, FAQL-PB), anxiety (SCAS, STAI) and perceived stress scale (PSS). Children also completed a nut allergy specific QoL questionnaire. Demographic data, details of previous reactions, test results and management plans were collected using parent-report questionnaires and hospital notes. Children with nut allergy had poorer emotional (p = 0.004), social (p = 0.043), and psychological (p = 0.006) QoL compared to healthy normative data. Maternal and child QoL and anxiety were not influenced by the severity of previous reactions. Mother and child reported lower anxiety (p = 0.043 and p < 0.001 respectively) when the child was prescribed an epinephrine auto-injector. Anxiety was not associated with whether the child carried the auto-injector or whether they strictly avoided traces of nuts in foods. Prescribing auto-injectors is associated with reduced anxiety for food allergic children and their mothers, but is not associated with improved adherence with medical management or reduced risk-taking behavior.

Fatigue cracking from stress concentration in mild steel

Pulsating; tension fatigue tests have been carried out on edge notched specimens of a mild steel. An electrical potential drop technique was used to determine the number of cycles taken to initiate cracks and the rate at which the cracks grew across the specimen. The results could be described by the range of stress intensity factor, which for crack initiation was modified to take account of the notch root radius. Analysis of elastic stress distributions at cracks and notches and models of plasticity at crack tips are used to discuss the results. Limited evidence in the literature indicates that the fracture mechanics approach may provide a general description of crack initiation and growth in notched specimens, and a simple graphical method of calculating fatigue lives is described. The results are used to illustrate the effects of specimen size and geometry on the fatigue life of notched specimens. The relevance of the work to the assessment of the significance of defects in welds is discussed.

Hypercholesterolaemia-induced oxidative stress at the blood-brain barrier

Blood cholesterol levels are not consistently elevated in subjectswith age-related cognitive decline, although epidemiological studies suggest that Alzheimer's disease and cardiovascular diseases share common risk factors. These include the presence of an unusual genetic variant, the APOE4 (apolipoprotein E4) allele, which modulates LDL (low-density lipoproteins) metabolism, increases free radical formation and reduces plasma antioxidant concentrations. Together, these risk factors support a mechanism for increased LDL circulation time and free radical modification of LDL. Plasma oxycholesterols, hydroxylated metabolites of cholesterol, are carried by oxidized LDL, and elevated lipids in mid-life are associated with increased longterm risk of dementia. Although brain cholesterol metabolism is segregated from the systemic circulation, during oxidative stress, plasma oxycholesterols could have damaging effects on BBB (blood-brain barrier) function and consequently on neuronal cells. Cholesterol-lowering drugs such as statins may prevent the modifications to LDL in mid-life and might show beneficial effects in later life. © The Authors Journal compilation © 2014 Biochemical Society.

Dapsone induces oxidative stress and impairs antioxidant defenses in rat liver

Dapsone (DDS) is currently used in the treatment of leprosy, malaria and in infections with Pneumocystis jirovecii and Toxoplasma gondii in AIDS patients. Adverse effects of DDS involve methemoglobinemia and hemolysis and, to a lower extent, liver damage, though the mechanism is poorly characterized. We evaluated the effect of DDS administration to male and female rats (30 mg/kg body wt, twice a day, for 4 days) on liver oxidative stress through assessment of biliary output and liver content of reduced (GSH) and oxidized (GSSG) glutathione, lipid peroxidation, and expression/activities of the main antioxidant enzymes glutathione peroxidase, superoxide dismutase, catalase and glutathione S-transferase. The influence of DDS treatment on express ion/activity of the main DDS phase-II- metabolizing system, UDP-glucuronosyltransferase (UGT), was additionally evaluated. The involvement of dapsone hydroxylamine (DDS-NHOH) generation in these processes was estimated by comparing the data in male and female rats since N-hydroxylation of DDS mainly occurs in males. Our studies revealed an increase in the GSSG/GSH biliary output ratio, a sensitive indicator of oxidative stress, and in lipid peroxiclation, in male but not in female rats treated with DDS. The activity of all antioxidant enzymes was significantly impaired by DDS treatment also in male rats, whereas UGT activity was not affected in any sex. Taken together, the evidence indicates that DDS induces oxidative stress in rat liver and that N-hydroxylation of DDS was the likely mediator. Impairment in the activity of enzymatic antioxidant systems, also associated with DDS-NHOH formation, constituted a key aggravating factor.

Developing an intervention to equip nurses for acute life threatening events (ALTEs) in hospital:a phenomenological approach to healthcare research

Objectives: To understand staff's experiences of acute life threatening events (ALTEs) in a pediatric hospital setting. These data will inform an intervention to equip nurses with clinical and emotional skills for dealing with ALTEs. Method: A mixed design was used in the broader research program; this paper focuses on phenomenon-focused interviews analyzed using interpretative phenomenological analysis (IPA). Results: Emerging themes included staff's relationships with patients and the impact of personhood on their ability to perform competently in an emergency. More experienced nurses described "automatic" competence generated through increased exposure to ALTEs and were able to recognize "fumbling and shaking" as a normal stress response. Designating a role was significant to staff experience of effectiveness. Key to nurses' learning experience was reflection and identifying experiences as "teachable moments." Findings were considered alongside existing theories of self-efficacy, reflective thought, and advocacy inquiry to create an experiential learning intervention involving a series of clinical and role-related scenarios. Conclusion: The phenomenological work facilitated an in-depth reading of experience. It accentuated the importance of exposure to ALTEs giving nurses experiential knowledge to prepare them for the impact of these events. Challenges included bracketing the personhood of child patients, shifting focus to clinical tasks during the pressured demands of managing an ALTE, normalizing the physiological stress response, and the need for a forum and structure for reflection and learning. An intervention will be designed to provide experiential learning and encourage nurses to realize and benefit from their embodied knowledge.

A lean termelési rendszer munkásokra gyakorolt hatása (Effects of lean production on quality of working life from workers’ point of view)

A lean termelési rendszer munkásokra gyakorolt hatásaival foglalkozó irodalomban nincsen egyetértés annak megítélésében, hogy a hatásokban a negatív vagy pozitív hatások dominálnak-e. A szerző tanulmánya ehhez a vitához a pszichológiai, egészségügyi, munkahelyi jellemzőkre és a dolgozói elégedettségre vonatkozó eredmények áttekintésével kapcsolódik. A munkások elégedettségének vizsgálata arra utal, hogy a lean termelési rendszer egyszerre növeli és csökkenti is az elégedettséget, így az összességében nem változik más termelési rendszerekhez képest. A lean termelés kritikusai azt hangsúlyozzák, hogy a többi tényező negatívan hat a munkásokra. Megállapításaik megalapozottsága a nagyon kevés empirikus munka miatt megkérdőjelezhető. Ugyanakkor a tevékenységmenedzsment kutatói érdemben nem tudják cáfolni a stressz, a sérülések és betegségek kockázatának növekedését és a munka intenzívebbé válását. A negatív hatások és a várt pozitív hatások hiányának kiemelése felveti, hogy a munkavállalók bevonásán alapuló lean termelési rendszer nehezen ültethető át a gyakorlatba, illetve hogy a lean termelés intenzifikáción alapuló modellje is elterjedt. _____________ This literature review contributes to the debate related to the effects of lean production on workers. The study reviews different dimensions of the debate and focuses on issues like worker’s satisfaction, psychological effects, health and safety aspects, and workplace characteristics. Findings of researches reviewed in this paper cannot confirm that from workers’ point of view lean production is better than other production initiatives. Lean production enhances and decreases worker’s satisfaction at the same time, altogether, the satisfaction of workers does not change significantly compared to other systems. The negative impact of the other factors (psychological etc.) on workers is usually emphasized in the critique of lean production. Although, the limited number of (empirical) studies doubts these critical voices. However, Operations Management can not reject negative effects like increasing level of stress, increased risks of health and safety problems or intensification of work. The emphasis of the negative effects and the lack of positive effects can refer to the difficult employment of lean involvement system, or simply reflect that the model of lean intensification system is widely spread.

Valued occupational roles and life satisfaction among south Florida HIV-infected and non-infected homosexual males: An exploratory study

A study was conducted in order to describe and understand the occupational role behavior of gay men with particular interest on understanding the impact of an HIV diagnosis on their roles and life satisfaction. A 137-item questionnaire was developed for this study and distributed through various gay community groups in south Florida. The process resulted in ranked description of 24 valued occupational roles of gay men (n = 80) along with a general understanding of potential shifts that may occur in those roles as a result of becoming infected with HIV. The study concludes that a diagnosis of HIV infection impacts gay men both by altering their value for particular roles and by darkening the images they hold of their future. The study also identified key factors which may contribute to the greater life satisfaction of gay men including greater confidence in personal knowledge of HIV, a more optimistic outlook an life, the use of stronger coping styles, and perceiving stronger social support and lower stress. ^

Comparative analysis of a moderating and mediating model of stress, appraisal, and coping in Hispanic and non-Hispanic Alzheimer's disease caregivers

This dissertation utilizes a cross-sectional study to examine the phenomenon of caregiving within a theoretically grounded stress, appraisal, and coping model. Hispanic and non-Hispanic caregivers were studied to examine the factors associated with variance in caregiver appraisal, coping, and outcomes of caregiving strain (depression and somatic complaints) and caregiving gain (life satisfaction, mastery, and personal gain). A purposive sampling strategy was used to recruit 204 Alzheimer's disease caregivers in South Florida. A self-report questionnaire was used to collect demographic data, and to measure stress, appraisal, coping, and psychological well-being of caregivers. Regression equations were developed to compare moderating and mediating models of appraisal and coping. Emotion-focused coping skills were found to significantly moderate the effects of stress (F [1,195] = 4.62, p < .05), explaining approximately 21% of the variance in satisfaction was found to moderate the effects of stress (F [1,195] = 7.09; p < .05), explaining approximately 27% of the variance in personal gain and approximately 8% of the variance in life satisfaction (F [1,195] = 4.14; p < .05). Appraisal of Burden was found to significantly mediate the effects of stress, explaining approximately 30% of the variance in somatic complaints (F [1,196] = 31.60; p < .001) and 32% of the variance in depression (F [1,196] = 38.18; p < .001). The results of the analyses indicate that appraisal and coping skills are important variables in the stress process. The results of this study underscore the importance of accounting for positive and negative outcomes in providing a fuller understanding of the stress, appraisal and coping process of Alzheimer's Disease caregivers. ^

Predicting posttraumatic stress reactions in children prior to traumatic exposure

The present study examined the relations among previously identified risk and protective variables associated with traumatic exposure and evaluated a model of resilience to traumatic events among Latino youth prior to traumatic exposure using structural equation modeling. Model tests were pursued in the context of Full Information Maximum Likelihood (FIML) methods as implemented in Mplus. The model evaluated the role of the following variables: (a) intervening life events; (b) child characteristics; (c) social support from significant others; and (d) children's coping. Data were collected from 181 Latino youth (M age = 9.22, SD = 1.38; 49.0% female) participants. Data analyses revealed that children's perceived available social support and use of coping strategies predicted low state anxiety following exposure to cues of disaster. Life events and preexisting depression symptoms did not significantly predict social support and coping, whereas preexisting anxiety was a significant predictor of perceived social support. This study represents an important initial step towards establishing and empirically evaluating a resilience model. Implications for preparedness interventions and a framework for the etiology of resilient reactions to disaster exposure are discussed.

Stress Urinary Incontinence in Female Athletes

Objective: The purpose of this study is to educate allied health professionals and female athletes of the anatomy of the pelvic floor, and the pathology, etiology, and prevalence of stress urinary incontinence in female athletes. Background: Urinary incontinence is not a life-threatening or dangerous condition, but it is socially embarrassing, may cause the individual to remove herself from social situations, and decrease quality of life. While typically associated with parous women who had vaginal delivery, research has shown prevalence of the condition in physically active women of all ages. Stress urinary incontinence has shown to lead to withdrawal from participation in high-impact activities such as gymnastics, aerobics, and running. It may be considered a barrier for life-long athletics participation in women. Description: An in-depth introduction to the cause and origin of stress urinary incontinence including review of the female pelvic floor anatomy and prevalence of stress urinary incontinence in the female athletic population. Clinical Advantages: Athletic trainers and other allied health professionals will develop an understanding of the multiple mechanisms that cause stress urinary incontinence. Clinician competency of the dynamics and mechanism of urinary incontinence prepares the individual to learn diagnostics, prevention, pharmacological intervention, and treatment of this pathology.

Reliability analysis of encapsulation methods for lead -based paint through an accelerated life testing

The adverse health effects of long-term exposure to lead are well established, with major uptake into the human body occurring mainly through oral ingestion by young children. Lead-based paint was frequently used in homes built before 1978, particularly in inner-city areas. Minority populations experience the effects of lead poisoning disproportionately. ^ Lead-based paint abatement is costly. In the United States, residents of about 400,000 homes, occupied by 900,000 young children, lack the means to correct lead-based paint hazards. The magnitude of this problem demands research on affordable methods of hazard control. One method is encapsulation, defined as any covering or coating that acts as a permanent barrier between the lead-based paint surface and the environment. ^ Two encapsulants were tested for reliability and effective life span through an accelerated lifetime experiment that applied stresses exceeding those encountered under normal use conditions. The resulting time-to-failure data were used to extrapolate the failure time under conditions of normal use. Statistical analysis and models of the test data allow forecasting of long-term reliability relative to the 20-year encapsulation requirement. Typical housing material specimens simulating walls and doors coated with lead-based paint were overstressed before encapsulation. A second, un-aged set was also tested. Specimens were monitored after the stress test with a surface chemical testing pad to identify the presence of lead breaking through the encapsulant. ^ Graphical analysis proposed by Shapiro and Meeker and the general log-linear model developed by Cox were used to obtain results. Findings for the 80% reliability time to failure varied, with close to 21 years of life under normal use conditions for encapsulant A. The application of product A on the aged gypsum and aged wood substrates yielded slightly lower times. Encapsulant B had an 80% reliable life of 19.78 years. ^ This study reveals that encapsulation technologies can offer safe and effective control of lead-based paint hazards and may be less expensive than other options. The U.S. Department of Health and Human Services and the CDC are committed to eliminating childhood lead poisoning by 2010. This ambitious target is feasible, provided there is an efficient application of innovative technology, a goal to which this study aims to contribute. ^

Temporal changes in immigration stress, adaptation, and the factors contributing to the immigration -adaptation process in newly immigrant parents

The adaptation process to a new land can be an arduous transition for families who migrate from their countries in an attempt to evade negative life conditions. Family-based immigration has been the cornerstone of immigration policy for the U.S. However, there has been a relative lack of attention given in immigration studies to the impact of immigration particularly on parents. Furthermore, little is known about their adjustment to their post-migration circumstances, particularly the initial phase of migration, where the psychological impact of immigration tends to be concentrated. It is even rarer that investigators have addressed longitudinally the dynamic process of parents' adaptation to a new ecology, which can shed a great deal of light on its mechanisms. In this dissertation, changes over time in levels of stress, adjustment (affect balance and life satisfaction), and the factors (social support, economic hardship, and discrimination) contributing to stress and adjustment were examined in newly immigrant parents from Argentina, Colombia, Cuba, Haiti, and the West Indies. Moderating effects of gender and country-of-origin were examined as well. This study also aimed to investigate to what extent the contributing factors impacted stress and adjustment, not only concurrently, but also over the first three years of post-migration. Analysis of variance results showed that both affect balance and social support increased whereas life satisfaction decreased over time. There was no significant change in stress, however. Both gender and group effects were also observed. Mothers experienced higher stress whereas fathers experienced higher discrimination. Among groups, Haitians appeared at the greatest risk in terms of stress, discrimination, and economic hardship. A structural equation modeling analysis showed that the relative importance of contributing factors changed over time in the process of immigrants' adaptation. Yet, social support emerged as a powerful protective factor in that its effects carried over time, and discrimination was a primary mediator through which other predictors were related to stress and adjustment. These findings shed light on the "hows and whys" of the immigration-adaptation process, by demonstrating the significance of specific conditions of life change to psychological outcomes as newly immigrant parents adapt to their post-migration ecology.

Perceived Risk of Predation Affects Reproductive Life - History Traits in Gambusia holbrooki, but Not in Heterandria formosa

Key to predicting impacts of predation is understanding the mechanisms through which predators impact prey populations. While consumptive effects are well-known, non-consumptive predator effects (risk effects) are increasingly being recognized as important. Studies of risk effects, however, have focused largely on how trade-offs between food and safety affect fitness. Less documented, and appreciated, is the potential for predator presence to directly suppress prey reproduction and affect life-history characteristics. For the first time, we tested the effects of visual predator cues on reproduction of two prey species with different reproductive modes, lecithotrophy (i.e. embryonic development primarily fueled by yolk) and matrotrophy (i.e. energy for embryonic development directly supplied by the mother to the embryo through a vascular connection). Predation risk suppressed reproduction in the lecithotrophic prey (Gambusia holbrokii) but not the matrotroph (Heterandria formosa). Predator stress caused G. holbrooki to reduce clutch size by 43%, and to produce larger and heavier offspring compared to control females. H. formosa, however, did not show any such difference. In G. holbrooki we also found a significantly high percentage (14%) of stillbirths in predator-exposed treatments compared to controls (2%). To the best of our knowledge, this is the first direct empirical evidence of predation stress affecting stillbirths in prey. Our results suggest that matrotrophy, superfetation (clutch overlap), or both decrease the sensitivity of mothers to environmental fluctuation in resource (food) and stress (predation risk) levels compared to lecithotrophy. These mechanisms should be considered both when modeling consequences of perceived risk of predation on prey-predator population dynamics and when seeking to understand the evolution of reproductive modes.