Think of genetic hypercalciuria when a child has urinary tract findings.

Genetic hypercalciuria, one of the most common mineral disorders in childhood, is frequently associated with a variety of urinary tract problems. Identifying and treating genetic hypercalciuria alleviates urinary tract problems and optimizes peak bone mass growth in affected children. Advanced practice pediatric nurses play a key role in identifying and coordinating care for children with genetic hypercalciuria.

Parents' reports of "tricks of the trade" for managing childhood chronic illness.

PURPOSE: To examine how parents respond to and manage the challenges of childhood chronic illness. DESIGN: Qualitative, comparative, secondary analysis. PARTICIPANTS: Fifty-eight families (55 mothers, 44 fathers) with a school-age child (6-15 years old) with a chronic illness. RESULTS: Three approaches to illness management were identified: strict adherence, flexible adherence, and selective adherence. These approaches varied in the extent to which parents developed and relied on target management behaviors that concurred with or deviated from the treatment plan prescribed by healthcare providers. CONCLUSIONS: The three management approaches contribute to understanding the processes associated with differing interactions between healthcare professionals and parents when a child has a chronic illness.

Sustained phenotypic correction of murine hemophilia A by in vivo gene therapy.

Hemophilia A is caused by a deficiency of blood coagulation factor VIII (FVIII) and has been widely discussed as a candidate for gene therapy. While the natural canine model of hemophilia A has been valuable for the development of FVIII pharmaceutical products, the use of hemophiliac dogs for gene therapy studies has several limitations such as expense and the long canine generation time. The recent creation of two strains of FVIII-deficient mice provides the first small animal model of hemophilia A. Treatment of hemophiliac mice of both genotypes with potent, human FVIII-encoding adenoviral vectors resulted in expression of biologically active human FVIII at levels, which declined, but remained above the human therapeutic range for over 9 months. The duration of expression and FVIII plasma levels achieved were similar in both hemophiliac mouse strains. Treated mice readily survived tail clipping with minimal blood loss, thus showing phenotypic correction of murine hemophilia A by in vivo gene therapy.

Perfil de la conducta alimentaria en adolescentes de escolaridad secundaria / Profile of the alimentary behavior in adolescents in secondary education

En el ámbito del programa de prevención de trastornos de la conducta alimentaria desarrollado en escuelas de enseñanza media del área programática del Hospital I. Pirovano se realizó una encuesta de hábitos asociados en adolescentes de 3ro. a 5to. año. El objetivo fue detectar hábitos alimentarios y de otro orden, associados a trastornos de la conducta alimentaria, definiendo así el perfil de esa conducta en los adolescentes

Perfil de la conducta alimentaria en adolescentes de escolaridad secundaria / Profile of the alimentary behavior in adolescents in secondary education

En el ámbito del programa de prevención de trastornos de la conducta alimentaria desarrollado en escuelas de enseñanza media del área programática del Hospital I. Pirovano se realizó una encuesta de hábitos asociados en adolescentes de 3ro. a 5to. año. El objetivo fue detectar hábitos alimentarios y de otro orden, associados a trastornos de la conducta alimentaria, definiendo así el perfil de esa conducta en los adolescentes

Building strong bones in childhood and adolescence: reducing the risk of fractures in later life.

The current focus on reducing the risk of osteoporosis and skeletal fractures in later life has placed an emphasis on the role of calcium in building strong bones during childhood and adolescence. Recent National Institutes of Health (NIH) Consensus Development Conference recommendations for optimal calcium intake encourage increased intake. Strategies to enhance optimal calcium intake in children and adolescents include dietary choices and the use of supplements.

Learning from stories: parents' accounts of the pathway to diagnosis.

Although the diagnosis of a child's chronic illness is typically a stressful time for parents, the events leading up to it vary considerably across families. As part of a larger study that addressed the experience of living with chronic illness, an analysis was undertaken to identify major themes in parental reports of the events preceding their child's diagnosis of chronic illness. Data are based on accounts given by parents in 63 families from three health science centers in the midwestern United States. Narrative analysis techniques were used to identify 5 major pathways to diagnosis (direct, delay, detour, quest, ordeal) and to explore parents' perceptions of the nature and quality of their interactions with health care providers. Results are discussed in terms of their implications for initiating positive working relationships between parents and health care providers.

Mothers' perceptions of sibling adjustment and family life in childhood chronic illness.

Researchers who study the effects of chronic illness on well siblings have generally focused on individual characteristics and their relationships with psychological adjustment. More recently, researchers suggest that sibling adjustment can be best understood within the context of the family. The purpose of this study was to examine variations in sibling behavioral adjustment in relation to mothers' perceptions of the illness experience and family life. Based on mothers' ratings on the behavior problem scale of the Child Behavior Checklist (CBCL), five siblings considered poorly adjusted and five very well-adjusted siblings were compared with respect to mothers' reports of individual family member's response to illness, illness management, parenting philosophy, presence of other stressors, availability of social supports, and impact of illness on family members and family life. Two major differences were found between mothers who rated healthy siblings either poorly or very well adjusted: (a) effects of illness on the healthy sibling, the ill child, and the marital relationship and (b) perceived controllability of the chronic illness. Devising ways of helping mothers feel confident in managing their child's illness is integral to creating an environment that promotes optimal development of their ill child and the child's siblings.

A case illustration of family management style.

Chronic illness management is a way of life for many children and their families. For these chronically ill children, the ability of the family to respond to the daily relentless demands of management dictates the quality of the child's and family's life. In an effort to better understand how a family responds to a chronic illness, Knafl and Deatrick's Family Management Style (FMS) model is applied to a family with a child with type I diabetes using a case-study analysis. Gallo derived dimensions of the model's components in an earlier application. These dimensions are applied to interview data obtained on the same family 1 year later to address the dynamic nature of family management style.

Risk factors, clinical signs, and survival in cats with a clinical diagnosis of idiopathic hypertrophic cardiomyopathy: 74 cases (1985-1989).

Population characteristics, risk factors, and survival characteristics were evaluated in 74 cats with hypertrophic cardiomyopathy (HC) seen at North Carolina State University veterinary teaching hospital from 1985 to 1989, and compared with 82 clinically normal cats. The mean (+/- SD) age of cats with HC was 6.5 (4.0) years. Neutered males were at significantly greater risk (odds ratio 3.1) than neutered females. Breed, body weight, or coat color were not determined to be risk factors for HC. Tricolor cats were significantly underrepresented, probably reflecting the male predisposition for HC and not a true risk reduction associated with coat color. Forty-one cats were without clinical signs of heart disease (murmur and/or gallop sound only), 24 were in congestive heart failure, and 9 had systemic arterial embolism, 3 of which had concomitant congestive heart failure. The median survival time for 61 cats with HC, for which survival information could be obtained and that were not euthanatized on day 1, was 732 days. Survival was not affected by age at diagnosis, breed, body weight, or sex. However, clinical signs were important in determining prognosis; cats with heart rates greater than 200 beats/min survived significantly longer (median survival greater than 1,830 days) than those with heart rates greater than or equal to 200 beats/min (median survival = 152 days). Cats without clinical signs (median survival greater than 1,830 days) survived longer than those with clinical signs, and cats in heart failure survived a median of 92 days, compared with 61 days for those with systemic arterial embolism. Analysis of survival revealed no significant difference between the 2 groups of cats with clinical signs; however, all cats with embolism and only 60% of cats with heart failure were dead 6 months after diagnosis.

Social competence of school-aged children with chronic illnesses.

This study examines social competence among 67 chronically ill children, aged 7 to 14 years, whose families participated in a grounded theory study of how families define and manage a child's chronic illness. Child Behavior Check List ratings (Achenbach & Edelbrock, 1983) by both fathers and mothers indicated a significantly greater risk for social competence difficulties among the chronically ill children as compared with the normative sample. Case vignettes, drawn from extensive interviews with family members, are used to show contrasting styles of family management and child coping and to suggest nursing interventions aimed at fostering social competence.

A case illustration of family management style in childhood end stage renal disease.

Families of children with end stage renal disease (ESRD) experience their situation based on how they define the illness, manage it, and view the consequences of the illness on the family and individual family members. The purpose of this study was to describe how a family with a child with ESRD defined and managed their situation. Interviews with individual family members from two separate interview sessions were analyzed. The family's management style changed from struggling to adaptive over a 1-year period following the child's kidney transplant.

Description of the illness experience by adolescents with chronic renal disease.

The purpose of this study was to describe the illness experience of five adolescents with chronic renal disease. The adolescents described how renal disease had affected themselves and their daily lives. Implications for nurses when interacting with adolescents with renal disease are discussed.

Infant feeding practices of low-income mothers.

This study describes infant feeding practices over the first year of life for 294 medically indigent, inner city mothers. These findings highlight the need for interventions to improve infant feeding knowledge and practices throughout the first year of life. Nutritional problems identified included low rates of breast-feeding; early introduction of solid food, especially cereal in the bottle; and excessive use of foods that are high in sugar.

Well siblings of children with chronic illness: parents' reports of their psychologic adjustment.

This article examines the psychologic adjustment among 28 well siblings of children with chronic illness, ages 6 to 16, as measured by parents' rating on the Child Behavior Checklist. Results indicate that, as a group, well siblings do not experience a higher incidence of behavior and social competence problems than the normative sample. These data suggest that well siblings may not be uniformly at greater risk for maladjustment. Sibling adjustment may be selective and vary depending on specific child characteristics and family environment influences.

Family adaptation in childhood chronic illness: a case report.

When a child is diagnosed with a chronic illness, families adapt by drawing on the perceptions of individual family members, on the family's existing resources, and on new resources. This method of family adaptation has been described by McCubbin and Patterson in their Family Adaptation Model. The Family Adaptation Model is illustrated through a case study of a family's experience with type I diabetes. The model and case study yield a list of nursing assessments and interventions for families with a chronically ill child.

Stigma in childhood chronic illness: a well sibling perspective.

The purpose of this study was to describe how well siblings view potential stigma in childhood chronic illness. Results of interview of 27 siblings are discussed using three major categories: revealing of the chronic illness to others, responses to the ill child, and impact of the illness on daily living.