Comparing adolescents' adjustment and family resilience in divorced families depending on the types of primary caregiver.

AIMS: This study compared three different types of primary caregiver in divorced families: father, mother and grandparent(s) and aimed to (1) compare adolescents' perception of their level of adjustment and family resilience and (2) identify the family resilience predictors of adolescents' adjustment. BACKGROUND: The Resiliency Model of Family Stress, Adjustment and Adaptation guided this study. DESIGN: Survey. METHOD: Adolescents in divorced families in Korea (n = 178) completed self-administered questionnaires. Family resilience was measured by Family Hardiness Index, Family Crisis Oriented Personal Evaluation Scale, Parent-Adolescent Communication Inventory, Social Support Appraisal Scale, Belief about Parental Divorce and Self-Esteem Scale. Korean-Child Behaviour Checklist was used to assess adolescents' adjustment. Descriptive statistics, chi-square test, anova, ancova and multiple regression analysis were used for data analysis. RESULTS: The level of adolescents' adjustment was not statistically different among the three groups. However, statistically significant differences were found in family hardiness, family communication and problem-solving/coping skill-seeking help among the family resilience measurements. Adolescents living with mothers reported the highest scores in family hardiness and family communication. The grandparent(s) group sought and accepted help outside of the family more often than did the other groups. Regardless of the types of primary caregiver, a common significant predictor for adolescents' adjustment was their positive belief about parental divorce; whereas high self-esteem and low level of seeking help were additional predictors for the father group and grandparent(s) group, respectively. CONCLUSIONS: Adolescents' belief about parental divorce is a major predictor for adolescents' adjustment to divorced family life. Nursing services that maximise the family resilience predictors found in this study would enhance adolescents' adjustment in divorced families. RELEVANCE TO CLINICAL PRACTICE: This study provides empirical evidence for nursing care of adolescents who live with differing primary caregivers in divorced families and enhances nurses' understanding of family resilience predictors that influence adolescents' adjustment in divorced families.

Unilateral ovarian metastasis in a case of squamous cervical carcinoma IA1.

Ovarian metastasis from early-stage squamous cervical cancer is rare. We report a case of unilateral ovarian metastasis from squamous cervical cancer IA1. Although ovarian metastasis from early-stage squamous cervical cancer is rare, gynecological oncologists should not overlook its possibility.

The effects of volatile anesthetics on spontaneous contractility of isolated human pregnant uterine muscle: a comparison among sevoflurane, desflurane, isoflurane, and halothane.

We examined the effects of equianesthetic concentrations of sevoflurane, desflurane, isoflurane, and halothane on the spontaneous contractility of isolated human pregnant uterine muscles. We also determined if their action was related to potassium channels. Uterine specimens were obtained from normal full-term pregnant women undergoing elective lower-segment cesarean delivery. Longitudinal muscle strips were mounted vertically in tissue chambers. Their isometric tension was recorded while they were exposed to 0.5-3 minimum alveolar concentration (MAC) of volatile anesthetics in the absence and presence of the high conductance calcium-activated potassium channel blocker, tetraethylammonium, or the adenosine triphosphate-sensitive potassium channel (K(ATP))-blocker, glibenclamide. The anesthetics examined produced a dose-dependent depression of contractility. The inhibitory potency of sevoflurane and desflurane was comparable to, whereas that of isoflurane was smaller than, that of halothane: concentrations causing 50% inhibition of the contractile amplitude (ED(50)) were 1.72, 1.44, 2.35, and 1.66 MAC (P < 0.05), respectively. Tetraethylammonium and glibenclamide did not affect the uterine response to the anesthetics, except for glibenclamide, which attenuated the response to isoflurane. These results indicate that the volatile anesthetics have inhibitory effects on the contractility of the human uterus. The inhibitory effect of isoflurane may in part be mediated through activation of K(ATP) channels.

Computational simulation of axial dynamization on long bone fractures.

BACKGROUND: Axial dynamization has been shown in previous studies to promote callus formation, improve bone healing at fracture sites, and enhance bone remodeling. However, the possibility of non-axial movements or uniform fracture site compression during dynamization, and the appropriate relaxation of fixator joints to achieve such function, have not been investigated. METHODS: This study used previously developed computational models based on two commercially available unilateral external fixators (Dynafix and Orthofix) to analyze the fixator joint adjustments used and the fracture site movements generated during dynamization. FINDINGS: When none of the fixator's sliding joints were parallel to the long bone axis, significant non-axial movements occurred during dynamization. The dual sliding joint design of the Dynafix fixator was beneficial in reducing these non-axial movements. When all of the fixator joints were allowed to adjust simultaneously during dynamization, exact axial movement or uniform compression at a complicated fracture site was achievable. INTERPRETATION: This study revealed that significant non-axial movements may occur during dynamization, and that such a deficiency can be corrected by relaxing certain fixator joints in addition to the sliding mechanism. The same modeling technique can also be applied in bone lengthening application to assure desirable limb alignment during the distraction process. These analysis results can aid the performance assessment of an external fixator and facilitate appropriate application of such a device to achieve either active or controlled axial movement.