Becoming unique: A qualitative study of identity development of adolescent kidney recipients.

Teenagers who receive a renal organ transplant have to take up the double challenge of identity development, the primary task of adolescence, and of overcoming the complexities of their illness. Previous qualitative studies found that adolescents felt that the organ transplant and its treatments mainly defined who they are. The relationship to the donor can be a source of concern for some of them, especially for those who received from a parent and feel an obligation to be obedient and grateful. While donor parents are known to interpret their gesture as giving life for a second time, no research to date has described how this particular gesture may influence adolescent development. The present article aims to examine and describe identity development of teenage kidney recipients in a context of parental or deceased donation. We used a qualitative design involving individual interviews with 10 adolescents. Five of them received from a donor parent, five from a deceased donor. Data were analyzed using IPA. Results suggest that identity development is influenced by similar concerns for all adolescents regardless of donor source: body image, social relationships, and anxiety about the future. One aspect that stood out from the discourse of those who received from a parent was feelings of guilt towards the donor when engaging in behaviors that could comprise graft survival, which was a challenge for identity development. Receiving the transplant freed teens from the struggle of just managing their illness and was a catalyst for exploration and engagement, which are crucial for identity development.

Resolution of diagnosis and parental attitudes among parents of adolescent kidney recipients.

The diagnosis of a chronic illness is described as an upsetting event that implies an emotional crisis for parents. Some are able to come to terms with their child's chronic condition and feel a sense of resolution, but for others, strong negative emotions persist through time. The present study examines diagnostic resolution among parents of teenagers with a transplant. The design was qualitative and involved individual interviews with nine parents. Five were donor to their child. Data were analyzed according to the principles of IPA. Early reactions to the diagnosis suggest that parents with an unresolved status experienced trauma. Many factors seem to contribute to diagnostic resolution such as good communication between spouses, positive relationship with the medical staff, and being the parent donor. For all parents, concerns over adherence are central to their relationship with their youth. Results call attention to the support needs of all parents and particularly those with an unresolved status.

Oculomotor Adaptation Elicited By Intra-Saccadic Visual Stimulation: Time-Course of Efficient Visual Target Perturbation.

Perception of our visual environment strongly depends on saccadic eye movements, which in turn are calibrated by saccadic adaptation mechanisms elicited by systematic movement errors. Current models of saccadic adaptation assume that visual error signals are acquired only after saccade completion, because the high speed of saccade execution disturbs visual processing (saccadic "suppression" and "mislocalization"). Complementing a previous study from our group, here we report that visual information presented during saccades can drive adaptation mechanisms and we further determine the critical time window of such error processing. In 15 healthy volunteers, shortening adaptation of reactive saccades toward a ±8° visual target was induced by flashing the target for 2 ms less eccentrically than its initial location either near saccade peak velocity ("PV" condition) or peak deceleration ("PD") or saccade termination ("END"). Results showed that, as compared to the "CONTROL" condition (target flashed at its initial location upon saccade termination), saccade amplitude decreased all throughout the "PD" and "END" conditions, reaching significant levels in the second adaptation and post-adaptation blocks. The results of nine other subjects tested in a saccade lengthening adaptation paradigm with the target flashing near peak deceleration ("PD" and "CONTROL" conditions) revealed no significant change of gain, confirming that saccade shortening adaptation is easier to elicit. Also, together with this last result, the stable gain observed in the "CONTROL" conditions of both experiments suggests that mislocalization of the target flash is not responsible for the saccade shortening adaptation demonstrated in the first group. Altogether, these findings reveal that the visual "suppression" and "mislocalization" phenomena related to saccade execution do not prevent brief visual information delivered "in-flight" from being processed to elicit oculomotor adaptation.

Growth-phase-dependent expression of the operon coding for the glycosylated autotransporter adhesin AIDA-I of pathogenic Escherichia coli.

The adhesin involved in diffuse adherence (AIDA-I) is an autotransporter found in pathogenic strains of Escherichia coli causing diarrhea in humans and pigs. The AIDA-I protein is glycosylated by a specific enzyme, the AIDA-associated heptosyltransferase (Aah). The aah gene is immediately upstream of the aidA gene, suggesting that they form an operon. However, the mechanisms of regulation of the aah and aidA genes are unknown. Using a clinical E. coli isolate expressing AIDA-I, we identified two putative promoters 149 and 128 nucleotides upstream of aah. Using qRT-PCR, we observed that aah and aidA are transcribed in a growth-dependent fashion, mainly at the start of the stationary phase. Western blotting confirmed that protein expression follows the same pattern. Using a fusion to a reporter gene, we observed that the regulation of the isolated aah promoter matched this transcription and expression pattern. Lastly, we found glucose to be a repressor and nutrient starvation to be an inducer. Taken together, our results suggest that, in the strain and the conditions we studied, aah-aidA is transcribed as a bicistronic message from a promoter upstream of aah, with maximal expression under conditions of nutrient limitation such as high cell density.