Disease-related Challenges Research Articles

Stress and coping of parents caring for a child with mitochondrial disease

Mitochondrial disease comprises a group of rare, genetic, life-limiting, neurodegenerative disorders known to affect children. Little is known about disease-related challenges, parental stress, and coping when caring for a child with a mitochondrial disease. Purpose: This study explored disease-related characteristics and parental stressors and coping behaviors related to caring for a child with mitochondrial disease. Methods: Internet surveys were posted on known mitochondrial disease websites for parent completion. Surveys included demographic items and two questionnaires: Coping Inventory for Parents (CHIP) and Pediatric Inventory for Parents (PIP). Descriptive data were collected and correlations used to determine relationships between parenting stress, coping, and demographic variables. Results: The majority of participants (n=231) were mothers (95%) of children with mitochondrial disease around the age of 10years (M=9.85). On average, children had 6 organs involved (M=6.02) and saw 7 different specialists (M=7.49); 61% were hospitalized in the past year. Significant correlations (p<0.05) were found between parenting stress and parent age, parent income, parent education, child age, child age at diagnosis, presence of developmental delays, number of hospitalizations, number of medical visits, number of organs involved, and number of specialists seen. Significant correlations were also found between parenting stress and coping behaviors such as family integration, social support and understanding health care. Conclusions: The ability to identify disease-related challenges, stressors, and coping strategies in parents of children with mitochondrial disease is novel and can assist nurses to provide disease-sensitive, family-focused care and improve child health outcomes.

Coping strategies, cognitive impairment, psychological variables and their relationship with quality of life in multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system typically affecting young adults. Psychological coping has proved to be crucially important for adjusting to the adaptive demands of chronic diseases, and in the last few years it has received growing interest in MS. A common finding in the literature is that MS patients tend to adopt dysfunctional avoiding strategies and to rely less on task-oriented and positive attitude strategies, which represent a better adjustment to disease-related challenges. Moreover, the studies show higher psychoticism in MS subjects compared with the general population, and higher levels of depression and anxiety that can contribute to lower QoL perception. In our study including 63 MS patients cognitive functioning did not seem to influence the type of coping. However, subjects with impairment on tasks that assess sustained attention and some aspects of executive function were less prone to adopt positive coping strategies. Cognitive and emotional problems should be carefully monitored, providing prompt diagnosis and treatment as appropriate.

SEARCHING FOR NEW PLAYERS IN CARDIOPROTECTION

Exercise training induces adaptations that improve pump performance and protect the heart from disease-related challenges. To understand the molecular signaling mechanisms of cardioprotection, it will be necessary to identify the proteins involved, as well as the transcriptional, translational, and posttranslational changes they undergo in response to exercise. PURPOSE Our long-term goal was to identify novel cardiac proteins that regulate exercise effects. The short-term goals were to evaluate the potential of a proteomic approach, and to optimize quantitation of protein abundance and peptide mass fingerprinting (PMF). METHODS Proteins were prepared from left ventricles of 8 sedentary and 8 exercise-trained rats. Two-dimensional electrophoresis (2-DE) consisted of isoelectric focusing with immobilized pH gradient strips (pH 5–8) and vertical polyacrylamide slab gels (8–12% gradient). A modified silver-staining (SS) technique was compared with ruthenium-based (RU) fluorescent dyes for quantitative linearity and for compatibility with PMF. Automated PMF (APMF) was compared to a manual procedure (MPMF) for identification of proteins extracted from the 2-DE gels. RESULTS The average coefficient of variation (CV) between gels was 49% for SS, and 32% for RU. Log transformation reduced the CV of spot ratios for SS gels from 49% to 14%, and for RU from 32% to 3%. Using MPMF, 6 of 34 reference spots (18%) were identified. APMF identified 36 of 45 reference spots (80%). Nineteen of 22 (86%) spots from SS gels were identified, and 26 of 36 (72%) spots from RU gels were identified. Among candidate spots that differed in abundance (p < 0.05) between exercise-trained and sedentary proteomes were 3α-hydroxysteroid dehydrogenase and a 20 kDa heat shock protein. CONCLUSION Reliability in protein abundance measurements was greatest with ruthenium-based dyes and was markedly improved by log transformation of the data. APMF is superior to MPMF and is equally compatible with SS and RU. Candidate proteins for the cardioprotective effects of exercise have been identified using a proteomic approach and require further study. Supported by the American Heart Association-Midwest Affiliate