[show abstract][hide abstract] ABSTRACT: The provision of family-centered care (FCC) emphasizes a partnership between parents and health-care providers so that families are involved in every aspect of services for their child. Our study examines factors related to parental perception of the family-centeredness of pediatric oncology services.
This Canadian multi-institutional cross-sectional study included children with cancer receiving active treatment. One parent from each family provided information about the child, parent/family demographics, diagnosis, and treatment. FCC was measured with the MPOC-20, a valid and reliable tool in the pediatric oncology setting that consists of two subscales: "Family-Centered Service" and "Providing General Information." Logistic multiple regression analyses were used to identify factors that were associated with lower ratings of FCC for each subscale.
Completed questionnaires were received back from 411 parents, giving an overall response rate of 80%. Worse perceived prognosis and worse parental psychosocial health were associated with less favorable ratings for both MPOC-20 subscales. In addition, parents who were not married or living common-law scored lower ratings for the Family-Centered Services subscale, whereas scores for the Provision of General Information subscale differed depending on the treatment facility at which the child received care.
Our study identified child/parent factors and health-care delivery factors associated with FCC provided in the pediatric oncology setting. These results could be used as the starting point for future research looking at optimization of the FCC process.
[show abstract][hide abstract] ABSTRACT: Utrophin up-regulation in muscle fibers of Duchenne muscular dystrophy patients represents a potential therapeutic strategy. It is thus important to delineate the regulatory events presiding over utrophin in muscle in attempts to develop pharmacological interventions aimed at increasing utrophin expression. A number of studies have now shown that under several experimental conditions, the abundance of utrophin is increased without a corresponding elevation in its mRNA. Here, we examine whether utrophin expression is regulated at the translational level in regenerating muscle fibers. Treatment of mouse tibialis anterior muscles with cardiotoxin to induce muscle degeneration/regeneration led to a large (approximately 14-fold) increase in the levels of utrophin A with a modest change in expression of its transcript (40%). Isolation of the mouse utrophin A 5'-untranslated region (UTR) revealed that it is relatively long with a predicted high degree of secondary structure. In control muscles, the 5'-UTR of utrophin A caused an inhibition upon translation of a reporter protein. Strikingly, this inhibition was removed during regeneration, indicating that expression of utrophin A in regenerating muscles is translationally regulated via its 5'-UTR. Using bicistronic reporter vectors, we observed that this translational effect involves an internal ribosome entry site in the utrophin A 5'-UTR. Thus, internal ribosome entry site-mediated translation of utrophin A can, at least partially, account for the discordant expression of utrophin A protein and transcript in regenerating muscle. These findings provide a novel target for up-regulating levels of utrophin A in Duchenne muscular dystrophy muscle fibers via pharmacological interventions.
Journal of Biological Chemistry 10/2005; 280(38):32997-3005.
[show abstract][hide abstract] ABSTRACT: The present study sought to quantify the relationships among physical activity (PA), health-related fitness and motor skill in children (Grades 4 to 6), and to determine whether specific tests of fitness or motor skill are independently associated with objectively-measured PA level. 491 students (56.4% female) wore a Digi-Walker pedometer for 7 consecutive days. Standardized protocols were used to assess health-related fitness (BMI percentile, waist circumference, 20m shuttle run, plank, handgrip, and trunk flexibility). Motor skill was evaluated using a validated obstacle course. Pearson correlations (with Holm adjustments for multiple comparisons) initially assessed associations among PA, health-related fitness and motor skill. Multi-variable linear regression was used to determine which factors were significantly associated with daily step counts, while adjusting for gender, age, testing season and socio-economic status. Step counts were significantly correlated with predicted aerobic power (r=0.30), obstacle course time (r=-0.27), obstacle course score (r=0.20), plank isometric torso endurance (r=0.16), and handgrip strength (r=0.12), but not with waist circumference (r=-0.10), trunk flexibility (r=0.10) or overweight status (rho=-0.06). In the multi-variable model, predicted aerobic power, obstacle course time, testing season, gender and the predicted aerobic power by gender interaction were significantly associated with step counts, explaining 16.4% of the variance. Specifically, the relationship between predicted aerobic power and step counts was stronger in girls. These findings suggest that aerobic fitness and motor skill are independently associated with children’s PA. Future longitudinal studies should evaluate whether interventions to enhance aerobic fitness and motor skill could enhance daily PA among children of this age.
Applied Physiology Nutrition and Metabolism 11/2013;