Michelle Darezzo Rodrigues Nunes

Diabetes mellitus tipo 1: evidências da literatura para seu manejo adequado, na perspectiva de crianças

El estudio objetivo identificar las evidencias disponibles en la literatura que aborden, en la perspectiva infantil, los factores relevantes para el manejo adecuado de la diabetes mellitus tipo 1. Se realizo revision integradora en bases de datos PubMed, CINAHL, LILACS, CUIDEN y PsycINFO, con los descriptores diabetes mellitus tipo 1, nino, prevencion y control, factores desencadenantes, emergencias, autocuidado, aprendizaje y educacion en salud, en periodo 1998 a 2008. Del total, se seleccionaron 19, su analisis permitio identificar las categorias: viviendo con la diabetes; autocuidado y perfil glucemico; actuacion de la familia, amigos y profesionales de saludo; y escuela. Las evidencias determinan que el nino aprecia el apoyo recibido por sus familiares, los cuales tienen relacion directa con la preparacion para el autocuidado. Otros miembros externos a su red tambien son valorizados. La escuela merece atencion, asi como la experiencia particular de cada nino y la educacion en salud.The objective of this study was to identify the evidence available in the literature that address, for childrens perspective, factors that are relevant for an appropriate management of type 1 diabetes mellitus. An integrative review was performed on the PubMed, CINAHL, LILACS, CUIDEN and PsycINFO databases, covering the period from 1998 to 2008 and using the following keywords: type 1 diabetes mellitus, child, prevention and control, triggering factors, emergencies, self care, learning and health education. Nineteen of the surveyed articles were selected, and their analysis revealed the following categories: living with diabetes; self care and glucose profile; the actions of family, friends and health professionals; and school. The evidence show that children appreciate the support they receive from their relatives, which have a direct relationship with being prepared for self care. Other members apart from their network are also valued. Areas that deserve attention are the school, the personal experience of each child, and health education.

Fatigue and Sleep Experiences at Home in Children and Adolescents With Cancer.

PURPOSE/OBJECTIVES To (a) investigate fatigue and sleep patterns of children and adolescents at home and (b) examine factors associated with fatigue and sleep.. DESIGN Descriptive with repeated measures
. SETTING Homes of study participants in Los Angeles and Orange, California
. SAMPLE 35 children and adolescents with cancer. METHODS Data were collected using the PedsQL Multidimensional Fatigue Scale, which was completed once at home by each participant, and sleep actigraphs, which were worn for five days at home following discharge from hospitalization
. MAIN RESEARCH VARIABLES General fatigue, cognitive fatigue, sleep-rest fatigue, sleep duration, sleep quantity, sleep efficiency, and wake after sleep onset
. FINDINGS More than half of the participants had problems with fatigue at home. Significant correlations were found between sleep/rest fatigue and sleep duration. Factors that affected fatigue were age, gender, and cancer diagnosis. Adolescents had more problems with fatigue than children, and female patients had more problems with fatigue than male patients. Patients with sarcoma had more problems with fatigue than those with leukemia, lymphoma, and other cancer diagnoses. Adolescents slept less than children. CONCLUSIONS Children and adolescents with cancer have fatigue and sleep problems at home that vary by age, gender, and cancer diagnosis
. IMPLICATIONS FOR NURSING Data from the current study support the need for nurses to provide teaching about fatigue and sleep at home in children and adolescents with cancer. Future studies are needed to examine interventions that may alleviate fatigue and improve sleep at home
.

[Type 1 diabetes mellitus: evidence from the literature for appropriate management in children's perspective].

El estudio objetivo identificar las evidencias disponibles en la literatura que aborden, en la perspectiva infantil, los factores relevantes para el manejo adecuado de la diabetes mellitus tipo 1. Se realizo revision integradora en bases de datos PubMed, CINAHL, LILACS, CUIDEN y PsycINFO, con los descriptores diabetes mellitus tipo 1, nino, prevencion y control, factores desencadenantes, emergencias, autocuidado, aprendizaje y educacion en salud, en periodo 1998 a 2008. Del total, se seleccionaron 19, su analisis permitio identificar las categorias: viviendo con la diabetes; autocuidado y perfil glucemico; actuacion de la familia, amigos y profesionales de saludo; y escuela. Las evidencias determinan que el nino aprecia el apoyo recibido por sus familiares, los cuales tienen relacion directa con la preparacion para el autocuidado. Otros miembros externos a su red tambien son valorizados. La escuela merece atencion, asi como la experiencia particular de cada nino y la educacion en salud.The objective of this study was to identify the evidence available in the literature that address, for childrens perspective, factors that are relevant for an appropriate management of type 1 diabetes mellitus. An integrative review was performed on the PubMed, CINAHL, LILACS, CUIDEN and PsycINFO databases, covering the period from 1998 to 2008 and using the following keywords: type 1 diabetes mellitus, child, prevention and control, triggering factors, emergencies, self care, learning and health education. Nineteen of the surveyed articles were selected, and their analysis revealed the following categories: living with diabetes; self care and glucose profile; the actions of family, friends and health professionals; and school. The evidence show that children appreciate the support they receive from their relatives, which have a direct relationship with being prepared for self care. Other members apart from their network are also valued. Areas that deserve attention are the school, the personal experience of each child, and health education.

Correlations between functional Interleukin-1 and changes in fatigue and quality of life in children and adolescents with cancer.

95 Background: Several studies have explored the hypothesis of involvement of the immune system in the cancer-related fatigue (CRF) and quality of life in adults with cancer via release of cytokines. However, how the immune system may produce these outcomes remains a largely unanswered question. Furthermore, research on fatigue in children and adolescents with cancer has included primarily self-reports of this symptom, with scarce although increasing data exploring biologic variables related to this symptom. METHODS To comprehensively examine the influence of cytokines in the fatigue and health related quality of life (HRQOL) in children and adolescents with cancer, we investigated the plasma levels of pro and anti-inflamatory cytokines and its correlation with fatigue and HRQOL in children and adolescents with cancer. Plasma levels of 6 cytokines were measured via flow cytometry. RESULTS The final sample consisted of 33 hospitalized children and adolescents aged between 8 and 18 years. We found a correlation between general fatigue and IL-1β (r = -0.361, p = 0.039) and correlation with quality of life was noted with IL-1β (r = -0.382, p = 0.028). The results of this research indicate that there may be a relationship between cytokines and fatigue, and HRQOL in children and adolescents with cancer. When analyzed the correlation between fatigue and some confounding variables found the link between general fatigue and neutrophils (r = -0.360, p = 0.040). This correlation is a novel found in this population under cancer condition, implicating a possible interleukin-hematological pathway for CRF in oncology. CONCLUSIONS Our study confirms the potential role of cytokines in developing cancer-related symptoms, thus supporting the utility of the neuroimmunological approach to the discovery of biomarkers linked to the clusters of cancer-related symptoms.

Diabetes mellitus tipo 1: evidencias de la literatura para su adecuado manejo, en la perspectiva infantil

El estudio objetivo identificar las evidencias disponibles en la literatura que aborden, en la perspectiva infantil, los factores relevantes para el manejo adecuado de la diabetes mellitus tipo 1. Se realizo revision integradora en bases de datos PubMed, CINAHL, LILACS, CUIDEN y PsycINFO, con los descriptores diabetes mellitus tipo 1, nino, prevencion y control, factores desencadenantes, emergencias, autocuidado, aprendizaje y educacion en salud, en periodo 1998 a 2008. Del total, se seleccionaron 19, su analisis permitio identificar las categorias: viviendo con la diabetes; autocuidado y perfil glucemico; actuacion de la familia, amigos y profesionales de saludo; y escuela. Las evidencias determinan que el nino aprecia el apoyo recibido por sus familiares, los cuales tienen relacion directa con la preparacion para el autocuidado. Otros miembros externos a su red tambien son valorizados. La escuela merece atencion, asi como la experiencia particular de cada nino y la educacion en salud.The objective of this study was to identify the evidence available in the literature that address, for childrens perspective, factors that are relevant for an appropriate management of type 1 diabetes mellitus. An integrative review was performed on the PubMed, CINAHL, LILACS, CUIDEN and PsycINFO databases, covering the period from 1998 to 2008 and using the following keywords: type 1 diabetes mellitus, child, prevention and control, triggering factors, emergencies, self care, learning and health education. Nineteen of the surveyed articles were selected, and their analysis revealed the following categories: living with diabetes; self care and glucose profile; the actions of family, friends and health professionals; and school. The evidence show that children appreciate the support they receive from their relatives, which have a direct relationship with being prepared for self care. Other members apart from their network are also valued. Areas that deserve attention are the school, the personal experience of each child, and health education.