Coping among adolescents with long-term health conditions: a mixed-methods study.

BACKGROUND: Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. AIM: To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. DESIGN: The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. RESULTS: 'Problem-focused disengagement' was the most-often used coping strategy. The second and third most common strategies were 'problem-focused engagement' and 'emotion-focused engagement'. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. CONCLUSION: Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.

Poly (Vinyl Alcohol)/Agar Hydrogel Electrolytes Based Flexible All-in-One Supercapacitors with Conducting Polyaniline/Polypyrrole Electrodes.

The major components of supercapacitor are electrodes and electrolytes which are fabricated using various materials and methods. Hydrogel is one such material that is used in supercapacitors as electrodes and electrolytes or both. Hydrogels are usually described as a soft and porous network of polymer materials that can swell in water because of the hydrophilic nature of its polymer chains, compriseng a 3D structure. It is well known that supercapacitors possess high-power density but low energy density. For enhancing energy density of these electrochemical cells and a boost in its electrochemical performance and specific capacity, binder free conducting polymer hydrogel electrodes have gained immense attention, especially polyaniline (PANI) and polypyrrole (PPy). Therefore, in this work, chemically crosslinked PVA/Agar hydrogel electrolytes have been prepared and employed. Agar has been added in PVA since it is environmentally friendly, biodegradable, and cost-effective natural polymer. Subsequently, the binder free polyaniline/polypyrrole electrodes were grown on the PVA/Agar hydrogel electrolytes to fabricate all-in-one flexible hydrogels. The synthesized hydrogels were characterized using X-ray diffraction (XRD) analysis, Fourier transform infrared (FTIR) analysis, Field emission scanning electron microscope (FESEM) and mechanical studies. Then, the all-in-one flexible supercapacitors were fabricated using the hydrogels. The electrochemical studies such cyclic voltammetry (CV), galvanic charge discharge (GCD), and electrochemical impedance spectroscopy (EIS) studies. The fabricated all-in-one lamination free supercapacitors showed promising results and by comparing all four samples, PAP2 where 5 mL of PVA was used in combination with 3 mL of Agar and 5 mL of PANI and PPy each, exhibited the highest areal capacitance of 750.13 mF/cm2, energy density of 103.02 µWh/cm2, and 497.22 µW/cm2 power density. The cyclic stability study revealed the 149% capacity retention after 15,000 cycles.

Efficacy and Safety of Endoscopic Esophageal Dilatation in Pediatric Patients with Esophageal Strictures.

MATERIALS AND METHODS: In this retrospective cross-sectional single center study, records of patients with esophageal strictures presented to the pediatric department, Salmaniya Medical Complex, Bahrain, in the period between 1995 and 2019 were reviewed. Demographic data, indications of endoscopic dilatations, the procedure success rate, and possible complications were assessed. RESULTS: Forty-six children were found to have esophageal strictures. Twenty-five (54.3%) patients were males. Most patients presented during infancy (86.5%, 32/37 patients). Twenty-six (56.5%) patients required 88 dilatation sessions, while the remaining 20 (43.5%) patients did not require dilatations. The median number of dilatation sessions per patient was three (interquartile range = 2-5). Savary-Gilliard bougienages were the main dilators used (80.8%, 21/26 patients). Anastomotic stricture (post esophageal atresia/tracheoesophageal fistula repair) was the main cause of esophageal strictures and was found in 35 (76.1%) patients. Patients with nonanastomotic strictures had more frequent dilatations compared to those with anastomotic strictures (P = 0.007). The procedure success rate was 98.8%. Yet, it was operator dependent (P = 0.047). Complete response to dilatation was found in 18 (69.2%) patients, satisfactory in seven (26.9%), and an inadequate response in one (3.9%). Those with satisfactory responses still require ongoing dilatations based on their symptoms and radiological and endoscopic findings. No perforation or mortality was reported. Patients with dilatations had more recurrent hospitalization (P < 0.0001), more dysphagia (P = 0.001), but shorter hospital stay (P = 0.046) compared to those without dilatations. Surgical intervention was required in one patient with caustic strictures. The median follow-up period was six years (interquartile range = 2.25-9.0). CONCLUSIONS: Endoscopic esophageal dilatation in children with esophageal strictures is effective and safe. Yet, it was operator dependent. Nonanastomotic strictures require more dilatations compared to anastomotic strictures. Findings of this study are comparable to those reported worldwide.

Effectiveness of mobile phone short message service on diabetes mellitus management; the SMS-DM study.

OBJECTIVE: To test the feasibility of short message service (SMS) usage between the clinic visits and to evaluate its effect on glycemic control in uncontrolled type 2 Diabetes Mellitus (DM) subjects. RESEARCH DESIGN AND METHODS: 34 cases with type 2 Diabetes were followed after fulfilling the inclusion criteria. The interventional group (n=12) had the same conventional approach of the control group but had two mobile numbers (physician and diabetic educator) provided for the SMS support until their next visit in 3 months. Both groups of age, BMI and the pre-study A1c were comparable. RESULTS: Both groups had a significant reduction in their A1c compared to their baseline visit. However, the interventional group had significantly greater reduction in A1c (p=0.001), 1.16% lower than controls. The service was highly satisfactory to the group. CONCLUSION: The results indicate effectiveness in lowering A1c and acceptance by the patients. Further research and large-scale studies are needed.