Selected predictors of parental satisfaction with child nursing care in paediatric wards in Poland-Cross-sectional study.

BACKGROUND: Assessment of parental satisfaction with child nursing is the key issue in evaluation of the care quality, enabling the adjustment of the services provided to the needs and expectations of recipients, and thus ensuring safety and achieving better long-term health effects. AIM: Assessment of parental satisfaction with child nursing in paediatric wards including its determinants. MATERIAL AND METHODS: The study covered 1030 parents of children hospitalised in paediatric and surgical wards of seven hospitals of different levels of health security in Poland. The Polish adaptation of the Empathic standardised questionnaire for assessment of the level of parents' satisfaction with nursing care, developed by Latour et al. and the self-constructed summary of socio-demographic data were applied in the study. RESULTS: More than 90% of respondents expressed high level of satisfaction with nurses' Availability, the lowest, but still high score of respondents' satisfaction was observed for Parental Participation. The highest satisfaction was observed among the parents of children at the preschool, early school and puberty stage, admitted to the hospital on the elective basis, referred for diagnostic assessment and with the length of hospital stay less than 7 and longer than 28 days. Achieving preschool age was the strongest factor which increased assessment of satisfaction in most domains. CONCLUSIONS: There is a need for optimising nursing care especially in the area of parental participation. The nursing care' quality improvement plan in paediatric departments should focus particularly on early childhood patients and their parents who are the most critical in satisfaction' assessment.

Serum cytokine levels in children with spectrum autism disorder: Differences in pro- and anti-inflammatory balance.

BACKGROUND: Autism Spectrum Disorders (ASDs) is a developmental and neurological disorder that affects all aspects of social communication, with limited and stereotypical interest, and atypical responses to sensory stimuli. Diagnosis of ASD is currently phenotype based with no reliable laboratory test available to assist clinicians. Researches have shown that individuals with autism often exhibit dysfunction of cytokines. METHODS: A total of 42 patients with ASD and 20 matched controls participants were recruited for the study. Diagnosis was conducted by medical specialists and based on the International Classification of Mental and Behavioral Disorders - ICD-10, DSM-5 and CARS sore. Whole blood samples were collected and serum IL's and chemokin levels were made using ELISA kits. RESULTS: Results demonstrated that in comparison to the controls, the individuals with autism showed significantly higher concentration of IL-1ß, IL-4, IL-6 and IL-13. We also demonstrated significant correlations between the levels of cytokines which implies the presence of an interactive network between them. The results of ROC analysis indicated the 4-factors (IL-1ß, IL-4, IL-6 and IL-13) could be potential biomarkers in diagnosis of ASD. CONCLUSIONS: In this study, serum levels of cytokine differed among children with ASD. However, the findings of this support the possibility of using an appropriate selection of serum cytokine for the diagnosis ASD and emphasize the need to standardize quantitative methods for serum analysis.

Determinants of Parental Satisfaction with Nursing Care in Paediatric Wards-A Preliminary Report.

Background: The quality of medical services for a child and their parents are tantamount to a sense of satisfaction with care. Purpose: The assessment of determinants of parental satisfaction with nursing care in paediatric wards. Methods: The study covered 336 parents of children hospitalised in paediatric departments and was based on the "EMPHATIC" questionnaire, standardized and adapted to Polish conditions. Results: The mean score of the overall parental satisfaction was high, amounting to 4.19 points. The lower level of satisfaction with nursing care was reported in parents of children under the age of 6 years, admitted in an emergency mode with a diagnosed post-trauma condition and those with higher education. The duration of hospitalisation, sex and age of parents did not have an influence on the satisfaction with care. Conclusions: The age of the child, admission mode and education of respondents are determinants of parental satisfaction with nursing care.

Cytokines concentrations in serum samples from allergic children-Multiple analysis to define biomarkers for better diagnosis of allergic inflammatory process.

BACKGROUND: Allergic diseases can expand at any age as a result of complicated interaction of environmental and genetic factors. Through the years, studies have found that allergic diseases are primarily described by elevated Th2 pathway activation, leading to increased serum IgE levels, allergen reactivity, blood eosinophil counts and secreted interleukins. METHODS: A total of 20 patients with allergy and 20 matched controls participants were recruited for the study. A study was designed with the framework of an ongoing project at the Regional Children's Hospital in Olsztyn on the analysis of the immune profile of children with allergy and asthma. Diagnosis was conducted by medical specialists. Whole blood samples were collected and serum IL's and chemokin levels were made using ELISA kits. RESULTS: Results demonstrated that in comparison to the controls, the individuals with allergy showed significantly higher concentration of IL-1ß, IL-4, IL-6, IL-8, IL-10, IL-13 and TNF-α. We also demonstrated significant correlations between the levels of cytokines which implies the presence of an interactive network between them. The results of ROC analysis indicated the 3-factors (IL-1ß, IL-4, IL-8) could be additional, helpful biomarkers in better diagnosis of allergy. CONCLUSIONS: In this study, serum levels of cytokine differed among children with allergy. However, the findings of this support the possibility of using an appropriate selection of serum cytokine for the diagnosis allergy and emphasize the need to standardize quantitative methods for serum analysis.

The influence of breast milk and infant formulae hydrolysates on bacterial adhesion and Caco-2 cells functioning.

The aim of the study was to determine the concentration of BCM7 in human milk and infant formulae (IF) before and after eznymatic hydrolysis, and to evaluate the effect of obtained hydrolysates on interleukin-8 (IL-8) secretion and on proliferation of enterocytes in the in vitro model (Caco-2 cells). This study evaluates also the effect of hydrolysates on the adhesion of intestinal microbiota isolated from faeces of both healthy (H) and allergic (A) infants. In the study we investigated breast milk delivered by mothers of healthy ('healthy milk'; HM) and allergic ('allergic milk'; AM) infants. Three infant formulae were investigated: from hydrolysed cow casein (IF1), from hydrolysed cow whey (IF2) and from whole cow milk (IF3). Intestinal bacteria: Bifidobacterium, lactic acid bacteria, Enterobacteriaceae, Clostridium and Enterococcus were isolated from faeces of five healthy and five allergic infants. Mixtures of bacterial isolates and bacteria adhering to Caco-2 cells were characterised qualitatively with PCR-DGGE, and quantitavely with FISH. Concentration of BCM7 in breast milk and infant formulae was 1.6 to 8.9 times higher after enzymatic hydrolysis in comparison to undigested samples. The presence of this peptide resulted in alteration of intestinal epithelial proliferation and increase in secretion of IL-8. The quantitative profile of adherred bacteria applied as a mix of all isolates from healthy infants (H-MIX) was unchanged in the presence of HM hydrolysate and was modulated (increased number of beneficial Bifidobacterium and reduced commensal Enterobacteriaceae) in the presence of all IF hydrolysates. The presence of IF hydrolysates affected the profile of adhering isolates obtained from allergic infants (A-MIX) and reduced the adhesion of Enterobacteriaceae; the IF2 and IF3 hydrolysates decreased also the total number of adhering bacteria (TBN). However, a stimulating effect of AM hydrolysate on A-MIX adhesion (increased TBN) was observed.

Parasitological stool examination from children without the typical symptoms of parasitic disease.

Most parasitic intestinal infestations in humans are sub-clinical and, therefore, they are rarely diagnosed. A number of general, non-specific symptoms of parasitic invasions are often attributed to other diseases. A parasitological examination of feces performed as part of this study confirmed the presence of intestinal parasites in 21.6% of samples. Among the patients who reported 6 different symptoms, the percentage of parasite-positive samples reached 80%. The obtained results suggest that coproscopic tests may establish the diagnosis in unclear cases, particularly in children. Many parasitic invasions are zoonoses and pets owe a reservoir. In view of the above, the results for pet owners and non-pet owners were compared in the study. There was no direct correlation between pet ownership and the incidence of parasitic infections.