社区老年慢性疼痛患者自我效能状况及影响因素

目的了解社区老年慢性疼痛患者自我效能状况及其影响因素。方法采用一般人口学资料调查表,汉化版慢性疼痛自我效能感量表,简明疼痛量表,激惹、抑郁和焦虑自评量表,医学应对问卷,对192例老年慢性疼痛患者进行调查分析。结果老年慢性疼痛患者自我效能得分(75.56±18.33)分,其中疼痛管理自我效能感(16.16±4.63)分,躯体功能自我效能感(32.45±8.60)分,症状应对自我效能感(27.21±8.37)分;影响自我效能感的主要因素是上1 w疼痛最痛程度得分、屈服、当前疼痛程度得分、抑郁、年龄和家庭经济状况,可解释35.6%的变异量。结论社区老年慢性疼痛患者自我效能水平不容乐观,主要受上1 w疼痛最痛程度得分、屈服的应对方式、当前疼痛程度得分、抑郁、年龄和家庭经济状况等因素的影响。     

社区慢性病老年女性一般自我效能与健康状况的相关性

目的探讨社区慢性病老年女性一般自我效能与健康状况的相关性及影响健康状况的因素。方法应用自我效能量表(CSES)、健康状况量表调查丹东市社区912例慢性病老年女性群体的自我效能状况及健康状况。结果居前4位的疾病依次是高血压(36.42%)、高血脂(27.52%)、冠心病(24.63%)、风湿性关节炎(21.49%);社区慢性病老年女性一般自我效能(26.23±5.83)分,随着年龄的增高自我效能感得分显著下降(P<0.05);随着年龄的增大,健康状况降低,在生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、社会功能(SF)、情感职能(RE)、生理健康、心理健康、总分维度差异有统计学意义(P<0.05);一般自我效能与健康状况得分各维度及总分呈正相关(P<0.05);多元回归显示健康状况得分的影响因素有年龄、自我效能感、收入情况。结论社区应加强老年女性慢性病的管理和相关知识的宣传教育,针对相关影响因素,改善老年人健康。     

中老年类风湿关节炎患者躯体功能与体力活动、自我效能的相关性

目的了解中老年类风湿关节炎(RA)患者躯体功能状况,分析体力活动、自我效能与躯体功能的相关性。方法采用一般资料调查表、健康评估问卷-残疾指数(HAQ-DI)、国际体力活动短问卷(IPAQ-S)、类风湿关节炎自我效能量表(RASE)、疲劳视觉模拟评分量表(VAS-疲劳)及疼痛视觉模拟评分量表(VAS-疼痛)对天津市第一中心医院门诊及住院治疗的45岁以上的RA患者进行问卷调查。结果 RA患者躯体功能得分为(1.18±0.39)分,体力活动得分为(1 768.89±98.92)分,自我效能得分为(73.61±13.35)分;疼痛(r=0.321)、疲劳(r=0.399)、自我效能(r=-0.387)、总体力活动(r=-0.302)得分与躯体功能得分呈显著相关性(均P0.05);多元线性回归分析显示疾病活动度、晨僵时间、疲劳、疼痛、总体力活动及自我效能对躯体功能有显著影响(P0.05),可解释总变异量的40.7%。结论医务人员应采取针对性的措施提高患者自我效能水平,增强其进行体力活动的信心,为患者提供个性化的功能锻炼指导,从而维持躯体功能,延缓关节功能丧失。     

社区老年慢性病患者自我超越与生存质量的相关性

目的了解老年慢性病患者自我超越与生存质量的状况,并分析两者的相关性。方法采用中文版自我超越量表与世界卫生组织生存质量量表简表(WHOQOL-BREF)对168例老年慢性病患者进行问卷调查。结果老年慢性病患者的自我超越得分为(41.71±9.63)分,生存质量总分为(51.24±5.65)分,自评总分为(77.30±6.34)分,4个领域:生理领域、心理领域、社会关系领域、环境领域得分分别为(12.18±3.01)分、(12.07±2.23)分、(13.57±3.29)分、(12.63±2.96)分。自我超越与生存质量各维度及总分均呈正相关(均P<0.05)。结论自我超越水平与生存质量呈正相关,可通过自我超越干预,提高老年人的生存质量。     

社区老年糖尿病患者自我效能现状及影响因素

目的了解社区老年糖尿病患者自我效能水平及其影响因素。方法应用自设一般资料问卷和糖尿病自我效能感量表(PDSMS)及自我感受性负担量表(SPB),对符合纳入标准的201名社区老年糖尿病患者进行问卷调查。结果社区老年糖尿病患者PDSMS得分为(28.28±5.92)分;不同文化程度、家庭人均月收入、治疗方式的患者PDSMS得分差异有统计学意义;自我效能感与自我感受性负担呈负相关(r=-0.271,P0.05)。结论社区老年糖尿病患者的自我效能感水平有待提高,尤其需要关注受教育程度低、低收入及使用胰岛素治疗的患者,同时还应关注患者的自我感受性负担水平。     

家庭关怀度及自我效能感对脑卒中后残疾患者伤残接受度的影响

目的探讨家庭关怀度及自我效能感对脑卒中后残疾患者伤残接受度(AOD)的影响。方法采用一般资料调查表、修订版伤残接受度量表(ADS-R)、家庭关怀度指数测评表(PAGAR问卷)、慢性病自我效能量表(SECD6),对180例脑卒中后患者进行问卷调查。结果患者ADS-R得分为(73.32±11.76)分,PAGAR问卷得分为(6.30±1.93)分,SECD6得分为(6.17±2.44)分;相关分析显示,AOD与家庭关怀度及自我效能感均呈显著正相关(P<0.01);分层回归分析显示:家庭关怀度、自我效能感是脑卒中后残疾患者AOD的主要影响因素。结论在临床护理工作中应增加家庭支持与心理干预,提高脑卒中后残疾患者家庭关怀度及自我效能感,帮助其尽早接受伤残现实,完成自我重建。     

农村中老年糖尿病患者自我效能现状及影响因素

目的探讨农村中老年糖尿病患者自我效能现状及其影响因素。方法应用糖尿病效能感量表(DSES)对唐山市456名农村糖尿病患者进行调查。结果唐山市农村中老年糖尿病患者总体自我效能得分为(3.61±0.82)分,其中有信心三餐固定吃与饥饿时挑选合适食物得分较高(3.96±1.68,3.72±1.21),而有信心判断异常身体状况与避免运动时低血糖的发生得分较低(3.47±1.32,3.43±1.21)。其影响因素为社会支持、糖尿病知识及是否有并发症(P<0.05)。结论唐山市农村中老年T2DM患者自我效能处于较低水平,可通过提升社会支持与糖尿病知识水平、减少并发症等途径提高自我效能水平。     

老年不同慢性病患者睡眠质量与焦虑现状

目的探讨长春市社区老年不同慢性病患者睡眠质量和焦虑现状及其相关性。方法使用一般资料调查表、匹茨堡睡眠质量指数量表(PSQI)和焦虑自评量表(SAS)对吉林省长春市4个社区335例老年慢性病患者进行问卷调查。结果 PSQI得分平均为(6.23±2.42)分,老年糖尿病患者PSQI总分(7.18±2.11)最高,脑血管疾病患者PSQI总分(5.36±2.65)最低。SAS得分平均为(57.03±6.72)分,老年呼吸系统疾病患者SAS总分(58.81±5.64)最高,脑血管疾病患者SAS总分(54.60±5.16)最低。老年脑血管疾病患者PSQI总分与SAS得分无相关性,其他不同慢性病患者PSQI总分与SAS得分均呈正相关(P<0.01)。结论长春市社区老年不同慢性病患者睡眠质量问题需要重视,应采取相应措施进一步加强改善老年不同慢性病患者睡眠质量的措施,降低焦虑的发生,提高老年人生活质量、卫生保健水平。     

金华市某三级医院老年功能性消化不良患者生存质量及其影响因素分析

背景老年功能性消化不良(functional dyspepsia, FD)是临床常见疾病之一,多以中老年患者为主.目前认为精神心理因素导致的躯体化是影响老年FD生存质量的危险因素.由于我国医疗资源分布不平衡,对老年FD患者生存质量认识不足,再加上很多患者症状可能较轻,自身对疾病缺乏正确认识,对其生存质量的影响因素进行分析尤为必要.目的旨在探讨金华市某三级医院老年FD患者生存质量及其影响因素分析.方法选择2017-06/2019-08在我院就诊的134例老年FD患者为研究对象.采用生存质量量表、精神心理状况量表及健康行为自我效能量表卷进行测评,并分析老年FD患者生存质量的影响因素.结果老年FD患者功能性消化不良生存质量量表(functional digestive disorder quality of life questionnaire,FDDQL)总分为57.62分±8.16分,其中日常活动得分为75.48分±7.23分,受损最轻;健康感觉得分为45.61分±9.57分,受损最严重;其次疾病控制得分为47.38分±10.36分.不同性别、焦虑自评量表(self-rating anxietyscale,SAS)评分、抑郁自评量表(depression self-ratingscale,SDS)评分、自我效能、体质指数(bodymassindex,BMI)、饮酒史、病程、居住情况、症状严重程度、自我调节情绪及是否规律运动等FDDQL得分比较,差异有统计学意义(P0.05,或P 0.01);不同BMI患者FDDQL得分比较,差异无统计学意义(P0.05).老年FD患者的性别、自我效能、B M I、饮酒史、病程、居住情况及规律运动等与FDDQL呈正相关(r=0.147-0.215, P 0.05);老年FD患者的SAS、SDS评分,症状严重程度及自我调节等与FDDQL呈负相关[r=-0.765-(-0.284), P 0.05].通过多元回归分析发现,焦虑、症状严重程度、病程、自我效能和抑郁是老年FD患者生存质量的影响因素.结论老年FD患者生存质量影响因素较多,而焦虑、症状严重程度、病程、自我效能和抑郁是重要危险因素,在临床工作中应通过上述影响因素采取合理的干预以提高患者生存质量.     

脑卒中患者病耻感水平及其影响因素

目的调查脑卒中患者病耻感水平,并分析其影响因素。方法采用社会影响量表(SIS)和人口学一般资料调查表对72例脑卒中患者进行调查,并分析其影响因素。结果脑卒中患者病耻感得分为(60. 68±4. 77)分,多元逐步回归分析结果显示,自理能力、文化程度、合并慢性病是患者病耻感水平的影响因素。结论脑卒中患者病耻感处于中等水平,不同文化程度、自理能力、合并慢性病患者的病耻感水平不同,提示医务工作者及家属应针对患者的具体情况及时进行干预。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.