Can domestic helpers moderate distress of offspring caregivers of cognitively impaired older adults?

Objective: This study examined the moderating effect of domestic helpers on distress of offspring caring for parents with cognitive impairments and with or without behavioural problems.

Method: This secondary analysis of data involved 5086 Hong Kong Chinese adults aged 60 or older applying for public long-term care services from 2010 to 2012. All variables were measured using the mandatory Hong Kong version of the Minimum Data Set-Home Care 2.0.

Results: Regarding taking care of parents with cognitive impairments, 10.7% of offspring primary caregivers were aided by domestic helpers, 55.54% reported distress, and 75.70% lived with their parents. Assistance from domestic helpers reduced offspring caregiver distress if the offspring provided psychological support to parents (ratio of OR = 0.655, p < .05) and were not living with parents (ratio of OR = 1.183, p < .01).

Conclusion: These findings might suggest: a) the positive effects of audience on psychological responses to stress; b) caregiving is usually less stressful for informal caregivers not residing with care recipients. Conversely, having a domestic helper could add to caregiving distress if offspring caregivers live with their parents, most likely because offspring may witness difficulties that domestic helpers face in providing dementia care.     

Autonomic Dysfunction in Unaffected First-Degree Relatives of Patients Suffering From Schizophrenia

Recent studies revealed cardiac autonomic dysfunction in patients with acute schizophrenia, which appears to be mainly related to reduced vagal and increased sympathetic modulation. To understand the significance of cardiac autonomic function in patients with schizophrenia, we extended these studies to relatives of patients. In this study, we assessed cardiac autonomic modulation in healthy first-degree relatives of patients with schizophrenia (n = 36) to investigate a putative genetic influence. Data were compared with control subjects matched for age, gender, and physical activity as well as to patients suffering from schizophrenia. First-degree relatives showed an attenuated, yet identical pattern in autonomic dysfunction as patients with decreased vagal modulation of heart rate, decreased baroreflex sensitivity, but no difference in blood pressure variability could be detected. The patients'' relatives also showed a similar pattern in regards to QT variability. In addition, the subgroup comparison of offspring vs. siblings showed a significant difference in heart rate variability suggesting a higher degree of heritability in offspring. In conclusion, the pattern of autonomic dysfunction seen in patients and relatives might indicate underlying disease-inherent genetic vulnerability, especially because autonomic parameters are heritable. In addition, these findings may be of value to identify the high-risk group of patients'' relatives in regards to serious cardiovascular events so that early preventive measures can be taken.     

Does marriage between first cousins have any predictive value for maternal and perinatal outcomes in pre-eclampsia?

AIM: To assess the consequences of consanguineous unions between first cousins on the severity of pre-eclampsia and associated perinatal morbidity. METHODS: Six hundred and eighty-six women admitted with a diagnosis of pre-eclampsia were included. The study group consisted of 62 preeclamptic women with a union between first cousins. The remaining patients admitted throughout the same period (n = 624) served as controls. The groups were compared regarding the presence of severe pre-eclampsia, hemolysis elevated liver enzymes low platelets (HELLP) syndrome, eclampsia, placental abruption, hematological complications, renal failure, requirement for antihypertensive or magnesium sulfate treatments, cesarean section for acute fetal distress, birthweight, Apgar scores, perinatal mortality and neonatal morbidity including admission to the neonatal intensive care unit, respiratory distress syndrome, sepsis, convulsions, intracranial hemorrhage, hypoglycemia, hypocalcemia, and jaundice. Student's t-test, chi(2)-test and logistic regression analysis were used for statistical evaluation. RESULTS: Univariate analysis yielded significant differences in parity (P = 0.034), maternal platelet counts (P = 0.02), and maternal serum potassium levels (P = 0.016) among the groups. Respiratory distress syndrome was more frequent (P = 0.043) in infants of unrelated couples. Multivariate analysis, controlling for the confounding factors, revealed that marriages between first cousins had no effect on any of our outcome variables including neonatal respiratory distress syndrome. CONCLUSIONS: Third-degree consanguinity in terms of a union between first cousins seems to have no effect on the development of maternal and perinatal complications in established pre-eclampsia.     

Vitamin D status during pregnancy and aspects of offspring health

Low maternal vitamin D levels during pregnancy have been linked to various health outcomes in the offspring, ranging from periconceptional effects to diseases of adult onset. Maternal and infant cord 25(OH)D levels are highly correlated. Here, we review the available evidence for these adverse health effects. Most of the evidence has arisen from observational epidemiological studies, but randomized controlled trials are now underway. The evidence to date supports that women should be monitored and treated for vitamin D deficiency during pregnancy but optimal and upper limit serum 25(OH)D levels during pregnancy are not known.     

Do Parental Stressors and Avoidance Coping Mediate Between Parental Depression and Offspring Depression? A 23‐Year Follow‐Up

We examined whether parents' stressors and avoidance coping when offspring were children helped to explain associations between parent depression at baseline and offspring's avoidance coping and depression in adulthood. Self‐report data were collected at baseline and 1 year from parents (N = 326) and at 23 years from adult offspring (N = 326). Associations between parents' depression symptoms at baseline, and their adult offspring's depression symptoms and avoidance coping 23 years later, were partially explained by parents' reliance on avoidance coping in response to negative events at 1 year after baseline.     

卵胞浆内单精子注射子代4岁龄智能发育情况分析

目的 分析卵胞浆内单精子注射(ICSI)子代4岁龄智能发育情况。方法 选取2009年1月-2009年12月在南京市妇幼保健院进行卵胞浆内单精子注射的单胎活产子代作为研究对象(ICSI,n=18例),以年龄、性别为匹配条件,选取该院出生的自然受孕单胎活产婴儿为作对照组(SC,n=36例);排除标准:孕周<32周,体重<1 500g,有宫内窘迫,出生窒息史者。利用中国韦氏学前儿童智力量表(C-WPPSI)分别比较两组儿童4岁龄的智力发育水平。结果 比较两组儿童4岁龄智能发育水平后发现,韦氏智力测验中ICSI子代总智商、言语智商及操作智商均值在正常范围,但得分均低于SC组(总智商:ICSI 100.67±11.45,SC 115.33±10.82;言语智商:97.72±14.21,111.72±12.40;操作智商:104.83±7.87,116.50±10.68),两者差异具有统计学意义(P<0.05)。进一步分析两组智力异常的发生率,发现ICSI子代图画填充项目量表分<7的人数明显高于SC组(ICSI 4/18,SC 0/36,χ²=8.64,P<0.05)。结论 有限的样本量结果提示,ICSI子代4岁龄智能发育在正常范围,但韦氏智力测验IQ值低于SC组。ICSI子代远期智能情况需要通过更广泛、长期、系统的随访跟踪才能得出更为详实的结论。     

燃煤型氟中毒对仔鼠氟斑牙和氧化应激的影响

摘要:目的 探讨燃煤型氟中毒对仔鼠氟斑牙发生和氧化应激的影响。方法 模拟病区燃煤方式,复制高氟空气环境,疫区煤烘玉米制作含氟饲料。48只SD大鼠按雌雄比例2:1随机分为4组,即高氟空气饲养室内分别给予饲料氟含量40mg/kg(高氟组)、25mg/kg(中氟组)、10mg/kg(低氟组)和阴性对照组。饲养8周后合笼交配。仔鼠出生后21天(哺乳期)观察下切牙氟斑牙发生情况,并检测血清中丙二醛(MDA)含量和超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物(GSH-Px)活性。结果 出生后21天,高氟组、中氟组仔鼠下切牙釉质出现棕白相间横纹等典型氟斑牙症状。与对照组相比,各实验组仔鼠血清中MDA含量升高(F=796.229,P<0.001),SOD、CAT活性降低(F=119.315、 P<0.001;F=133.670,P<0.001),且随着亲代染氟剂量的增加呈加重趋势;GSH-Px活性变化无统计学意义(F=1.666,P=0.188)。结论 亲代大鼠摄入燃煤来源过量氟可以导致仔鼠氟斑牙的发生和血清氧化-抗氧化系统失衡,氧化应激在氟斑牙发生过程中可能起重要作用。     

六味地黄丸对产后母性应激导致仔鼠生长迟缓的影响

目的探讨六味地黄丸（TJ-87）对产后母性束缚应激致仔代生长迟缓的影响。方法应用ICR小鼠建立产后母性束缚应激模型,产后第2天将母鼠移离仔鼠,给予母鼠每天1次每次3小时的束缚应激,持续至产后3周断乳时结束。本研究以仔鼠为研究对象：①研究断乳时模型组及正常对照组,观察两组仔鼠的体质量、身长、股骨长、血中胰岛素样生长因子（IGF-1）水平及脑垂体生长激素GH mRNA表达情况;②研究断乳后给予六味地黄丸（TJ-87）大、中、小剂量各治疗组（药物与饲料混合浓度为1．8％,1．2％,0．6％剂量组,连续给药8周）与模型组,观察治疗后各组仔鼠的体质量、身长、股骨长、血中IGF-1水平及脑垂体GH mRNA表达情况。结果①与正常对照组比较,产后3周断乳时模型组仔鼠表现出低体质量、低身长及低股骨长,同时模型组仔鼠血浆IGF-1水平降低,垂体GH mRNA相对表达低下,差异均有统计学意义（P〈0．01）。②经六味地黄丸治疗8周后,与模型组比较,六味地黄丸大、中剂量组仔鼠身长及股骨长增加,同时六味地黄丸大、中剂量组仔鼠血浆IGF-1水平升高,其垂体GH mRNA相对表达也升高,差异有统计学意义（P〈0．05,P〈0．01）;六味地黄丸大、中、小剂量组仔鼠体质量差异均无统计学意义（P〉0．05）。结论六味地黄丸可能通过GH—IGF-1通路改善产后母性束缚应激仔代的生长。     

Perinatal exposure to androgen excess and the effects on the rat uterine estradiol responsiveness

Androgen exposure during sexual development induces alterations in steroidal target tissues. The objective of this study was to evaluate the uterine responsiveness to estradiol after perinatal androgenization. Pregnant Wistar rats were exposed to corn oil or testosterone propionate at 0.05, 0.1, or 0.2 mg/kg from gestational day 12 until postnatal day 21. Female offspring was challenged with estradiol (E₂) after weaning (0.4 mg/kg) and at adulthood (10 or 100 µg/day), when the pituitary response was also evaluated. At adulthood, control and 0.05 mg/kg groups presented a uterine weight increment when exposed to 100 µg/day of E₂, 0.1 mg/kg group only responded to 10 µg/day of E₂, and the 0.2 mg/kg group showed increased uterine weight at both doses. The pituitary weight was similarly increased after estradiol stimulation in all experimental groups. In conclusion, testosterone propionate exposure induced an abnormal stimulation of uterine tissue growth by estrogen stimulus without affecting pituitary response. More studies are needed to clarify whether these alterations are capable of impairing the reproductive capacity of the female tract. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1460–1468, 2016.