Do Subjective Norms Predict the Screening of Cancer Patients’ First-Degree Relatives? A Systematic Review and Meta-Analysis

Background: Early detection and preventive measures can reduce the risk of cancer among first degree relatives (FDRs) of cancer patients.Several studies investigated the effect of subjective norm in relation to FDRs’ tendency to conduct preventive behaviors. Therefore, the purpose of this study was to systematically evaluate the effect of subjective norms on cancer patients’ FDRs as well as their willingness for screening. Methods: PubMed and Scopus were studied to investigate the effect of subjective norms on preventive measures such as breast cancer self-examination, colonoscopy, PSA testing, skin examination, and genetic testing. Odds Ratio (OR), correlation was and confidence intervals were extracted for meta-analysis. After reviewing the studies, only 16 studies met the criteria to be included in this systematic review. Results: The meta- analysis and OR showed that Physician Recommendation (OR=6.98, 95% CI; 2.55–19.09, P<0.001), Health Care Provider (HCP) (OR=2.79, 95% CI; 1.26-6.16; P=0.011), family and friends (OR=1.82, 95% CI; 1.33–2.50, P <0.001) significantly enhanced the likelihood of referring for screening and preventive measures. Conclusions: The results of the current study indicated that subjective norms can significantly increase willingness to screening.     

Public satisfaction with health care system in 30 countries: The effects of individual characteristics and social contexts

In this article, the associations among individual socio-economic characteristics, the institutional set-up of health care systems, and satisfaction with the health care system are investigated. Data from the 2011 International Social Survey Program (30 countries, 34,212 respondents) is used. Multilevel analyses across countries have shown how the state financing context affects satisfaction at the individual level. Consistent with previous research, at individual level, personal experiences with medical providers, age, gender as well as income are significant predictors of satisfaction with the health care system. At the country level, real input indicators such as density of physicians and density of hospital beds are negative predictors of satisfaction with the health care system whereas the percentage of total health expenditures comprised by public sources is a positive predictor of satisfaction with the health care system. However, findings from the cross-level interactions indicate that the negative effect of lower income is more prominent in predominantly publicly-funded health care systems. Specifically, in primarily publicly-funded health care systems, the model-predicted probability of satisfaction with the health care system is higher, but the gap in the probability of satisfaction with the health care system between individuals with lower income and those with higher income is greater than that in mostly privately-financed health care systems. The findings in this study suggest that the future direction of health care system reform should be focused on balancing the distribution of resources between private and public sectors.     

2型糖尿病患者的血脂水平及其与脂质过氧化的关系

目的探讨2型糖尿病患者血脂水平与脂质过氧化的关系。方法采用病例鄄对照研究方法,检测了147例2型糖尿病患者及149例健康对照者的血脂水平。结果糖尿病组的血清总胆固醇[(4.488±1.608)mmol/L]及高密度脂蛋白胆固醇[(0.804±0.385)mmol/L]含量明显低于对照组[分别为(5.155±1.702)mmol/L、(1.307±0.435)mmol/L],而血清丙二醛含量[穴5.002±2.896雪mmol/L]和过氧化物歧化酶含量[(104.444±29.046)NU/ml]明显高于对照组[分别为(3.976±2.394)mmol/L熏(93.294±24.108)NU/ml]熏P<0.05;血清低密度脂蛋白与NO含量虽无差异显著性,但P值均接近于0.05。结论糖尿病患者的血脂水平和脂质过氧化的改变,可能与其并发症的发生有密切的关联。     

中国人口婚姻挤压状况及对生育保健的挑战

目的分析中国1985-1999年的婚姻挤压方向、程度及变化趋势，为生育保健策略的制定提供依据。方法利用中国2000年第五次人口普查资料，计算男女终身不婚率及婚姻挤压指数。结果中国人口在19851999年15年间一直呈现为男性婚姻挤压，且挤压程度从1991年开始有所升高。结论应重视不能成婚的男性这一弱势群体，开展可行、有效的男性保健；同时，应针对女性开展防范性暴力的健康教育。     

氯化甲基汞染毒对亲仔两代ICR小鼠脑、肝、肾中汞分布的影响

[目的]通过ICR孕鼠饮水接触低剂量氯化甲基汞,研究汞在亲仔两代小鼠脑、肝、肾及血清中的分布及其相关性。[方法]ICR孕鼠随机分为对照组、低剂量组(0.01mg/L)和高剂量组(0.10mg/L),于怀孕第6天起分别自由饮用蒸馏水及氯化甲基汞含量分别为0.01、0.10mg/L的蒸馏水直至哺乳期结束,用原子荧光法测定汞在各脏器内的含量,并做血清汞和脏器汞含量的相关性分析。[结果]在低剂量甲基汞作用下,亲仔两代未出现明显的毒性反应。随着染毒剂量的增加,亲仔两代小鼠血清中的总汞含量增加,对照组、低剂量组和高剂量组母鼠血清中总汞含量分别为1.228、2.358和6.195μg/L,仔鼠为0.801、3.217和3.763μg/L,高剂量组和对照组间差别有显著性(P<0.05);随着染毒剂量的增加,各脏器中的总汞含量也增加,对照组、低剂量组和高剂量组母鼠肾脏总汞含量分别为13.890、25.780、253.980ng/g组织湿重,肝脏为3.710、11.520、100.820ng/g组织湿重,脑组织为2.820、3.070、23.810ng/g组织湿重;对照组、低剂量组和高剂量组仔鼠肾脏总汞含量分别为6.940、13.090、102.170ng/g组织湿重,肝脏为2.660、5.450、38.850ng/g组织湿重,脑组织为1.600、2.660、8.120ng/g组织湿重;母鼠和仔鼠脏器中总汞蓄积的模式一样:肾脏>肝脏>脑组织。在低剂量下,母鼠血清总汞含量与肝脏、肾脏、脑组织中的总汞含量的相关系数分别为0.830、0.967、0.802;在高剂量下,与肝脏、肾脏、脑组织的相关系数分别为0.997、0.833、0.850,均有较高的相关性(P<0.05)。而仔鼠在高剂量下血清总汞与肝脏、肾脏、脑组织的相关系数分别为0.737、0.672、0.702,其血清总汞和脏器总汞也有相关性(P<0.05);在低剂量时血清总汞与肝脏、肾脏、脑组织总汞的相关系数分别为0.040、0.300、0.080,没有相关性(P>0.05)。[结论]母鼠接触低剂量甲基汞即可在亲仔两代各脏器中蓄积,亲代血清总汞含量和脏器总汞含量具有明显的相关性;仔代在高剂量时血清总汞含量和脏器总汞含量有明显的相关性,而在低剂量下无相关性。     

Communicating to promote informed decisions in the context of early pregnancy loss

ObjectiveTo evaluate residents’ ability to engage standardized patients in informed decision making during a pregnancy loss scenario.MethodsForty patient encounters between interns and standardized patients were coded to assess informed decision-making practices, exploration of unexpressed concerns, and support provision.ResultsInterns engaged in minimum informed decision making but did not address all of the communicative elements necessary for informed decisions, and most elements were only partially addressed. Patients in this study did not receive information about all management options, their concerns were not addressed, and there was limited support communicated for their decision.ConclusionThis study offers an initial assessment of a communicative approach to evaluate and improve decision making during early pregnancy loss. A comprehensive approach to making informed decisions must include discussion of all management options, exploration of patient preferences and concerns, and support for the patient’s decision.Practice implicationsPhysicians could benefit from communication skills training to communicate more effectively with patients to help them make more informed decisions.     

Poly I:C primes the suppressive function of human palatine tonsil-derived MSCs against Th17 differentiation by increasing PD-L1 expression

It has been established that mesenchymal stem cells (MSCs) can have a suppressive effect on T cells, yet much remains unknown about the underlying mechanisms that support this effect. The T cell co-stimulatory pathway involving the programmed death-1 (PD-1) receptor and its ligand PD-L1 regulates T cell activation, tolerance, and subsequent immune-mediated tissue damage. In this study, human palatine tonsil-derived MSCs (T-MSCs) constitutively expressed PD-L1 and exhibited a suppressive activity that specifically targeted murine Th17 differentiation. Additionally, polyinosinic–polycytidylic acid (poly I:C), a Toll-like receptor 3 (TLR3) ligand, increased PD-L1 expression on T-MSCs. The elevated PD-L1 levels enhanced the suppressive functions of T-MSCs on Th17 differentiation. Therefore, pre-stimulation of T-MSCs with poly I:C may serve as an effective therapeutic priming step for modulating Th17-dominant immune responses.     

The use of weighted blankets as a novel approach for treatment of persistent vocalizations in late stage dementia

This study explored the use of weighted blankets as a non-pharmacological treatment for persistent vocalizations in late stage dementia. A weighted blanket was applied to three individuals with a diagnosis of dementia who had frequent and intense persistent vocalizations which were not responsive to other treatment modalities and necessitated in-patient hospitalization within a specialized behavioural unit. The evaluation found a non-statistically significant reduction in the duration of persistent vocalizations during the ten-minute application of the weighted blanket and a statistically significant reduction in the duration of persistent vocalizations during the ten minutes following the application of the weighted blanket. The use of weighted blankets may therefore be a promising non-pharmacological intervention for the treatment of persistent vocalizations in late stage dementia.