Using the demand–control model of job strain to predict caregiver burden and caregiver satisfaction in the informal caregivers of heart failure patients

Objectives The demand–control (D–C) model of job strain has generated a considerable body of empirical support in predicting psychological health outcomes in the context of work. This study aimed to extend previous work using the D–C model of job strain to predict caregiver burden and satisfaction in the informal caregivers of patients with heart failure. Design and method Data were gathered from 60 caregiver/patient dyads in a cross‐sectional design. Patients with chronic stable heart failure were recruited from out‐patient clinics. The dependent variables were caregiver burden and satisfaction. Demand and control were measured using both patient‐ and caregiver‐derived measures. Results The D–C model accounted for 15 and 19% of the variance in caregiver burden, after controlling for age, gender and relationship to the patient. Lower control was associated with higher burden. The D–C model did not predict caregiver satisfaction. Conclusion The D–C model was associated with caregiver burden, but not satisfaction in caregivers, with control being the dominant predictor. Research linking the theory and findings from job strain and informal caregiving studies may elucidate both fields of research. Using the demand–control model of job strain to predict caregiver burden and caregiver satisfaction in the informal caregivers of heart failure patients.     

Macrophage-tumour cell interactions: identification of MUC1 on breast cancer cells as a potential counter-receptor for the macrophage-restricted receptor, sialoadhesin

In many carcinomas, infiltrating macrophages are commonly found closely associated with tumour cells but little is known concerning the nature or significance of adhesion molecules involved in these cellular interactions. Here we demonstrate in primary human breast cancers that sialoadhesin (Sn), a macrophage-restricted adhesion molecule, is frequently expressed on infiltrating cells that often make close contact with breast carcinoma cells. To determine whether Sn could act as a specific receptor for ligands on breast cancer cell lines, binding assays were performed with a recombinant form of the protein fused to the Fc portion of human immunoglobulin G1 (IgG1) (Sn-Fc). Sn-Fc was found to bind specifically and in a sialic acid-dependent manner to the breast cancer cell lines MCF-7, T47.D and BT-20 both in solid- and solution-phase binding assays. To investigate the nature of the sialoglycoproteins recognized by Sn on breast cancer cells, MCF-7 cells were labelled with [6-3H]glucosamine. Following precipitation with Sn-Fc, a major band of approximately 240000 MW was revealed, which was shown in reprecipitation and Western blotting experiments to be the epithelial mucin, MUC1.     

Extrapulmonary effects of maintenance therapy with theophylline and inhaled albuterol in patients with chronic asthma

The extrapulmonary effects of slow-release theophylline and an inhaled beta 2-agonist (albuterol) were examined separately and in combination among 18 adults and adolescents with asthma during a 3-month randomized, double-blind, crossover trial. Although neither global impressions nor daily diaries revealed differences in adverse effects, a structured questionnaire completed at the end of each regimen suggested a small but statistically significant increase in nausea and depressive and caffeine-like symptoms during the theophylline-containing regimens. Theophylline was also associated with improved verbal learning but decreased motor steadiness. Metabolic effects associated with theophylline included lower serum bicarbonate, greater urinary calcium excretion, and higher serum calcium, uric acid, and creatinine. Albuterol was associated with lower neutrophil counts and lower serum theophylline concentrations. There were no drug-induced effects on cardiac rhythm.     

Production of a monoclonal antibody with specificity for deoxynivalenol, 3‐acetyldeoxynivalenol and 15‐acetyldeoxynivalenol

Monoclonal antibodies reactive with deoxynivalenol were generated following the immunization of mice with a deoxynivalenol‐mouse serum albumin conjugate. One of the anti‐deoxynivalenol monoclonal antibodies, designated C6–1, exhibited cross‐reactivity with 3‐acetyldeoxynivalenol and 15‐acetyldeoxynivalenol but not with nivalenol, T‐2 tetraol or scirpentriol. An indirect competitive ELISA based on this monoclonal antibody gave 50% inhibition values of 0–6 μg ml^‐1 for deoxynivalenol, 0–2 μg ml^‐1 for 15‐acetyldeoxynivalenol and 10 μg ml^‐1 for 3‐acetyldeoxynivalenol.     

Orders to limit emergency treatment for an ambulance service in a large metropolitan area

We describe a policy allowing paramedics and emergency physicians to honor orders from nursing home records not to perform resuscitation or endotracheal intubation. The policy was adopted by the regional body coordinating emergency medical care and endorsed by the county medical society. The policy establishes community-wide definitions for "do not resuscitate" and "do not intubate" orders. It requires physicians to write such directives in patient's medical records and to update them every two years. It urges long-term care facilities to adopt policies to help ensure good decision-making practices in the formulation of these directives. The policy intends to partially address the unnecessary loss of patient autonomy that occurs when emergency care is administered according to routine orders.     

Using Longitudinal Social Network Analysis to Evaluate a Community-Wide Parenting Intervention

Prevention Science - Harsh parenting attitudes and behaviors negatively impact children’s behavior and development, and are linked to heightened levels of violence in children. Parent...     

Human Diversity of Killer Cell Immunoglobulin-Like Receptors and Human Leukocyte Antigen Class I Alleles and Ebola Virus Disease Outcomes

We investigated the genetic profiles of killer cell immunoglobulin-like receptors (KIRs) in Ebola virus–infected patients. We studied the relationship between KIR–human leukocyte antigen (HLA) combinations and the clinical outcomes of patients with Ebola virus disease (EVD). We genotyped KIRs and HLA class I alleles using DNA from uninfected controls, EVD survivors, and persons who died of EVD. The activating 2DS4–003 and inhibitory 2DL5 genes were significantly more common among persons who died of EVD; 2DL2 was more common among survivors. We used logistic regression analysis and Bayesian modeling to identify 2DL2, 2DL5, 2DS4–003, HLA-B-Bw4-Thr, and HLA-B-Bw4-Ile as probably having a significant relationship with disease outcome. Our findings highlight the importance of innate immune response against Ebola virus and show the association between KIRs and the clinical outcome of EVD.     

Benign neonatal seizures

Benign neonatal seizures is a rare but increasingly recognized syndrome characterized by seizures in the neonatal or infantile period. Two forms are recognized: familial and nonfamilial. In both instances, the seizures may be quite severe, and status epilepticus is common. The nonfamilial form is characterized by idiopathic, self-limited seizures occurring in previously normal neonates. The seizures most commonly occur at day 5 and have been called "fifth-day fits" by some authors. Familial seizures most frequently have their onset during the first week of life, but onset may occur as late as early infancy. These seizures may recur for several months before resolving. No cause is found for the seizures, and the patient appears healthy during the interictal period. The family history reveals benign neonatal seizures in other family members. Although the prognosis is favorable in both syndromes, seizures may occasionally occur later in life in the familial form. The familial form of benign neonatal seizures is autosomal dominant, and the gene has been localized to chromosome 20.     

Weight change, survival time and cause of death in Dutch elderly

Weight change, subsequent survival time and cause of death are reported from the Dutch Longitudinal Study among the Elderly. Data consist of a national sample of persons aged 65-99 years. Six hundred and fifty-eight subjects were examined in the baseline years 1955-1957 and were re-examined 5 years later. Vital status and cause of death were ascertained for 604 of these subjects through 1983. Those subjects who experienced a decline in body mass index (BMI, kg/m(2)) during the period of observation, were likely to be in poorer health and have a shorter survival time than those subjects with stable weight, regardless of initial BMI. Weight gain was associated with shorter survival time only in the age group 65-74 and in those with heart disease. Weight loss, on the other hand, was most likely to result in decreased survival time among those ultimately dying of stroke, pneumonia/influenza or heart disease. As such, weight loss may be an indicator of the severity of disease. The noted associations remained, even when those surviving less than two years were omitted from the analyses. Thus, in longer survivors, weight loss may be associated with decreased vitality and decreased ability to survive once a disease becomes apparent.     

Effects of dietary aluminum,calcium, and phosphorus on egg and bone of European starlings

Egg and bone of passerine birds nesting in acidified habitats may be affected by high levels of Al or P, or low levels of Ca. Nine treatments of three levels of dietary Al (target levels of 200, 1,000, and 5,000 g/g) and three levels of Ca:P (target levels of NN = 1.3% Ca: 0.9% P; LL = 0.19 Ca:0.45 P; LH = 0.19 Ca: 1.65 P) were fed to 16–17 starling pairs during two breeding seasons. Eggs of starlings fed the LH diet were smaller and weighed less than eggs from the NN and LL treatments. Treatment effects on thickness, strength, and weight of eggshells were not consistent between seasons, probably because of differences in actual dietary levels of Al, Ca, and P or in incubation intervals. In one season, birds fed the highest Al diet had thicker eggshells than those from the other Al treatments (no effect from Ca:P); the following season, eggshells from the NN and LH treatments were thicker and stronger than those from the LL treatment. Eggshells from the NN treatment weighed more than those from the other Ca:P treatments. Starlings on the LH diet had the strongest femurs, but the effect was interactive with different levels of dietary Al. Effects of Ca:P on egg and bone were more evident than Al effects.