Challenges in geriatric oral health research methodology concerning caregivers of cognitively impaired elderly adults

Little is known about oral health care behaviors of community-dwelling, cognitively impaired elderly (CIE) persons. Few studies have been conducted regarding the actual provision of oral care for CIE persons or the attitudes and concerns about oral health among their caregivers. The CIE person's ability to perform self-care decreases over time, and the role of the caregiver in daily oral care becomes increasingly important. The purpose of this pilot study was to explore the attitudes toward oral health and identify related concerns among caregivers who care for community-dwelling CIE persons. Caregivers were surveyed by means of a self-administered, mailed questionnaire. To maintain confidentiality, an intermediary was used for recruitment and data collection. Overall, 148 caregivers were invited by an intermediary to participate in the survey; only 21 (14%) consented to participate and returned the questionnaire. This paper discusses some of the numerous methodological challenges identified when an attempt was made to survey caregivers' attitudes toward and barriers to providing oral care for a dependent CIE.     

Comparison of the treadmill exercise score and single-photon emission computed tomographic thallium imaging in risk assessment

Background  

This study compared the prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging with that of treadmill exercise score in medically treated patients with coronary artery disease (CAD)     

Regular ingestion of tea does not inhibit in vivo lipid peroxidation in humans.

Prospective studies suggest that tea may protect against cardiovascular disease. A potential mechanism for such an effect involves inhibition of lipid peroxidation by polyphenolic antioxidants derived from tea. Our objective was to determine whether regular ingestion of tea could inhibit in vivo lipid peroxidation. Two controlled intervention studies assessed the effects of regular ingestion of tea on lipid peroxidation determined by measurement of urinary F(2)-isoprostane excretion. Study 1: The effects of 1000 mL/d of green tea and black tea were compared with hot water containing caffeine in 13 subjects with elevated blood pressure using a randomized 3-period (7 d each) crossover design. Study 2: The effects of 1250 mL/d of black tea were compared with hot water in 22 subjects with mildly raised serum total cholesterol concentrations using a randomized 2-period (4 wk each) crossover design. F(2)-isoprostane excretion was not altered after regular ingestion of green tea (273 +/- 48 pmol/mmol creatinine) or black tea (274 +/- 39 pmol/mmol creatinine) in comparison with hot water (263 +/- 47 pmol/mmol creatinine; Study 1), or by regular ingestion of black tea (334 +/- 71 pmol/mmol creatinine) in comparison with hot water (355 +/- 75 pmol/mmol creatinine; Study 2). These results do not support the suggestion that polyphenolic antioxidants derived from tea inhibit in vivo lipid peroxidation.     

Bereavement and remarriage for older adults

The purpose of this study was to assess differences in bereavement outcomes between surviving spouses aged 50 and over who remarried within 4-5 years and those who did not. Fifteen bereaved respondents out of 192 in a longitudinal prospective study who later remarried were compared with 15 other matched nonremarried respondents. Analyses of sociodemographic data, standardized measures of depression, life-satisfaction, resolution of grief, and self-perceived ratings of coping, stress, self-esteem, health and social support were performed with correlated t-tests. Statistically significant differences indicated that over time, the remarried subjects displayed more positive outcomes.     

Determinants of salvage of jeopardized myocardium after coronary thrombolysis

Coronary thrombolysis is an attractive approach for salvaging jeopardized, ischemic myocardium. The advent of second- and third-generation clot-selective thrombolytic agents will make this approach safer and more widely applicable in the future. However, residual stenoses and reocclusion are common after the thrombolytic therapy. In addition to thrombolysis, future management of coronary thrombosis may include adjunctive pharmacologic therapy such as calcium-channel antagonists, beta-blockers, or oxygen free radical scavengers, and/or mechanical interventions such as balloon or laser angioplasty, or bypass surgery.