Diversification of care policy measures supporting older people: towards greater flexibility for carers?

Originally part of the private domain of families, care of the older people is now the concern of public policy. Yet, in the European context of cost containment, it is not easy to make a case for increasing public support and the caring function of families remains prominent in social policy. In this paper, the authors question public policies around care of the older people in relation to both the needs of old people, but also those of adult children, mainly women, who work and provide care for their old parents. We investigate the interactions between public support in long-term care and the caring function of families. The paper presents some results of a comparative research study based on the identification of the policy measures which have been implemented in different European countries in the sector of care of the older people, and on the detailed analysis of care arrangements set up by a sample of 86 family carers in these various national contexts. We argue that in a context of cost containment, whatever the usual patterns of care and the role given to the family and public authorities, the policy measures which have been introduced since the 90s aim to support family carers in various ways with the common objective of giving them the flexibility they need in the organisation of care arrangements, combining various resources (formal professional care, unpaid informal care, semi-formal care). Different patterns of flexibility can be identified according to the regulation of the policy measures.     

Modification of fibrous membrane for organic and pathogenic contaminants removal: from design to application

In this study, a flexible multifunctional fibrous membrane for heterogeneous Fenton-like removal of organic and pathogenic contaminants from wastewater was developed by immobilizing zerovalent iron nanoparticles (Fe-NPs) on an amine/thiol grafted polyester membrane. Full characterization of the resulting polyester membranes allowed validation of successful grafting of amine/thiol (NH₂ or SH) functional groups and immobilization of Fe-NPs (50–150 nm). The Fenton-like functionality of iron immobilized fibrous membranes (PET–Fe, PET–Si–NH₂–Fe, PET–NH₂–Fe, and PET–SH–Fe) in the presence of hydrogen peroxide (H₂O₂) was comparatively studied in the removal of crystal violet dye (50 mg L⁻¹). The effect of pH, amount of iron and H₂O₂ concentration on dye removal was systematically investigated. The highest dye removal yield reached 98.87% in 22 min at a rate constant 0.1919 min⁻¹ (R² = 95.36) for PET–SH–Fe providing 78% toxicity reduction assessed by COD analysis. These membranes could be reused for up to seven repeated cycles. Kinetics and postulated mechanism of colour removal were proposed by examining the above results. In addition, the resultant membranes showed substantial antibacterial activity against pathogenic bacteria (Staphylococcus epidermidis, Escherichia coli) strains studied through disc diffusion-zone inhibitory and optical density analysis. These findings are of great importance because they provide a prospect of textile-based flexible catalysts in heterogeneous Fenton-like systems for environmental and green chemistry applications.

Multifunctional fibrous membrane for heterogeneous Fenton-like removal of organic and pathogenic contaminants from wastewater was developed by immobilizing zerovalent iron nanoparticles (Fe-NPs) on an amine/thiol grafted polyester membrane.     

Controlled synthesis of ultrathin MoS2 nanoflowers for highly enhanced NO2 sensing at room temperature

Fabrication of a high-performance room-temperature (RT) gas sensor is important for the future integration of sensors into smart, portable and Internet-of-Things (IoT)-based devices. Herein, we developed a NO₂ gas sensor based on ultrathin MoS₂ nanoflowers with high sensitivity at RT. The MoS₂ flower-like nanostructures were synthesised via a simple hydrothermal method with different growth times of 24, 36, 48, and 60 h. The synthesised MoS₂ nanoflowers were subsequently characterised by scanning electron microscopy, X-ray diffraction, Raman spectroscopy, energy-dispersive X-ray spectroscopy and transmission electron microscopy. The petal-like nanosheets in pure MoS₂ agglomerated to form a flower-like structure with Raman vibrational modes at 378 and 403 cm⁻¹ and crystallisation in the hexagonal phase. The specific surface areas of the MoS₂ grown at different times were measured by using the Brunauer–Emmett–Teller method. The largest specific surface area of 56.57 m² g⁻¹ was obtained for the MoS₂ nanoflowers grown for 48 h. This sample also possessed the smallest activation energy of 0.08 eV. The gas-sensing characteristics of sensors based on the synthesised MoS₂ nanostructures were investigated using oxidising and reducing gases, such as NO₂, SO₂, H₂, CH₄, CO and NH₃, at different concentrations and at working temperatures ranging from RT to 150 °C. The sensor based on the MoS₂ nanoflowers grown for 48 h showed a high gas response of 67.4% and high selectivity to 10 ppm NO₂ at RT. This finding can be ascribed to the synergistic effects of largest specific surface area, smallest crystallite size and lowest activation energy of the MoS₂-48 h sample among the samples. The sensors also exhibited a relative humidity-independent sensing characteristic at RT and a low detection limit of 84 ppb, thereby allowing their practical application to portable IoT-based devices.

Controlled synthesis of ultrathin MoS₂ nanoflowers is crucial to develop a high-performance room-temperature NO₂ gas sensor for the future integration of sensors into smart, portable and Internet-of-Things (IoT)-based devices.     

颧骨颧弓缩小联合下颌角截骨术前及术后早期颞颌关节和咬肌的三维螺旋CT形态学测量

目的:探讨颧骨颧弓缩小联合下颌角截骨术前、术后颞颌关节和咬肌的变化。方法:随机选取颧骨颧弓及下颌角肥大者80例,于术前、术后10天分别做三维CT检查,并对颜面部进行三维测量,采用自身对照进行配对资料t检验。结果:颧骨颧弓及下颌角截骨整形术后0°指标及60°指标术前术后差异无统计学意义(P>0.05),120°指标及180°指标术前术后差异有统计学意义(P<0.05);咬肌宽度及厚度术前术后差异有统计学意义(P<0.05)。结论:颧骨颧弓及下颌角截骨整形术后短期内颞颌关节上间隙及关节后间隙发生了改变,差异有统计学意义但差值较小,颞颌关节的改变仍在其代偿范围内;由于术中部分骨质的去除及咬肌被剥离附着位置发生改变再加上手术操作对咬肌的损伤,咬肌的形态随之改变,短期内咬肌宽厚度较术前增大。     

黑川式和改良黑川式双开门椎板成形椎管扩大术治疗颈椎疾病的对比研究

目的 观察和对比黑川式和改良黑川式双开门椎板成形椎管扩大术治疗颈椎疾病的中远期疗效.方法 回顾性分析2002年1月至2010年12月行颈椎双开门椎板成形椎管扩大术并获随访的172例患者资料,男性126例,女性46例,年龄35 ～ 80岁,平均(57±l9)岁.其中颈椎病106例,颈椎管狭窄症45例,颈椎后纵韧带骨化症21例.其中行黑川式手术69例(传统术式组),行改良黑川式手术103例(改良术式组).两组患者具有可比性,比较两组疗效根据资料不同采用t检验、x2检验和秩和检验.结果 所有患者均获随访,随访时间12～120个月,平均(52±33)个月;其中随访时间≥2年的患者123例,≥5年的患者71例.所有患者末次随访JOA评分均较术前明显改善(t=3.420,P＜0.01),两组术后改善率差异无统计学意义(P＞0.05);但术后3个月改良术式组患者术后出现轴性症状的比例(3.9％)要明显低于传统术式组(14.5％)(x2 =7.548,P＜0.05).改良术式组术后3个月颈椎椎间活动度下降情况优于传统术式组(27％±6％比19％±4％,Z=6.34,P=0.036＜0.05),中远期随访椎间活动度两组差异无统计学意义.结论 黑川式和改良黑川式双开门椎板成形椎管扩大术临床应用中远期疗效满意.改良黑川式手术因避免颈后部的伸肌组群损伤,可以降低术后轴性症状的发生率.     

A switch from GnRH agonist to GnRH antagonist in castration-resistant prostate cancer patients leads to a low response rate on PSA

Purpose

At the time of castration resistance, it is recommended to realize hormonal manipulations before chemotherapy. We evaluated the impact of a switch from GnRH agonist to antagonist in patients with castration-resistant prostate cancer on PSA and testosterone levels at 3 months.

Methods

Retrospectively, 17 patients from 5 different centers undergoing androgen deprivation therapy and presenting rising PSA confirmed on 3 blood samples 2 weeks apart and despite a castrate testosterone level (<0.5 ng/ml) were reviewed. Antiandrogen withdrawal syndrome had been tested before the switch. Degarelix was administered as followed: 240 mg for the first injection and then 80 mg every month, subcutaneously. We evaluated the PSA and testosterone level variation 3 months after the switch. Patients who experienced a variation in PSA of less than 10% compared to the baseline or who had a more than 10% PSA decrease were defined as responders.

Results

Mean PSA level at the switch was 34.3 ± 50.3 ng/ml, with a mean testosterone level of 0.21 ± 0.13 ng/ml. Three months after the switch, mean PSA level was 59.9 ± 81.6 ng/ml (P = 0.061), with a mean testosterone level of 0.19 ± 0.08 ng/ml (P = 0.086). At 3 months, 4 patients (23%) responded to therapy. Thirteen patients (77%) experienced a rise in PSA of more than 10% compared to baseline; 41% of patients decreased their testosterone level. The limitations of this study are its retrospective nature and the limited number of patients.

Conclusion

Switch from an agonist to an antagonist of GnRH has a limited impact on PSA at 3 months in castration-resistant prostate cancer patients.