健康老年人外周血自然杀伤细胞活性的研究

本文应用~(125)IUdR标记K_(562)靶细胞技术测定健康老年人(60～87岁)和健康青年人(21～28岁)外周血淋巴细胞自然杀伤(NK)活性。结果表明,健康老年人NK细胞活性与健康青年人相比没有显著性差异(P>0.05)。对照前人的研究,该结果认为NK细胞活性不存在明显的随龄变化。     

Self-reported comorbidities,perceived needs,and sources for usual care for older and younger homeless adults

BACKGROUND: While older individuals who are homeless tend to be in poorer health, it is less clear how they view their health care needs and whether their self-reported patterns for accessing health services differ from younger homeless counterparts. METHODS: Cross-sectional, community-based survey of homeless adults in Pittsburgh and Philadelphia using face-to-face interviews from population proportionate sampling of sites and random sampling of subjects. Survey questions included physical and mental health comorbidities, self-reported health care, social services and personal needs, means of economic support, and sources for usual health care. For analysis purposes, respondents were grouped by age 18 to 49 years old and 50 years old or older. RESULTS: Overall, 531 adults were interviewed, with 74 respondents 50 years old or older (13.9%). Older homeless persons were 3.6 times more likely to report a chronic medical condition, 2.8 times more likely to have health insurance, and 2.4 times more likely to be dependent on heroin than homeless persons less than 50 years old. However, they also tended to use shelter-based clinics and street outreach teams more commonly as their source of usual care (20.9% vs 10.6%, P=.02) and were significantly less likely to report a need for substance abuse treatment despite high rates of abuse. CONCLUSION: Older homeless adults have a greater disease burden than their younger counterparts. However, it is unclear whether these needs are being appropriately identified and met. There is a need for specific and targeted outreach to connect them to appropriate services.     

Effectiveness of web-based versus folder support interventions for young informal carers of persons with mental illness: A randomized controlled trial

Objective

Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness.

Methods

This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N = 241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes.

Results

The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being.

Conclusion

Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low well-being. This signals a need for support.

Practice implications

The non-significant differences show that each intervention can be effective, and that it depends upon the individual's preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy.     

Modeling of Recovery Profiles in Mentally Disabled and Intact Patients after Sevoflurane Anesthesia; A Pharmacodynamic Analysis

Purpose

Mentally disabled patients show different recovery profiles compared to normal patients after general anesthesia. However, the relationship of dose-recovery profiles of mentally disabled patients has never been compared to that of normal patients.

Materials and Methods

Twenty patients (10 mentally disabled patients and 10 mentally intact patients) scheduled to dental surgery under general anesthesia was recruited. Sevoflurane was administered to maintain anesthesia during dental treatment. At the end of the surgery, sevoflurane was discontinued. End-tidal sevoflurane and recovery of consciousness (ROC) were recorded after sevoflurane discontinuation. The pharmacodynamic relation between the probability of ROC and end-tidal sevoflurane concentration was analyzed using NONMEM software (version VII).

Results

End-tidal sevoflurane concentration associated with 50% probability of ROC (C₅₀) and γ value were lower in the mentally disabled patients (C₅₀=0.37 vol %, γ=16.5 in mentally intact patients, C₅₀=0.19 vol %, γ=4.58 in mentally disabled patients). Mentality was a significant covariate of C₅₀ for ROC and γ value to pharmacodynamic model.

Conclusion

A sigmoid Emanx model explains the pharmacodynamic relationship between end-tidal sevoflurane concentration and ROC. Mentally disabled patients may recover slower from anesthesia at lower sevoflurane concentration at ROC an compared to normal patients.     

An Exploratory Study on the Meaning of Using Community Psychiatric Rehabilitation among Persons with Psychiatric Disabilities

This study explores the meaning of the use of community psychiatric rehabilitation (CPR) services to gain knowledge to improve services and shed more light on how to facilitate recovery. The topics explored included: the motivation for participation, perception and expectation towards CPR, the interactions with professionals in the CPR Center, and the feelings towards activities. A qualitative approach was adopted, and 30 consumers were interviewed face-to-face by using semi-structured interview guide. Data were analyzed using the open coding method of grounded theory. The consumer accounts provided information on the eight aspects of CPR services. The findings revealed that the CPR Center created a lifeworld, a friendly place similar to home with structure and activities. Professional relationship was the key change agent for rehabilitation. Most professionals adopted recovery-oriented approach to empower participants by giving opportunities and choices. The essential ingredients of this lifeworld covered rehabilitation goals, physical exercises, psychological impact, social interactions, learning, and economic gains. The services were venues for interpersonal interactions and provided structure for daily life, which helped consumers reach their rehabilitation goals and brought existential meaning to their lives. Yet, the accounts also revealed negative phenomena in the CPR center. Suggestions were made to improve services.     

肥可消方治疗老年单纯性肥胖症的临床研究

目的:观察肥可消方对老年单纯性肥胖症的临床疗效。方法:将60例老年单纯性肥胖症患者分为中药组和对照组各30例。中药组予肥可消方口服,结合饮食控制及适当运动治疗;对照组单纯采用饮食控制和适当运动治疗。检测两组治疗前后体重、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)等指标的变化。结果:中药组总有效率96.7%,优于对照组的83.3%(P<0.05);治疗后两组患者的血脂水平均较治疗前有所改善(P<0.01),中药组对血脂水平的改善亦优于对照组。结论:中药肥可消方能有效治疗老年单纯性肥胖症,且能改善患者的血脂水平,在运用中药针对老年人群心脑血管疾病进行一级预防方面作出了有益的探索。