Loneliness,social support,social isolation and wellbeing among working age adults with and without disability: Cross-sectional study

BackgroundLoneliness is significantly related to health and wellbeing. However, there is little information on the prevalence of loneliness among people with disability or the association between disability, loneliness and wellbeing.Objective/hypothesisFor a nationally representative sample of adults (age 16–64) with/without disability, to examine exposure to three indicators of low social connectedness (loneliness, low perceived social support, social isolation), and to evaluate the association between low social connectedness and wellbeing. To test whether disability status moderated the relationship between low social connectedness and wellbeing.MethodsSecondary analysis of data from three annual rounds of the cross-sectional English Community Life Survey (CLS) 2016–19.ResultsPeople with disability experienced loneliness, low perceived social support and social isolation at significantly higher rates than people without disability. Effect sizes were significantly greater for loneliness. Disability was associated with lower wellbeing. With one exception, low social connectedness was associated with lower wellbeing. Again, effect sizes were significantly greater for loneliness. The prevalence of loneliness was highest among adults with disability who were younger, economically inactive, living in rented or other accommodation, living alone and with low levels of access to environmental assets. There was no evidence that disability status moderated the association between exposure to low social connectedness and low wellbeing.ConclusionsLoneliness was a particularly significant driver of poor wellbeing among people with disability. The relative independence between different indicators of social connectedness suggests that interventions to reduce loneliness will need to do more than simply increase rates of social contact or social support.     

传染病动力学模型在登革热疫情防控中的应用

目的 应用传染病动力学模型研究登革热暴发流行的传播规律,并对灭蚊、病例隔离等防控措施的效果进行定量评价。 方法 根据登革热疾病的自然史建立登革热暴发流行的SEIR模型。收集2014年广州市的登革热暴发疫情数据,将模型与之拟合,利用χ²检验评价模型模拟数据与实际疫情数据的拟合优度,获得模型关键参数。应用模型模拟一起由输入性病例引发的社区暴发疫情,并对无干预、灭蚊、隔离、灭蚊+隔离状态下的疫情发展趋势及不同防控效果进行定量评价,寻找最优防控方案。 结果 通过模型模拟,在10 000人的社区中输入1例感染登革II型病毒病例,未干预状态下,登革热疫情发展很快,发病人数呈直线上升趋势,疫情持续超过100 d,超过450人发病。采取隔离措施后,疫情控制效果不明显。采取灭蚊措施后,疫情很快得到控制。采取灭蚊+隔离综合措施的效果和采取单项灭蚊措施效果无差别,越早采取灭蚊措施效果越好。 结论 在登革热的暴发疫情处置中,灭蚊是最关键的防控措施,一旦疫情在人群中形成传播,隔离并不能达到阻断传染源的目的 ,只能作为疫情控制的辅助措施。     

促细菌快速生长繁殖因子的研究

目的 通过对促细菌快速生长繁殖因子即细菌培养基成分进行科学配比研究,促使细菌能快速生长繁殖,并在同一体系内同时对细菌进行鉴定防止耐药菌株泛滥作了初步探讨^[1,2]。方法 采用V型板体系内培养,并同时进行鉴定和药敏试验。结果 细菌鉴定报告时间缩短至4～8小时,与常规方法对比其中标准菌株符合率为100%,临床分离株符合率为98%。结论 初步建立了细菌检验的快速常规程序,使临床细菌学检验更好的为临床提供正确,及时的诊断依据。     

维生素E对培养肝细胞抗脂质过氧化作用的影响

目的：观察维生素E对体外培养大鼠肝细胞抗脂质过氧化影响,探讨维生素E抗肝纤维化作用。方法：以TBA反应法观察4种不同浓度的维生素E对培养大鼠肝细胞上清丙二醛的影响;细胞计数观察合适浓度维生素E对肝纤维化大鼠肝细胞的保护作用。结果：不同浓度维生素E抗脂质过氧化作用不一,浓度过大或太小,其抗脂质过氧化作用均降低;合适浓度的维生素E对大鼠肝细胞有一定的保护作用。结论：在合适浓度下,维生素E对体外培养肝细胞有较强的抗脂质过氧化及保护作用。     

一种简便又经济的肝脏贮脂细胞分离方法

目的建立一种简便而经济的大鼠肝脏贮脂细胞的分离方法。方法采用链霉蛋白酶和Ⅳ型胶原酶循环灌注大鼠 肝脏后,以１１％Nycodenz密度梯度离心,分离肝脏贮脂细胞。结果细胞得率为２×１０～３×１０个／只,活力在９５％以上, 纯度超过９０％。结论本法简化了肝脏贮脂细胞的分离过程,使之既简便又经济,且细胞得率也较高。     

Health-related quality of life,uncertainty and coping strategies in solid organ transplant recipients during shielding for the COVID-19 pandemic

Strict isolation of vulnerable individuals has been a strategy implemented by authorities to protect people from COVID-19. Our objective was to investigate health-related quality of life (HRQoL), uncertainty and coping behaviours in solid organ transplant (SOT) recipients during the COVID-19 pandemic. A cross-sectional survey of adult SOT recipients undergoing follow-up at our institution was performed. Perceived health status, uncertainty and coping strategies were assessed using the EQ-5D-5L, Short-form Mishel Uncertainty in Illness Scale (SF-MUIS) and Brief Cope, respectively. Interactions with COVID-19 risk perception, access to health care, demographic and clinical variables were assessed. The survey was completed by 826 of 3839 (21.5%) invited participants. Overall, low levels of uncertainty in illness were reported, and acceptance was the major coping strategy (92%). Coping by acceptance, feeling protected, self-perceived susceptibility to COVID-19 were associated with lower levels of uncertainty. Health status index scores were significantly lower for those with mental health illness, compromised access to health care, a perceived high risk of severe COVID-19 infection and higher levels of uncertainty. A history of mental health illness, risk perceptions, restricted healthcare access, uncertainty and coping strategies was associated with poorer HRQoL in SOT recipients during strict isolation. These findings may allow identification of strategies to improve HRQoL in SOT recipients during the pandemic.     

Preservation of pancreas in the University of Wisconsin solution supplemented with AP39 reduces reactive oxygen species production and improves islet graft function

Ischemia-reperfusion injury (IRI) results in increased rates of delayed graft function and early graft loss. It has recently been reported that hydrogen sulfide (H₂S) protects organ grafts against prolonged IRI. Here, we investigated whether the preservation of pancreas in University of Wisconsin (UW) solution supplemented with AP39, which is a mitochondrial-targeted H₂S donor, protected pancreatic islets against IRI and improved islet function. Porcine pancreata were preserved in the UW solution with AP39 (UW + AP39) or the vehicle (UW) for 18 h, followed by islet isolation. The islet yields before and after purification were significantly higher in the UW + AP39 group than in the UW group. The islets isolated from the pancreas preserved in UW + AP39 exhibited significantly decreased levels of reactive oxygen species (ROS) production and a significantly increased mitochondrial membrane potential as compared to the islets isolated from the pancreas preserved in the vehicle. We found that the pancreas preserved in UW + AP39 improved the outcome of islet transplantation in streptozotocin-induced diabetic mice. These results suggest that the preservation of pancreas in UW + AP39 protects the islet grafts against IRI and could thus serve as a novel clinical strategy for improving islet transplantation outcomes.     

Clinical use of donation after circulatory death pancreas for islet transplantation

Due to a shortage of donation after brain death (DBD) organs, donation after circulatory death (DCD) is increasingly performed. In the field of islet transplantation, there is uncertainty regarding the suitability of DCD pancreas in terms of islet yield and function after islet isolation. The aim of this study was to investigate the potential use of DCD pancreas for islet transplantation. Islet isolation procedures from 126 category 3 DCD and 258 DBD pancreas were performed in a 9-year period. Islet yield after isolation was significantly lower for DCD compared to DBD pancreas (395 515 islet equivalents [IEQ] and 480 017 IEQ, respectively; p = .003). The decrease in IEQ during 2 days of culture was not different between the two groups. Warm ischemia time was not related to DCD islet yield. In vitro insulin secretion after a glucose challenge was similar between DCD and DBD islets. After islet transplantation, DCD islet graft recipients had similar graft function (AUC C-peptide) during mixed meal tolerance tests and Igls score compared to DBD graft recipients. In conclusion, DCD islets can be considered for clinical islet transplantation.     

聚集性新冠肺炎疫情期间某综合医院隔离留观病房运行分析与思考

2020年6月中旬,北京市新发地聚集性新型冠状病毒肺炎(以下简称新冠肺炎)疫情发生,首都医科大学大兴教学医院共确诊新冠肺炎患者65例。通过临时改建隔离留观病房,建立隔离留观病房工作机制与工作流程,探索适宜的会诊方法等措施,保障了隔离留观病房的平稳运行。通过总结、分析疫情期间患者就诊情况及诊治效果,认为聚集性疫情发生后患者的就诊行为有一定特点与规律性,隔离留观病房在新冠肺炎排查、诊治过程中发挥了重要作用。一旦发生新冠肺炎疫情,可根据具体情况设置、运行隔离留观病房。     

社区老年人社会隔离与抑郁症状的纵向研究

目的 采用交叉滞后分析模型探讨社区老年人社会隔离与抑郁症状的纵向关联。方法 采用分层整群抽样法对济南市789名社区老年人在2019年10月至2020年8月进行为期10个月的纵向追踪调查,使用Lubben社会网络量表简化版和老年抑郁量表简化版进行两次测量（T1和T2）。结果 社区老年人社会隔离与抑郁症状均具有一定稳定性;2个时间点的社会隔离与抑郁症状均呈负相关（r=-0.429,-0.327,P<0.001）。交叉滞后回归分析显示,在控制T1抑郁症状后,T1社会隔离显著预测T2抑郁症状（β=-0.136,P<0.001）;控制T1社会隔离后,T1抑郁症状对T2社会隔离的预测作用无统计学意义（β=-0.012,P=0.750）。结论 社会隔离是老年人抑郁症状的前因变量,社会隔离可以显著预测抑郁症状。