Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis

Scand J Caring Sci; 2011; 25; 3–11
Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one’s own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one’s social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.     

Unmet care needs and key outcomes in dementia

OBJECTIVES: To determine how unmet needs for activity of daily living tasks influenced nursing home placement, death, or loss to follow-up in dementia. DESIGN: An 18-month longitudinal design, with interviews administered every 6 months. SETTING: Eight catchment areas in the United States. PARTICIPANTS: Five thousand eight hundred thirty-one dementia patients and their caregivers were included at baseline. MEASUREMENTS: Measures of sociodemographic context of care; functional, cognitive, and behavioral status of care recipients; caregiver stress and well-being; and formal and informal resources served as covariates. The independent variables of interest were unweighted unmet care need scores and unmet need scores weighted by importance and severity in a prior sample of older consumers of long-term care. Outcomes included nursing home placement, death, and loss to follow-up. RESULTS: Cox regression models suggested that greater unmet need was predictive of nursing home placement, death, and loss to follow-up. These results were apparent when the unweighted and the weighted scores for unmet need with activity of daily living dependencies were used. CONCLUSION: Unmet need may be useful in identifying dementia care recipients at risk for nursing home placement and death. Further study of unmet need is needed to effectively assess and target intervention protocols during the course of dementia.     

抗癫药物分类及作用机制的研究进展

 药物是治疗癫的一线手段,抗癫药物已经经历了一个多世纪的发展。从1978年以前上市的传统抗癫药物,到1993年以后上市的新型抗癫药物,抗癫药物在作用机制、疗效与不良反应方面的研究都取得了一些新进展。近年一批新药正在进行临床试验,未来有望用于临床;某些可能具有抗癫作用的靶点、机制及通路也是目前的研究热点。本文将从药理机制上对历代抗癫药物及其可能的新的作用机制的研究进展作一回顾与综述。     

3-取代吲哚-2-酮类化合物的设计、合成及抗肿瘤活性研究

目的设计合成对微管蛋白和血管内皮细胞生长因子受体2(VEGFR-2)激酶具有双重抑制作用的3-取代吲哚-2-酮类化合物,考察其体外抑瘤活性。方法以取代的苯胺为起始原料,经缩合、环合、还原、取代等反应制得系列目标化合物,并考察该系列化合物对微管蛋白和肿瘤细胞的抑制活性。结果共合成了11个新的目标化合物。实验结果显示,化合物j9对微管蛋白和VEGFR-2激酶具有双重抑制活性。所有目标化合物对3种肿瘤细胞株均有中等强度的抑制活性。结论该类化合物是一类具有多靶点作用的抗肿瘤化合物。     

香菇多糖结构修饰研究进展

目的　对香菇多糖化学结构的修饰方法及其生物活性进行系统总结。方法　通过查阅近年来中英文相关文献,对香菇多糖已经报道的化学结构修饰方法及修饰后的生物活性进行了系统分析,总结阶段性进展。结果　香菇多糖结构修饰方法有化学修饰,包括硫酸化、羧甲基化、磷酸化及与金属离子螯合法等,物理修饰和生物修饰法等。不同的修饰方法对香菇多糖的生物活性有较大的影响。结论　结构修饰及其药理活性的深入研究仍是香菇多糖一个重要的研究方向。     

中药豨莶草的化学成分及其药理作用研究进展

目的探讨菊科植物豨莶草化学成分及其近年来药理作用研究进展。方法检索、整理、归纳国内外有关豨莶草化学成分及其药理作用研究文献。结果与结论豨莶草主要含有二萜类、倍半萜类、黄酮类等化学成分,豨莶草提取物及化学成分具有抗炎镇痛、抗过敏、心血管保护等生物活性。