Impact of Physical Activities on Frailty in Community-Dwelling Older Women

Aims: The aim of the study was to determine whether increased physical activities (PA) affect frailty for old women, 75 years and older (OO), compared to 60–74 years old (YO). Methods: This cross-sectional study measured 19 frailty indicators (muscle strength and endurance, balance, gait characteristics, and function), using 46 community-dwelling women. PA were divided into three levels by caloric expenditure per week (<2,000 kcal/week, 2,000–3,999 kcal/week, >4,000 kcal/week). Results: As PA level increased, a gap (=difference) between OO and YO narrowed for step length and function, but for quadriceps strength and endurance, a gap widened. Conclusions: Frailty progresses with aging but older women who engage in a high level of physical activity (>4,000 kcal/week) can increase mobility and functional capacity, but not for muscle strength and endurance. Starting regular resistance training activities early in the aging process is critical to improve or maintain muscle quality to offset age-related frailty.     

Shoulder pain after stroke – experiences,consequences in daily life and effects of interventions: a qualitative study

Purpose: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions.

Method: A qualitative interview study including 13 community-dwelling persons (six women; median age 65?years) with persistent shoulder pain after stroke.

Results: Three categories emerged from the content analysis. In “Multiple pain characteristics” an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand. An explanation of the pain was seldom given. In “Limitations caused by the pain” it was described how the pain negatively influenced personal care, household activities and leisure, but also could lead to emotional reactions. In “Multiple pain interventions with various effects” a variety of interventions were described. Self-management interventions with gentle movements were perceived most effective. A restraint attitude to pain medication due to side effects was reported.

Conclusions: Shoulder pain after stroke can lead to a variety of pain characteristics. As the pain is complex and may affect many important areas in a person’s life, multidisciplinary rehabilitation interventions are important.

• Implications for rehabilitation

• Shoulder pain after stroke can lead to a variety of pain characteristics with radiation to the arm and hand

• Shoulder pain often influence personal care, household activities and leisure negatively, which may lead to emotional reactions

• Self-management interventions with gentle movements are perceived most effective

• As the shoulder pain after stroke is complex, interventions by a multidisciplinary team may be needed

     

The psychometric properties of the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions

Purpose: The purpose of this study is to psychometrically test the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions.

Materials and methods: One thousand and two hundred people with ankylosing spondylitis; osteoarthritis; systemic lupus erythematosus; systemic sclerosis; chronic pain; chronic upper limb disorders; or Primary Sjögren’s syndrome completed the Evaluation of Daily Activity Questionnaire, Health Assessment Questionnaire and Short-Form Health Survey v2. We examined internal construct validity using Rasch analysis, internal consistency, concurrent validity with the Health Assessment Questionnaire and Short-Form Health Survey v2. Participants repeated the Evaluation of Daily Activity Questionnaire to assess test–retest reliability.

Results: The 12 domains satisfied Rasch model expectations for fit, local dependency, unidimensionality and invariance by age and gender, in each musculoskeletal condition. Internal consistency was consistent with individual use (Cronbach’s α?>?0.90); concurrent validity was strong (Health Assessment Questionnaire:?r_s?=?0.60–0.92; Short-Form Health Survey v2 Physical Function:?r_s?=??0.61 to ?0.91) and test–retest reliability excellent (Intra-Class Correlation Coefficient(2,1)?=?0.77–0.96).

Conclusion: The Evaluation of Daily Activity Questionnaire satisfied Rasch model requirements for construct validity and has good reliability and validity in each MSC. The Evaluation of Daily Activity Questionnaire can be used as a measure of everyday activity in practice and research with people with musculoskeletal conditions.

• Implications for rehabilitation

• The Evaluation of Daily Activity Questionnaire evaluates users’ ability to perform common daily activities (in 12 domains) that were identified as problematic by people with seven musculoskeletal conditions (i.e., osteoarthritis, systemic lupus, ankylosing spondylitis, chronic pain, chronic upper limb conditions, systemic sclerosis, Sjogren’s syndrome).

• Most patients considered the Evaluation of Daily Activity Questionnaire was the right length and would be helpful for discussing everyday problems with an occupational therapist.

• The 12 domains have good reliability and validity and can be combined into two components: Self-Care and Mobility.

• The Evaluation of Daily Activity Questionnaire is suitable for use both in clinical practice and research and a User Manual is available for therapists and researchers.

     

盐炒杜仲和杜仲炭的药理对比实验研究

目的:观察盐炒杜仲和杜仲炭对小鼠单核-巨噬细胞、血压、中枢镇静作用的影响,以区别两种炮制品药理作用,为临床应用作为参考。方法:选取100只小鼠随机分为空白对照组、2.0g·kg-1盐炒杜仲醇煎液组、8.0 g·kg-1盐炒杜仲醇煎液组、2.0g·kg-1杜仲炭醇煎液组、8.0 g·kg-1杜仲炭醇煎液组,观察不同剂量的盐炒杜仲和杜仲炭对小鼠单核-巨噬细胞的影响。选取100只小鼠随机分为空白对照组、3.0 g·kg-1盐炒杜仲醇煎液组、9.0 g·kg-1盐炒杜仲醇煎液组、3.0 g·kg-1杜仲炭醇煎液组、9.0 g·kg-1杜仲炭醇煎液组,观察不同剂量的盐炒杜仲和杜仲炭对小鼠血压的影响。选取100只小鼠随机分为空白对照组、5.0g·kg-1盐炒杜仲醇煎液组、10.0 g·kg-1盐炒杜仲醇煎液组、5.0 g·kg-1杜仲炭醇煎液组、10.0 g·kg-1杜仲炭醇煎液组,观察不同剂量的盐炒杜仲和杜仲炭对小鼠中枢镇静作用的影响。结果:与空白对照组比较,高剂量的盐炒杜仲醇煎液组和杜仲炭醇煎液组均显著升高(P<0.05),但杜仲炭醇煎液组的免疫效果更加明显。与空白对照组比较,高剂量的盐炒杜仲醇煎液组和杜仲炭醇煎液组均显著降低小鼠的收缩压和舒张压(P<0.05),但杜仲炭醇煎液组降压效果更加明显。与空白对照组比较,高剂量的盐炒杜仲醇煎液组和杜仲炭醇煎液组均显著促进小鼠睡眠(P<0.05),但杜仲炭醇煎液组镇静效果更加显著。结论:盐炒杜仲和杜仲炭均具有较好的免疫作用、较强的降血压作用和中枢镇静作用,但杜仲炭的药理活性更强。文献引用:李轩.盐炒杜仲和杜仲炭的药理对比实验研究[J].中医学报,2015,30(2):238-240.     

A scoping review of time-use research in occupational therapy and occupational science

Background: Time use is a defining interest within occupational therapy and occupational science. This is evident through the range of contributions to the disciplinary knowledge base. Indeed it has been suggested that time-use methods are amongst the most established research techniques used to explore aspects of human occupation. However, the extent and nature of such activity in occupational therapy and occupational science has not been examined to date. Aim: This study sought to map the extent and nature of time-use research in occupational therapy and occupational science journals and the extent to which studies explored the relationship between time-use and health. Method: A scoping review method was used. Results: Sixty-one studies were included. Scandinavian countries contributed the largest number of studies (n = 16, 26%). While time-use diaries were used most frequently (n = 30, 49%) occupational therapists and occupational scientists have developed a range of data-collection instruments. Forty-nine studies (80%) focused on time-use in clinical or defined population sub-groups. Ten studies (16%) included an empirical examination of the relationship between time-use and health. Conclusion: Future research should examine time-use and health amongst well populations across the lifespan and in different parts of the world.     

锰胁迫对甘草生理和生长特性的影响

目的通过对甘草进行不同质量浓度锰处理的研究,探讨锰胁迫对甘草植株生理和生长特性的影响。方法以1年生甘草移栽苗为实验材料,采用盆栽蛭石的方法,共设置5个锰质量浓度水平,分别为CK(0),1.81,18.1,36.2和54.3mg·L-1,在测定甘草叶片色素含量、光合指标及各抗氧化酶活性的同时,对甘草生长指标和地上、地下生物量进行测定。结果甘草各项生理和生长指标随着锰处理质量浓度的增加均呈现先升高后下降的趋势,且适当质量浓度的锰处理与CK和54.3mg·L-1处理之间比较差异均显著(P<0.05)。在质量浓度18.1mg·L-1处理时,甘草叶片各色素含量和净光合速率(Pn)、气孔导度(Gs)、蒸腾速率(Tr)达到最大值,与54.3mg·L-1处理之间比较差异显著(P<0.05)。超氧化物歧化酶(SOD)和过氧化物酶(POD)活性在质量浓度18.1mg·L-1时达到最大值,与54.3mg·L-1处理之间比较差异显著(P<0.05),而过氧化氢酶(CAT)活性在质量浓度36.2mg·L-1处理时达到最大值,随后三者活性均开始下降。同时,甘草株高、地茎和芦头直径在质量浓度36.2mg·L-1处理,地上和地下部分干质量在18.1mg·L-1处理时达最大值后,均开始下降,且与54.3mg·L-1处理之间比较差异显著(P<0.05)。结论适当质量浓度的锰处理能够显著提高甘草的各项生理和生长指标,但过高质量浓度的锰则会对甘草生长产生胁迫,抑制其光合产物的积累。     

Cardioversion of recent-onset atrial fibrillation using intravenous antiarrhythmics: A European perspective

Pharmacological cardioversion using intravenous antiarrhythmic agents is commonly indicated in symptomatic patients with recent-onset atrial fibrillation (AF). Except in hemodynamically unstable patients who require emergency direct current electrical cardioversion, for the majority of hemodynamically stable patients, pharmacological cardioversion represents a valid option and requires the clinician to be familiar with the properties and use of antiarrhythmic agents. The main characteristics of selected intravenous antiarrhythmic agents for conversion of recent-onset AF, the reported success rates, and possible adverse events are discussed. Among intravenous antiarrhythmics, flecainide, propafenone, amiodarone, sotalol, dofetilide, ibutilide, and vernakalant are commonly used. Antazoline, an old antihistaminic agent with antiarrhythmic properties was also reported to give encouraging results in Poland. Intravenous flecainide and propafenone are the only Class I agents still recommended by recent guidelines. Intravenous new Class III agents as dofetilide and ibutilide have high and rapid efficacy in converting AF to sinus rhythm but require strict surveillance with electrocardiogram (ECG) monitoring during and after intravenous administration because of the potential risk of QT prolongation and Torsades de Pointes, which can be prevented and properly managed. Vernakalant, a partial atrial selective was shown to have a high success rate and to be safe in real-life use.     

Improvement of Risk Prediction After Transcatheter Aortic Valve Replacement by Combining Frailty With Conventional Risk Scores

Objectives

This study sought to evaluate whether frailty improves mortality prediction in combination with the conventional scores.