Care Needs and Caregivers: Associations and Effects of Living Arrangements on Caregiving to Older Adults in India

As the ageing phenomenon continues in India, we explore the care needs of older adults and identify caregivers for specific care needs across living arrangements. Using the United Nations Population Fund (UNFPA) conducted Building Knowledge Base on Population Ageing in India (BKPAI 2011) data comprising 9850 older adults, we employed statistical methods to analyze the data, find associations and used binary logistic regression to model the adjusted and unadjusted effects of living arrangements on caregiving to older adults for specific care needs. Care-requiring situations considered were acute sickness, sickness requiring hospitalization, chronic morbidity, functional disability represented by ADL and IADL limitations, and locomotor disability. Results indicate that living arrangements of older adults were significantly associated with health, functional status and disability as well as caregiving patterns. Our results suggest that co-residence with children and all others was beneficial to older adults in obtaining care from a family caregiver for their hospitalization and chronic morbidity needs while living with spouse or living with a partner was advantageous for older adults in receiving care for their ADL limitations and during hospitalizations. Mean number of children was also significantly associated with the availability of a caregiver during hospitalization, locomotor disability, chronic morbidity and acute sickness. The study also highlights a little known phenomenon, that there was familial help available to older adults who lived alone. Notably, non-family sources of caregiving were steadily becoming visible (as high as 8–10 % of the caregiving component) especially among older adults living alone.     

Single-dose single-point method in amitriptyline therapy

Twenty-one depressed patients participated in a study that assessed the predictability of amitriptyline (AT) dosage based on plasma drug concentrations after a single dose. In 11 patients maintained on a fixed dose regimen, the 18-h single-dose level was confirmed to be predictive of steady-state levels. The dose for the next 10 patients was derived from their 18-h level aiming to attain steady-state levels of 200 ng/ml. The patients achieved a mean steady-state level of 213 ng/ml with 80% attaining therapeutic levels. All the patients improved within 2 weeks. These preliminary results suggest that dose prediction based on a single-dose TCA level is reliable and beneficial.     

Citrinin and endosulfan induced maternal toxicity in pregnant Wistar rats: pathomorphological study

Dietary exposures to environmental food pollutants such as mycotoxin(s) or pesticide(s) have gained immense significance due to their adverse effects on production and reproduction in animal and human populations. The present investigation was conducted to evaluate the maternal toxicity of citrinin (CIT) and endosulfan administered per os either alone or in combination in pregnant rats during gestational days 6-20. CIT (group I, 10 mg kg(-1) feed, through diet) and endosulfan (group II, 1 mg kg(-1) body weight, by oral intubation) when administered either alone or in combination (group III) in Wistar rats caused clinical signs of toxicity and pathomorphological changes in all the toxin treated groups, the severity being more pronounced in the combination treatment compared with that observed in the control (group IV). The rate of fetal resorptions was highest (22.22%) in the combination treatment followed by endosulfan (16.48%) and CIT (12.50%) treatment groups compared with the control group (3.86%). The histopathological changes such as engorged vasculature, vacuolar degeneration and karyomegaly in liver; congestion, tubular degeneration and cast formation in kidneys; vascular changes and hemosiderosis in uterus and lymphocytic depletion and apoptosis in the lymphoid organs were recorded in the animals of the toxin treated groups. The lesions were consistent and more severe in the combination treatment group compared with the individual treatment groups, suggesting an additive interaction of CIT and endosulfan in inducing maternal toxicity in Wistar rats.     

Safe extracranial vascular evaluation and surgery without preoperative arteriography

Carotid surgery without preoperative arteriography was performed in 101 consecutive patients with an average age of 68.5 years and almost equal sex distribution. This prospective study analyzed risk factors, operative approach, bruits, indications for surgery, and outcome. All patients were studied by real-time B-mode ultrasound and spectral analysis and none were referred for arteriogram. The majority of patients had a standard carotid endarterectomy, and the findings at surgery correlated with noninvasive imaging. No mortality was recorded in this series of patients; a 1% rate of neurologic morbidity was noted. These results suggest that one can safely operate on the basis of a duplex scan. A preoperative arteriogram is not always necessary for carotid evaluation.Presented at the Eastern Vascular Surgery Association Meeting, Washington, DC, May 20–21, 1988.     

Genetic association between highly active esterases and organophosphate resistance in Culex tarsalis

The genetics of two highly active esterases, A3H and B3H, in a methyl parathion-resistant strain (MP-R) of Culex tarsalis was investigated in relation to organophosphate (OP) resistance. The increased activity of esterase A3 and of esterase B3 is under the control of two distinct and closely linked (approximately 4.4 centimorgans) genes. Each gene possesses two forms, one controlling high activity (A3H or B3H, respectively) and one controlling low activity (A3L or B3L, respectively) of the enzymes. Organophosphate resistance in the MP-R strain is strongly associated with the presence of these highly active esterases. The results are discussed in relation to the present knowledge on the mechanisms responsible for high activity of esterases observed in other OP-resistant mosquitoes of the genus Culex.     

The effects of intraperitoneal administration of the GABA(B) receptor agonist baclofen on food intake in CFLP and C57BL/6 mice

The effects of the GABA(B) receptor agonist baclofen were investigated on food intake in non-deprived CFLP and C57BL/6 mice. In Experiment 1, baclofen (1-8 mg /kg) administered i.p. to CFLP mice, produced a dose-related increase in food intake. The 4 and 8 mg/kg doses produced significant increases in cumulative feeding when measure 120 min after administration (at least P < 0.05, in each case). In Experiment 2, baclofen (1-10 mg/kg), administered intraperitoneally (i.p.) to C57BL/6 mice, also produced a dose-related increase in food intake. The 4 mg/kg dose of baclofen significantly increased cumulative food intake at 60 min (P < 0.05), while the 2 and 4 mg/kg doses significantly increased cumulative food intake at 120 min (P < 0.01, in each case). The 10mg/kg dose was without effect. These data show that systemic administration of the GABA(B) agonist baclofen produces an increase in food consumption in two different strains of mice and extend previous observations made in rat to another rodent species.