Zarit burden interview among caregivers of community-dwelling older adults in a caribbean setting (Jamaica): Reliability and factor structure

The Zarit Burden Interview has been the most popularly used tool for measuring caregiver burden and with the 60 years and over population in Jamaica and developing countries expected to increase, caregiver burden and its assessment assume increased importance. Establishing the reliability and underlying factor structure of instruments such as the ZBI is critical. This study sought to determine the reliability of the Zarit Burden Interview and to assess its underlying factor structure. The ZBI was administered to 180 caregivers of community dwelling older persons in Jamaica in a nationally representative sample across four geographic health regions in 2016. The factor structure was identified using exploratory factor analysis (EFA) with Varimax rotation. Cronbach's alpha was used to assess internal consistency/reliability of the instrument. The internal consistency/reliability of the ZBI instrument was high (Cronbach's α = 0.859) and the corrected item-total correlations ranged from 0.134 to 0.730. The ZBI mean score was found to be 16.92 ± 12.04. EFA produced a six-factor model comprised of 19 items which explained 48.97% of total variance, and was subsequently reduced to four (37.27% of total variance) via the use of parallel analysis and scrutiny of confidence intervals. The four factors identified were ‘personal strain’, ‘social relations disruption’, ‘resource strain/imbalance’ and ‘role intensity’. The ZBI-22 tool is a reliable instrument for evaluating caregiver burden among community dwelling older persons in Jamaica. A four factor model has emerged providing greater insights on the underlying constructs of the ZBI, the most widely used caregiver burden assessment tool.     

Pavlovian autoshaping procedures increase plasma corticosterone levels in rats

Pavlovian autoshaping conditioned responses (CRs) are complex sequences of conditioned stimulus (CS)-directed skeletal-motor responses that are elicited by CS objects predictive of food unconditioned stimulus (US). Autoshaping CRs are observed under conditions known to be conducive to elevations in plasma corticosterone levels, as, for example, in response to the eating of food as well as in response to signals predictive of food. Two experiments investigated the relationships between Pavlovian autoshaping procedures, the performance of Pavlovian autoshaping CRs, and plasma corticosterone levels in male Long-Evans rats. In Experiment 1, rats in the CS-US paired group (n=30) were given 20 daily sessions of Pavlovian autoshaping training wherein the insertion of a retractable lever CS was followed by the response-independent presentation of the food US. Tail blood samples obtained after the 20th autoshaping session revealed higher plasma corticosterone levels in the CS-US paired group than in the CS-US random control group (n=10). In Experiment 2, rats (n=35) were assessed for basal plasma corticosterone levels 2 weeks prior to autoshaping training. Plasma samples obtained immediately following the first autoshaping session, and prior to the acquisition of lever-press autoshaping CR performance, revealed higher plasma corticosterone levels in the CS-US paired group (n=24) relative to basal levels. This effect was not observed in the CS-US random control group (n=11). Data suggest that corticosterone release is a physiological endocrine Pavlovian CR induced by lever CS-food US pairings during Pavlovian autoshaping procedures, rather than a by-product of autoshaping CR performance. Implications of the link between autoshaping procedures and corticosterone release are discussed.     

Hemoglobinopathies in pregnancy

Hemoglobinopathies represent a unique set of genetic disorders.Formerly, many affected individuals did not survive to childbearing age. Affected women now commonly reach childbearing age and desire pregnancy. Successful pregnancy is possible in many cases with carefully coordinated obstetric and medical management.Genetic screening and prenatal diagnosis is an important aspect of prenatal care in these disorders. DNA mutation analysis offers rapid and accurate fetal diagnosis. Pregnancy also offers a unique situation in that cord blood has become a valuable source of stem cells for transplant. This allows the potential role of the unaffected fetus as a donor for affected siblings. In addition, it was proposed that the fetus may be able to act as a donor of stem cells for an affected mother. Despite current screening recommendations,many couples are not aware that they are carriers; it is common for a child to be born with an unexpected, serious hemoglobinopathies.For this reason, newborn screening programs have been introduced in most high-risk areas. Early diagnosis can facilitate implementation of proper preventive health measures, education of the parents regarding their carrier status, and provide the child with ongoing comprehensive care.