869 research outputs found
A community study on burden and depressive symptoms among carers of demented relatives
Background: Most mild to moderate demented patients
are cared at home. Studies have shown that carers face
increased stress and are prone to depression. In order to
understand their needs, a collaboration study between
District Board, Community Rehabilitation Network and
local hospitals was done. Objective: (1) To understand
care needs of demented patients and their carers in the
family. (2) To assess difficulties faced by carers and evaluate
their stress. (3) To find out which factors may aggravate
or relieve carer stress. Method: The study was performed
by interviewing 100 carers by questionnaire. Three main
themes were studied: (1) presence of depression by Center
for Epidemiological Studies Depression Scale (CES-D), (2)
caregiver burden by Zarit Burden Interview (ZBI), patients’
memory and behavioural problems by Revised Memory
and Behaviour Problems Checklist (RMBPC), patient ADL
performance, and (3) carer coping abilities by Brief COPE
and perceived social support by Multidimensional Scale
of Perceived Social Support (MSPSS). Results: 49% of
patients are in moderate to severe stage, with moderate to
high ADL dependency level (mean ADL score: 62.4, with
40% of patients scoring 60 or below). On average carers
spent 13.8 hours per day on their relative. 24% of carers
have rated self-perceived health status as poor or very
poor. 36% have little or no knowledge about the dementia
illness. Regarding carer depression, 49% had CES-D score
in the moderately and severely depressed range. Caregiver burden was high with ZBI score of 38.2 (>24 being highly
associated with depression). Memory and behavioural
symptoms were common with mean RMBPC 38.2. Carer
coping abilities as measured by Brief COPE was 24.6.
Perceived social support as measured by MSPSS was
56.2. Carer depression was found to be correlated with
cognitive and behaviour problems as well as carer burden;
whereas it was negatively correlated with social support.
After multiple linear regression analysis, caregiver burden
was the most significant factor contributing to caregiver
depression (β=0.55, T=5.43, p<0.001). Conclusions: This
cohort of carers, having spent long hours caring for their
demented relatives had limited knowledge, poor perceived
health and emotional problems. They had high burden
and showed signs of depression. Caregiver depression
was found to be associated with a higher level of burden.published_or_final_versio
Changes in Staff Expectations, Competence, and Confidence in Providing EOL Care after Launching a 2-year End-of-life Care Pilot Project in Care and Attention Home
Conference Theme: Clinical, Legal and Administrative ChallengesFree Paper Presentation Ipublished_or_final_versio
Global sea-surface iodide observations, 1967-2018
The marine iodine cycle has significant impacts on air quality and atmospheric chemistry. Specifically, the reaction of iodide with ozone in the top few micrometres of the surface ocean is an important sink for tropospheric ozone (a pollutant gas) and the dominant source of reactive iodine to the atmosphere. Sea surface iodide parameterisations are now being implemented in air quality models, but these are currently a major source of uncertainty. Relatively little observational data is available to estimate the global surface iodide concentrations, and this data has not hitherto been openly available in a collated, digital form. Here we present all available sea surface (<20 m depth) iodide observations. The dataset includes values digitised from published manuscripts, published and unpublished data supplied directly by the originators, and data obtained from repositories. It contains 1342 data points, and spans latitudes from 70°S to 68°N, representing all major basins. The data may be used to model sea surface iodide concentrations or as a reference for future observations
Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study
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在香港護理安老院舍推行生命晚期照護服務–成本效益分析
Conference Theme: Ageing at Home-Mobilizing Community Participation for Long Term Care of Elderlypostprin
Expanding genotype/phenotype of neuromuscular diseases by comprehensive target capture/NGS
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FibroScan-aspartate aminotransferase (FAST) score for monitoring histological improvement in non-alcoholic steatohepatitis activity during semaglutide treatment: post-hoc analysis of a randomised, double-blind, placebo-controlled, phase 2b trial
\ua9 2023Background: Currently, assessment of candidate pharmacotherapies in patients with non-alcoholic steatohepatitis (NASH) involves invasive liver biopsy. Non-invasive scores, such as the FibroScan-aspartate aminotransferase (FAST) score, are used to identify candidates for therapy, but their ability to assess disease progression or treatment effect is unknown. We aimed to assess the association between FAST score and histological endpoints. Methods: We conducted a post-hoc analysis using data from a prior randomised, double-blind, placebo-controlled, phase 2b trial at 143 sites across 16 countries. Patients (aged 18–75 years) with biopsy-confirmed NASH, fibrosis stage 1–3, and a Non-alcoholic fatty liver disease Activity Score (NAS) ≥4 were enrolled between January 2017 and September 2018, and randomly assigned to receive once-daily subcutaneous semaglutide 0.1, 0.2, or 0.4 mg or placebo for 72 weeks. A subgroup analysis of patients with FAST score and histological data in the pooled semaglutide treatment and placebo arms at baseline and week 72 was performed. The original trial is registered at ClinicalTrials.gov, NCT02970942. Findings: A total of 122 patients were included in this post-hoc analysis (93 received semaglutide and 29 received placebo). FAST score reduction was associated with achieving the primary endpoint of NASH resolution without worsening of fibrosis in the pooled semaglutide group (area under the receiver operating curve 0.69; 95% confidence interval [CI] 0.58, 0.81). Mean FAST score reduction from baseline to week 72 was greatest in patients who met the primary endpoint vs those who did not in both the semaglutide (−0.40 [95% CI –0.84, 0.04] vs −0.22 [95% CI –0.74, 0.30] points; p = 0.002) and placebo groups (−0.25 [95% CI –0.72, 0.23] vs 0.00 [95% CI –0.50, 0.50] points; p = 0.047). Similarly, mean reductions in FAST score at week 72 were greater in those with NAS improvement vs those without in the semaglutide and placebo groups (≥1 point, −0.36 [95% CI –0.82, 0.11] vs −0.08 [95% CI –0.53, 0.38] points [p < 0.001] and −0.25 [95% CI –0.64, 0.14] vs −0.06 [95% CI –0.40, 0.53] points [p = 0.001]; ≥2 points, −0.40 [95% CI –0.86, 0.06] vs −0.14 [95% CI –0.56, 0.28] points [p < 0.001] and −0.29 [95% CI –0.67, 0.09] vs −0.05 [95% CI –0.40, 0.50] points; [p < 0.001]). A FAST score reduction of more than 0.22 points after semaglutide treatment was associated with meeting the primary endpoint (sensitivity 78%; specificity 60%; positive likelihood ratio 1.26; negative likelihood ratio 0.25; odds ratio 4.93). Interpretation: The potential of the FAST score as a non-invasive monitoring tool to identify histological changes following treatment requires further evaluation and validation. Funding: Novo Nordisk A/S
Identification of Patients with Advanced Fibrosis Due to Nonalcoholic Fatty Liver Disease: Considerations for Best Practice
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) prevalence has increased in the past two decades, resulting in a significant but under-recognised public health burden. This impacts the prevalence of advanced fibrosis, end-stage liver disease and associated extrahepatic manifestations. To understand the challenges in recognising patients with advanced fibrosis due to NASH and develop a standardised approach to screen these patients, the authors of this document provided their opinions and expertise from practice and published evidence to identify key challenges and current approaches for diagnosing NASH. The severity of liver fibrosis due to NASH is the main indicator of associated morbidity and mortality outcomes. Therefore, identifying patients with, or at risk of, advanced fibrosis due to NASH and linking them to appropriate care is critical. This can be challenging due to a lack of awareness of NASH among healthcare professionals and a lack of standardised protocols for identifying patients. Simple noninvasive tests may provide an opportunity to facilitate early identification of these patients. This article proposes a simple, universally applicable diagnostic algorithm for use in clinical practice, that includes sequential use of noninvasive tests, ideally a biological marker and an imaging technique, which may help to facilitate early diagnosis of these patients. In the opinion of the authors, early detection of advanced fibrosis is fundamental in the efforts to halt the progression of NASH and diagnostic algorithms may facilitate pre-emptive interventions to curtail the disease
Plasma high sensitivity troponin T levels in adult survivors of childhood leukaemias: determinants and associations with cardiac function
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Enhanced IL-6/IL-6R Signaling Promotes Growth and Malignant Properties in EBV-Infected Premalignant and Cancerous Nasopharyngeal Epithelial Cells
Nasopharyngeal carcinoma (NPC) is etiologically associated with Epstein-Barr virus (EBV) infection. However, the exact role of EBV in NPC pathogenesis remains elusive. Activation of signal transducer and activator of transcription 3 (STAT3) is common in human cancers including NPC and plays an important role in the pathogenesis and progression of human cancers. Interleukin-6 (IL-6), a major inflammatory cytokine, is a potent activator of STAT3. In this study, we report that EBV-infected immortalized nasopharyngeal epithelial (NPE) cells often acquire an enhanced response to IL-6-induced STAT3 activation to promote their growth and invasive properties. Interestingly, this enhanced IL-6/STAT3 response was mediated by overexpression of IL-6 receptor (IL-6R). Furthermore, IL-6R overexpression enhanced IL-6-induced STAT3 activation in uninfected immortalized NPE cells in vitro, and promoted growth and tumorigenicity of EBV-positive NPC cell line (C666-1) in vivo. Moreover, it is shown for the first time that IL-6R was overexpressed in clinical specimens of NPC. IL-6 expression could also be strongly detected in the stromal cells of NPC and a higher circulating level of IL-6 was found in the sera of advance-staged NPC patients compared to the control subjects. Therefore, IL-6R overexpression, coupled with enhanced IL-6/STAT3 signaling may facilitate the malignant transformation of EBV-infected premalignant NPE cells into cancer cells, and enhance malignant properties of NPC cells. © 2013 Zhang et al.published_or_final_versio
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