Daily Illness Characteristics and Health Care Decisions of Older People

Although investigations of health care decision making typically deal with patterns of health service use, increasing attention has focused on lay- and self-care actions in response to illness symptoms. This study examined the health care actions of a community sample of 142 older adults, who recorded illness symptoms and corresponding health care actions in daily health diaries for a 14-day period. Self-treatment and no-action decisions were found to be the most frequent response to illness symptoms. Professional-care decisions were associated with greater health care need, such as multiple symptoms and increased pain. Lay-care decisions were significantly related to symptoms of shorter duration. Women were also more likely than men to self-treat their illness symptoms. Results suggest that older people deal with a greater number of recurrent chronic symptoms than previously thought and that they make most treatment decisions without consulting their doctors or other health care providers. This investigation underscores the importance of a prospective diary methodology for studying the daily complex ities of chronic illness experiences and for validating and conducting useful interventions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67082/2/10.1177_073346489101000204.pd

Gata6 Promotes GLI3 Repressor Activities in the Limb

Gli3 is a major regulator of Hedgehog signaling during limb development. In the anterior mesenchyme, GLI3 is proteolytically processed into GLI3R, a truncated repressor form that inhibits Hedgehog signaling. Although numerous studies have identified mechanisms that regulate Gli3 function in vitro, it is not completely understood how Gli3 function is regulated in vivo. In this study, we show a novel mechanism of regulation of GLI3R activities in limb buds by Gata6, a member of the GATA transcription factor family. We show that conditional inactivation of Gata6 prior to limb outgrowth by the Tcre deleter causes preaxial polydactyly, the formation of an anterior extra digit, in hindlimbs. A recent study suggested that Gata6 represses Shh transcription in hindlimb buds. However, we found that ectopic Hedgehog signaling precedes ectopic Shh expression. In conjunction, we observed Gata6 and Gli3 genetically interact, and compound heterozygous mutants develop preaxial polydactyly without ectopic Shh expression, indicating an additional prior mechanism to prevent polydactyly. These results support the idea that Gata6 possesses dual roles during limb development: enhancement of Gli3 repressor function to repress Hedgehog signaling in the anterior limb bud, and negative regulation of Shh expression. Our in vitro and in vivo studies identified that GATA6 physically interacts with GLI3R to facilitate nuclear localization of GLI3R and repressor activities of GLI3R. Both the genetic and biochemical data elucidates a novel mechanism by Gata6 to regulate GLI3R activities in the anterior limb progenitor cells to prevent polydactyly and attain proper development of the mammalian autopod

世田谷区船橋地域「子どもぶんか村」の活動を通してみる世代間交流 : 子どもの側からみる大人との交流

Children lack sufficient life experience to socialize fruitfully with older people. Although fostering social interaction between generations is not a primary goal of the "Kodomo-Bunkamura" in Funabashi, Setagaya Ward, the event has a positive effect on socializing between the different generations involved. Recognition of this fact motivates our research. Survey Method: By observing the activities from 2005 to 2007 and conducting and analyzing a questionnaire survey, we discovered the following points. 1. Diverse social interactions between people of different generations and of different social status were initiated and promoted through ongoing activities at the "Kodomo-Bunkamura." 2. Throughout the activities, children experienced 17 different sessions of social interaction. Activities such as "Experiencing the Same Activity," "Children and Adults Standing Face to Face," "Working toward the Same Objective and Achieving it," "Skinship," and "Cooperating" provide the sort of social interaction that motivates children to remain involved in the activities. 3. Children have a positive impression of the social interaction between the different generations that is experienced through the activities

Symptoms and Self-Care in Old Age

Self-care has recently come to be recognized as the predominant form of response to illness among the general population, but little is known regarding beliefs and practices of the aged. In this study, beliefs regarding the appropriate response to 53 common symptoms were investigated and contrasted to actual responses. Various forms of self-care were seen as appropriate responses to symptoms ranging from minor to potentially serious. Preference for self-care responses appears to be related to perceived severity of symptoms and the perceived effectiveness of available self-care responses.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66474/2/10.1177_073346488600500207.pd

Studies on Sphingomyelins in Human Erythrocytes and Plasma.

Two sphingophospholipids, that is, the fast moving and the slow moving on TLC, were separated from each other by Silica Gel G TLC of the alkali- and acid-stable phospholipids isolated from human erythrocytes and plasma. The examination and the comparison of the chemical structures of thus separated lipids were studied by IR analysis and by paper chromatography, TLC and GLC of the products from acid hydrolysis, performic acid-HIO4 cleavage and KMnO4 oxidation. From the results both substances were found to be sphingomyelins of ordinary type. A distinguished difference between two lipids was in the composition of fatty acid component. The GLC of fatty acids indicated that, in erythrocytes as well as in plasma, fatty acids higher than C20 predominated and concentrated in the fast moving sphingomyelin, whereas major fatty acids in the slow moving one were palmitic acid and stearic acid. The ratios of phosphorus amounts of the fast moving sphingomyelin to the slow moving one were 2.6 in plasma and 3.2 in erythrocytes respectively

Self care: Japan and the U.S. compared

Experience of common symptoms and subsequent self care behaviors among older adults are compared between Japan and the United States, two industrial countries with different cultural backgrounds and health insurance systems. Based on a modification of the Health Belief Model, perceived susceptibility to illness and belief in the efficacy of physician care were selected as major explanatory concepts for the decision to use self care for a complaint. Among 900 respondents in Japan and 728 in the United States, in three communities of varying size, self evaluations of good health, an indicator of low susceptibility, were very similar. Although Japanese respondents claimed fewer experiences of physician error, they still expressed lower preference for physician care than did those in the U.S. In addition, the Japanese reported far fewer symptoms than their U.S. counterparts during a three month period, and were more likely to use self care, even for symptoms they considered more serious. Disparate effects of such variables as good health behaviors, presence of a chronic condition and desire for autonomy are discussed in terms of cultural differences in the two countries.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29655/1/0000744.pd

Investigation of QOL of hospice patients by using EORTC-QLQ-C30 questionnaire

This study was designed to investigate the quality of life (QOL) of cancer patients being cared for in a hospice, in the expectation that the results would serve as useful basic materials for improving the care of such patients. The subjects were 24 patients who had been diagnosed as having cancer and were hospitalized in the hospice wing of a hospital. The study was carried out as a crossing investigation using the Japanese version of the EORTC-QLQ-C30 Ver.3 questionnaire prepared by the European Organization for Research and Treatment of Cancer. The results of the survey showed that it was important to be prepared to prevent or treat diarrhea at the time of bowel movement and confirmed the need for care aimed at reducing fatigue. In addition, the emotional functioning and financial problems of the patients showed strong correlations with the QOL, revealing the need for psychological and financial support of cancer patients in hospices