A Preliminary Study on Self-Healing and Self-Health Management in Older Adults: Perspectives From Healthcare Professionals and Older Adults in Taiwan.

The human body has tremendous self-healing capacity and regeneration after injuries and pathogen invasions. These factors are particularly important in older adults which take longer to heal and recover physically. In addition to clinical investigations, perspectives from both experts in the field and the living experiences of the general public could play significant roles to enhance the body's healing mechanisms in older adults. A semi-structured interview was conducted which included 15 participants (9 experts and 6 older adults aged 65 years and older). Content analysis with an inductive approach was employed about participants' experiences and perspectives. All participants in this study revealed that self-healing mechanisms can be enhanced through physiological, psychological, and socio-environmental factors. When more of these factors can be integrated into a recovery management plan, it can hasten self-healing in older adults. Social capability has a profound impact on an individual's mental health while oral health and hygiene significantly affect the nutritional intake status. In regards to physical aspects, regular daily activity patterns, nutritious eating, moderate exercise, and sleep quality are significant, while psychological aspects such as cheerfulness, positive attitudes, and good interpersonal relationships can help control chronic diseases.

Malnutrition, Family Support, and Possible Sarcopenia in Patients Undergoing Transcatheter Aortic Valve Implantation.

BACKGROUND: Possible sarcopenia, aortic valve stenosis, and malnutrition are important issues that afflict older adults. OBJECTIVE: The aims of this study were to compare the differences in nutritional status and family support in older adults with possible sarcopenia and those without sarcopenia after undergoing transcatheter aortic valve implantation (TAVI) and to identify the predictors of malnutrition and demonstrate changes in heart function over time after undergoing TAVI. METHODS: A case-control design was conducted. Possible sarcopenia was identified by measuring calf circumference, grip strength, and gait speed. The Mini Nutritional Assessment-Short Form and numerical family support rating scale were used to collect data. Left ventricular ejection fraction and New York Heart Association (NYHA) functional class were assessed at 5 time points to evaluate heart function. RESULTS: Eighty-one participants were categorized into those without sarcopenia (34) and those with possible sarcopenia (47). Logistic linear regression showed albumin and possible sarcopenia to be predictors of malnutrition (odds ratio, 5.5; 95% confidence interval, 1.02-30.19). Family support was associated with nutrition status (P = .019). For patient heart function, the results of NYHA functional class and left ventricular ejection fraction improved over time after TAVI. The improvement in NYHA functional class at T2 was significantly different between the 2 groups compared with that at T0. CONCLUSIONS: The nutrition level was higher among participants without sarcopenia than those with possible sarcopenia. Approximately 90% of the participants indicated that they had high family support. Demographic factors and albumin levels could be used to evaluate risk of malnutrition. Patients without possible sarcopenia showed greater improvement in NYHA class.

Resilience among older cardiovascular disease patients with probable sarcopenia.

AIM AND OBJECTIVES: The purpose of this study was to investigate the factors associated with resilience among probable sarcopenia older adults with cardiovascular disease. INTRODUCTION: Resilience has been reported to be positively correlated with the mental health and physical functioning of older adults. Previous research has found that the development of resilience constitutes a form of compensation for loss of physical health. It is important for older adults, especially those with other underlying conditions, such as cardiovascular disease and sarcopenia, to have the ability to overcome adversity during the aging process. Thus, resilience becomes a critical characteristic in achieving a better life. METHODS: A cross-sectional study design was used. A demographic questionnaire and the Chinese version of the Resilience Scale (CRS) were used to collect data. Multiple logistic regression was used to evaluate the predictors of low resilience. RESULTS: A total of 267 participants were recruited, including 126 females and 141 males. Of the participants, 56% of their scores indicated low resilience. Income, education level, exercise time, primary caregiver, and having hypertension were the predictors of resilience. CONCLUSION: The population with sarcopenia is increasing worldwide. Understanding resilience levels among older adults with probable sarcopenia is essential for promoting their mental health. Clinicians can use the results of this study to identify populations at high risk for low resilience and design specific interventions to promote better health outcomes.

Predicting dropout in the first 3 months of 12-step residential drug and alcohol treatment in an Australian sample.

OBJECTIVE: Premature termination from treatment is a major factor associated with poorer drug and alcohol treatment outcomes. The present study investigated client-related baseline predictors of dropout at 3 months from a faith-based 12-step residential drug treatment program. METHOD: Data were collected over a period of 14 months from eight residential drug and alcohol treatment programs run by The Australian Salvation Army. The final sample consisted of 618 participants, including 524 men (84.8%) and 94 women (15.2%). Predictor variables of interest were age, gender, primary drug of concern, criminal involvement, psychological distress, drug cravings, self-efficacy to abstain, spirituality, forgiveness of self and others, and life purpose. At 3 months, 264 participants (42.7%) remained in the treatment program, and 354 participants (57.3%) had dropped out. RESULTS: Binary logistic regression revealed that individuals were more likely to drop out by the 3-month time frame if at intake their primary drug of concern was a drug other than alcohol or they reported greater forgiveness of self. CONCLUSIONS: To the authors' knowledge, this is the first study to examine forgiveness as a predictor of dropout from a drug treatment program. Assessing patient's primary drug of concern and levels of forgiveness may be useful for residential drug treatment providers in constructing programs that provide differential treatment based on the results of these assessments.

Effects of chloroacetaldehyde in 2-chloroethanol-induced cardiotoxicity.

Cardiovascular effects have often been found in 2-chloroethanol (2-CE) intoxicated patients, but the 2-CE elicits cardiovascular toxicity mechanism is not clear. Recently, we have found that chloroacetaldehyde (CAA) accumulation in 2-CE-intoxicated rat's blood and play an important role in 2-CE intoxication. In this study, we used an isolated rat atrium model to examine the cardiotoxicity of 2-CE and CAA. Results indicated that 2-CE did not cause tension arrest in isolated rat right atria, but CAA did. 2-CE caused tension inhibition in the isolated rat left atria. In addition, CAA caused significant tension inhibition and contracture in the isolated rat left atria. Nifedipine, an L-type calcium channel blocker, decreased CAA-induced tension inhibition and contracture. Meanwhile, atrial nNOS and calmodulin (CaM) had significantly greater expression in the 2-CE group and the CAA group than control group. Nifedipine could decrease CAA-induced nNOS and CaM expression. 2-CE-induced cardiovascular toxicity might be due to its metabolite CAA. CAA-induced cardiovascular toxicity might be mediated by calcium channel and nifedipine protected against nNOS-triggered cardiovascular effects.

Coherence in children with Attention-Deficit/Hyperactivity Disorder and excess beta activity in their EEG.

OBJECTIVE: This study investigated differences in coherence measures between two groups of children with Attention-Deficit/Hyperactivity Disorder (ADHD) - with the typical EEG profile (increased theta and decreased beta activity), and with excess beta activity - and a normal control group. METHODS: Thirty-four children with ADHD were included in each of the typical and excess beta groups, and were age and sex matched with 34 control subjects. EEG was recorded from 21 sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric and eight interhemispheric electrode pairs, for the delta, theta, alpha and beta bands. RESULTS: In comparison to the controls, the typical ADHD group primarily had increased intrahemispheric theta and beta coherence at short-medium inter-electrode distances, and increased interhemispheric coherence for theta in the frontal and central/parietal/occipital regions. Their laterality effect for interhemispheric short-medium inter-electrode distances was reduced in the theta band. Differences between the excess beta group and the control group were primarily found in laterality of the intrahemispheric theta coherence at short-medium electrode distances, and increased interhemispheric theta coherence in the frontal regions. Reduced delta coherence in the temporal regions was also found. CONCLUSIONS: These results suggest that ADHD children with excess beta power have an underlying brain dysfunction in the frontal lobes which is found in common with children with the typical EEG profile. However a number of qualitative differences exist which could be associated with other aspects of the ADHD diagnosis or another comorbid condition. SIGNIFICANCE: This is the first study to investigate EEG coherence in ADHD children who have increased beta power.

Effects of methylphenidate on EEG coherence in attention-deficit/hyperactivity disorder.

This study investigated the effects of methylphenidate on intrahemispheric and interhemispheric EEG coherence in children with Attention-Deficit/Hyperactivity Disorder (AD/HD). Twenty boys with AD/HD Combined type and 20 age- and sex-matched control subjects, aged 8 to 13 years, participated in this study. EEG was recorded from 21 sites during an eyes-closed resting condition. Wave-shape coherence was calculated for eight intrahemispheric electrode pairs (four in each hemisphere), and eight interhemispheric electrode pairs, within each of the delta, theta, alpha and beta bands. AD/HD children were tested both off and, 6 months later, on a therapeutic dose of methylphenidate. In intrahemispheric comparisons, AD/HD children had lower theta coherences at long inter-electrode distances, and reduced lateralisation at both long and short-medium inter-electrode distances than controls. For interhemispheric comparisons, AD/HD children showed increased coherences in the frontal regions for the low frequency bands (delta and theta), and reduced coherences in the alpha bands in all other regions. These EEG coherences suggest reduced cortical differentiation and specialisation in AD/HD, particularly in the frontal regions. Methylphenidate did not produce any changes in coherence values. The lack of sensitivity of coherence measures to methylphenidate in the present study suggests that eyes-closed resting EEG coherence measures are associated with structural connectivity of the underlying regions of the brain rather than the degree of functionality of these regions. These results suggest the existence of structural as well as functional brain dysfunction in AD/HD.

Age and gender effects in EEG coherence: II. Boys with attention deficit/hyperactivity disorder.

OBJECTIVE: This study investigated intra-hemispheric and inter-hemispheric EEG coherences as a function of age in boys with different subtypes of Attention Deficit/Hyperactivity Disorder (AD/HD), in comparison with a control group of normal boys. METHODS: Three groups of 40 children (AD/HD combined type, AD/HD inattentive type, and normal controls) participated. Each group contained 8 males in each 1 year band from 8 to 12 years. EEG was recorded from 21 sites during an eyes-closed resting condition. Wave-shape coherence was calculated for 8 intra-hemispheric electrode pairs (4 in each hemisphere), and 8 inter-hemispheric electrode pairs, within each of the delta, theta, alpha and beta bands. RESULTS: Developmental effects in intra-hemispheric coherences at shorter and longer inter-electrode distances generally supported Thatcher's two-compartment model. Control boys showed evidence of development in longer-range inter-hemispheric coherences which was not apparent in AD/HD boys. Boys with AD/HD of the combined type showed qualitatively different anomalies than boys with AD/HD of the inattentive type. CONCLUSIONS: EEG coherences in normal boys of this age range develop systematically with age in a non-linear fashion. Boys with AD/HD do not show this development. They display coherence anomalies which differ in nature between DSM-IV subtypes, suggesting differences which are not relatable to simple symptom severity. SIGNIFICANCE: The data reported here indicate differences in the development of EEG coherences in boys with AD/HD, and point to differences between the AD/HD subtypes which may help understanding of the disorder.