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OBJECTIVES: More than 15 million individuals receive home health care (HHC) for chronic conditions, which allows them to maintain a level of independence and self-sufficiency. Although poor mental health can negatively impact health outcomes, little research has been done on the mental health of these individuals. METHODS: Utilizing National Health Interview Survey years 2019-2022, we ran a cross-sectional analysis to determine rates of depression among individuals who indicated that they utilized HHC services, based on their sociodemographic statuses and diagnosis, as well as their rate of depression by condition whether they utilized HHC services. RESULTS: HHC recipients were significantly more likely to be depressed if they reported being female, age 55-64, low income, low educational attainment, American Indian/Alaskan Native, Hispanic, or lived in a rural area. HHC recipients were more likely to be depressed than their non-HHC recipient counterparts. CONCLUSIONS: These results underscore the need for integrated mental health care in home health. Further, the financial burden of HHC, which may have an additional impact on stress, emphasizes the need for expanded accessibility of these services. CLINICAL IMPLICATIONS: General practitioners and home health professionals should inquire about mental health concerns of these care recipients, and treat or refer accordingly.
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BACKGROUND: Caregiver distress is the strain experienced by individuals providing care for people with chronic conditions which limit their self-sufficiency for tasks of daily living. Over 1 in 5 Americans are caregivers-a number expected to increase with an aging population. METHODS: We performed a cross-sectional analysis using the 2021 Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Centers for Disease Control and Prevention (CDC) to determine rates of depressive disorders among caregivers and associations between demographic and relational aspects of the care recipient. RESULTS: The included sample size for analysis was 32,676, representing 17,274,935 US caregivers. We found that caregivers who were female, American Indian/Alaskan Native, race-not-listed, earning less than $15,000 a year, or did not complete high school, had higher rates of depression diagnosis. The rates of depression were higher among caregivers if the recipient had a mental or chronic respiratory condition, or if the recipient was their live-in partner. Rates of depression were lower for caregivers of their mother-in-law or spouse. LIMITATIONS: Results were based on self-reported survey data, which are susceptible to social desirability bias. Diagnoses of depression may also be over or under reported across several demographic variables, which may confound results. CONCLUSION: Our findings add to previous research showing that specific groups of caregivers are at higher risk for caregiver stress. Future qualitative research may elucidate underlying causes of depression among caregivers. Analysis into the risk factors for depression among caregivers is vital in providing effective therapeutic options for the caregiver.
Assuntos
Cuidadores , Depressão , Humanos , Feminino , Idoso , Masculino , Depressão/epidemiologia , Depressão/diagnóstico , Prevalência , Estudos Transversais , FamíliaRESUMO
There are many reports of an arginine-dependent nitric oxide synthase activity in plants; however, the gene(s) or protein(s) responsible for this activity have yet to be convincingly identified. To measure nitric oxide synthase activity, many studies have relied on a citrulline-based assay that measures the formation of L-citrulline from L-arginine using ion exchange chromatography. In this article, we report that when such assays are used with protein extracts from Arabidopsis, an arginine-dependent activity was observed, but it produced a product other than citrulline. TLC analysis identified the product as argininosuccinate. The reaction was stimulated by fumarate (> 500 microM), implicating the urea cycle enzyme argininosuccinate lyase (EC 4.3.2.1), which reversibly converts arginine and fumarate to argininosuccinate. These results indicate that caution is needed when using standard citrulline-based assays to measure nitric oxide synthase activity in plant extracts, and highlight the importance of verifying the identity of the product as citrulline.
Assuntos
Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Argininossuccinato Liase/metabolismo , Citrulina/metabolismo , Óxido Nítrico Sintase/metabolismo , Arabidopsis/enzimologia , Arginina/metabolismo , Ácido Argininossuccínico/metabolismo , Bioensaio/métodos , Catálise/efeitos dos fármacos , Cromatografia por Troca Iônica , Cromatografia em Camada Fina , Fumaratos/metabolismo , Fumaratos/farmacologia , Cinética , Extratos Vegetais/metabolismoRESUMO
We examined UV-B radiation flux and its environmental control within and among streams of northern Michigan. UV-B flux was estimated in streams by plastic dosimetry strips, which allow for the simultaneous and repeated in situ measurement of solar radiation. During the summer of 2004, UV-B flux was measured across depth gradients and along longitudinal transects in seven streams, which were chosen to encompass a range of dissolved organic carbon (DOC) concentrations and canopy cover. Attenuation coefficients of UV-B (K(d) (UV-B)) were estimated using plastic dosimeters placed along a depth gradient. K(d UV-B) were positively correlated with DOC concentration and similar to values obtained with laboratory and in situ spectrometry. Along 100 m longitudinal transects, UV-B flux varied along all streams regardless of their canopy cover and DOC concentration. Within-stream fluxes of UV-B were correlated to canopy cover in the only two streams that both had relatively low DOC concentration and variable canopy cover. Large differences were found among streams in the average UV-B flux (corrected for incident solar flux) reaching the dosimeters at 5 cm depth. These among-stream differences were largely accounted for by the stream width, canopy cover, and DOC concentration. Our results illustrate an inherent variability in UV-B flux within and among streams of northern Michigan that is strongly tied to the interactions of DOC concentration, stream size and riparian vegetation.