Effects of a HAPA-based multicomponent intervention to improve self-management precursors of older adults with tuberculosis: A community-based randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of a multicomponent intervention based on the Health Action Process Approach (HAPA) model to improve the self-management precursors of older adults with tuberculosis (TB). METHODS: A cluster-randomised controlled trial was conducted. Older adults with TB in the intervention communities received HAPA-based multicomponent interventions at the beginning of treatment and in the first and sixth months after treatment initiation, and those in the control communities received health education alone. Self-management precursors were measured at baseline and 1 week after each intervention. RESULTS: Among 262 randomized patients, 244 (93%) completed the trial. Compared with the control group, self-management precursor scores for the intervention group increased significantly over time (ßgroup*time = 2.92, p < 0.001) in the following 3 precursors: behaviour belief (ßgroup*time = 0.35, p < 0.001), behaviour plan (ßgroup*time = 0.72, p < 0.001), and self-efficacy (ßgroup*time = 1.85, p < 0.001). Education was significantly associated with behaviour belief (ß = 0.18, p < 0.05). Chronic comorbidity was significantly associated with behaviour plan (ß=-0.26, p < 0.05). CONCLUSION: Compared with single health education, the HAPA-based multicomponent interventions significantly improved the self-management precursor of older adults with TB. PRACTICE IMPLICATIONS: This HAPA-based multicomponent intervention strategy may be a promising self-management mode for the routine health care of TB patients.

Effectiveness of comprehensive social support interventions among elderly patients with tuberculosis in communities in China: a community-based trial.

BACKGROUND: With the increasing of ageing population, tuberculosis in the elderly brings a challenge for the tuberculosis (TB) control in China. Enough social support can promote the treatment adherence and outcome of the elderly patients with TB. Exploring effective interventions to improve the social support of patients is of great significance for TB management and control. METHODS: A community-based, repeated measurement trial was conducted. Patients with TB >65 years of age were allocated into the intervention or control group. Patients in the intervention group received comprehensive social support interventions, while those in the control group received health education alone. The social support level of patients was measured at baseline and at the first, third and sixth months during the intervention to assess the effectiveness of comprehensive social support interventions. RESULTS: A total of 201 patients were recruited into the study. Compared with the control group, social support for patients in the intervention group increased significantly over time (ßgroup*time=0.61, P<0.01) in the following three dimensions: objective support (ßgroup*time=0.15, P<0.05), subjective support (ßgroup*time=0.32, P<0.05) and support utilisation (ßgroup*time=0.16, P<0.05). The change in the scores in the control group was not statistically significant. CONCLUSIONS: The intervention programme in communities, including health education, psychotherapy and family and community support interventions, can improve the social support for elderly patients with TB compared with single health education. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-16009232.

Association between the TPH1 A218C polymorphism and risk of mood disorders and alcohol dependence: evidence from the current studies.

BACKGROUND: Several studies have assessed the association between genetic polymorphisms of tryptophan hydroxylase (TPH1) and risk of mood disorders and alcohol dependence, with controversial results. Our aim was to assess the association of TPH1 A218C polymorphism (rs1800532) with mood disorders, including major depressive disorder and bipolar disorder, and alcohol dependence by using meta-analysis. METHODS: Data were collected from the related literatures published until November 25, 2010 from MEDLINE, EMBASE and ISI Web of Science databases, and meta-analysis stratified by ethnicity was performed in either fixed or random effect model as appropriate by using Stata Statistical Package (version 10.0). RESULTS: Twenty-seven individual studies were included in the current study, among which, there were 9 studies for bipolar disorder, with 1951 cases and 2161 controls, 14 studies for major depressive disorder, with 2340 cases and 3204 controls, and 4 studies for alcohol dependence, with 601 cases and 711 controls. We found that in Caucasian population, the TPH1 218AA genotype was significantly associated with increased bipolar disorder risk (recessive comparison: OR, 1.42; Bonferroni-adjusted P=0.006; homozygote comparison: OR, 1.63; Bonferroni-adjusted P=0.072), and elevated alcohol dependence risk (recessive comparison: OR, 1.83; Bonferroni-adjusted P=0.012), while the association was not significant in Asian population. Moreover, the A218C polymorphism did not appear to have any effect on major depressive disorder risk either in Caucasians or in Asians. CONCLUSION: The TPH1 A218C polymorphism is a potential biomarker for bipolar disorder and alcohol dependence risk in Caucasian population.

Electroacupuncture modulates cortical activities evoked by noxious somatosensory stimulations in human.

A noninvasive high-resolution imaging technique of cerebral electric activities has been developed to directly link scalp potential measurement with the magnetic resonance images of the subjects, which is very helpful for the elucidation of the cortical processing following various stimulations. Here, we used a 64-channel Neuroscan ESI-128 system to explore the specific cortical activities elicited by electroacupuncture (EA) acupoint in normal volunteers and the modulatory effect of EA on cortical activities evoked by noxious somatosensory stimulation. A specific later-latency somatosensory-evoked potential (SEP, P150) located in bilateral anterior cingulated cortex was observed after EA acupoint but not non-acupoint. Two pain-specific SEP components (P170 and N280), located in bilateral suprasylvian operculum and anterior cingulated cortex respectively were observed following painful median nerve stimulation. Binding EA acupoint with painful median nerve stimulation, the amplitudes of P170 and N280 appeared to be attenuated significantly, 2D topography exhibited tremendous decrease of cortical activation between 120 ms and 296 ms in latency, and visual analogue scale (VAS) changes also showed a similar pattern to the change of amplitude. The bilateral anterior cingulated cortex recruited following acupoint stimuli might, to some extent, suggest that EA has the specific physiological effects. Decrease of pain-induced cortical activation by EA acupoint was considered to be mainly due to an interaction of the signals in anterior cingulated cortex ascending from the pain stimulation and EA.

[Effect of electroacupuncture at "Neiguan" (PC 6) on expression of c-fos gene in myocardium of the rat with acute myocardial ischemia].

OBJECTIVE: To explore the mechanism of electroacupuncture at "Neiguan" (PC 6) improving acute myocardial ischemia. METHODS: The rats were randomly divided into a sham operation group, a myocardial ischemia model group and a myocardial ischemia model plus electroacupuncture group. The acute myocardial ischemia model was developed byligation of the descending anterior branch of the coronary artery, and electroacupuncture was given at bilateral "Neiguan" (PC 6). Serum myocardial enzymes was determined by biochemical method and the expression of c-fos mRNA in myocardium was detected by using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The activities of serum myocardial enzymes and the expression of c-fos mRNA in ischemic myocardium were significantly increased as compared with those in the sham operation group (P < 0.05), and after electroacupuncture they were significantly decreased (P < 0.05). CONCLUSION: The mechanism of electroacupuncture at "Neiguan" (PC 6) improving acute myochadial ischemia is possibly related with down-regulation of expression of c-fos mRNA in myocardium.