Effectiveness of home-based palliative care programmes for older people and their family caregivers in Thailand.

BACKGROUND: People in Thailand receiving palliative care at home can have complex needs and this means that the family caregiver can have a high burden of care. AIM: To assess the impact of a nursing care activities for a home-based palliative care programme (NHBPC) on the care burden among family caregivers and the care quality in older people at the palliative care stage. METHODS: This quasi-experimental repeated measure study was used to investigate the effects of the nursing care activities for a NHBPC programme. RESULTS: The mean caregiving burden and care quality scores in the experimental and control groups at post-test and 2-weeks follow-up showed significant differences (p<.05). In addition, improvement was not seen in the control group. CONCLUSION: The NHBPC programme significantly improved caregiving burden and quality of care in Thai older people and their family caregiver. This confirms that the NHBPC programme plays a crucial role in helping them to improve quality of life.

Effects of Laughing Training on Stress Levels in Thai Private Office Workers.

BACKGROUND: Laughing is a kind of well known alternative medicine used to treat stressful persons or depressive patients to relax. The laughing program used in this study was initially designed by Thai psychiatrists. It consists of deep diaphragmatic breathing exercises, voice expression, facial expression exercises and aerobic exercises, which are expected to promote good health. OBJECTIVE: To evaluate the effects of the laughing training on stress levels in Thai private office workers. MATERIAL AND METHOD: Thirty-eight subjects whose age 25-60 years were recruited to enroll in this program. They were randomly divided into two groups: 20 people for the experimental group and 18 persons for the control group. The experimental subjects participated in laughing program for 3 days/week, 60 minutes/day for 8 consecutive weeks. The program took place from June to July 2013. The level of stress was assessed using the Suanprung stress test-60 (SPST-60). The data were analyzed by descriptive statistics, t-test dependent and t-test independent with p < 0.05 considered significant. RESULTS: After they joined the laughing program, no significant difference was found in the mean scores of the level of stress between the control and experimental groups. However, the sensitivities to the arousal events in the experimental group had a tendency to decrease. CONCLUSION: Laughing training may be used as a tool to promote better health. There was no significant difference in the stress levels after the program was ended except a decrement tendency in the sensitivities to the arousal events. For further study, duration and intensity of the course may be adjusted for a more effective training program.

The stimulatory effect of mu- and delta-opioid receptors on bovine pinealocyte melatonin synthesis.

Mammalian pinealocytes synthesize and secrete melatonin. The synthesis of melatonin is regulated by several biogenic amine, amino acid and peptide transmitters. In our previous study, the delta- and mu-opioid receptors have been identified and characterized in bovine pinealocytes. In order to elaborate the function of different types of opioid receptors in regulating melatonin synthesis, we used a selective mu-opioid receptor agonist, Tyr-[D-Ala(2), N-methyl-phe(4), glycol(5)] (DAMGO), a selective delta-opioid receptor agonist, Enkephalin [D-Pen(2), D-Pen(5)], (DPDPE) and a selective kappa-opioid receptor agonist, ((+)-(5alpha, 7alpha, 8beta)-N-methyl-N-[7- (1-pyrrolidinyl)-1-oxaspiro [4,5] dec-8-yl]-benzene acetamide) (U69593) to investigate the activity of N-acetyltransferase (NAT) activity and melatonin secretion. The results of the present study show that both DAMGO and DPDPE stimulated NAT activity and increased the level of melatonin in cultured bovine pinealocytes. These stimulatory effects were blocked by naloxone, an opioid receptor antagonist. However, the kappa-opioid receptor agonist U69593 was unable to alter either the activity of NAT or the level of melatonin. In order to clarify the mechanism of how the activation of mu- and delta-opioid receptors in bovine pinealocytes leads to an increase in NAT activity, cyclic AMP levels were measured after bovine pinealocytes were treated with morphine, DAMGO and DPDPE. The results indicated that these stimulatory effects acted via induction of cAMP production. This study reveals that the stimulatory effect of opioid receptor on melatonin synthesis is mediated via the activation of adenylate cyclase system.