Psychological Distress in Caregivers of Liver and Lung Transplant Candidates

Although organ transplantation represents a stressful experience for the entire family, surprisingly little research has focused on the adjustment of caregivers. The purpose of this study was to examine what caregivers report to be the greatest benefits and stressors pretransplant, the prevalence of psychological distress and caregiver strain in pretransplant caregivers as compared to normative populations, and the physical, psychological, and demographic variables that predict distress. Fifty-two caregivers of transplant candidates (28 liver and 24 lung) completed a series of questionnaires, including the Psychosocial Adjustment to Illness Scale (PAIS-SR), SF-36 Health Survey, Caregiver Strain Index (CSI), and qualitative questions about benefits and stressors. The most commonly reported benefit of being a caregiver could be categorized as Helping the Patient, and the most common stressors were associated with Uncertainty/Waiting/Fears. Compared to normative samples of caregivers of patients with Alzheimer's disease, caregivers of liver transplant candidates reported more caregiver strain; there were no differences for lung transplant caregivers. Caregiver social functioning was found to be the only significant predictor of caregiver distress, with those caregivers who report greater distress also reporting extreme and frequent interference with normal social activities. Implications of these findings for psychological interventions are discussed.     

Stress and Immunity: Age Enhances the Risks

A competent immune response is central to good health. There is good evidence that both aging and psychological stress can dysregulate immune function, resulting in changes in various aspects of the immune response that are large enough to have consequences for health. Older adults appear to show even greater immunological impairments associated with stress or depression than younger adults. Thus, the data suggest that aging interacts with stress and depression to enhance risks for morbidity and mortality among older adults.     

中国消费者价格容忍度的特点

运用多维线性模型,对我国消费者对不同产品价格涨落的容忍态度进行了研究。研究对象为26384名购买过各类产品的消费者。结果表明：（1）消费者对不同产品的价格容忍度不同,对日用消费品的价格容忍度较高,对耐用消费品的价格容忍度相对较低;（2）消费者的年龄和受教育程度对价格容忍度有负向的影响,消费者的年龄和受教育程度越高,对产品的价格容忍度越低;（3）男性消费者的价格容忍度高于女性消费者,女性消费者对价格较为敏感。     

Fighting experiences and natural killer cell activity in male laboratory mice

There is currently much interest in the potential impact of psychological factors on immune responses. An attempt was made to assess the effects of dominant/subordinate polarity in male mice on the cytotoxic activities of their natural-killer (NK) cells. On the basis of repeated agonistic encounters, categories of subordinate and dominat animals were selected. These animals were compared with manipulated controls (introduced to a novel test cage without an opponent on each occasion) and undisturbed controls (who remained in isolation without manipulation). In terms of NK activity, immunosuppression was observed in both dominant and subordinate categories when compared to undisturbed controls. There were, however, no differences between the fighting exposed subjects and the manipulated controls, suggesting that stress accounts for any changes. © 1994 Wiley-Liss, Inc.     

Perceptions of Liver Transplant Candidates with or Without an Alcohol Use History

Cirrhosis secondary to alcohol use is a primary cause of liver disease and a medical condition for which liver transplantation is a viable treatment option. However, there remains considerable debate within both the lay and the medical communities regarding the distribution of a scarce medical resource to adults with alcoholism. This study examined college students' perceptions toward an adult, presented in a written vignette, for whom liver transplantation was medically indicated. The influence of gender (female and male) and alcohol use history (no alcohol history, alcoholism history with long-term abstinence, alcoholism history with current use) on these ratings was examined. Subjects rated the adult presented with no alcohol history more positively than they did the adults presented with a history of alcoholism. Also, the adult with no alcohol history was more likely to be offered transplantation and was given higher priority ratings for transplantation by subjects. While subjects' own alcohol use history and organ donor registration status were not associated with ratings, having a family member with an alcohol problem and personally knowing a transplant recipient were related to more favorable ratings toward the adult presented in the vignette. Implications of these findings as well as limitations of the study are discussed.     

糖尿病的免疫抑制治疗

淡化糖尿病的分型为我们提供了一个全新的思维空间。即传统的1型和至少部分2型糖尿病可能都是一种自身免疫性疾病,而目前流行的炎症学说可能是对认可免疫损伤是糖尿病发病理论的一个过渡,我们应该重新审视糖尿病的早期治疗和研究其慢性并发症的发病机理。我们则采用小别量、长时间的治疗理念,早期接受这种免疫治疗的患者出现低血糖的症状,遂减少胰岛素的剂量;再次出现低血糖,我们就继续减少胰岛素的剂量。结果,有部分患者完全摆脱了胰岛素。我们对糖尿病的再认识是建立在对多脏器活检的基础之上。我们的活检结果表明,糖尿病肾病存在着免疫损伤。糖尿病眼底病变是使患者致盲的主要病因,糖尿病患者的眼底病变是一种自身免疫损伤的结果。我们尝试用小剂量的免疫抑制剂环孢菌素A（25mgbid）治疗糖尿病眼底出血,取得了不错的疗效,也证实糖尿病眼底病变是一种血管炎,与自身免疫病变有关。其他的器官还包括垂体、大脑的血管、糖尿病足、冠心病、皮肤的病变和肌肉活检的免疫组化也均有证据表明,免疫损伤是导致多种慢性并发症的罪魁祸首,是一种多器官免疫损伤的结果无论是1型糖尿病,还是2型糖尿病,肌细胞表面或多或少均有免疫复合物沉积。这些免疫复合物的存在势必会影响胰岛素与肌肉细胞表面的胰岛素受体结合,即胰岛素抵抗的存在。为此,我们在临床上广泛采用了免疫抑制治疗的理念治疗糖尿病。应用小剂量胰岛素和小剂量环孢素A治疗早期发现的糖尿病取得了不错的疗效。唯一担心的副作用发生在肝脏,即部分糖尿病患者会出现总胆红素升高,而也有一部分患者总胆红素不升高。     

Selling the War? System‐Justifying Effects of Commercial Advertising on Civilian Casualty Tolerance

In times of war, news media coverage of the plight of civilian casualties plays a critical role in shaping attitudes regarding war's human costs. We proposed that these attitudes may also be surreptitiously influenced by the commercial advertisements that often accompany this coverage. Specifically, we hypothesized that when newspaper articles pertaining to civilian victims of war are flanked by luxury ads, conservatives, relative to liberals, will subsequently exhibit less concern for these victims. This proposition was based on the notion that commercial ads, particularly those promoting luxury items, make salient the gap between the “haves” and the “have‐nots” and thereby, at least implicitly, threaten the legitimacy of the current socioeconomic system. Drawing upon system justification theory, we posited that this threat would lead individuals with stronger system‐justification tendencies (conservatives), relative to those more open to challenging the current system (liberals), to show greater tolerance for civilian war casualties in order to defend the system's integrity. Evidence consistent with this hypothesis was found in a quasi‐experimental study (n = 329).     

The effects of stressor predictability on lymphocyte proliferation in humans

Abstract

To demonstrate the effects of predictable and unpredictable stressors on immune function, 36 male subjects were randomly assigned to complete ten trials of either a predictable or unpredictable cold pressor task or a non-stressful warm pressor control task. The predictable and no-stressor groups were given information about the duration of each pressor trial and a countdown of seconds passed from beginning to end of each trial. The unpredictable stressor group received no information. Self-report, cardiovascular, and biochemical measures were taken throughout the tasks in order to ascertain the effectiveness of the predictability and stressor manipulations. Lymphocyte proliferation to concanavalin A (Con A) and pokeweed mitogen (PWM) were measured before, during and after the tasks. Lymphocyte proliferation to Con A (10/μg/ml) was significantly reduced only in response to the unpredictable stressor suggesting that predictability buffered the effect of the stressor on immune function. Proliferation to PWM followed a similar pattern but was not statistically significant. Blood pressure responses were negatively correlated with proliferation values suggesting that stressor predictability may attenuate stress-associated immune decreases by reducing sympathetic arousal.