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衰弱、尊嚴、韌力與生活品質於心臟疾病患者之探討 - 質量性研究

為了解決DAILY LAB Dcard的問題，作者徐清樺 這樣論述：

目的：探討心臟疾病患者衰弱、尊嚴、韌力與生活品質之相關性，以及心臟疾病患者的罹病過程經歷與生活經驗。方法：本研究為質量混合型研究設計。量性部分採方便取樣於北部某區域醫院心臟內科門診與病房進行樣本收集共101位病人，使用結構式問卷包括：基本屬性、疾病特徵、中文版介護風險評估篩檢量表(Kihon Checklist - Chinese)、中文版病人尊嚴量表(Patient Dignity Inventory - Mandarin version)、心理韌性量表中文版(Chinese version of Resilience Scale)、及歐洲生活品質五面項量表(EuroQol 5-dimen

sion questionnaire)為研究工具，資料收集後透過SPSS 20.0版電腦套裝統計軟體進行頻次、百分比、平均數、標準差、最大/最小值、獨立樣本t檢定、單因子變異數分析、卡方檢定、皮爾森積差相關及階層迴歸進行統計分析，另使用SAS 9.4版電腦套裝統計軟體以潛在類別模式對低生活品質之樣本進行潛在類別分析。質性部分採立意取樣自問卷調查中的101位受訪者選取訊息豐富且可清楚描述之個案共10位進行訪談，以胡賽爾的現象學觀點藉由半結構式訪談大綱引導進行訪談，訪談文本使用內容分析法進行分析。結果：本研究結果顯示心臟疾病患者的生活品質會受到年齡、教育程度、職業狀態、經濟來源、主要照顧者，以及疾

病種類的影響，且衰弱、尊嚴、韌力都是生活品質的預測因子。無配偶、有菸酒習慣、經濟來源、合併有慢性腎病變或周邊動脈硬化等基本屬性與疾病屬性是低生活品質的潛在類別。心臟疾病患者的罹病過程歷程包含衝擊、調適、及重生三個主題，從對生命失去期待，到感受與接受外界環境支持以調整面對疾病的態度，到思想昇華及生命重啟等階段。結論：本研究可瞭解心臟疾病患者衰弱、尊嚴、韌力與生活品質之相關性，生活品質之預測因子，及罹病過程經歷與生活經驗。研究結果可提醒臨床照護人員對患者尊嚴、韌力之觀察，辨識低生活品質之潛在患者，並適時介入輔導，以維護患者的生活品質。

新興植生素LABG在蛋雞的功能與作用機制

為了解決DAILY LAB Dcard的問題，作者陳明 這樣論述：

Healthy gut microbiota is requisite for laying hens to increase the global egg values to reach ~162.39 billion USD by 2022. Gut microbiota disturbance during aging and antibiotic treatment is one primary factor to drop egg production. Phytogenics, alternatives to antibiotics that jeopardize public

health due to drug residue and antimicrobial resistance (AMR). However, the role of phytogenics in shaping gut microbiota responding to animal health and performance is poorly understood. Here, we dissected the functions and mechanisms of a plant extract named lactic acid bacteria growth promoter (L

ABG) in 54-week old layers. A LABG diet dose-dependently improved average daily mortality and egg production rate in 12000 layers associated with an increasing number of Lactobacillus, and decreasing numbers of Escherichia coli and AMR bacteria dropping 236% total reads of AMR genes (ARGs). Next, LA

BG selectively upregulated and downregulated gut microbiome composition of probiotics and pathogens, respectively. LABG at 4 µg/mL and more promoted probiotic growth of LAB, however, 100-time higher dose and more reduce E. coli growth suggesting an indirect pathogenic killing of LABG via probiotic.

Meanwhile, this antagonism of LAB was identified by its five major antimicrobial metabolites against pathogens. Surprisingly, LABG augmented the levels of these metabolites both in vitro and in vivo to disrupt the cell membrane of the pathogen to lower the vertical ARGs transfer. Furthermore, an ARG

-associated mobile genetic element, the class 1 integron was significantly reduced by LABG in chicken stools to diminish the horizontal ARGs transfer. Overall, this work suggests that LABG promotes layer health and egg production through increasing probiotics and decreasing pathogens and AMR dissemi

nation.