Program, and will further describe instructors training challenges. Part Three: Program Background Over the past few years, research has repeatedly indicated that many of the changes attributed to aging may also be the cumulative effect of inactivity and the long-term effects of a sedentary lifestyle - leading to physical incapacity to the point where disability is reached. Associated with a sedentary lifestyle are losses in: balance and flexibility, muscular strength and endurance, bone density, joint function and cardiovascular endurance. These physical losses all contribute to decreases in perceived mobility, sense of self, life expectations and sleeping habits; and increases in anxiety, depression and other related psychological ailments. Physical activity can help maintain mobility and quality of life in frail older adults, which the project Fit to REALLY Live addresses. The needs of frail, shut-in older adult fitness focus on improving mobility through increases in large muscles strength, torso stability, balance, flexibility and cardiovascular function. 189 CAREGIVERS DESERVE A BREAK Peggy MacLeod, RN, MN College of Nursing ; , Bev Peterson, RN, BSN Older Adult Wellness, Public Health Services ; , Saskatoon Council on Aging, 109 - 3rd. Ave. N., Saskatoon, SK S7K 2H4. sca sk.sympatico ; Tel: 306 ; 652-2255, Fax: 306 ; 652-7525 The Saskatoon Council on Aging, with its partners, has been working to answer some of the needs of informal caregivers within the boundaries of Saskatoon District Health. The first goal of the Caregiver Project is to respond to caregiver needs for information, emotional support, and coordination of resources by establishing a caregiver network and a help centre. The second goal is to increase societys awareness of the needs and contributions of the older adult caregiver in the community by: increasing public awareness of financial implications of caregiving, increasing employers awareness of caregiving needs and potential responses to those demands. The appreciation for the needs will be accomplished by involving a variety of sectors in the community in responsive actions. Our partners and informal caregivers have worked together on a Steering Committee and a number of working committees. The working committees have engaged other community members and are immersed in diverse efforts. We will report on the successes, dilemmas, and sustained vision of this three year project, currently in its second year. 190 PROGRAM EVALUATION OF SUPPORT GROUPS FOR 1 ; CAREGIVERS ONLY ; AND FOR 2 ; PATIENTS AND CAREGIVERS USING A LOGIC MODEL FOR CONCEPTUALIZING PROGRAM PLANNING, IMPLEMENTATION AND EVALUATION OF SHORT AND LONG TERM OUTCOME OBJECTIVES Maureen Gorman, Ph.D., Psychology Dept., Queen Elizabeth 2 Health Sciences Centre, 5909 Veterans Memorial Lane, Halifax, NS, B3H 2E2 psymcg qe2-hsc.ns ; Tel: 902 ; 473-8617; Marilynn Grant, Director of Support Services, Alzheimer Society of Nova Scotia; Bonnie Carlson, M.S.W., R.S.W., A.C.S.W., Dept. of Social Work; & Laureen Morley, B .N., R.N., Dept. of Nursing. An interdisciplinary and interagency ; support program for caregivers of the patients seen in the Memory Clinic, Geriatric Ambulatory Care, has been conducted since 1989 under the direction of the first author. In 1994, the first group including the patient, for instance, zanaflex pictures.
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2. Tizanidine Tizanidine [5-chloro-4- 2-imidazolin-2-ylamino ; -2, 1, 3-benzothiodiazole hydrochloride] is a centrally-acting skeletal muscle relaxant that has been in clinical use for over 20 years brand names, Sirdalud and Zwnaflex ; . In addition to its use in chronic spasticity conditions such as multiple sclerosis MS ; , tizanidine is commonly used, for example, in migraine, tension-type headache and musculoskeletal pain Wagstaff & Bryson 1997, Lake & Saper 2002, Freitag 2003 ; . The chemical structure Figure 1 ; of tizanidine molecular weight 253.72 ; is related to other 2-adrenoceptor agonists such as the antihypertensive drugs clonidine and moxonidine Koch et al. 1989 ; . 2.1. Pharmacodynamics Tizanidine is an 2-adrenergic agonist and reduces spasticity presumably by increasing presynaptic inhibition of motor neurons. By stimulating presynaptic 2receptors tizanidine inhibits the release of catecholamines norepinephrine, i.e. noradrenaline ; , thereby inhibiting the stimulation of N-methyl-D-aspartate NMDA ; receptors. The transmission of polysynaptic signals is hence inhibited and muscle tone is decreased Davies 1982, Coward 1994 ; . Besides its spasticity reducing effect, the pharmacodynamic effects of tizanidine are in most cases undesirable but still common in many patients, and closely resemble those of clonidine. These effects are probably mediated by 2-adrenergic agonism; the inhibition of norepinephrine release leads to decreased activity of the sympathetic nervous system and hence to the hypotension and bradycardia associated with tizanidine use. Other effects due to 2-adrenergic agonism in the central nervous system are, for example, sedation and tiredness, muscle weakness, dizziness, and dry mouth Miettinen et al. 1996 ; . Use in neurological spasticity. Spasticity is a common problem among neurological rehabilitation patients, for example patients with MS or traumatic spinal cord injury SCI ; . Tizanidine reduces spasticity caused by spinal cord and brain injuries. The reduction of muscle tone correlates with tizanidine plasma concentration, but the plasma concentrations vary interindividually at a given dose Emre et al. 1994, Roberts et al. 1994, Nance et al. 1997 ; . Tizanidine has a similar anti-spastic efficacy as diazepam and baclofen Lataste et al. 1994, Wallace 1994 ; and can be used in combination with other antispastic agents with different mechanisms of action, such as baclofen. Central nervous system effects. In a multiple dose study, nearly half of the 111 patients receiving 2 to 36 mg of tizanidine reported sedation as an adverse event, compared to only 3 of the 109 patients receiving placebo Smith et al. 1994 ; . Furthermore, dry mouth and dizziness were reported in almost 60% and 20.
Canada ; , P. Tattersall Yale University School of Medicine, New Haven, Connecticut, USA ; and S. Modrow Institut fur medizinische Mikro$ biologie und Hygiene and Innere Medizin, Universita$ t Regensburg, Germany ; for the generous gifts of NS polyclonal antibodies without which this study would not have been possible. We thank P. Beard ISREC, Epalinges, Switzerland ; for the kind gift of BP-06 plasmid DNA and zyloprim.
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1. Smith RJ, Bodine EN, Wilson DP, Blower SM. Evaluating the potential impact of vaginal microbicides to reduce the risk of acquiring HIV in female sex workers. AIDS 2005; 19: 413421. Foss AM, Vickerman PT, Heise L, Watts CH. Shifts in condom use following microbicide introduction: should we be concerned? AIDS 2003; 17: 12271237. Foss AM, Vickerman PT, Heise L, Watts CH. Care should be taken when promoting microbicide use among sex workers who are able to use condoms consistently. AIDS 2005; 19: in press ; . 4. Wilson DP, Blower SM. Microbicides: anti-HIV efficacy and ethics. Science 2004; 306: 1890; author reply 1890. 5. Vickerman P, Watts C, Delany S, Rees H. The potential impact of microbicides in Johannesburg, South Africa: model projections and implications for product promotion. London: International Family Health and Global Campaign for Microbicides; 2004. Available at: : ifh pdf South%20Africa%20 policy%20document . Accessed: 3 May 2005. 6. Monitoring human development: enlarging people's choices. United Nations Development Programme; 2004. Available at: : hdr.undp statistics data pdf hdr04 table 8 . Accessed: 12 May 2005. 7. Rwandan Office National de la Population. Demographic and Health Survey 2000. Calverton, MD: Macro International; 2001. 8. Laumann EO, Gagnon JH, Michael RT, Michaels S. The social organization of sexuality in the United States. Chicago: University of Chicago Press; 1994 and accupril.
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