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Abuse of vulnerable adults in institutional settings has been reported from various countries; however, there has been no systematic description of the characteristics of the victims and their abusers. Our aim was to identify and synthesize the literature on victims and perpetrators of abuse in institutions in order to inform interventions to prevent such abuse.
Search of MEDLINE(OVID), CINHAL(EBSCO), EMBASE(OVID) and PsychINFO(OVID) databases identified 4279 references. After screening of titles and abstracts, 123 citations merited closer inspection. Applying inclusion and exclusion criteria, 22 articles were included in the review.
The review suggested that the evidence available on risk factors is not extensive but some conclusions can be drawn. Patient, staff, institution and environment factors may play a role in increasing the risk of abuse. Cases of abuse may be often underreported.
Patients who are considered to be at higher risk need closer monitoring. Patients and staff may often lack the awareness and knowledge to identify and report abuse. Institutions should take proactive steps to monitor patients, train staff and devise systems that would be able to identify and report incidents of abuse and take steps to prevent such incidents from recurring. There should be well advertised policies for staff of all ranks to be aware of and report when they suspect or identify abuse. There is need for further research into the association between the individual factors and abuse. Such information may be useful in quantifying risk to individual patients and planning their care.
Frozen raw breaded chicken products (FRBCP) have been identified as a risk factor for Salmonella infection in Canada. In 2017, Canada implemented whole genome sequencing (WGS) for clinical and non-clinical Salmonella isolates, which increased understanding of the relatedness of Salmonella isolates, resulting in an increased number of Salmonella outbreak investigations. A total of 18 outbreaks and 584 laboratory-confirmed cases have been associated with FRBCP or chicken since 2017. The introduction of WGS provided the evidence needed to support a new requirement to control the risk of Salmonella in FRBCP produced for retail sale.
Exposure to prenatal hypoxia in rats leads to intrauterine growth restriction (IUGR), decreases fetal cardiomyocyte proliferation and increases the risk to develop cardiovascular diseases (CVD) later in life. The tumor necrosis factor-related weak inducer of apoptosis (TWEAK) induces cardiomyocyte proliferation through activation of the fibroblast growth factor-inducible molecule 14 (Fn-14) receptor. The TWEAK/Fn-14 pathway becomes quiescent shortly after birth, however, it becomes upregulated with CVD; suggesting that it could be a link between the increased susceptibility to CVD in pregnancies complicated by hypoxia/IUGR. We hypothesized that offspring exposed to prenatal hypoxia will exhibit reduced cardiomyocyte proliferation due to reduced Fn-14 expression and that the TWEAK/Fn-14 pathway will be expressed in those adult offspring. We exposed pregnant Sprague Dawley rats to control (21% oxygen) or hypoxic (11% oxygen) conditions from gestational days 15 to 21. Ventricular cardiomyocytes were isolated from male and female, control and hypoxic offspring at postnatal day 1. Proliferation was assessed in the presence or absence of r-TWEAK (72 h, 100 ng/ml). Prenatal hypoxia was not associated with differences in Fn-14 protein expression in either male or female offspring. Cardiomyocytes from prenatal hypoxic male, but not female, offspring had decreased proliferation compared with controls. Addition of r-TWEAK increased cardiomyocyte proliferation in all offspring. In adult offspring of all groups, the TWEAK/Fn-14 pathway was not detectable. Cardiomyocyte proliferation was reduced in only male offspring exposed to prenatal hypoxia but this was not due to changes in the Fn-14 pathway. Studies addressing other pathways associated with CVD and prenatal hypoxia are needed.
Although quality of life (QoL) is receiving increasing attention in bipolar disorder (BD) research and practice, little is known about its naturalistic trajectory. The dual aims of this study were to prospectively investigate: (a) the trajectory of QoL under guideline-driven treatment and (b) the dynamic relationship between mood symptoms and QoL.
In total, 362 patients with BD receiving guideline-driven treatment were prospectively followed at 3-month intervals for up to 5 years. Mental (Mental Component Score – MCS) and physical (Physical Component Score – PCS) QoL were measured using the self-report SF-36. Clinician-rated symptom data were recorded for mania and depression. Multilevel modelling was used to analyse MCS and PCS over time, QoL trajectories predicted by time-lagged symptoms, and symptom trajectories predicted by time-lagged QoL.
MCS exhibited a positive trajectory, while PCS worsened over time. Investigation of temporal relationships between QoL and symptoms suggested bidirectional effects: earlier depressive symptoms were negatively associated with mental QoL, and earlier manic symptoms were negatively associated with physical QoL. Importantly, earlier MCS and PCS were both negatively associated with downstream symptoms of mania and depression.
The present investigation illustrates real-world outcomes for QoL under guideline-driven BD treatment: improvements in mental QoL and decrements in physical QoL were observed. The data permitted investigation of dynamic interactions between QoL and symptoms, generating novel evidence for bidirectional effects and encouraging further research into this important interplay. Investigation of relevant time-varying covariates (e.g. medications) was beyond scope. Future research should investigate possible determinants of QoL and the interplay between symptoms and wellbeing/satisfaction-centric measures of QoL.
How do animals communicate using sounds? How did animal vocal communication arise and evolve? Exploring a new way to conceptualize animal communication, this new edition moves beyond an earlier emphasis on the role of senders in managing receiver behaviour, to examine how receivers' responses influence signalling. It demonstrates the importance of the perceiver role in driving the evolution of communication, for instance in mimicry, and thus shifts the emphasis from a linguistic to a form/function approach to communication. Covering a wide range of animals from frogs to humans, this new edition includes new sections on human prosodic elements in speech, the vocal origins of smiles and laughter and deliberately irritating sounds and is ideal for researchers and students of animal behaviour and in fields such as sensory biology, neuroscience and evolutionary biology.
Abuse of vulnerable adults in institutional settings has been reported from various countries; however, there has been no systematic review of the characteristics of the victims and their abusers. Our aim was to identify and synthesise the literature on victims, perpetrators and institutions where abuse occured in order to inform interventions to prevent such abuse.
Searches of MEDLINE (OVID), CINHAL (EBSCO), EMBASE (OVID) and PsychINFO (OVID) databases identified 4279 references. After screening of titles and abstracts, 123 citations merited closer inspection. After applying inclusion and exclusion criteria, 22 articles were included in the review.
Our review suggested that the evidence available on risk factors is not extensive but some conclusions can be drawn. Clients, staff, institutional and environmental factors appear to play a role in increasing the risk of abuse.
Vulnerable clients need closer monitoring. Clients and staff may lack the awareness and knowledge to identify and report abuse. Institutions should take proactive steps to monitor clients, train staff and devise systems that allow for the identification and prevention of incidents of abuse.There is a need for further research into the associations between the individual client, staff, institutional characteristics and abuse.
This article presents an analysis of long-term care-workers' work motivation that examines the way this is shaped by the social contexts in which they operate. We conducted a thematic analysis of 19 in-depth interviews with care-workers. Three core themes were identified as underpinning their motivation: those of ‘fulfilment’, ‘belonging’ and ‘valuing’, and together these contributed to a central theme of ‘pride’. We also found an overarching theme of ‘shared experience’ to be integral to the way in which care-workers made sense of their motivation and work experience. We draw on the social identity approach to provide a conceptual framework through which to understand how this shared experience shapes care-workers' motivation and the quality of care they deliver. In particular, we note the importance that care-workers' attach to their relationships with clients/patients and highlight the way in which this relational identification shapes their collective identification with their occupation and organisation and, through this, their motivation.
Enteric viruses including norovirus and rotavirus are leading causes of gastroenteritis in Canada. However, only a small number of clinical cases are actually tested for these pathogens leading to systematic underestimation of attributed hospitalizations in administrative databases. The objective of this analysis was to estimate the number of hospitalizations due to norovirus and rotavirus in Canada. Hospitalization records for acute gastroenteritis-associated discharges at all acute-care hospitals in Canada between 2006 and 2011 were analysed. Cause-unspecified gastroenteritis hospitalizations were modelled using age-specific negative binomial models with cause-specified gastroenteritis admissions as predictors. The coefficients from the models were used to estimate the number of norovirus and rotavirus admissions. The total annual hospitalizations for rotavirus were estimated to be between 4500 and 10 000. Total annual hospitalizations for norovirus were estimated to be between 4000 and 11 000. The mean total annual cost associated with these hospitalizations was estimated to be at least $16 million for rotavirus and $21 million for norovirus (all figures in Canadian dollars). This study is the first comprehensive analysis of norovirus and rotavirus hospitalizations in Canada. These estimates provide a more complete assessment of the burden and economic costs of these pathogens to the Canadian healthcare system.