Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services

BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge. AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care. METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis. RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality. CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

The First Provenance Challenge

The first Provenance Challenge was set up in order to provide a forum for the community to understand the capabilities of different provenance systems and the expressiveness of their provenance representations. To this end, a Functional Magnetic Resonance Imaging workflow was defined, which participants had to either simulate or run in order to produce some provenance representation, from which a set of identified queries had to be implemented and executed. Sixteen teams responded to the challenge, and submitted their inputs. In this paper, we present the challenge workflow and queries, and summarise the participants contributions.

On the impossibility of prisoner's dilemmas in adversarial preference games

Why don't agents cooperate when they both stand to gain? This question ranks among the most fundamental in the social sciences. Explanations abound. Among the most compelling are various configurations of the prisonerís dilemma (PD), or public goods problem. Payoffs in PDís are specified in one of two ways: as primitive cardinal payoffs or as ordinal final utility. However, as final utility is objectively unobservable, only the primitive payoff games are ever observed. This paper explores mappings from primitive payoff to utility payoff games and demonstrates that though an observable game is a PD there are broad classes of utility functions for which there exists no associated utility PD. In particular we show that even small amounts of either altruism or jealousy may disrupt the mapping from primitive payoff to utility PD. We then examine some implications of these results ñ including the possibility of conflict inducing growth.

Fidelidade ao cartão de crédito em troca de milhas aéreas: um estudo empírico desta relação no mercado brasileiro

No competitivo mercado brasileiro de cartão de crédito, a presença de um programa de fidelidade pode ser uma atividade de marketing relevante para os bancos reterem os seus clientes. No entanto, em um cenário com vários programas de fidelidade similares, é necessário que os bancos encontrem formas eficazes de estimular as intenções do cliente em direção ao uso continuado do seu cartão. Estes programas são comumente requisitados por clientes que procuram trocar pontos (milhas) por passagens aéreas. As milhas aéreas são recompensas ofertadas pelo banco, porém, envolvem elevados custos e são controladas por empresas intermediárias que também buscam a fidelidade deste cliente para si. Em um mercado ainda em desenvolvimento no tema, existe a barreira dos clientes não conhecerem as dinâmicas dos programas e não entenderem o resgate (troca) como um esforço do banco para premiá-lo. Neste contexto, torna-se importante que os bancos compreendam os fatores que mais influenciam a associação de marca do cliente e a fidelidade ao seu cartão. O presente trabalho propõe identificar estes fatores através da aplicação de uma survey com uma amostra de usuários de cartão de crédito participantes de programas de fidelidade. O estudo identificou que, na visão do portador do cartão, a atratividade do programa, o conhecimento sobre programa, os custos de troca percebidos e a preferência por milhas como recompensa são fatores que o banco deve considerar se quiser obter melhores associações à sua marca no âmbito do processo de resgate de milhas. Verificou-se que a associação de marca não é um elemento necessário para se atingir a fidelidade do cliente, contudo, sugere-se que a marca possa, além de ajudar no processo de fidelização, aproximar o cliente do banco e possivelmente apresentá-lo a outros produtos, alavancando assim os resultados do banco.

Allergic asthma exhaled breath metabolome: a challenge for comprehensive two-dimensional gas chromatography

Allergic asthma represents an important public health issue, most common in the paediatric population, characterized by airway inflammation that may lead to changes in volatiles secreted via the lungs. Thus, exhaled breath has potential to be a matrix with relevant metabolomic information to characterize this disease. Progress in biochemistry, health sciences and related areas depends on instrumental advances, and a high throughput and sensitive equipment such as comprehensive two-dimensional gas chromatography–time of flight mass spectrometry (GC × GC–ToFMS) was considered. GC × GC–ToFMS application in the analysis of the exhaled breath of 32 children with allergic asthma, from which 10 had also allergic rhinitis, and 27 control children allowed the identification of several hundreds of compounds belonging to different chemical families. Multivariate analysis, using Partial Least Squares-Discriminant Analysis in tandem with Monte Carlo Cross Validation was performed to assess the predictive power and to help the interpretation of recovered compounds possibly linked to oxidative stress, inflammation processes or other cellular processes that may characterize asthma. The results suggest that the model is robust, considering the high classification rate, sensitivity, and specificity. A pattern of six compounds belonging to the alkanes characterized the asthmatic population: nonane, 2,2,4,6,6-pentamethylheptane, decane, 3,6-dimethyldecane, dodecane, and tetradecane. To explore future clinical applications, and considering the future role of molecular-based methodologies, a compound set was established to rapid access of information from exhaled breath, reducing the time of data processing, and thus, becoming more expedite method for the clinical purposes.

Are the preference and selection patterns of hermit crabs for gastropod shells species- or site-specific?

Experimental analyses of hermit crabs and their preferences for shells are essential to understand the intrinsic relationship of the crabs' dependence on shells, and may be useful to explain their shell use pattern in nature. The aim of this study was to evaluate the effect of crab species and site on the pattern of shell use, selection, and preference in the south-western Atlantic hermit crabs Pagurus brevidactylus and Pagurus criniticornis, comparing sympatric and allopatric populations. Differently from the traditional approach to evaluate shell preference by simply determining the shell selection pattern (i.e., the number of shells of each type selected), preference was defined (according to [Liszka, D., Underwood, AJ., 1990. An experimental design to determine preferences for gastropod shells by a hermit-crab. J. Exp. Mar. Biol. Ecol., 137(1), 47-62]) by the comparison of the number of crabs changing for a particular shell type when three options were given (Cerithium atratum, Morula nodulosa, and Tegula viridula) with the number of crabs changing for this same type when only this type was offered. The effect of crab species was tested at Cabelo Gordo Beach, where P. brevidacrylus was found occupying shells of C. atratum, M. nodulosa, and T viridula in similar frequencies, whereas P. criniticornis occupied predominantly shells of C atratum. In laboratory experiments the selection patterns of the two hermit-crab species for these three gastropods were different, with P criniticornis selecting mainly shells of C atratum, and R brevidactylus selecting more shells of M. nodulosa. The shell preference was also dependent on crab species, with P. criniticornis showing a clear preference for shells of C atratum, whereas P. brevidactylus did not show a preference for any of the tested shells. The effect of site was tested for the two species comparing data from Cabelo Gordo to Preta (P brevidactylus) and Araca beaches (P. criniticornis). The pattern of shell use, selection, and preference was demonstrated to be dependent on site only for P. brevidactylus. The results also showed that the shell use pattern of P criniticornis can be explained by its preference at both sites, whereas for P. brevidactylus it occurred only at Cabelo Gordo, where the absence of preference was correlated with the similar use of the three gastropod species studied. Finally, the results showed that the shell selection pattern cannot be considered as a measure of shell preference, since it overestimates crab selectivity. (C) 2009 Elsevier B.V. All rights reserved.

Challenge of pacu (Piaractus mesopotamicus) fed diets supplemented with vitamins C and E by Aeromonas hydrophila under different temperature

Pacus Piaractus mesopotamicus alimentados com dietas contendo três níveis de vitaminas C e E (zero, 250 e 500mg/kg de ração) foram desafiados, em diferentes temperaturas, com Aeromonas hydrophila. Os peixes foram mantidos em caixas plásticas de 300L e, com o objetivo de reduzir as reservas vitamínicas, durante os primeiros 60 dias, foram alimentados com dietas isentas das vitaminas C e E. Após esse período, os peixes foram estocados na densidade inicial de 14 peixes/caixa e as dietas-teste foram oferecidas durante 60 dias. Ao final do experimento, todos os peixes foram infectados com 6×10(6) UFC de A. hydrophila/peixe, injetada intraperitonealmente. Não houve interação nível de vitamina C vs. nível de vitamina E quanto à mortalidade. A suplementação com as vitaminas C e E não reduziu a taxa de mortalidade dos peixes desafiados com A. hydrophila. Independentemente da suplementação vitamínica, após o desafio, os peixes menores apresentaram maior taxa de mortalidade que os maiores e o grupo mantido em ambiente com temperatura mais alta apresentou maior taxa de mortalidade após o desafio.

Oviposition preference hierarchy in Ceratitis capitata (Diptera, Tephritidae): influence of female age and experience

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Feeding non-preference by Spodoptera frugiperda and Spodoptera eridania on tomato genotypes

Lagartas do gênero Spodoptera spp. são altamente polífagas, podendo causar danos econômicos em diversas culturas agrícolas. em vista de sua emergente importância na cultura do tomate, principalmente o destinado à indústria, este trabalho teve por objetivo avaliar a não preferência, para alimentação, de lagartas de Spodoptera frugiperda (J. E. Smith, 1797) e Spodoptera eridania (Cramer, 1782) por genótipos de tomateiro, e classificá-los quanto aos graus de resistência. Como padrão susceptível, utilizou-se o cultivar comercial Santa Clara e, como resistente, a linhagem PI 134417, sendo avaliadas, ainda, as linhagens PI 134418, PI 126931, LA 462 e LA 716. Realizaram-se testes de não preferência, para alimentação, com e sem chance de escolha, avaliando-se a atratividade dos genótipos de tomateiro para as lagartas, em tempos pré-estabelecidos após sua liberação, além da massa foliar consumida. em geral, os genótipos LA 716 e PI 126931 foram os menos atrativos para a S. frugiperda, enquanto Santa Clara foi o mais atrativo e consumido. Quanto a S. eridania, os genótipos PI 126931, LA 462, LA 716 e PI 134418 foram os menos preferidos, para a alimentação, pelas lagartas, e Santa Clara e PI 134417 foram os mais atrativos e consumidos. Os genótipos LA e PI 126931 são moderadamente resistentes, do tipo não preferência para alimentação, para a S. frugiperda e S. eridania; PI 134418 e LA 462 são moderadamente resistentes a S. eridania; PI 134417 é susceptível a S. frugiperda e S. eridania; Santa Clara é altamente susceptível a S. frugiperda e S. eridania.

Adult attractiveness and oviposition preference of Bemisia tabaci (Genn.) (Homoptera: Aleyrodidae) B-biotype in cotton genotypes

Considerada importante praga do algodoeiro, a mosca-branca Bemisia tabaci biótipo B pode através de sua alimentação, diminuir o vigor das plantas, trasmitir vírus e prejudicar a qualidade da fibra. Visando avaliar a resistência de genótipos de algodoeiro, Gossypium hirsutum (L.), à mosca-branca Bemisia tabaci biótipo B, realizaram-se testes de atratividade e não-preferência para oviposição, com e sem chance de escolha, em telado, a temperatura ambiente. Verificou-se baixa atratividade das plantas dos genótipos Fabrika, CNPA Ita 90, Makina, Coodetec 407 e IAC 01-639 CPA 02-24 a adultos dessa mosca-branca, o que pode representar um componente de resistência destes materiais genéticos ao inseto. Os genótipos BRS Aroeira, Coodetec 406, Fabrika e Coodetec 401 apresentaram resistência do tipo não-preferência para oviposição, nos testes com e sem chance de escolha. Os números de tricomas e de glândulas de gossipol por cm² não foram adequados para se avaliar a não-preferência para oviposição de adultos da mosca-branca em genótipos de algodoeiro.

Newcastle disease in white Pekin ducks: response to experimental vaccination and challenge

A total of 120 Pekin ducks were distributed at random into four experimental groups, vaccinated or not against Newcastle disease (ND): G1 (Ulster 2C strain), G2 (B1 strain), G3 (LaSota strain), and G4 (nonvaccinated group). At 60 days of age, all groups were challenged with a pathogenic ND virus (NDV) suspension, and a group of specific pathogen free (SPF) chicks (G5) was also inoculated. Cloacal and tracheal swabs from all birds were collected after six, 14, 20, and 30 days post-challenge for virus isolation. NDV was isolated in 100% of SPF chicks. Pekin ducks from all groups, vaccinated or not, did not show any ND clinical signs, demonstrating that these birds are not susceptible to ND clinical disease. In the control group (G4), the virus was isolated 20 to 30 days after challenge, suggesting their possible NDV carrier state. In the vaccinated groups, no virus was isolated. This demonstrates that vaccination of white Pekin ducks against NDV is important to reduce NDV shedding in the field.

Efficacy of several Salmonella vaccination programs against experimental challenge with Salmonella gallinarum in commercial brown layer and broiler breeder hens

The protective effect of various Salmonella vaccines regimens against an experimental Salmonella Gallinarum challenge (SGNalr strain at 12 wk of age) was evaluated in two experiments. In Experiment 1 commercial brown layers were vaccinated according to one of the following programs: (i) two doses of a SE bacterin (Layermune SE; group 1); (ii) a first dose of a live SG9R vaccine (Cevac SG9R) followed by a SE bacterin (Layermune SE; group 2); (iii) one dose of each of two different multivalent inactivated vaccines containing SE cells (Corymune 4 & Corymune 7; group 3) or (iv) not vaccinated (group 4). In Experiment 2, broiler breeders were given the same vaccination treatments except for the group vaccinated with the multivalent vaccines. Overall, in both experiments, all vaccination schemes were effective in reducing mortality after challenge with a SG field strain. Primary vaccination with an initial dose of a live SG9R vaccine followed some weeks later by a dose of an inactivated SE bacterin was the most effective (p<0.05) vaccination program against mortality induced by field SG experimental challenge in both experiments. In conclusion, Salmonella vaccination programs containing SE bacterins alone or in combination with a live SG9R vaccine are effective in preventing mortality induced by infection of field SG. Nevertheless, it is important to emphasize that any vaccination program against any Salmonella serotype will only be effective if it is part of a sound and comprehensive biosecurity program designed for Salmonella control in poultry farms.