scholarly journals Long-term biodiversity intervention shapes health-associated commensal microbiota among urban day-care children

2021 ◽  
Vol 157 ◽  
pp. 106811
Author(s):  
Marja I. Roslund ◽  
Riikka Puhakka ◽  
Noora Nurminen ◽  
Sami Oikarinen ◽  
Nathan Siter ◽  
...  
Keyword(s):  
Day Care ◽  
Commensal Microbiota

Comparative Study of Outcomes for Older People with Long Term Conditions Attending Day Care Services Delivered by Paid Staff or by Volunteers

2020 ◽  
Author(s):  
Catherine Lunt ◽  
Chris Shiels ◽  
Christopher Dowrick ◽  
Mari Lloyd-Williams
Keyword(s):  
Older People ◽  
Comparative Study ◽  
Day Care ◽  
Symptom Burden ◽  
Well Being ◽  
Long Term Conditions ◽  
North West ◽  
Age In Place ◽  
Care Services

Abstract Background Day care services can support older people living with multiple long term conditions (LTCs), to age in place, but little research on outcomes of Day Care attendance. Aims The aims of this comparative study were to determine outcomes for older people with LTCs attending day care services run entirely by paid staff or predominantly volunteers Methods Newly referred older people with LTCs to nine day care services in North West of England and North Wales were invited to participate in this longitudinal study with data being collected at baseline attendance and at 6 and 12 weeks. Demographic information was collected and the EQ-5D-3L and De Jong Loneliness 6 item questionnaire were completed at each time point.RESULTS 94 older people (64% female),age range 65 - 99 years (mean 82 years) were recruited. The mean number of LTCs was 4.3 (range 2-9) and 52% people lived alone. More than a third (36%) lived in one of the 20% most deprived local authorities in England and Wales. The outcomes in this exploratory study over 12 weeks appeared to be similar for paid, blended (paid staff and volunteers) and for volunteer led service, with those attending volunteer led services were significantly more likely to report fewer health problems in follow-up (OR=3.45, 95% CI 1.01-12.8, P=0.04). CONCLUSIONS This study suggests that Day Care Services for older people with long term conditions provide benefits in terms of self-rated physical and emotional well-being. Older people attending paid staff services were more likely to have greater number of LTCs associated with a higher symptom burden. However, at baseline there was no difference in self-reported health by service type. This study suggests that Day Care Services provided by volunteers can provide comparable outcomes. Following the Covid-19 pandemic, it is increasingly urgent to support older people with long term conditions who have lost physical and cognitive function during lockdown and to maintain and improve their function. Our study suggests that volunteers may be able to complement the care provided by paid staff freeing up resources and enabling increasing numbers of people to be supported.

scholarly journals Impact of Long-Term Erythromycin Therapy on the Oropharyngeal Microbiome and Resistance Gene Reservoir in Non-Cystic Fibrosis Bronchiectasis

mSphere ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. e00103-18 ◽  
Author(s):  
Jocelyn M. Choo ◽  
Guy C. J. Abell ◽  
Rachel Thomson ◽  
Lucy Morgan ◽  
Grant Waterer ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Quantitative Pcr ◽  
Resistance Genes ◽  
Low Dose ◽  
Controlled Trial ◽  
Macrolide Resistance ◽  
Microbiota Composition ◽  
Content Type ◽  
Commensal Microbiota

ABSTRACT Long-term macrolide therapy reduces rates of pulmonary exacerbation in bronchiectasis. However, little is known about the potential for macrolide therapy to alter the composition and function of the oropharyngeal commensal microbiota or to increase the carriage of transmissible antimicrobial resistance. We assessed the effect of long-term erythromycin on oropharyngeal microbiota composition and the carriage of transmissible macrolide resistance genes in 84 adults with bronchiectasis, enrolled in the Bronchiectasis and Low-dose Erythromycin Study (BLESS) 48-week placebo-controlled trial of twice-daily erythromycin ethylsuccinate (400 mg). Oropharyngeal microbiota composition and macrolide resistance gene carriage were determined by 16S rRNA gene amplicon sequencing and quantitative PCR, respectively. Long-term erythromycin treatment was associated with a significant increase in the relative abundance of oropharyngeal Haemophilus parainfluenzae (P = 0.041) and with significant decreases in the relative abundances of Streptococcus pseudopneumoniae (P = 0.024) and Actinomyces odontolyticus (P = 0.027). Validation of the sequencing results by quantitative PCR confirmed a significant decrease in the abundance of Actinomyces spp. (P = 0.046). Erythromycin treatment did not result in a significant increase in the number of subjects who carried erm(A), erm(B), erm(C), erm(F), mef(A/E), and msrA macrolide resistance genes. However, the abundance of erm(B) and mef(A/E) gene copies within carriers who had received erythromycin increased significantly (P < 0.05). Our findings indicate that changes in oropharyngeal microbiota composition resulting from long-term erythromycin treatment are modest and are limited to a discrete group of taxa. Associated increases in levels of transmissible antibiotic resistance genes within the oropharyngeal microbiota highlight the potential for this microbial system to act as a reservoir for resistance. IMPORTANCE Recent demonstrations that long-term macrolide therapy can prevent exacerbations in chronic airways diseases have led to a dramatic increase in their use. However, little is known about the wider, potentially adverse impacts of these treatments. Substantial disruption of the upper airway commensal microbiota might reduce its contribution to host defense and local immune regulation, while increases in macrolide resistance carriage would represent a serious public health concern. Using samples from a randomized controlled trial, we show that low-dose erythromycin given over 48 weeks influences the composition of the oropharyngeal commensal microbiota. We report that macrolide therapy is associated with significant changes in the relative abundances of members of the Actinomyces genus and with significant increases in the carriage of transmissible macrolide resistance. Determining the clinical significance of these changes, relative to treatment benefit, now represents a research priority.

Decentralisation of long-term care in the Netherlands: the case of day care at green care farms for people with dementia

2013 ◽  
Vol 35 (4) ◽  
pp. 704-724 ◽  
Author(s):  
STÉPHANIE J. M. NOWAK ◽  
CLAUDIA C. M. MOLEMA ◽  
CAROLINE A. BAAN ◽  
SIMON J. OOSTING ◽  
LENNEKE VAANDRAGER ◽  
...  
Keyword(s):  
The Netherlands ◽  
Day Care ◽  
Central Government ◽  
Municipal Services ◽  
Term Care ◽  
Care Services ◽  
People With Dementia ◽  
Health And Social Care ◽  
Green Care Farms

ABSTRACTResponsibility for health and social care services is being delegated from central to local authorities in an increasing number of countries. In the Netherlands, the planned transfer of responsibility for day care for people with dementia from the central government to municipalities is a case in point. The impacts of this decentralisation process for innovative care concepts such as day care at green care farms are largely unknown. We therefore interviewed representatives of municipalities and green care farms to explore what consequences they expected of decentralisation for their organisations and people with dementia. Our study shows that communication and collaboration between municipalities and green care farms is relatively limited. Consequently, municipalities are insufficiently aware of how green care farms can help them to perform their new tasks and green care farmers know little about what municipalities expect from them in the new situation. We therefore recommend that municipalities and green care farms keep each other informed about their responsibilities, duties and activities to ensure a tailored package of future municipal services for people with dementia.

Uptake of Hib vaccination in long‐term day care centres in Perth, Western Australia

1994 ◽  
Vol 160 (3) ◽  
pp. 165-165
Author(s):  
Anne W Read ◽  
Melinda R Berinson ◽  
Robert Condon ◽  
Beverly Petterson
Keyword(s):  
Western Australia ◽  
Day Care ◽  
Day Care Centres

scholarly journals FACTORS ASSOCIATED WITH DIMINISHED COUGH INTENSITY IN COMMUNITY-DWELLING ELDERLY USING DAY CARE SERVICES: A PILOT STUDY

2019 ◽  
pp. 1-7
Author(s):  
R. Mikiya ◽  
C. Momoki ◽  
D. Habu
Keyword(s):  
Nutritional Status ◽  
Day Care ◽  
Peak Flow ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Term Care ◽  
Care Services

Purpose: We investigated factors affecting diminished cough intensity in community-dwelling elderly using day care services. Participants and Methods: A total of 61 elderly males and females aged ≥65 years who were certified to receive long-term adult day care services were enrolled in this study. Assessments included: Cough intensity (assessed using cough peak flow measurements, as well as possible determinants of cough intensity, lifestyle, and demographic characteristics), nutritional status (using the Mini Nutritional Assessment-Short Form), dietary intake (using the Dietary Variety Score), routine activity (using the Japanese version of the International Physical Activity Questionnaire), care-related factors (including day care services utilization and an oral exercise regimen) as well as age, need for long-term care, gender, sarcopenia status, the Charlson Comorbidity Index, and body mass, limb skeletal mass, and respiratory indices. Results: A reduced cough peak flow (odds ratio 4.46, 95% confidence interval: 1.08–18.43) was associated with sarcopenia and was weakly (not significantly) associated with age, gender, and the Mini Nutritional Assessment-Short Form score. Conclusion: A reduced cough peak flow was independently associated with sarcopenia and associated with age, gender, and nutritional status.

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