Abstract Objective In Europe, the demand for informal care is high and will increase because of the ageing population. Although caregiving is intended to contribute to the care recipient's health, ...its effects on the health of older European caregivers are not yet clear. This study explores the association between providing informal personal care and the caregivers' health. Method Data were used from the longitudinal cohort (2004/2005–2010/2011) of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 7858). Generalized estimating equations were used to explore the longitudinal association of informal care and the caregiver's health using poor self-rated health (less than good), poor mental health (EURO-D score for depression ≥ 4), and poor physical health (≥ 2 health complaints). Results Providing informal personal care was significantly associated with poor mental health (OR = 1.23, 95% CI = 1.04–1.47) and poor physical health (OR = 1.18, 95% CI = 1.01–1.38), after adjusting for various socio-demographic and health-related factors. No statistical significant association was found for self-rated health in the adjusted models. Conclusion Providing informal personal care may negatively influence the caregiver's mental and physical health. More awareness of the beneficial and detrimental effects of caregiving among policy makers is needed to make well-informed decisions concerning the growth of care demands in the ageing population.
The present study investigated the psychological foundations of the perceived prejudice asymmetry, that is, the observation that members of privileged groups are more likely to consider ‘downward’ ...bias—advantaged group members displaying ambiguous intolerant behaviour towards disadvantaged groups—as instances of prejudice than ‘upward’ bias—disadvantaged group members behaving negatively towards advantaged groups. Specifically, we tested whether a higher moral obligations account could explain these divergent judgements of prejudice. We hypothesised that advantaged witnesses implicitly ascribe higher social power—and hence, elevated moral obligations—to advantaged (compared to disadvantaged) groups. The resulting differential morality judgements, in turn, lead to divergent attributions of prejudice. Five experiments (total N = 1063) provided converging evidence for our predictions, although we also obtained evidence for a reverse causal pathway in which perceived prejudice determines morality judgements. Challenges for other accounts of the perceived prejudice asymmetry are discussed.
Whole genome sequencing (WGS) is widely used for outbreak analysis of bacteriology and virology but is scarcely used in mycology. Here, we used WGS for genotyping
isolates from a potential
outbreak ...in an intensive care unit (ICU) during construction work. After detecting the outbreak, fungal cultures were performed on all surveillance and/or patient respiratory samples. Environmental samples were obtained throughout the ICU. WGS was performed on 30 isolates, of which six patient samples and four environmental samples were related to the outbreak, and twenty samples were unrelated, using the Illumina NextSeq 550. A SNP-based phylogenetic tree was created from outbreak samples and unrelated samples. Comparative analysis (WGS and short tandem repeats (STRs), microsatellite loci analysis) showed that none of the strains were related to each other. The lack of genetic similarity suggests the accumulation of
spores in the hospital environment, rather than a single source that supported growth and reproduction of
. This supports the hypothesis that the
outbreak was likely caused by release of
spores during construction work. Indeed, no new
cases were observed in the ICU after cessation of construction. This study demonstrates that WGS is a suitable technique for examining inter-strain relatedness of
in the setting of an outbreak investigation.
Social support has been shown to be a crucial element in the well-being of children and adolescents. The present research article investigated how various sources of social support (i.e., parental ...support, teacher support and peer support) are related to school well-being and general well-being,. A survey was administered to
= 12,215 primary school pupils, pertaining to three ethnic-cultural groups, i.e., the national majority group, the Eastern European minority group and the Middle Eastern minority group. The results showed that perceived teacher support was most strongly and positively related to school well-being, although peer support was also an important determinant of school well-being. All three sources of perceived support were positively related to general well-being. Furthermore, and contrary to previous research, no significant differences were found between both minority groups and the national majority in terms of perceived teacher support. Conversely, both minority groups reported lower perceived parental and peer support. It was further shown that minority status moderated the relationship between the various sources of support and school well-being, although it should be articulated that these effects sizes were fairly small. School diversity, finally, did not yield any relevant effects. Similarities and differences with the existing literature on school well-being are delineated, and potential explanations for these divergences are discussed.
Little is known about the practice of ventilation management in patients with COVID-19. We aimed to describe the practice of ventilation management and to establish outcomes in invasively ventilated ...patients with COVID-19 in a single country during the first month of the outbreak.
PRoVENT-COVID is a national, multicentre, retrospective observational study done at 18 intensive care units (ICUs) in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The primary outcome was a combination of ventilator variables and parameters over the first 4 calendar days of ventilation: tidal volume, positive end-expiratory pressure (PEEP), respiratory system compliance, and driving pressure. Secondary outcomes included the use of adjunctive treatments for refractory hypoxaemia and ICU complications. Patient-centred outcomes were ventilator-free days at day 28, duration of ventilation, duration of ICU and hospital stay, and mortality. PRoVENT-COVID is registered at ClinicalTrials.gov (NCT04346342).
Between March 1 and April 1, 2020, 553 patients were included in the study. Median tidal volume was 6·3 mL/kg predicted bodyweight (IQR 5·7-7·1), PEEP was 14·0 cm H
O (IQR 11·0-15·0), and driving pressure was 14·0 cm H
O (11·2-16·0). Median respiratory system compliance was 31·9 mL/cm H
O (26·0-39·9). Of the adjunctive treatments for refractory hypoxaemia, prone positioning was most often used in the first 4 days of ventilation (283 53% of 530 patients). The median number of ventilator-free days at day 28 was 0 (IQR 0-15); 186 (35%) of 530 patients had died by day 28. Predictors of 28-day mortality were gender, age, tidal volume, respiratory system compliance, arterial pH, and heart rate on the first day of invasive ventilation.
In patients with COVID-19 who were invasively ventilated during the first month of the outbreak in the Netherlands, lung-protective ventilation with low tidal volume and low driving pressure was broadly applied and prone positioning was often used. The applied PEEP varied widely, despite an invariably low respiratory system compliance. The findings of this national study provide a basis for new hypotheses and sample size calculations for future trials of invasive ventilation for COVID-19. These data could also help in the interpretation of findings from other studies of ventilation practice and outcomes in invasively ventilated patients with COVID-19.
Amsterdam University Medical Centers, location Academic Medical Center.
We report on a 7-year-old female who presented paroxysmal episodes of loss of consciousness with clonic movements. The electroencephalogram (EEG) evidenced diffuse slow wave activations, with no ...symptoms. Epilepsy was suspected but antiepileptic drugs were ineffective. Video-EEG monitoring revealed that the syncope was triggered by stretching with a tachycardia that started during the stretch maneuver and diffuse slow waves on the EEG 2s before the symptoms. Stretch syncope can result in striking manifestations with subcortically driven clonic movements that can be mistaken for signs of epilepsy. Stretching might lead to transient hypoxia of the brainstem; in turn, this might activate the thalamocortical loop and thus generate cardiovascular changes, EEG slow waves, and physical manifestations.
Whole genome sequencing (WGS) is widely used for outbreak analysis of bacteriology and virology but is scarcely used in mycology. Here, we used WGS for genotyping Aspergillus fumigatus isolates from ...a potential Aspergillus outbreak in an intensive care unit (ICU) during construction work. After detecting the outbreak, fungal cultures were performed on all surveillance and/or patient respiratory samples. Environmental samples were obtained throughout the ICU. WGS was performed on 30 isolates, of which six patient samples and four environmental samples were related to the outbreak, and twenty samples were unrelated, using the Illumina NextSeq 550. A SNP-based phylogenetic tree was created from outbreak samples and unrelated samples. Comparative analysis (WGS and short tandem repeats (STRs), microsatellite loci analysis) showed that none of the strains were related to each other. The lack of genetic similarity suggests the accumulation of Aspergillus spores in the hospital environment, rather than a single source that supported growth and reproduction of Aspergillus fumigatus. This supports the hypothesis that the Aspergillus outbreak was likely caused by release of Aspergillus fumigatus spores during construction work. Indeed, no new Aspergillus cases were observed in the ICU after cessation of construction. This study demonstrates that WGS is a suitable technique for examining inter-strain relatedness of Aspergillus fumigatus in the setting of an outbreak investigation.
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