Investigating the association between COVID-19 vaccination and care home outbreak frequency and duration.

OBJECTIVES: At the end of 2020, many countries commenced a vaccination programme against SARS-CoV-2. Public health authorities aim to prevent and interrupt outbreaks of infectious disease in social care settings. We aimed to investigate the association between the introduction of the vaccination programme and the frequency and duration of COVID-19 outbreaks in Northern Ireland (NI). STUDY DESIGN: We undertook an ecological study using routinely available national data. METHODS: We used Poisson regression to measure the relationship between the number of RT-PCR confirmed COVID-19 outbreaks in care homes, and as a measure of community COVID-19 prevalence, the Office for National Statistics COVID-19 Infection Survey estimated the number of people testing positive for COVID-19 in NI. We estimated the change in this relationship and estimated the expected number of care home outbreaks in the absence of the vaccination programme. A Cox proportional hazards model estimated the hazard ratio of a confirmed COVID-19 care home outbreak closure. RESULTS: Care home outbreaks reduced by two-thirds compared to expected following the introduction of the vaccination programme, from a projected 1625 COVID-19 outbreaks (95% prediction interval 1553-1694) between 7 December 2020 and 28 October 2021 to an observed 501. We estimated an adjusted hazard ratio of 2.53 of the outbreak closure assuming a 21-day lag for immunity. CONCLUSIONS: These findings describe the association of the vaccination with a reduction in outbreak frequency and duration across NI care homes. This indicates probable reduced harm and disruption from COVID-19 in social care settings following vaccination. Future research using individual level data from care home residents will be needed to investigate the effectiveness of the vaccines and the duration of their effects.

Effects of group discussion and guided patient care experience on nurses' attitudes towards care of patients with AIDS.

Nurses with limited experience in caring for persons with AIDS (PWAs) were randomized into three groups receiving an educational session on universal precautions and (a) three group discussion sessions; (b) three sessions of caring for a PWA; or (c) assessment materials only. Both interventions were conducted by a nursing instructor experienced in care of PWAs and infectious diseases over a 3-4 week period. Measures included instruments for assessing prejudicial attitudes towards homosexual PWAs, self-ratings of infectious disease knowledge, ratings of perceived comfort and confidence in caring for PWAs, and a measure of willingness to provide care to PWAs. Results showed no significant change in willingness to provide care over time in any of the groups. Multiple regression exploring predictors of willingness to provide care found only the measure of AIDS prejudice to be an independent predictor of willingness to provide care to PWAs 6 months after completion of the intervention phase.

Inhibition of prostacyclin release from cultured endothelial cells by nitrovasodilator drugs.

Pretreatment (18 h) of the bovine aortic endothelial cell line AG4762 to 500 microM sodium nitroprusside (SNP), glyceryl trinitrate (GTN) or 3-morpholino-sydnonimine (SIN-1) significantly inhibited 100 nM bradykinin-stimulated prostacyclin (PGI2) release. SIN-1 produced the greatest reduction (67 +/- 6%), followed by SNP (47 +/- 12%) and GTN (45 +/- 9%). Only SIN-1 and GTN inhibited basal PGI2 release where again the effect of SIN-1 (66 +/- 6%) was greater than that of GTN (31 +/- 15%). There was no effect of SNP on basal PGI2 release. We have demonstrated this inhibition of bradykinin-stimulated PGI2 release is not the result of cell death. In addition, 8-bromo-cyclic GMP, whilst having no effect on basal PGI2 release, demonstrated a small but significant inhibition (15 +/- 6%) of the enhanced response to 100 nM bradykinin. These studies may reflect a mechanism by which the release of vasodilators from endothelial cells is altered during therapy with nitrovasodilators and thus may contribute to the development of tolerance to these drugs.

A cluster of cases of feline dysautonomia (Key-Gaskell syndrome) in a closed colony of cats.

Twenty-five cases of feline dysautonomia (Key-Gaskell syndrome) occurred in a closed cat colony over a period of three weeks. The clinical and pathological signs were sufficiently similar to those reported during the 1982-1986 outbreak to establish a positive diagnosis. The special epidemiological and environmental circumstances of the outbreak provide a new insight into the cause(s) of the syndrome.

Zinc concentration in erythrocyte membranes in normal volunteers and in patients with taste and smell dysfunction.

Erythrocyte membrane zinc concentration was measured in 14 normal volunteers and in 36 patients with taste and smell dysfunction, and compared with zinc concentration in erythrocyte cytosol and blood plasma in the normal volunteers and with zinc concentration in erythrocyte cytosol, blood serum, urine, and parotid saliva in the patients. A A significant negative correlation was found between age and membrane zinc concentration in the normals. A significant positive correlation was found between parotid saliva zinc and erythrocyte membrane zinc concentrations in the patients. Concentration of zinc in the erythrocyte membrane is 50% greater than its concentration in cytosol, and three times greater than the zinc concentration in plasma or serum; membrane zinc concentration in humans is approximately one-half that reported in the dog or in the mouse.

Effects of pH on sodium uptake in Norwegian brown trout (Salmo trutta) from an acid river.

Sodium uptake rates were measured in wild and hatchery reared Norwegian brown trout (Salmo trutta) exposed to media of a range of pH. Sodium uptake was strongly dependent on external acidity, being reduced in media of low pH. Wild fish from the naturally acid R. Tovdal (S. Norway) were more tolerant of acid media than hatchery reared fish. The effects of increasing external sodium concentrations were strongly influenced by low external pH. The results are discussed with respect to brown trout population decline in certain areas of S. Norway.

Acclimation to an acid medium in the brown trout Salmo trutta.

Data are presented which demonstrate acclimation of brown trout (Salmo trutta) to an acid medium. Sodium fluxes, transepithelial gill potentials and plasma electrolyte concentrations were measured in brown trout exposed to an acid medium of pH 6.0 for a period of 6 weeks. Sodium loss rates in acid exposed fish are reduced compared to normal fish, and sodium uptake in insensitive to external pH following long-term acid exposure. Changes in gill potential and sodium turnover rate following acid exposure can be accounted for by changes in the relative permeability of the gills to sodium and chloride. In neutral media the permeability ratio phi Na+/phi Cl- = 1.12 but this falls to 0.76 during acid exposure. The ability to acclimate to acid conditions seems to depend largely on changes in gill permeability to sodium.

Maximize your fund-raising potential.

Of all the capital financing alternatives, fund raising is the most profitable. To be successful fund raisers, hospital trustees should adopt a corporate orientation, recognizing that donors, like stockholders, expect a return on their investment. Trustees also need to be aware of three aspects of donor psychology that are representative of the new emphasis on "return" accountability.