The Factors Influencing the Sense of Home in Nursing Homes: A Systematic Review from the Perspective of Residents.

Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1) psychological factors (sense of acknowledgement, preservation of one's habits and values, autonomy and control, and coping); (2) social factors (interaction and relationship with staff, residents, family and friends, and pets) and activities; and (3) the built environment (private space and (quasi-)public space, personal belongings, technology, look and feel, and the outdoors and location). Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.

Daily lives of residents with dementia in nursing homes: development of the Maastricht electronic daily life observation tool.

BACKGROUND: Daily life is a dynamic and multidimensional concept, for which appropriate assessment tools are lacking. This study describes the development of the Maastricht Electronic Daily Life Observation tool (MEDLO-tool), a freely accessible, easy to use, electronic observation tool to assess relevant daily life aspects for nursing home residents with dementia. METHODS: (1) Determining relevant aspects of daily life for nursing home residents with dementia based on a literature search and expert interviews; (2) pilot testing observation procedures and operationalizations of the aspects of daily life; and (3) exploring inter-rater reliability and feasibility of the tool in a nursing home facility with 16 residents (56% female, mean age: 77). RESULTS: The following aspects of daily life are assessed with the MEDLO-tool: (1) activity (activity performed by resident, engagement in this activity, and the degree of physical effort); (2) physical environment (location of the resident and interaction with the physical environment); (3) social interaction (the level and type of social interaction, and with whom this social interaction took place); and (4) emotional well-being (mood and agitation). Each aspect of daily life is observed and scored using standardized scoring options. Agreement on the aspects is high with an average absolute agreement of 86%. Users of the MEDLO-tool indicated that it was feasible in practice and contained clear operationalization of the aspects of daily life. CONCLUSIONS: The MEDLO-tool is a promising tool to gain real time insight into the aspects of the daily lives of nursing home residents with dementia.

Living at the farm, innovative nursing home care for people with dementia - study protocol of an observational longitudinal study.

BACKGROUND: In nursing home care, new care environments directed towards small-scale and homelike environments are developing. The green care farm, which provides 24-h nursing home care for people with dementia, is one such new care environment. Knowledge is needed on the relation between environmental features of green care farms such as nature, domesticity and offering care in small groups and the influence on the daily lives of residents. The aim of this study is to explore (1) the daily lives of residents, (2) the quality of care and (3) the experiences of caregivers on green care farms compared with other nursing home care environments. METHODS/DESIGN: An observational longitudinal study including a baseline and a six-month follow-up measurement is carried out. Four types of nursing home care environments are included: (1) large scale nursing home ward, (2) small scale living facility on the terrain of a larger nursing home (3) stand-alone small scale living facility and (4) green care farm. Quality of care is examined through structure, process and outcome indicators. The primary outcome measure is the daily life of residents, assessed by ecological momentary assessments. Aspects of daily life include (1) activity (activity performed by the resident, the engagement in this activity and the degree of physical effort); (2) physical environment (the location of the resident and the interaction with the physical environment); (3) social environment (the level and type of social interaction, and with whom this social interaction took place) and (4) psychological well-being (mood and agitation). In addition, social engagement, quality of life, behavioral symptoms and agitation are evaluated through questionnaires. Furthermore, demographics, cognitive impairment, functional dependence and the severity of dementia are assessed. Semi-structured interviews are performed with caregivers regarding their experiences with the different nursing home care environments. DISCUSSION: This is the first study investigating green care farms providing 24-h nursing home care for people with dementia. The study provides valuable insight into the daily lives of residents, the quality of care, and the experiences of caregivers at green care farms in comparison with other nursing home care environments including small-scale care environments and large scale nursing home wards.

Description of a new species, Bifidobacterium crudilactis sp. nov., isolated from raw milk and raw milk cheeses.

A new Bifidobacterium species is described based on the study of ten Gram-positive strains with fructose-6-phosphate phosphoketolase activity. They are part of a phenotypic group comprising 141 strains isolated from raw milk and raw milk cheeses in French raw milk cheese factories. This group was separated by a numerical analysis based on API 50CH, API 32A tests and growth at 46 degrees C. A strong similarity of 16S rRNA sequences (99.8%) was shown between strain FR62/b/3(T) and Bifidobacterium psychraerophilum LMG 21775(T). However, low DNA-DNA relatedness was observed between their DNAs (31%). The new isolates are able to grow at low temperatures (all ten strains up to 5 degrees C) and strain FR62/b/3(T) grows under aerobic conditions, as does B. psychraerophilum. However, contrary to B. psychraerophilum, they do not ferment L-arabinose, D-xylose, arbutin or melezitose, but they do acidify lactose. The DNA G+C content of FR62/b/3(T) is 56.4mol%. Therefore, the name Bifidobacterium crudilactis sp. nov. is proposed, with its type strain being FR62/b/3(T) (=LMG 23609(T)=CNCM I-3342(T)).

Bifidobacterium species isolated from animal feces and from beef and pork meat.

Bifidobacteria were isolated from 122 of 145 samples of animal feces (from cattle, swine, sheep, goats, horses, rabbits, chickens, geese, and pigeons) from farms in France and Austria and from 92 of 955 production and processing chain samples of beef and pork (obtained at slaughter, cutting, and retail). Bacterial strains were identified to species by phenotypic numerical classification based on API 50CH and ID 32A tests and DNA-DNA hybridization. Bifidobacterium pseudolongum was present in 81% (99 of 122 samples) of all Bifidobacterium-positive fecal samples and predominated in samples from all animal species except those from swine from Austria. In these Austrian swine samples, the majority of strains were identified as Bifidobacterium thermophilum (78%), followed by B. pseudolongum (48%). The distribution of B. thermophilum and B. pseudolongum differed significantly between Austrian swine and cattle samples such as those collected along beef and pork production and processing chains. Bifidobacterium animalis was isolated from swine feces, and Bifidobacterium ruminantium was isolated from cow dung. Six fecal isolates (from cattle, swine, rabbits, goats, and horses) were identified as belonging to Bifidobacterium species of predominantly human origin: B. adolescentis, B. bifidum, and B. catenulatum. Only one other species, Bifidobacterium choerinum, was detected with low frequency in a pork processing chain. B. pseudolongum subsp. pseudolongum was predominant in pig feces, whereas B. pseudolongum subsp. globosum was predominant in feces from other animal species. Four strains closely related to both subspecies (58 to 61% DNA reassociation) formed a distinct genomic group. PCR techniques, which are more rapid and sensitive than culture-based methods, could be used to detect directly B. pseudolongum and B. thermophilum as indicators of fecal contamination along the meat processing chain.

The use of generic failure frequencies in QRA: the quality and use of failure frequencies and how to bring them up-to-date.

Quantitative Risk Assessment (QRA) is a method which is often used in the chemical industry and, in some countries, also in land-use planning. In QRA calculations the frequency of an accident scenario is most often assessed by a generic failure frequency approach. The credibility and validity of the failure frequencies used in the Netherlands for land-use planning is evaluated by means of an historical review. Furthermore, the possibility is presented how these generic data can be revised and updated.

Evaluation of the hygienic quality of raw milk based on the presence of bifidobacteria: the cow as a source of faecal contamination.

Fifty-eight samples of raw milk from three different farms were examined for the presence of bifidobacteria. Isolates were identified and compared with bifidobacteria isolated from dung of the cows that provided the milk. Of the raw milk samples, 88% harboured Bifidobacterium pseudolongum subsp. globosum, as did 95% of the dung samples.

Origin and identification of bifidobacteria strains isolated from meat and meat products.

Forty-seven strains of bifidobacteria isolated from meat and meat products have been identified following phenotypic numerical analysis and DNA-DNA hybridization. Twenty-three strains were identified to the species B. thermophilum and 14 to B. pseudolongum subsp. pseudolongum. All others were also of animal origin, except for two strains -- B. longum and B. pseudocatenulatum -- that were of human origin. These strains were isolated from artificially contaminated meat by manual handling.

Bifidobacteria as indicators of faecal contamination in meat and meat products: detection, determination of origin and comparison with Escherichia coli.

Faecal contamination of meat and meat products and its origin, whether human or animal, was determined by using the presence of bifidobacteria as an indicator. Enrichment of samples in Beerens liquid selective medium was followed by spreading onto Columbia agar containing paromomycin. In comparison with the detection of Escherichia coli (E. coli) the following results were obtained from 50 samples: E. coli. +; Bifidobacterium. +: 38; E. coli -; Bifidobacterium -: 9; E. coli, +; Bifidobacterium. -: 2; E. coli, -; Bifidobacterium. +: 1. From 39 positives samples, 50 strains of bifidobacteria were isolated. Two were of human origin, 48 of animal origin.

Detection of bifidobacteria by using propionic acid as a selective agent.

This study introduces the use of the filtration membrane technique and the enrichment method to detect and enumerate bifidobacteria from various animal species.

[In vitro activity of an ofloxacin-metronidazole combination against anaerobic bacteria. Kinetics of the action of metronidazole against Bacteroides fragilis]. / Activité in vitro de l'association ofloxacine-métronidazole sur les anaérobies stricts. Cinétique d'action du métronidazole sur Bacteroides fragilis.

The activity of metronidazole combined with ofloxacin was investigated by the checkerboard method in liquid medium against 60 obligate anaerobes. The bacteriostatic effect of the combination was assessed by calculating the FIC index. Two metronidazole resistant strains of Propionibacterium acnes (MIC greater than 32 mg/l) were inhibited by 0.125 mg/l of this former antibiotic in presence of an ofloxacin concentration equal to half the value of the MIC. On the 58 other anaerobic strains, the combination of metronidazole plus ofloxacin had an additive bacteriostatic effect (30 strains) or a synergistic effect (26 strains). No antagonism was noted with any strain. For selected anaerobic or mixed infections the combination of metronidazole and ofloxacin may be useful. Killing curves demonstrated that, under good anaerobic conditions, metronidazole acted rapidly against Bacteroides fragilis. At a concentration of 8 mg/l, a decrease of log10 of the population was observed after 2 hours. After a contact ranging from 1 to 8 hours, depending of the investigated strains, a bactericidal effect was observed with metronidazole.

Bacterial colonization of the large intestine in newborns delivered by cesarean section.

Colonization of the gastrointestinal tract in newborns delivered by Cesarean section occurs during the first days of life by bacteria provided by the environment. It is more rapid in breast-fed infants than in bottle-fed babies. The intestinal flora is more diversified if the infants receive formula feeding. The first bacteria encountered are facultative anaerobes; they remain predominant during the first two weeks of life. In comparison to vaginal delivery, there were low levels of strict anaerobes after Cesarean section; members of the Bacteroides fragilis group were still completely lacking after 14 days of life and Bifidobacteria were only isolated sporadically.

Rapid detection of Clostridium perfringens: comparison of lactose sulfite broth with tryptose-sulfite-cycloserine agar.

The lactose sulfite (LS) medium recommended for the detection and identification of Clostridium perfringens in foods was compared with a reference method using tryptose-sulfite-cycloserine (TSC) agar for the enumeration of this organism in a variety of foods and food ingredients. C. perfringens was detected and enumerated in 17 of the 54 samples examined with LS broth, but its presence could be confirmed in only 9 of the samples with TSC agar. In only 2 instances, C. perfringens was detected on TSC agar but not in LS broth. A positive response (FeS + and gas +) in LS broth incubated at 46 degrees C always corresponded to the presence of C. perfringens; whereas the black colonies formed on TSC agar incubated at 37 degrees C were frequently found to be Clostridium species other than C. perfringens. Thus, because of its highly selective nature, LS broth was superior to TSC agar for enumerating and confirming the small numbers of C. perfringens that were present in a majority of the samples. This was especially true when other clostridia were also present. Besides its greater selectivity and sensitivity, LS broth had the additional advantages of requiring less work and giving confirmed results within 24-48 h compared with 3 days for the TSC agar method.

Bacterial interactions.

Bacterial interactions are important both in the formation of polymicrobial abscesses and in the control of the balance of the natural human floras. Investigations of the mechanisms controlling normal flora might be based on gnotobiology, but most of the conclusions are at present obtained indirectly by observations of the flora composition. One example is the typical bifid flora observed during breast-feeding. We studied changes in this following the introduction of bottle-feeding.

[Microbiologic study of a new disinfectant: decyloxy-3-hydroxy-2-amino-1-propane hydrochloride]. / Etude microbiologique d'un nouveau désinfectant : le chlorhydrate de décyloxy-3 hydroxy-2-amino-1 propane.

Decominol exhibits bactericidal activity in a concentration of 0.05% (NF T 72-151). This concentration is increased five-fold in the presence of an albumin-yeast extract mixture, and 2.5-fold in the presence of hard water (60 degrees French). At pH 5.0, 0.5% concentration is not bactericidal (NF T 72-171) Fungicidal activity (T 72-201) is weak at 20 degrees and 50 degrees C and the sporicidal tests (T 72-231) establish the lack of sporicidal activity at 10%. Decyloxy-3 hydroxy-2 in 0.2 amino-1 propane hydrochloride to 1.5% concentrations used in a meat-canning factory ensures satisfactory disinfection of correctly cleansed surfaces. It also proves useful for sterilization of circuits where it can be used as an adjunct to the lethal action of heat.

Influence of breast-feeding on the bifid flora of the newborn intestine.

Because of the predominance of Bifidobacterium bifidum in the intestine of the breast-fed infant, growth promoting factors were sought in human milk. In vitro, studies showed the presence of specific growth factors for B. bifidum in human milk. Other milks, including cow's milk, sheep's milk, pig's milk, and infant formulas did not promote the growth of this species, but did show activity on Bifidobacterium infantis and Bifidobacterium longum.

[Humanization of milk: "in vitro" influence of human milk, cow milk and infant formulae on the growth of "Bifidobacterium" (author's transl)]. / Contribution à l'étude de la maternisation des laits: influence in vitro du lait maternel, du lait de vache et de laits maternisés sur la croissance de Bifidobacterium.

Fresh human milk not only influence the physicochemical conditions in the infant's intestine, but also enhances the in vitro growth of Bifidobacterium Various Bifidobacterium strains belonging to different species can be clearly distinguished by their growth properties with different kinds of milk. Only B. bifidium, the predominant species in the intestine of breast-fed infants, is stimulated by human milk.