ABSTRACT
Nursing homes are facing the rapid spread of COVID-19 among residents and staff and are at the centre of the public health emergency due to the COVID-19 pandemic. As policy changes and interventions designed to support nursing homes are put into place, there are barriers to implementing a fundamental, highly effective element of infection control, namely the isolation of suspected or confirmed cases. Many nursing home residents have dementia, associated with impairments in memory, language, insight, and judgment that impact their ability to understand and appreciate the necessity of isolation and to voluntarily comply with isolation procedures. While there is a clear ethical and legal basis for the involuntary confinement of people with dementia, the potential for unintended harm with these interventions is high, and there is little guidance for nursing homes on how to isolate safely, while maintaining the human dignity and personhood of the individual with dementia. In this commentary, we discuss strategies for effective, safe, and compassionate isolation care planning, and present a case vignette of a person with dementia who is placed in quarantine on a dementia unit.
Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Dementia/therapy , Nursing Homes/standards , Pandemics/prevention & control , Patient Isolation/methods , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Quarantine/methods , Aged , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/transmission , Dementia/complications , Female , Humans , Involuntary Treatment/ethics , Involuntary Treatment/methods , Patient Isolation/ethics , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , Quarantine/ethics , SARS-CoV-2ABSTRACT
As the human genome sequence is nearly deciphered, it is important to turn the attention to the physiological functions of the genes. Thus, the study of the gene products, the proteins, is the next big challenge. The proteins, however, are not the final gene products in many cases. It has been shown that carbohydrates participate in post-translational modifications and in many other functional regulations, hence the study of the glycome, the entire collection of carbohydrates is essential in order to determine the functions of all genes, and will greatly enhance the field of chemical genetics. Known biological function / targets of carbohydrates and combinatorial synthesis & structural analysis of natural / non-natural carbohydrates are surveyed in this review. Methods to search for new biological targets that include carbohydrate mimetics and carbohydrate scaffolds along with chip technology, are also presented.
