Contrasting Vantage Points between Caregivers and Residents on the Perception of Elder Abuse and Neglect During Long-Term Care.

BACKGROUND: Elder abuse and neglect can be defined as refusing or failing to fulfil a caregiver's obligation to meet the needs of elderly individuals in order to punish or hurt them. We aimed to explore perceptions of elder mistreatment of both caregivers and residents during long-term care, and highlight significant differences in the overall mistreatment perception regarding socio-demographic variables, as well as the type of care facility. SUBJECTS AND METHODS: The study involved 171 caregivers and 245 elderly individuals in stationary facilities. Two structured questionnaires were used - one for caregivers and the other for institutionalized elderly residents, whose initial validation concerning question and factor selection has been based upon exploratory factor analysis and discriminant validity. Parametric and nonparametric tests were employed in the statistical analysis, and statistical significance was set at p<0.05 (two-sided). RESULTS: We found significant differences in the perception of elder abuse and neglect between caregivers and elderly residents. More specifically, caregivers tend to recognize unnecessary or inappropriate medical/care procedures as indicators of elder mistreatment, while the elderly residents emphasize the removal of their personal belongings and inappropriate physical contact. According to the care facility, residents reported abuse/neglect more frequently in extended care units (21.4%), compared to the county-owned nursing home (11.4%) and private nursing home (12.1%) (p=0.001). Similarly, caregivers reported abuse/neglect more frequently in extended care units (75.4%), in comparison to county-owned nursing home (24.6%) and private nursing home (0%) (p=0.039). Shift work was also a significant predictor, as the morning nursing staff perceived abuse/neglect more frequently (p=0.011). CONCLUSIONS: This study has shown that residents and caregivers have contrasting vantage points in relation to elder abuse/neglect perception, which underlines the need for evidence-based standardization of procedures to prevent any type of elder mistreatment.

The effects of ketamine on viability, primary DNA damage, and oxidative stress parameters in HepG2 and SH-SY5Y cells.

Ketamine is a dissociative anaesthetic used to induce general anaesthesia in humans and laboratory animals. Due to its hallucinogenic and dissociative effects, it is also used as a recreational drug. Anaesthetic agents can cause toxic effects at the cellular level and affect cell survival, induce DNA damage, and cause oxidant/antioxidant imbalance. The aim of this study was to explore these possible adverse effects of ketamine on hepatocellular HepG2 and neuroblastoma SH-SY5Y cells after 24-hour exposure to a concentration range covering concentrations used in analgesia, drug abuse, and anaesthesia (0.39, 1.56, and 6.25 µmol/L, respectively). At these concentrations ketamine had relatively low toxic outcomes, as it lowered HepG2 and SH-SY5Y cell viability up to 30 %, and low, potentially repairable DNA damage. Interestingly, the levels of reactive oxygen species (ROS), malondialdehyde (MDA), and glutathione (GSH) remained unchanged in both cell lines. On the other hand, oxidative stress markers [superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT)] pointed to ketamine-induced oxidant/antioxidant imbalance.