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Commentary on: Shepperd S, Gonçalves-Bradley DC, Straus SE, Wee B. Hospital at home: home-based end-of-life care. Cochrane Database of Systematic Reviews. 2021;Issue 3. 10.1002/14651858.CD009231.pub3 When a person has been diagnosed with a terminal illness and has less than 6 months to live, and curative treatments are no longer effective, end-of-life care or hospice care may be initiated. Studies suggest that approximately 7 million people a year are given this type of care, which strives to reduce distress and improve quality of life for patients and their families by providing comprehensive physical, psychosocial, and spiritual support. Surveys show that most individuals would prefer to receive this care at home when given the option. However, there are still some uncertainties regarding the effects of end-of-life care at home on a range of important patient outcomes. As a result, a Cochrane review was conducted/updated to study the effects of receiving end-of-life care at home, looking at these outcomes. The aim of this commentary is to critically appraise this Cochrane review and expand upon the findings of the review in context to practice.
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Serviços de Assistência Domiciliar , Cuidados Paliativos na Terminalidade da Vida , Assistência Terminal , Humanos , Qualidade de Vida , Revisões Sistemáticas como Assunto , Assistência Terminal/psicologia , HospitaisRESUMO
In older adults living with diabetes, there is a higher prevalence of frailty and a greater risk of cognitive impairment. Cognitive frailty is defined by the presence of both and is associated with an increased risk of mortality. A systematic review was undertaken to estimate the prevalence of cognitive frailty in community-dwelling older adults living with diabetes and associated risk factors. This commentary critically appraises the review and explores the implications of the findings for community practice.
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Diabetes Mellitus , Fragilidade , Idoso , Humanos , Cognição , Idoso Fragilizado/psicologia , Fragilidade/psicologia , Avaliação Geriátrica , Vida Independente , Prevalência , Fatores de Risco , Revisões Sistemáticas como AssuntoRESUMO
Frailty in older adults is a major health concern for individuals, families and society. Increasing physical activity helps to reduce frailty in older adults and improve health outcomes. Mobility is also essential to independence and well-being in older adults. A systematic review was undertaken to explore the impact of mobility training on older persons living with frailty in the community. This commentary critically appraises the review and explores the implications for practice.
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Idoso Fragilizado , Fragilidade , Humanos , Idoso , Idoso de 80 Anos ou mais , Vida Independente , Exercício FísicoRESUMO
Hypertension affects more than 1 in 4 adults, equating to around 1.39 billion people worldwide. Hypertension is defined as an elevation in systolic blood pressure above 140mmHg. This can increase cardiovascular and stroke risk. By lowering blood pressure, individuals can mitigate an increased risk of stroke and end-organ damage. While medications have proven beneficial to lowering blood pressure, they do have the potential for side effects. Other non-pharmacological lifestyle and dietary changes exist. This article critically appraises a systematic review which assesses whether walking can reduce blood pressure.
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The ubiquity of pathogenic E. coli isolate possessing antimicrobial resistance was investigated in seafood samples procured from major seafood supply chain markets established for export and domestic consumption along Tuticorin coast. Out of 63 seafood samples examined, 29 (46%) were found to be contaminated by pathogenic E. coli harbouring one or more genes of virulent potential. Based on virulome profiling, 9.55% of isolates belonged to enterotoxigenic E. coli (ETEC), 8.08% to enteroaggregative E. coli (EAEC), 7.35% to enterohemorrhagic E. coli (EHEC), 2.20% to enteropathogenic E. coli (EPEC), and 2.20% to uropathogenic E. coli (UPEC). All the 34 virulome positive and haemolytic pathogenic E. coli have been serogrouped as O119, O76, O18, O134, O149, O120, O114, O25, O55, O127, O6, O78, O83, O17 and clinically significant O111, O121, O84, O26, O103, and O104 (non-O157 STEC) serotypes in this study. Multi-drug resistance (MDR) (≥ 3 antibiotic classes/sub-classes) was exhibited in 38.23% of the pathogenic E. coli, and 17.64% were extensive drug resistant (XDR). Extended spectrum of ß-lactamase (ESBL) genotypes were confirmed in 32.35% isolates and 20.63% isolates harboured ampC gene. One sample (Penaeus semisulcatus) collected from landing centre (L1) harboured all ESBL genotypes blaCTX-M, blaSHV, blaTEM, and ampC genes. Hierarchical clustering of isolates revealed the separation of ESBL isolates into three clusters and non-ESBL isolates into three clusters based on phenotypic and genotypic variations. Based on dendrogram analysis on antibiotic efficacy pattern, carbapenems and ß-lactam inhibitor drugs are the best available treatment for ESBL and non-ESBL infections. This study emphasizes the significance of comprehensive surveillance of pathogenic E. coli serogroups that pose serious threat to public health and compliance of AMR antimicrobial resistant genes in seafood that hinder seafood supply chain.
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Escherichia coli , beta-Lactamas , beta-Lactamas/farmacologia , beta-Lactamases/genética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Genótipo , Alimentos MarinhosRESUMO
One to two percent of the population in developed countries are affected by chronic heart failure and this increases to greater than 10% in those over 70 years old. Heart failure (HF) predisposes patients to thromboembolic events. Anticoagulants are often used to prevent thromboembolic events in specific patient populations, such as those with atrial fibrillation. Currently, no guidance exists on the long-term use of anticoagulants for patients with HF in sinus rhythm. This article critically appraises a systematic review which assesses whether the long-term use of oral anticoagulants reduces total mortality and stroke in patients with HF in sinus rhythm.
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White spot syndrome virus (WSSV) is a pathogen causing significant economic losses to shrimp aquaculture worldwide. Previously, five genome sequences of the virus from farmed shrimp (Penaeus vannamei and Penaeus monodon) in India were reported, all originating from farms located on the east coast of the country. Here, we report three new and distinct WSSV genome sequences, two from shrimp (P. vannamei) farmed on the west coast of India and the third from the east coast.