High frequency of extended-spectrum beta-lactamase-producing Enterobacteriaceae carriers at a Japanese long-term care hospital

IntroductionLong-term care hospitals (LTCHs) are at a high risk for the inflow and spread of antimicrobial resistance (AMR) pathogens. However, owing to limited laboratory resources, little is known about the extent to which AMR organisms are endemic.MethodsWe performed active surveillance for carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in newly admitted patients at Marugame Medical Center, a nearly 200-bedded LTCH located in Kagawa, Japan. From August to December 2021, we tested stool samples from patients wearing diapers and confirmed the genetic variants using specific PCR assays. We also collected clinical variables and compared them between AMR carriers and non-carriers.ResultsStool samples were collected from 75 patients, with a median age of 84 years. CRE strain was not detected, but 37 strains of ESBL-E were isolated from 32 patients (42.7%). During the study period, 4.9% of in-hospital patients (37 per 756 patients) were identified to be ESBL-E carriers in the routine microbiological processing, suggesting that active surveillance detected approximately 9-fold more ESBL-E carriers. The bla_CTX-M-9 group was the most common (38.5%), followed by the bla_TEM (26.9%). The clinical backgrounds of the ESBL-E non-carriers and carriers were not significantly different.ConclusionOur active screening demonstrated that nearly half of the patients hospitalized or transferred to a Japanese LTCH were colonized with ESBL-E. We highlight the enforcement of universal basic infection prevention techniques at LTCHs where patients carrying AMR pathogens gather.     

吸毒人员回归社会后的应对方式与生活质量——自我概念的中介作用

目的 本研究旨在探讨吸毒人员回归社会后的自我概念及应对方式是否会影响其生活质量。方法 在四川省成都市、德阳市、西昌市、宜宾市等地招募201名已回归社会的男性吸毒人员（平均年龄22.65±8.31岁，年龄16~59岁）进行调查。参与者完成田纳西自我概念量表（TSCS）、特质应对方式问卷（TCSQ）和药物成瘾者生命质量测定量表（QOL-DA）。结果 高自我概念组吸毒人员的积极应对得分和生活质量均高于低自我概念组，差异具有统计学意义（P<0.05）；吸毒人员的自我概念在积极应对与生活质量之间的中介效应值为0.224（95%CI:0.063~0.434），中介效应显著，占总效应的26.4%。结论 自我概念介导了回归社会的吸毒人员应对方式与生活质量之间的关系，应在学校和特定社区开展提高自我概念和应对技巧的培训。     

Facing an Aging Society: Taiwan’s Universities in crisis

ABSTRACT

As a result of the phenomenon of a rapidly aging population and low birth rates, Taiwanese universities face a shortage of traditionally aged students and as a result must respond to older learners’ needs. In response to this demand, the Ministry of Education issued the Lifelong Learning Act in 2002 and White Paper for implementing education for older persons in an aging society in 2006. Universities now face unprecedented challenges as they play a leading role in facilitating these programs. The purpose of this article is to explore the challenges Taiwanese universities face in educating an aging society and to provide some suggestions. First, this article notes current challenges. Second, the development of the status quo of senior education is presented. Third, the changing landscape of universities is discussed. Finally, some suggestions are presented for both university administration and program developers. In conclusion, universities should grasp this opportunity to modify strategies for involving older adults.     

Getting consent into perspective

This article continues a debate with Gareth Jones about the ethics of anatomy. The article discusses the distinction between direct and indirect reasons to require the deceased's consent prior to anatomical use. Getting this distinction wrong has potentially radical and unwelcome implications for the ethics of many uses of dead bodies. The article then exposes an ambiguity in asking what anatomical uses are ethical: we must distinguish between, on the one hand, who ought to have the power to make decisions and, on the other, how those with power ought to exercise it. It then applies this distinction to the ethics of the public display of bodies for entertainment. Clin. Anat. 27:844–846, 2014. © 2014 Wiley Periodicals, Inc.     

Self Tapping Screws v/s Erich Arch Bar for Inter Maxillary Fixation: A Comparative Clinical Study in the Treatment of Mandibular Fractures

Introduction and Objective  

Numerous methods have been described for achievement of Intermaxillary fixation in the treatment of fractures of facial skeleton. Conventional methods like Erich arch bars and eyelet wires are currently most common methods for achieving intermaxillary fixation (IMF), but they have their own disadvantages. Since 1989, IMF using intraoral self tapping IMF screws has been introduced for treatment of mandibular fractures. The aim of this work was to compare the efficacy, advantages, disadvantages indications and potential complications associated with Erich archbar v/s self tapping IMF screws in the management of mandibular fractures.     

The role of the physical environment in adolescent mental health

The existing literature suggests an association between the physical environment and mental health but also complex relationships between the social and the physical environment as well as between objective and subjective measures of the environment. In this study, we attempted to explore the role of the residential neighbourhood's physical environment in adolescent mental health, taking this complexity into account. Using data on 3683 ten- to 15-year-olds from England and Wales who participated in Understanding Society, we investigated the role of neighbourhood greenspace and air pollution in adolescent mental health (measured with the Strengths and Difficulties Questionnaire) while controlling for measures of neighbourhood and family socio-economic disadvantage as well as subjective perceptions of social cohesion, crime, safety, and noise in the neighbourhood. In linear regression models, greenspace and air pollution could not predict mental health. However, fear of being a victim of crime was a consistent predictor of mental health and behaviour, indicating the essential role of young people's subjective experience of their neighbourhoods for their mental health and well-being.     

慢性肾病患者社会支持和生活质量的相关性研究?

目的：了解慢性肾病(chronic kidney disease,CKD)患者的社会支持和生活质量现状并分析其相关性。方法采用多中心抽样方法,选取2014年3~6月在泸州市3所综合性医院住院的 CKD 患者200例,运用社会支持评定量表(SSRS)和肾病相关生活质量量表(KDQOL-SFTM )进行调查。结果CKD 患者客观支持得分高于全国常模(P <0.05);主观支持、社会支持利用度和社会支持总分得分低于全国常模(P <0.05)。CKD 患者生活质量低于60分项目由低到高为：肾病带来的负担(BKD)、工作状况(WS)、性功能(SexF)、体力所致工作和生活受限(RP)、总体健康(GH)。CKD 患者社会支持和生活质量呈正相关(P <0.05)。结论CKD 患者社会支持低于全国常模,与生活质量呈正相关。加强 CKD 患者的社会支持,改善患者生活质量是目前的主要任务之一。