Will environmental changes in temperature affect the course of COVID-19?

While the outbreak has reached every region of the world, it is undeniable that countries in the southern hemisphere seem to be less affected, where cases have been reported, these have been imported and travel related. We analyzed the climate temperature from various regions according to their current ongoing human-to-human transmission status. We studied 3 groups; Group 1, 10 provinces from China with majority of COVID-19 cases; Group 2, areas where continuous horizontal transmission outside of China had been reported; and group 3, areas where imported cases had been detected and no horizontal transmission had been documented after at least seven days since the first case was reported. The regions without ongoing human-to-human transmission showed significantly higher temperatures when compared to China and countries with ongoing human-to-human transmission, with over an 11-degree difference. The average rainfall during the study period was significantly higher in those regions without OHHT when compared to the Chinese provinces with ongoing human-to-human transmission and the regions with active transmission of SARS-CoV-2. Our findings show statistically significant differences between regions with ongoing human-to-human transmission of COVID-19 cases compared to those regions without horizontal transmission. This phenomenon could have implications in the behavior of the ongoing COVID-19 outbreak in the following months.     

Providing outcomes information to nursing homes: can it improve quality of care?

PURPOSE: This study examined whether providing outcomes information to 120 nursing homes facilitated improvements in quality over a 12-month period, as compared with 1,171 facilities not receiving this information. The outcomes information provided consisted of a report mailed to administrators that examined six measures of care quality. These were the rates of physical restraint use, urethral catheterization, contractures, pressure ulcers, psychotropic medication use, and certification survey quality of care deficiencies. DESIGN AND METHODS: Data used in this investigation came from the 1998 and 1999 On-line Survey, Certification and Recording (OSCAR) system. With the use of generalized least squares regression and each of the six quality indicators as dependent variables, risk-adjustment models were developed by using aggregate resident variables as independent variables. These risk-adjustment models were used to compare the outcome measures for the intervention facilities with the same outcome measures in other facilities in the same states (Kansas, Maine, Mississippi, New York, Texas, and South Dakota). The difference between 1998 predicted scores less actual scores was calculated, and the difference between 1999 predicted scores less actual scores for each facility was calculated. Subtracting these 1998 difference scores from the 1999 difference scores gives some indication of the change in outcomes controlling for resident mix. RESULTS: Physical restraint use and psychotropic medication use were significantly lower after 12 months in the intervention facilities, suggesting that quality had improved. IMPLICATIONS: This study may provide evidence that some of the outcomes initiatives currently being pursued in the long-term care arena will positively affect quality of care.     

Will Africa experience a spike in COVID-19 cases?

正Due to increase in trade and air travel between countries affected by the novel coronavirus disease 2019 (COVID-19) epidemic and Africa[1],Africa stands to be at a high risk of a possible surge in the number of COVID-19 cases.The biggest concern for the continent and public health experts is whether Africa will experience an uncontrollable spike in the spread of the disease,as it has recently been designated a pandemic by World Health Organization (WHO).This concern may be attributed to the deficiency in health systems in     

Reminiscence intervention in nursing homes: what and who changes?

The results of experimental studies of reminiscing are not as uniformly optimistic about its therapeutic value as is the theoretical literature. Moreover, anecdotal evidence regarding the impact of reminiscence interventions is more positive than the statistical evidence. This study suggests reasons for these previous findings, and examines data from a discussion group intervention in thirty nursing homes, in which 185 residents completed pre- and posttests. It analyzes the characteristics of participants in relation to modifications in selected attitudes and behaviors over the intervention period. Analysis of variance and discriminant analysis revealed no significant relationships between attitudinal or behavioral modifications and demographic or other characteristics, with one exception. Value-choices made by participants were related to such modifications. The findings are interpreted in terms of the "mental adaptability" of participants and the compensatory nature of reminiscence in an institutional setting.     

Innovation in nursing homes: which facilities are the early adopters?

PURPOSE: This study examined organizational and market factors associated with nursing homes that are most likely to be early adopters of innovations. Early adopter institutions, defined as the first 20% of facilities to adopt an innovation, are important because they subsequently facilitate the diffusion of innovations to others in the industry. DESIGN AND METHODS: Two groups of innovations were examined, special care units and subacute care services. I used discrete-time logistic regression analysis and nationally representative data from 13,162 facilities at risk of being early adopters of innovations during twelve 6-month intervals from 1992 to 1997. RESULTS: Organizational factors that increase the likelihood of early innovation adoption are larger bed size, chain membership, and high levels of private-pay residents. Four market factors that increase the likelihood of early innovation adoption are: a retrospective Medicaid reimbursement methodology, a more competitive environment, higher average income in the county, and a higher number of hospital beds in the county. IMPLICATIONS: This analysis shows that organizational and market characteristics of nursing homes affect their propensity toward early adoption of innovations. Some of the results may be useful for nursing home administrators and policy makers attempting to promote innovation.     

Pressure ulcers in nursing homes: does negligence litigation exceed available evidence?

Nursing homes today face an increasing amount of oversight as they comply with regulations from federal, state, and local governments and agencies. The trend of judicial oversight, particularly in cases involving pressure ulcers, presents a unique set of challenges to the nursing home industry. The standards of care that are increasingly applied to establish the incidence of negligence in relevant cases are dependent on an under-researched area of the clinical phenomenon of skin breakdown within a frail elderly population. As the nursing home population continues to grow and resources are further strained, finding ways to best utilize resources becomes imperative. Consideration must be given to the growing body of evidence indicating that some patients are incapable of mounting a "normal" response to the physical forces responsible for the damage observed with pressure ulcers. Pressure ulcers have evolved to the status of being a synonym for neglect and/or abuse. Clinicians must focus on establishing a realistic and far more nuanced body of knowledge regarding pressure ulcers among the frail elderly.     

MRSA in nursing homes in the Netherlands 1989 to 1998: a developing reservoir?

The prevalence of methicillin resistant Staphylococcus aureus (MRSA) in Dutch nursing homes in 1998 was higher than that found in 1989 to 1997. The increased prevalence of MRSA could lead to colonisation outside these nursing homes. A study of the prevale