Symptoms of gastroesophageal reflux disease in severely mentally retarded people: a systematic review

<p>Abstract</p> <p>Background</p> <p>Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently backs up (or refluxes) into the gullet (or esophagus), and it has serious consequences for the quality of life. Usually this is felt as heartburn. Because severely mentally retarded people usually do not utter complaints of heartburn, it requires a high index of suspicion to discover possible GERD. Therefore it is relevant for care professionals such as nurses to have knowledge of those with a higher risk of GERD and of the possible manifestations of GERD.</p> <p>Methods</p> <p>Using a predefined search method, electronic databases were searched for studies relating the presence of symptoms to the presence of GERD. Relevant data were extracted and the methodological quality of the studies assessed. The results of the included studies were synthesized and conclusions about the level of evidence were drawn.</p> <p>Results</p> <p>Nineteen studies were found relating symptoms to the presence of GERD. Only four were of good methodological quality. The studies were very diverse concerning the studied population, the study method, and the kind of symptoms examined. This makes it difficult to synthesize the results of the studies. There is evidence that patients with cerebral palsy, patients using anticonvulsive drugs, and those with an IQ lower than 35 more frequently have GERD. There is also evidence that vomiting, rumination and hematemesis are associated with a higher risk of the presence of GERD, whereas there is no clear scientific evidence that particular behavior symptoms are indicative for GERD.</p> <p>Conclusion</p> <p>The possible manifestations of GERD are many and varied. A guideline will be made for care professionals to aid systematic observation of possible manifestations of GERD.</p

Ca(2+) spikes in the flagellum control chemotactic behavior of sperm

The events that occur during chemotaxis of sperm are only partly known. As an essential step toward determining the underlying mechanism, we have recorded Ca(2+) dynamics in swimming sperm of marine invertebrates. Stimulation of the sea urchin Arbacia punctulata by the chemoattractant or by intracellular cGMP evokes Ca(2+) spikes in the flagellum. A Ca(2+) spike elicits a turn in the trajectory followed by a period of straight swimming (‘turn-and-run'). The train of Ca(2+) spikes gives rise to repetitive loop-like movements. When sperm swim in a concentration gradient of the attractant, the Ca(2+) spikes and the stimulus function are synchronized, suggesting that precise timing of Ca(2+) spikes controls navigation. We identified the peptide asterosap as a chemotactic factor of the starfish Asterias amurensis. The Ca(2+) spikes and swimming behavior of sperm from starfish and sea urchin are similar, implying that the signaling pathway of chemotaxis has been conserved for almost 500 million years

Umsetzung der Influenzaimpfempfehlung in Alten- und Pflegeheimen

Bewohner und Pflegekräfte aus Alten- und Pflegeheimen nehmen in der Influenzaimpfprävention eine wichtige Rolle ein. Ziel der vorliegenden Erhebung war es, einen ersten Einblick zu gewinnen, inwiefern Aktivitäten in Alten- und Pflegeheimen zur Influenzaimpfung durchgeführt werden und ob weiterer Informationsbedarf besteht. Im Rahmen der vom Robert Koch-Institut (RKI) und der Bundeszentrale für gesundheitliche Aufklärung (BZgA) gemeinsam durchgeführten Kampagne „Wir kommen der Grippe zuvor“ wurden im September 2013 Medienpakete zur Influenzaimpfaufklärung an 10.700 Pflegedienstleitungen der Alten- und Pflegeheime im gesamten Bundesgebiet verschickt. Die Einrichtungen erhielten zusätzlich einen Fragebogen, den sie postalisch, per Fax oder online beantworten konnten. Es wurden Daten aus 988 Heimen in die Analysen einbezogen. Ein Großteil der Einrichtungen informierte sowohl seine Bewohner (88,9 %) als auch die Pflegekräfte (81,2 %) über die Influenzaimpfung. Konkrete Impfaktionen für Bewohner wurden von 64,7 % der Einrichtungen durchgeführt. Hingegen erhielt das Pflegepersonal nur in der Hälfte der Einrichtungen (49,3 %) das Angebot, sich durch den Betriebsarzt impfen zu lassen. Als Hauptgrund gegen ein aktives Aufklärungs- oder Impfangebot für das Personal wurde angeführt, dass diese Aufgabe primär beim Hausarzt liege. Insgesamt erhoben nur 4,9 % der Heime jährlich Impfquoten bei ihren Pflegekräften. Ein Drittel aller befragten Einrichtungen (33,6 %) wünschte weitere Informationen zur Influenzaimpfung. Eine intensivierte Aufklärungsarbeit ist notwendig, um auf die Wichtigkeit der Influenzaimpfung in Alten- und Pflegeheimen hinzuweisen mit dem Ziel, in diesen Risikopopulationen die Influenza-assoziierte Morbidität und Mortalität zu senken.Residents and staff of nursing homes are important target groups for influenza vaccination in Germany. The aim of this study was to gain the first insights into whether nursing homes organize activities with respect to vaccination against influenza and whether there is a demand for further information. In the context of the national influenza immunization campaign—which is jointly carried out by the Robert Koch Institute (RKI) and the Federal Centre for Health Education (BZgA) on an annual basis—influenza information kits were sent to the management of 10,700 nursing homes in September 2013. Along with the information material, the institutions also received a questionnaire to which they were able to respond via mail, fax, or online. Data from 988 homes were included in the analysis. The majority of institutions informed both residents (88.9 %) and nursing staff (81.2 %) about influenza vaccination. However, only 64.7 % of nursing homes carried out specific immunization activities for their residents and only half (49.3 %) offered a flu shot to their staff. When asked why the institutions do not provide influenza-specific information and vaccination to their staff, the majority had the opinion that this is the responsibility of each individual’s general practitioner. Overall, only 4.9 % of nursing homes assessed influenza vaccination coverage among their staff annually. A third of all surveyed institutions (33.6 %) expressed a demand for additional influenza vaccine-related information. In conclusion, improved health education is needed to raise awareness about the importance of influenza vaccination among residents and employees of nursing homes in Germany so as to prevent influenza-associated morbidity and mortality in this risk group

Motility and guidance of sea urchin sperm

The sperm tail movement is a direct result from contributions of fluid mechanics, elasticity, and molecular-motor activity. Within the flagellum, the axonemal engine yields overall mechanical response and, ultimately, motility. This chapter attempts to provide a comprehensive and integrative overview of the relationship between the mechanics, signaling of sperm propulsion, and the physiological function of these cells in 3D. Sperm swimming, with its intricate coupling between the regulations of the flagellar beating has to ultimately fulfill its evolutionary function honed in their natural environment, the open sea. The strategies that are being employed to unravel this fascinating and fundamental process are revisited, where the sliding of water bodies shape chemical landscapes sensed by sperms during their journey, affecting motility patterns and directly determining gamete encounter rates.A.G. and C.B. acknowledge grants from the Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica UNAM (PAPIIT/DGAPA) IA202417 to A.G. and IN206016 and IN215519 to C.B. A.G. acknowledge the Consejo Nacional de Ciencia y Tecnologıa (CONACyT, 252213). We thank CONACYT and PAPIIT for fellowships to H.R. I.T. acknowledges the support from the Spanish Ministry of Economy and Competitiveness Grants No. FIS2016-77692-C2-1-P