The influence of the quality of the sibling bond between sisters on caregiver\u27s burden

The various stresses experienced, by the individual providing care for an elderly spouse or parent are referred to as caregiver\u27s burden. The present study examines the influence of the relationship between sisters on the perceived burden of the caregiving daughter. In addition to the quality of the sibling bond, the effect of proximity is also examined. The 58 participants completed questionnaires which assessed the amount of caregiving, the perceived burden, and the quality of the relationship with the sister. Correlational analyses indicated a strong negative correlation between burden and closeness (p \u3c .01). The results of regression analyses indicated that proximity to the sister was not a significant predictor of burden (p \u3c .25), but that closeness to the sister predicted 6% of the variance in perceived burden (p \u3c .01). The findings of this study illustrate that the quality of the sibling bond between sisters can be an important influence on the perception of caregiver\u27s burden. When sisters have a close relationship, even when they do not live in proximity, the perceived burden of the caregiving daughter can be mediated

Every Dog Has Its Data:Evaluation of a Technology-Aided Canine Rabies Vaccination Campaign to Implement a Microplanning Approach

Background: Robust dog vaccination coverage is the primary way to eliminate canine rabies. Haiti conducts annual canine mass vaccination campaigns, but still has the most human deaths in the Latin American and Caribbean region. We conducted an evaluation of dog vaccination methods in Haiti to determine if more intensive, data-driven vaccination methods, using smartphones for data reporting and geo-communication, could increase vaccination coverage to a level capable of disrupting rabies virus transmission.Methods: Two cities were designated into “Traditional” and “Technology-aided” vaccination areas. Traditional areas utilized historical methods of vaccination staff management, whereas Technology-aided areas used smartphone-supported spatial coordination and management of vaccination teams. Smartphones enabled real time two-way geo-communication between campaign managers and vaccinators. Campaign managers provided geographic instruction to vaccinators by assigning mapped daily vaccination boundaries displayed on phone handsets, whilst vaccinators uploaded spatial data of dogs vaccinated for review by the campaign manager to inform assignment of subsequent vaccination zones. The methods were evaluated for vaccination effort, coverage, and cost.Results: A total of 11,420 dogs were vaccinated during the 14-day campaign. The technology-aided approach achieved 80% estimated vaccination coverage as compared to 44% in traditional areas. Daily vaccination rate was higher in Traditional areas (41.7 vaccinations per team-day) compared to in technology-aided areas (26.8) but resulted in significantly lower vaccination coverages. The cost per dog vaccinated increased exponentially with the associated vaccination coverage, with a cost of $1.86 to achieve 25$2.51 for 50% coverage, and $3.19 for 70% coverage.Conclusions: Traditional vaccination methods failed to achieve sufficiently high vaccination coverages needed to interrupt sustained rabies virus transmission, whilst the technology-aided approach increased coverage above this critical threshold. Over successive campaigns, this difference is likely to represent the success or failure of the intervention in eliminating the rabies virus. Technology-aided vaccination should be considered in resource limited settings where rabies has not been controlled by Traditional vaccination methods. The use of technology to direct health care workers based on near-real-time spatial data from the field has myriad potential applications in other vaccination and public health initiatives

Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak.

Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point locations; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limitations, and logistics may impact a country's ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban and peri-urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP?+?CVR), and door-to-door vaccination with oral vaccination (DDV?+?ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV?+?ORV, and 65% (61%-69%) for MSP?+?CVR (differences with MSP and DDV?+?ORV significant at p?<?0.01). Total dog vaccination coverage was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP?+?CVR and 78% (77%-80%) for DDV?+?ORV (differences significant at p?<?0.001). Overall, the least expensive campaign was MSP, with an estimated cost of about $2039 per day ($4078 total), and the most expensive was DDV?+?ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were$2.20 for MSP and $2.28 for MSP?+?CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030

Can ethanol help mitigate the impact of fuelwood use on the environment in Haiti?

As in many other developing countries, the overuse of fuelwood (charcoal and firewood) creates the problem of deforestation in Haiti. Although there have been efforts to tackle the problem of harvesting trees and the use of fuelwood as the primary energy for cooking and other commercial and household activities, the country still faces the acute problem of deforestation in the twenty-first century. Kerosene, liquefied petroleum gas, and electricity were introduced as alternatives in the early 1960s, but most households still depend on charcoal for cooking, and a few small businesses still rely on firewood for their commercial activities. Without a practical solution, the problem of deforestation that triggers environmental degradation will remain a real threat in Haiti. This paper explores the viability of ethanol as new alternative to fuelwood. It argues that Haiti has the potential to produce ethanol because of its sugar cane production and distilleries, but that it will only be accepted if the price is the same as or lower than charcoal and firewood. Drawing on data on the cost of ethanol and other cooking fuels in five low-income African countries, the paper calculates that the average cost of ethanol there is less than the actual cost of charcoal in Haiti. While there are limitations to this analysis, it does suggest that ethanol may indeed be a viable alternative and that it would be worth further research and development

The influence of perception of forgetting and gender, ethnicity, and closeness on likelihood of caregiving

As life expectancy increases, the population of older adults is increasing rapidly. The caregiving of older parents by adult children has become a normative experience. Much of the gerontological literature has examined the caregiving experience, particularly in terms of the stresses involved. However, research is only beginning to examine the factors which motivate adult children to begin caregiving. The research described here examined how an elderly parent\u27s memory behavior might influence caregiving decisions. In addition, gender, ethnicity, and parent-adult child closeness were examined to explore how these individual difference variables might influence those caregiving decisions. Participants read one of two vignettes describing a social visit with an elderly widow (target). In the vignette, the elderly target experiences several instances of forgetting. The vignettes depicted forgetting behavior established in pilot work as normal or serious. The normal forgetting vignette did not arouse concern and the serious forgetting vignette did arouse concern when the middle-aged participants imagined their mothers in the role of the vignette target. Participants rated their likelihood of engaging in eight caregiving behaviors if their mothers behaved like the vignette target. They also rated their closeness with their own mothers. Multivariate analyses of variance indicated main effects for vignette type, gender, ethnicity, and attachment. The likelihood of caregiving was higher when forgetting was more serious and when participants were female, Hispanic, and were highly attached to their mothers. Interaction effects showed that gender differences decreased with increased seriousness of forgetting, and ethnic differences were only significant for the normal forgetting condition. Multiple regression analyses indicated that attachment was the most significant predictor of likelihood of caregiving. Gender and ethnicity predicted specific caregiving behaviors. Females were more likely to engage in phoning and cooking, and Hispanics were more likely to engage in visiting and suggesting mother move in

Can ethanol help mitigate the impact of fuelwood use on the environment in Haiti?

As in many other developing countries, the overuse of fuelwood (charcoal and firewood) creates the problem of deforestation in Haiti. Although there have been efforts to tackle the problem of harvesting trees and the use of fuelwood as the primary energy for cooking and other commercial and household activities, the country still faces the acute problem of deforestation in the twenty-first century. Kerosene, liquefied petroleum gas, and electricity were introduced as alternatives in the early 1960s, but most households still depend on charcoal for cooking, and a few small businesses still rely on firewood for their commercial activities. Without a practical solution, the problem of deforestation that triggers environmental degradation will remain a real threat in Haiti. This paper explores the viability of ethanol as new alternative to fuelwood. It argues that Haiti has the potential to produce ethanol because of its sugar cane production and distilleries, but that it will only be accepted if the price is the same as or lower than charcoal and firewood. Drawing on data on the cost of ethanol and other cooking fuels in five low-income African countries, the paper calculates that the average cost of ethanol there is less than the actual cost of charcoal in Haiti. While there are limitations to this analysis, it does suggest that ethanol may indeed be a viable alternative and that it would be worth further research and development

The Effect of Single Accreditation on Medical Student Match Rates in Surgical Specialties

Introduction The year 2020 marked the first year in which a match under single accreditation took place. Both osteopathic (DO) and allopathic (MD) students would participate in the first match cycle without a dedicated DO match system. Our primary objective was to investigate how single accreditation has impacted the DO applicants attempting to match into surgical specialties. Our secondary objective was to investigate the impact of single accreditation at the program director (PD) level and whether or not this process would see a change in DO PD distribution in previously American Osteopathic Association (AOA)-approved programs. Method Information on number of applicants and post-match positions was gathered from AOA and National Residency Match Program (NRMP) websites. Credentials of PDs were obtained from the Accreditation Council on Graduate Medical Education website. Based on the available data, the following surgical specialties were compared for the years 2020, 2018, and 2016: General Surgery, Neurological Surgery (NSGY), Orthopedic Surgery, Otolaryngology/ENT (ENT), Plastic Surgery, and Thoracic Surgery. Data from 2016 were not included in the results as the AOA match results analysis was insufficient and unable to be directly compared to the NRMP data. Results of matched DO and MD applicants were compared using bivariate analysis. A p-value of \u3c0.05 was considered significant. Results From the year 2018 to 2020, the DO applicants saw a decrease of 3% in the total number of matched postgraduate year 1 spots in surgical specialties. NRMP results from 2020 saw that 51.7% of DO applicants matched and 67.7% (p \u3c 0.001) of MD applicants matched for the specialties examined. Percent of matched:applied for DO applicants was lower than MD applicants in the fields of NSGY (p \u3c 0.001), ENT (p \u3c 0.001), Plastic Surgery (p \u3c 0.001), General Surgery (p \u3c 0.001), and Thoracic Surgery (p = 0.011). After evaluating 60 former AOA General Surgery programs, 56% were found to have MD as PD. Another 26 former AOA surgical programs were investigated, and 58% were found to have MD PD. Conclusion Single accreditation has impacted the match process now that a large number of both MD and DO applicants are using the NRMP match system for postgraduate placement. Based on the available data, our results indicate that in the examined surgical specialties, there is a statistically significant difference in the number of MD and DO residents