Perceptions of the role of diversional therapy within nursing homes by directors of nursing

Provision of leisure and recreational services has the ability to significantly contribute to the quality of life of older adults living in residential settings including those residents living in nursing homes. Therefore diversional therapy services should be seen as a vital part of these facilities. Currently, there is a feeling within the diversional therapy profession that there is a lack of understanding ofthe true role of the diversional therapist within various health care facilities, including nursing homes. The purpose of this study is to examine the perceptions of the role of the diversional therapist within nursing homes by directors of nursing. Qualitative research methods were used with the aim of gaining the true perceptions that directors of nursing have on various areas of diversional therapy practice. Thirteen in-depth interviews were conducted with directors of nursing at various nursing homes in the Sydney area. The interview data suggests that although the directors of nursing were generally supportive of diversional therapy, there is clearly a lack of understanding on behalf of the directors of nursing on various areas of diversional therapy practice, including roles, skills, training and education of a diversional therapist. Other issues were revealed in the interviews and are also of importance in relation to the diversional therapy profession such as suitability of the name diversional therapy, employment conditions and other professional issues affecting diversional therapy practice. This study aims to increase diversional therapists knowledge in relation to the perceived roles that directors of nursing hold on the diversional therapy profession and therefore to give the diversional therapy profession some kind of base line on which to focus their educational programs on the diversional therapy profession. Also, to increase the documented research base on diversional therapy practice and associated issues

Formalin Versus Bouin Solution for Rat Testicular Tissue Fixation: A Histochemical and Immunohistochemical Evaluation

Background: An accurate histopathological assessment and reporting of testicular biopsies require an appropriate tissue fixative. We assessed the histological, histochemical, and immunohistochemical quality of testicular biopsies, comparing 10% formalin versus Bouin solution as tissue fixatives. Methods: This experimental study utilized 20 adult male albino rats equally divided into five cages for 30 days. By the end of the experiment, all animals were anesthetized, and both testes were removed and weighted; one testicle was fixed in 10% formalin and the other testicle in Bouin solution, offering 40 specimens and then subjected to histological, morphometric, histochemical, and immunohistochemical assessments. Results: Formalin revealed high-quality cytological details and better nuclear chromatin detail (P=0.03). At the architectural level, the Bouin solution showed better quality details with less cytoplasmic shrinkage of seminiferous tubule germ cells (P=0.001). Bouin’s fixed tissues were more suitable for staining by trichrome methods but unsuitable when subsequent immunohistochemistry was requested. The diagnostic concordance between the Bouin solution versus formalin-fixed biopsies was 91.7%. Conclusion: This study supports that the morphology of testicular tissue fixed with Bouin solution was nearly comparable to those fixed with 10% neutral buffered formalin. However, the Bouin solution cannot substitute formalin when subsequent immunohistochemistry is considered

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Use of data from registered clinical trials to identify gaps in health research and development

OBJECTIVE: To explore what can be learnt about the current composition of the "global landscape" of health research and development (R & D) from data on the World Health Organization's International Clinical Trials Registry Platform (ICTRP). METHODS: A random 5% sample of the records of clinical trials that were registered as interventional and actively recruiting was taken from the ICTRP database. FINDINGS: Overall, 2381 records of trials were investigated. Analysis of these records indicated that, for every million disability-adjusted life years (DALYs) caused by communicable, maternal, perinatal and nutritional conditions, by noncommunicable diseases, or by injuries, the ICTRP database contained an estimated 7.4, 52.4 and 6.0 trials in which these causes of burden of disease were being investigated, respectively. For every million DALYs in high-income, upper-middle-income, lower-middle-income and low-income countries, an estimated 292.7, 13.4, 3.0 and 0.8 registered trials, respectively, were recruiting in such countries. CONCLUSION: The ICTRP constitutes a valuable resource for assessing the global distribution of clinical trials and for informing policy development for health R & D. Populations in lower-income countries receive much less attention, in terms of clinical trial research, than populations in higher-income countries

The presence of contact details according to recruitment status for trials registered in 2012.

<p>Legend <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0084727#pone-0084727-t003" target="_blank">Table 3:</a> Percentages of records for which different aspects of contact details were present for recruiting and not-recruiting trials.</p><p>¹ Numbers of records for subcategories do not add up to 386 because for three trials no primary sponsor was registered.</p

The presence of contact details in registered records in 2008/2009 and 2012.

<p>Legend <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0084727#pone-0084727-t002" target="_blank">Table 2:</a> Percentages of records for which different aspects of contact details were present in 2008/2009 and 2012.</p><p>*  =  significant difference between 2008/2009 and 2012.</p><p>¹ Numbers of records for subcategories do not add up to total because in 2008/2009 for one trial no primary sponsor was registered and in 2012 for three trials no primary sponsor was registered.</p

Flowcharts for the old 2009 study and for the new 2013 study.

<p>Flowcharts for the old 2009 study and for the new 2013 study.</p

Characteristics of the 238 patients by gender and CKD stage.

<p>Characteristics of the 238 patients by gender and CKD stage.</p