Institutional risk factors for norovirus outbreaks in Hong Kong elderly homes: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>Most of the institutional outbreaks of norovirus in Hong Kong occur in elderly homes, the proportion being 69% in 2006. Residents in elderly homes are a special population seriously affected by norovirus infections, it is necessary to investigate the risk factors of the norovirus outbreaks in Hong Kong elderly homes at the facility level.</p> <p>Methods</p> <p>A cohort of 748 elderly homes was followed up from January 2005 to December 2007; each elderly home was treated as one observation unit and the outcome event was the norovirus outbreak. Cox regression models were fitted to estimate the rate ratio (RR) and 95% confidence interval (CI) for the potential risk factors.</p> <p>Results</p> <p>A total of 276 norovirus outbreaks were confirmed during the study period; the outbreak rate was 12.2 (95% CI: 9.9-14.6) per 100 home-years; elderly homes with a larger capacity (RR = 1.4, 95% CI: 1.3-1.5 (per 30-resident increment)), a higher staff-to-resident ratio (RR = 1.2, 95% CI: 1.1-1.3 (per 1/30 increment) and better wheelchair accessibility (RR = 2.0, 95% CI: 1.3-3.2) were found to have an elevated norovirus outbreak rate in Hong Kong elderly homes; Elderly homes with partitions between beds had a lower rate of norovirus outbreaks (RR = 0.6, 95% CI: 0.4-0.8).</p> <p>Conclusions</p> <p>Elderly home capacity, staff-to-resident ratio and wheelchair accessibility were risk factors for norovirus outbreaks in Hong Kong elderly homes. Partitions between beds were a protective factor of norovirus outbreaks. These results should be considered in the infection control in Hong Kong elderly homes.</p

Recommended Practice for Daylighting Buildings

This Recommended Practice conveniently gathers the basic data and techniques which help those concerned with the design of buildings and lighting systems understand and appreciate the opportunities and constraints inherent in daylighting. Daylighted buildings offer significant benefits that include visual and thermal comfort, occupant satisfaction, a connection to the outdoor environment, and reduced energy consumption, maintenance costs, and greenhouse gas emissions. Daylighting can result in significant electric lighting reduction in commercial buildings – 40% or more in side-lighted daylight zones and more than 50% is top-lighted daylight zones. The challenges of daylighting include glare, unwanted solar heat gain, the control of electric lighting, shading systems and coordination of the multiple disciplines affecting daylighting performance from initial planning to actual occupancy. In addition RP-5-13 also addresses daylight delivery methods and fenestration properties of various glazing systems, shading techniques, and control strategies. Measurements and daylight performance simulation tools are also described

Lighting and the visual environment for seniors and the low vision population

RP-28-16 is intended to increase the designers understanding of age-related vision loss and the importance of their design decisions that could impact the safety and independence of this growing sector of the population. In the 2007 edition, applications were primarily directed at housing and senior care facilities but in the 2016 edition, coverage has been expanded to new areas of interest including offices, hospitality, healthcare, commercial and places of assembly. RP-28-16 has also been revised to serve a wider range of users, including individuals, design professionals, owners/managers of commercial buildings, code and regulatory agencies and legislative bodies. It is well understood that healthcare costs will increase as our elderly population ages. As the United States braces for this huge economic impact, appropriate lighting and a supportive visual environment should be considered as a preventive measure to reduce the risk of falls, sleep disorders and long-term care, and therefore given a top priority by all code officials, governmental agencies and the tax-paying public