Caring for the elderly - identity transitions in informal carers

Population demographics in the UK are changing, with an increased number of elderly and infirm individuals which is expected to continue to rise. The requirements of care need for this population outstrip the present level of informal care provision by social and health services, care and nursing homes etc. resulting in a care needs gap. This gap is being filled by informal carers – family members, friends and neighbours who provide care to the elderly and infirm in their own homes, without formal payment.Research into carers has been considerable – we know who carers are, how they care and how much, but the actual experience of carers remains under-researched. Consideration to how carers experience caring, how they see themselves and the change to their lives has been scant. Essentially, how carers’ self-identity transitions with the onset or changes in informal care is not understood.The objective of this research is to address this gap in the knowledge by identifying types of ‘distance’ associated with and affecting care identities and their relationships with others and to understand the transitional process of self-identity in carers.Using the lens of self-identity and the construct of ‘distance’ this phenomenological study revealed how carers transition from their previous identity to that of carer. A total of 31 face to face interviews and statements with carers and care recipients in East Yorkshire and Hull took place throughout 2016, data was transcribed and analysed using an abductive approach. The research revealed four concepts of distance associated with and affecting carer identities and relationships; Geographical/Physical; Social; Psychological and Emotional. Of these four, emotional distance was identified as a method for carers to manipulate their self-identity between their previous identity and that of a carer.A conceptual framework was developed that reflected the transitional process of carer identity using motivators, moderators and manifestations to highlight the transitional process and re-positioning of carer identity on a continuum between previous life, activities, roles and responsibilities (their previous life identity or PLI) and carer life, activities, roles and responsibilities (their carer life identity or CLI).This study assists in understanding the wants and needs of carers in an effort to improve their everyday lives and will be of interest to policy-makers, industry and charities as well as carers themselves

United against rabies forum:The one health concept at work

Human deaths from rabies are preventable and can be eliminated by applying a systematic One Health approach. However, this ancient disease still threatens the lives of millions of people in up to 150 countries and kills an estimated 59, 000 people every year. Rabies today is largely a disease of poverty, almost always linked to dog bites, with most deaths occurring in neglected communities in Africa and Asia. The disease places an immense economic burden on its victims, a cost that far outweighs the investment needed to control it. A global framework for rabies elimination in humans is set out in Zero by 30: The Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. Despite the existence of proven control strategies and agreement on the path to eliminating human rabies deaths, mortality numbers from rabies remain high, and COVID-19 has set back efforts even further. But COVID-19 has also highlighted the value of a One Health approach to zoonotic disease and pandemic prevention. Rabies control programs offer a practical route to building One Health capacities that can also address other zoonotic threats, including those with pandemic potential. The United Against Rabies Forum aims to accelerate progress on rabies elimination while applying a One Health approach. The Forum promotes cross-sector collaboration among stakeholders and supports countries in their rabies elimination efforts. Increased political engagement and resource mobilization, both internationally and nationally, will be needed to achieve global rabies goals and can also make One Health implementation a reality

Physical and emotional nourishment: Food as the embodied component of loving care of elderly family relatives

Purpose This purpose of this study is to examine the fluidity of family life which continues to attract attention. This is increasingly significant for the intergenerational relationship between adult children and their elderly parents. Using practice theory, the aims are to understand the role of food in elderly families and explore how family practices are maintained when elderly transition into care. Design/methodology/approach A phenomenological research approach was used as the authors sought to build an understanding of the social interactions between family and their lifeworld. Findings This study extends theory on the relationship between the elderly parent and their family and explores through practice theory how families performed their love, how altered routines and long standing rituals provided structure to the elderly relatives and how care practices were negotiated as the elderly relatives transitioned from independence to dependence and towards care. A theoretical framework is introduced that provides guidance for the transition stages and the areas for negotiation. Research limitations/implications This research has implications for food manufacturers and marketers, as the demand for healthy food for the elderly is made more widely available, healthy and easy to prepare. The limitations of the research are due to the sample located in East Yorkshire only. Practical implications This research has implications for brand managers of food manufacturers and supermarkets that need to create product lines that target this segment by producing healthy, convenience food. Social implications It is also important for health and social care policy as the authors seek to understand the role of food, family and community and how policy can be devised to provide stability in this transitional and uncertain lifestage. Originality/value This research extends the body of literature on food and the family by focussing on the elderly cared for and their family. The authors show how food can be construed as loving care, and using practice theory, a theoretical framework is developed that can explain the transitions and how the family negotiates the stages from independence to dependence

Physical and emotional nourishment: Food as the embodied component of loving care of elderly family relatives

Purpose This purpose of this study is to examine the fluidity of family life which continues to attract attention. This is increasingly significant for the intergenerational relationship between adult children and their elderly parents. Using practice theory, the aims are to understand the role of food in elderly families and explore how family practices are maintained when elderly transition into care. Design/methodology/approach A phenomenological research approach was used as the authors sought to build an understanding of the social interactions between family and their lifeworld. Findings This study extends theory on the relationship between the elderly parent and their family and explores through practice theory how families performed their love, how altered routines and long standing rituals provided structure to the elderly relatives and how care practices were negotiated as the elderly relatives transitioned from independence to dependence and towards care. A theoretical framework is introduced that provides guidance for the transition stages and the areas for negotiation. Research limitations/implications This research has implications for food manufacturers and marketers, as the demand for healthy food for the elderly is made more widely available, healthy and easy to prepare. The limitations of the research are due to the sample located in East Yorkshire only. Practical implications This research has implications for brand managers of food manufacturers and supermarkets that need to create product lines that target this segment by producing healthy, convenience food. Social implications It is also important for health and social care policy as the authors seek to understand the role of food, family and community and how policy can be devised to provide stability in this transitional and uncertain lifestage. Originality/value This research extends the body of literature on food and the family by focussing on the elderly cared for and their family. The authors show how food can be construed as loving care, and using practice theory, a theoretical framework is developed that can explain the transitions and how the family negotiates the stages from independence to dependence

Recurrent candidiasis and early-onset gastric cancer in a patient with a genetically defined partial MYD88 defect

Gastric cancer is caused by both genetic and environmental factors. A woman who suffered from recurrent candidiasis throughout her life developed diffuse-type gastric cancer at the age of 23 years. Using whole-exome sequencing we identified a germline homozygous missense variant in MYD88. Immunological assays on peripheral blood mononuclear cells revealed an impaired immune response upon stimulation with Candida albicans, characterized by a defective production of the cytokine interleukin-17. Our data suggest that a genetic defect in MYD88 results in an impaired immune response and may increase gastric cancer risk

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 associated with romaine lettuce consumption, 2011.

BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) O157:H7 is the causal agent for more than 96,000 cases of diarrheal illness and 3,200 infection-attributable hospitalizations annually in the United States. MATERIALS AND METHODS: We defined a confirmed case as a compatible illness in a person with the outbreak strain during 10/07/2011-11/30/2011. Investigation included hypothesis generation, a case-control study utilizing geographically-matched controls, and a case series investigation. Environmental inspections and tracebacks were conducted. RESULTS: We identified 58 cases in 10 states; 67% were hospitalized and 6.4% developed hemolytic uremic syndrome. Any romaine consumption was significantly associated with illness (matched Odds Ratio (mOR) = 10.0, 95% Confidence Interval (CI) = 2.1-97.0). Grocery Store Chain A salad bar was significantly associated with illness (mOR = 18.9, 95% CI = 4.5-176.8). Two separate traceback investigations for romaine lettuce converged on Farm A. Case series results indicate that cases (64.9%) were more likely than the FoodNet population (47%) to eat romaine lettuce (p-value = 0.013); 61.3% of cases reported consuming romaine lettuce from the Grocery Store Chain A salad bar. CONCLUSIONS: This multistate outbreak of STEC O157:H7 infections was associated with consumption of romaine lettuce. Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply Grocery Store Chain A and a university campus linked to a case with the outbreak strain. An investigation at Farm A did not identify the source of contamination. Improved ability to trace produce from the growing fields to the point of consumption will allow more timely prevention and control measures to be implemented

Recurrent candidiasis and early-onset gastric cancer in a patient with a genetically defined partial MYD88 defect

Gastric cancer is caused by both genetic and environmental factors. A woman who suffered from recurrent candidiasis throughout her life developed diffuse-type gastric cancer at the age of 23 years. Using whole-exome sequencing we identified a germline homozygous missense variant in MYD88. Immunological assays on peripheral blood mononuclear cells revealed an impaired immune response upon stimulation with Candida albicans, characterized by a defective production of the cytokine interleukin-17. Our data suggest that a genetic defect in MYD88 results in an impaired immune response and may increase gastric cancer risk