Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review

BACKGROUND: For more than 60 years, psychiatric services has gradually gone from an asylum model to a community model. This change has led to the emergence of a deinstitutionalization movement. This movement seems to have left behind long-term hospitalized aging individuals with severe and disabling mental disorders. The objective of this article is to conduct a review on the challenges and issues associated with the process of deinstitutionalization among hospitalized aging individuals with severe and disabling mental disorders. METHODS: Using PRISMA statement, the research methodology was carried out in English and French in 16 databases with a combination of 3 lists of keywords. The selection process was then followed by a thematic analysis which aimed at categorizing by theme and classifying the writings selected. RESULTS: A total of 83 articles published between 1978 and 2019 were selected and organized into six categories: (a) a forgotten population in research and health policies, (b) an economic presentation of the deinstitutionalization process, (c) an improvement in quality of life and global functioning for deinstitutionalized patients (d) from stigmatization to the rejection of elderly psychiatric inpatients from deinstutionalization process, (e) a difficult community-based care offer and a difficult epistemological identification, (f) from the lack of community services to the phenomenon of transinstitutionalization. The current state of scientific research, institutional policies and clinical practices associated with the deinstitutionalization process of SVPTSIH are then commented. CONCLUSIONS: Recommendations are proposed to researchers and professionals concerned with the support of long-term hospitalized aging individuals with severe and disabling mental disorders

Exploring the institutional market for fresh vegetables in the Southern Philippines

Given the many different ways the product may be used, the institutional market for fresh vegetables in the Southern Philippines can be segmented on the basis of the role market intermediaries perform in the supply chain, where they are, what customers they serve, the range of products required, the volume of product required and the quality specifications. Potential market opportunities are identified and the various constraints smallholder farmers face in endeavouring to meet the needs of institutional buyers are highlighted

Spherically symmetric steady states of galactic dynamics in scalar gravity

The kinetic motion of the stars of a galaxy is considered within the framework of a relativistic scalar theory of gravitation. This model, even though unphysical, may represent a good laboratory where to study in a rigorous, mathematical way those problems, like the influence of the gravitational radiation on the dynamics, which are still beyond our present understanding of the physical model represented by the Einstein--Vlasov system. The present paper is devoted to derive the equations of the model and to prove the existence of spherically symmetric equilibria with finite radius.Comment: 13 pages, mistypos correcte

Electronic Health Record-Based Surveillance for Community Transmitted COVID-19 in the Emergency Department

Introduction: SARS-CoV-2, a novel coronavirus, manifests as a respiratory syndrome (COVID-19) and is the cause of an ongoing pandemic. The response to COVID-19 in the United States has been hampered by an overall lack of diagnostic testing capacity. To address uncertainty about ongoing levels of SARS-CoV-2 community transmission early in the pandemic, we aimed to develop a surveillance tool using readily available emergency department (ED) operations data extracted from the electronic health record (EHR). This involved optimizing the identification of acute respiratory infection (ARI)-related encounters and then comparing metrics for these encounters before and after the confirmation of SARS-CoV-2 community transmission.Methods: We performed an observational study using operational EHR data from two Midwest EDs with a combined annual census of over 80,000. Data were collected three weeks before and after the first confirmed case of local SARS-CoV-2 community transmission. To optimize capture of ARI cases, we compared various metrics including chief complaint, discharge diagnoses, and ARI-related orders. Operational metrics for ARI cases, including volume, pathogen identification, and illness severity, were compared between the pre- and post-community transmission timeframes using chi-square tests of independence.Results: Compared to our combined definition of ARI, chief complaint, discharge diagnoses, and isolation orders individually identified less than half of the cases. Respiratory pathogen testing was the top performing individual ARI definition but still only identified 72.2% of cases. From the pre to post periods, we observed significant increases in ED volumes due to ARI and ARI cases without identified pathogen.Conclusion: Certain methods for identifying ARI cases in the ED may be inadequate and multiple criteria should be used to optimize capture. In the absence of widely available SARS-CoV-2 testing, operational metrics for ARI-related encounters, especially the proportion of cases involving negative pathogen testing, are useful indicators for active surveillance of potential COVID-19 related ED visits

Thin-film flow in helically wound rectangular channels with small torsion

Laminar gravity-driven thin-film flow down a helically-wound channel of rectangular cross-section with small torsion in which the fluid depth is small is considered. Neglecting the entrance and exit regions we obtain the steady-state solution that is independent of position along the axis of the channel, so that the flow, which comprises a primary flow in the direction of the axis of the channel and a secondary flow in the cross-sectional plane, depends only on position in the two-dimensional cross-section of the channel. A thin-film approximation yields explicit expressions for the fluid velocity and pressure in terms of the free-surface shape, the latter satisfying a non-linear ordinary differential equation that has a simple exact solution in the special case of a channel of rectangular cross-section. The predictions of the thin-film model are shown to be in good agreement with much more computationally intensive solutions of the small-helix-torsion Navier–Stokes equations. The present work has particular relevance to spiral particle separators used in the mineral-processing industry. The validity of an assumption commonly used in modelling flow in spiral separators, namely that the flow in the outer region of the separator cross-section is described by a free vortex, is shown to depend on the problem parameters

DprE2 is a molecular target of the anti-tubercular nitroimidazole compounds pretomanid and delamanid

Abstract Mycobacterium tuberculosis is one of the global leading causes of death due to a single infectious agent. Pretomanid and delamanid are new antitubercular agents that have progressed through the drug discovery pipeline. These compounds are bicyclic nitroimidazoles that act as pro-drugs, requiring activation by a mycobacterial enzyme; however, the precise mechanisms of action of the active metabolite(s) are unclear. Here, we identify a molecular target of activated pretomanid and delamanid: the DprE2 subunit of decaprenylphosphoribose-2’-epimerase, an enzyme required for the synthesis of cell wall arabinogalactan. We also provide evidence for an NAD-adduct as the active metabolite of pretomanid. Our results highlight DprE2 as a potential antimycobacterial target and provide a foundation for future exploration into the active metabolites and clinical development of pretomanid and delamanid

Central contracts in Test cricket: a model of best practice?

Across the last two decades, management of international cricket players has changed substantially, with the main Test playing nations using central contracts to guide their team selection. Increased management control over player workload has been a key focus of this. This paper aims to analyse selection in relation to performance for eight Test playing nations in 1,135 matches over thirty years (1985-2015), particularly in relation to the introduction of central contracts. The results demonstrated a relationship between selection stability (i.e. changes made) and performance (overall results and win ratio). The improvement was more pronounced immediately following the introduction of a contract system, as the competitive advantage appears to be at its highest in the two years following their introduction. The data presented argues that the implementation of central contracts as a best practice model has been a beneficial addition to nations' performance in Test matches. Despite this, team managers, coaches and selectors should focus their work on developing an organisational culture where the elite environment has long term stability as its focus. This is particularly pertinent as selection uncertainty can be a de-stabilising factor, as suggested in this paper and in previous research