Older women's perceptions of a programmable video monitoring system at home : a pilot study

Introduction：　Developing technologies to help older adults to age in place is paramount in coping with health challenges related to the ageing population. Camera-based technologies are efficient for home monitoring; however, few studies exist of users’ perceptions of these technologies. To monitor night walks and the person-environment interaction, a programmable video monitoring system (VS) was implemented at home. This study explores users’ perceptions of this VS. Methods：　For this multiple case study, six older women were recruited according to these criteria: (1) ≥65 years old; (2) ≥ one fall within the last 12 months; (3) woke up at night to go to the toilet; (4) lived alone. The VS was implemented for seven nights. Perceptions were explored with semi-structured interviews before and after the experiment. Data were analysed qualitatively following a cross-case method. Results Participants had positive opinions of the VS before the implementation; they appreciated three features: (1) the programmable movement detection during chosen time slots, respecting privacy; (2) the LED indicating the recording; (3) the small cameras. After the experiment, participants reported positive experiences, though some expressed some discomfort. During the experiment, participants’ perceptions changed because they got used to the system. Conclusion：　Older women’s favourable opinion of programmable VS supports the use of ambient technologies to facilitate ageing in place. Future research should involve larger samples to confirm the possibility of using programmable VS with community-dwelling older adults

Troubles musculo-squelettiques chez les téléopérateurs des centres d’urgence 911, des contraintes physiques aux contraintes psychosociales

À la demande de l’Association paritaire pour la santé et sécurité du travail secteur « affaires municipales » du Québec (APSAM), une programmation de recherche thématique a été élaborée dans le but d’intervenir pour réduire la prévalence des troubles musculo-squelettiques et de santé psychologique affectant les téléopérateurs des centres d’urgence 911. Cet article présente une première étude dont l’objectif est de décrire la prévalence et d’identifier les problématiques sous-jacentes à la présence de troubles musculo-squelettiques. La méthodologie adoptée comporte l’administration de questionnaires, la réalisation d’observations et d’entrevues ouvertes dans cinq centres d’urgence 911. Les résultats montrent des taux de prévalence de troubles musculo-squelettiques beaucoup plus élevés que ceux d’un échantillon représentatif de travailleurs et travailleuses québécois. L’analyse des résultats statistiques à la lumière des observations et des entrevues ouvertes a permis de préciser les problématiques sous-jacentes afin de développer un projet d’intervention.At the request of the Association paritaire pour la santé et sécurité du travail secteur “affaires municipales” du Québec (APSAM, joint sector-based occupational health and safety association, municipal affairs), a thematic research program was developed so that action could be taken to reduce the prevalence of musculoskeletal and psychological health disorders affecting 911 emergency call centre agents. This article presents an initial study whose objective was to describe the prevalence of musculoskeletal disorders and to identify their underlying issues. The adopted methodology involved the administration of questionnaires, observations, and open-ended interviews in five 911 emergency call centres. The results show musculoskeletal disorder prevalence rates much higher than those of a representative sample of Québec workers. The analysis of the statistical results in the light of the observations and open-ended interviews led to the identification of the underlying issues so that an intervention project could be developed.A pedido de la Asociación paritaria por la salud y la seguridad en el trabajo sector « asuntos municipales » del Quebec (APSAM), se elaboró una programación de investigación temática cuyo propósito es intervenir para reducir la prevalencia de lesiones músculo esqueléticas (LMS) y de problemas psicológicos que afectan a los tele-operadores de los centros de urgencia 911. Este artículo presenta un primer estudio cuyo objetivo es describir la prevalencia e identificar las problemáticas subyacentes a la presencia de las LMS. La metodología empleada comporta la administración de cuestionarios, la realización de observaciones y entrevistas abiertas en cinco centros de urgencia 911. Los resultados muestran tasas de prevalencia de LMS mucho más elevadas que aquellas de una muestra representativa de trabajadores y trabajadoras del Quebec. El análisis de los resultados estadísticos a la luz de las observaciones y entrevistas permitió precisar las problemáticas subyacentes con el fin de desarrollar un proyecto de intervención

The human milk endocannabinoidome and neonatal growth in gestational diabetes

ObjectiveEndocannabinoids and their N-acyl-ethanolamines (NAEs) and 2monoacyl-glycerols (2-MAGs) congeners are involved in the central and peripheral regulation of energy homeostasis, they are present in human milk and are associated with obesity. Infants exposed in utero to gestational diabetes mellitus (GDM) are more likely to develop obesity. The objective of this cross-sectional study is to compare the profile of eCBome mediators in milk of women with gestational diabetes (GDM+) and without (GDM-) and to assess the association with offspring growth. The hypothesis is that the eCBome of GDM+ human milk is altered and associated with a difference in infant growth.MethodsCirculating eCBome mediators were measured by LC-MS/MS in human milk obtained at 2 months postpartum from GDM+ (n=24) and GDM- (n=29) women. Infant weight and height at 2 months were obtained from the child health record. Z-scores were calculated.ResultsCirculating Npalmitoylethanolamine (PEA) was higher in human milk of GDM+ women than in GDM- women (4.9 ± 3.2 vs. 3.3 ± 1.7, p=0.04). Higher levels were also found for several 2monoacyl-glycerols (2-MAGs) (p<0.05). The levels of NAEs (β=-4.6, p=0.04) and especially non-omega-3 NAEs (B=-5.6, p=0.004) in human milk were negatively correlated with weight-for-age z-score of GDM+ offspring.ConclusionThe profile of eCBome mediators in human milk at 2 months postpartum was different in GDM+ compared to GDM- women and was associated with GDM+ offspring growth at 2 months.Clinical trial registrationClinicalTrials.gov, identifier (NCT04263675 and NCT02872402)

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

Background: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non-oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non-OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction

Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Publisher Copyright: © 2021 The Authors, some rights reserved.Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-alpha and/or IFN-omega are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-alpha and/or IFN-omega (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-beta. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-alpha and/or IFN-omega are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-beta do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases.Peer reviewe

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research