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Welsh Rooney posted an update 6 months, 3 weeks ago
Moreover, different amino acid changes were detected in the ribosomal proteins L3 and L4 in S. epidermidis isolates. All S. epidermidis isolates belonged to the multilocus sequence type ST2. Linezolid-resistant staphylococci (LRS) showed a multiresistance phenotype, including methicillin resistance that was detected in all isolates but one, and was mediated by the mecA gene. The cfr gene in the MRSA isolate was located together with the fexA gene on a conjugative 38,864 bp plasmid. Linezolid- and methicillin-resistant S. epidermidis ST2 showing mutations in the 23S rRNA and in the ribosomal proteins L3 and L4 are spread among Spanish hospitals, whereas LRS carrying acquired linezolid resistance genes are rarely detected.Background Recently, awareness of children’s decision making has increased in an effort to enhance palliative care. However, the conceptual framework for decision making among children with cancer remains unclear. Aims We clarified the decision-making process of children with cancer regarding their care, treatment, and support from family and health care professionals, and identified their needs and preferences. Design We used metaethnography to conduct a metasynthesis of relevant studies. Data sources We searched PubMed, EMBASE, PsycINFO, MEDLINE, and CINAHL. This report was prepared in accordance with the PRISMA statement. Results Of the 7,237 retrieved studies, 27 met our inclusion criteria. Four themes emerged that reflected the decision-making process of children with cancer (a) facing changes brought about by a health threat, (b) preparing for action, (c) asserting one’s choice, and (d) internal and external influences. Conclusion Children with cancer initially undergo a decision-making process. Respecting children’s preferences, values, and emotions may help build trusting relationships and promote their decision-making capability. selleck compound Future research should focus on children’s emotions, cognition, development, and interactions with parents and health care professionals.Purpose We aimed to characterize couple-level private insurance coverage among same-sex and different-sex couples before and after the Obergefell v. Hodges (OvH) decision legalizing same-sex marriage in the United States. Methods National Health Interview Survey data were obtained for 2012-2014 (pre-OvH) and 2016-2018 (post-OvH). Coresiding couples with both partners aged 27-64 years and at least one having private insurance were included. Couple-level coverage was private for both; private for one, other coverage for another; and private for one, none for another. Secondary analysis examined whether either partner was covered by the policy of a family member in the household (partner/spouse coverage). Results The analysis included 69,251 couples. Ninety percent had private coverage for both partners; 5% had one partner with other coverage; and 5% had one partner uninsured. The share of same-sex couples with both partners having private coverage increased from 79% to 88% after OvH (p = 0.003), whereas it remained at 90% among different-sex couples. In multivariable analysis, this increase was explained by the increase in legal marriage post-OvH. Among unmarried same-sex couples where both partners had private coverage, the odds of one partner being covered by another’s policy decreased by 61% after OvH (95% confidence interval 35%-76%). Conclusion OvH was associated with greater access to private insurance for same-sex couples and lower risk that one partner would have private insurance while another would be uninsured. Yet, partners in unmarried same-sex couples became less likely to share the same private policy.Background Many older adults with serious illness who depend on others for care have symptoms that are difficult to manage. Supporting caregivers in symptom assessment (SA) may reduce suffering. Objective Pilot an SA-Toolkit for caregivers to assess older adults’ symptoms at home. Design Pilot study. Setting/Subjects English-speaking patients ≥65 years of age and their caregivers from a home-based geriatrics program in San Francisco. Measurements With multiple stakeholder input, we created a SA-Toolkit consisting of illustrations depicting symptoms, validated Faces Scale, and easy-to-use tracking system with phone numbers of family/friends/clinicians. At baseline and one week, we assessed change in patients’ symptoms and caregivers’ self-efficacy with SA (5-point scale) using Wilcoxon signed-rank tests. We assessed acceptability at one week. Results Eleven patient/caregiver dyads participated in the study. Patients were 84.7 years old (SD 5.7), 81.8% women, 27.3% non-white. From baseline to one week, mean number of symptoms decreased (3.7 to 2.6 , p = 0.03). Specifically, patients with pain decreased from 63.6% to 36.4%, anxiety 54.6% to 18.2%, depression 45.5% to 27.3%, and loneliness 36.4% to 18.2%. Caregiver self-efficacy increased (4.6 to 4.8 , p = 0.09). Patients found the symptom illustrations easy to use (8.7 on 10-point scale), but the Faces Scale less so (7.3/10) because it provided “too many choices.” Caregivers liked the SA-Toolkit because it was easy to use; nearly all (10/11, 90%) would recommend it to others. Conclusions The SA-Toolkit resulted in decreased symptom burden among patients and higher caregiver self-efficacy in SA. The SA-Toolkit is acceptable and may help reduce suffering in frail, older patients.is a bacterial pathogen that causes epidemic outbreaks of European foulbrood (EFB) in honey bee populations. The pathogenicity of a bacterium depends on its virulence, and understanding the mechanisms influencing virulence may allow for improved disease control and containment. Using a standardized in vitro assay, we demonstrate that virulence varies greatly among sixteen M. plutonius isolates from five European countries. Additionally, we explore the causes of this variation. In this study, virulence was independent of the multilocus sequence type of the tested pathogen, and was not affected by experimental co-infection with Paenibacillus alvei, a bacterium often associated with EFB outbreaks. Virulence in vitro was correlated with the growth dynamics of M. plutonius isolates in artificial medium, and with the presence of a plasmid carrying a gene coding for the putative toxin melissotoxin A. Our results suggest that some M. plutonius strains showed an increased virulence due to the acquisition of a toxin-carrying mobile genetic element.