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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To better understand nursing practice in geriatric care settings as it relates to infections, a survey of nursing attitudes about a variety of infection control issues was undertaken. Nurses were recruited from four settings: a university-affiliated, private nursing home (N = 46), a hospital-based nursing home (N = 33), a private nursing home (N = 20), and a home care agency (N = 26). The nurses appropriately recognized the importance of pneumonia and influenza as major threats to health in these settings and also reported some indifference regarding the notification of physicians about fevers under 38.9 degrees C (102.0 degrees F). Among the groups, similar attitudes about infection control principles were recorded, except that the ratings by the home care agency nurses were different from those of the institution-based nurses in the following areas: isolation as a means to prevent infection spread, proper waste disposal methods, and frequency of catheter change. Assessment of personnel attitudes and practices are important in detecting problems, guiding in-service programing, and revising care practices.
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PMID:Survey of nursing personnel attitudes toward infections and their control in the elderly. 318 42

Based on recent quantitative EEG findings of increased slow activity in negative schizophrenia indicating organicity, it was hypothesized that neuroleptics decreasing delta/theta activity should be beneficial for schizophrenics with predominantly negative symptoms. Thus, a double-blind, clinical, psychometric and neurophysiological study was carried out in 40 hospitalized patients with unproductive schizophrenia (mean age: 31 years; ICD diagnoses: 295.0, 295.1 and 295.6) who were treated randomly either with the benzamide amisulpride (AMI; n = 19) or low doses of fluphenazine (FLU; n = 21). In the first 2 weeks the daily doses were 50 mg AMI or 2 mg FLU, respectively, from the third week on up to the sixth week 100 mg AMI and 4 mg FLU. Clinical evaluations, psychometry and EEG mapping were performed on day 1 (hours 0 and 4--acute effect), on day 14 (hour 0--subacute effect) and on day 42 (hours 0 and 4--chronic and superimposed effects). Three AMI patients discontinued therapy prematurely because of productive symptoms (days 14, 28 and 35), while in the FLU group 2 patients dropped out due to depressive symptoms (days 21, 28), 1 due to productive symptoms (day 35), 1 due to ineffectiveness (day 28), and 1 because of an akinetic crisis (day 6). Statistical evaluation demonstrated a significant improvement in the AMDP apathy and Andreasen SANS score in both groups with the patients remaining severely ill as rated by the CGI. FLU-treated patients needed significantly more anticholinergic medication than the AMI-treated group. Psychometric evaluation showed in regard to the noopsyche significant improvement after subacute, chronic and superimposed AMI, while FLU-treated patients showed significant improvement only after subacute treatment. AMI was significantly superior to FLU at the hours 0 and 4 of day 42. The thymopsyche improved after subacute, chronic and superimposed administration of both compounds with a significant superiority of AMI on days 14 and 42 (4 h postdrug). EEG mapping showed a decrease of delta/theta and increase of beta activity as well as an acceleration of the centroid after acute and superimposed AMI on day 42 as compared with baseline; FLU patients exhibited a decrease of delta/theta activity and an acceleration of the total centroid too, while alpha activity was augmented and beta activity tended to be reduced. Our study demonstrated that, in addition to the new benzamide AMI, FLU in low doses may also be regarded as a neuroleptic with activating properties and may be utilized in the treatment of schizophrenics with predominantly negative symptoms.
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PMID:Clinical, EEG mapping and psychometric studies in negative schizophrenia: comparative trials with amisulpride and fluphenazine. 791 19

In two of its regular sessions, the Royal Academy for Medicine of Belgium consulted with influenza experts on the current threat of a severe pandemic outbreak, and in particular on the eventuality that this outbreak may be caused by a virus identical or related to the avian influenza virus H5N1. On the basis of this consultation, the Academy issued an advisory statement to the Belgian federal and Flemish regional Health Authorities. The Academy shares the experts' concern that the forthcoming influenza pandemic may well affect a larger part of the population than previous pandemics in 1958, 1968 and 1977. The Academy found it satisfying that the Belgian government is developing an appropriate pandemic containment plan. A primary objective of the plan is to safeguard general health care during the pandemic. Availability of staff and infrastructure and continuity of medical supplies must by all means remain intact. Therefore, employees in these sectors are an important target group of preparatory actions, in particular briefing about, and field rehearsals of the containment plan. Health care workers, elderly people and the chronically ill constitute a priority group eligible for vaccination with the antigens of the pandemic virus and for the administration of virus inhibitors. The effectiveness of antiviral treatment and prophylaxis during a pandemic is, given the lack of experience, uncertain. The fact that such remedies will be available must not create a false sense of security and must certainly not lead to reduced alertness with regard to the preparation and implementation of other measures. Panic reactions among the population must be avoided. Therefore, the population must be informed in due course about appropriate ways of conduct when a pandemic strikes, e.g. recognition of the early signs of influenza, the need to consult a general practitioner at once, the reason why being nursed at home is to be preferred to being hospitalized, etc. Indifference towards vaccination must be overcome. In the period prior to the pandemic people must be encouraged to obtain vaccination against the prevalent interpandemic virus strains. Belgium does not stand alone in the avian influenza threat and can largely benefit from participating in the current international initiatives to co-ordinate measures.
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PMID:[Recommendation of the Royal Academy for Medicine of Belgium to the responsible policy authorities in connection with the continually increasing threat of an outbreak of an influenza epidemic]. 1680 Feb 43

Older adults disproportionately sustain morbidity and mortality due to vaccine-preventable illnesses. Despite this observation, adult immunization rates continue to lag behind national goals. Reduced vaccine efficacy in older adults leading to apathy regarding the need for vaccine administration, unrealistic expectations for disease prevention rather than reduced illness severity, and system issues that make vaccine administration and tracking difficult all contribute to this problem. In this review, the biologic and system-based causes for vaccine failure in aged adults are reviewed, issues of efficacy and cost-effectiveness in older adults are summarized for influenza and pneumococcal vaccine, and ways to improve vaccine effectiveness in older adults, now and in the future, are outlined.
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PMID:Immunizations in older adults. 1763 Dec 40

The objective of the study was to evaluate influenza vaccination coverage in Austria in the season of 2006/07 and to understand motivations and barriers. Two-thousand telephone interviews with individuals over 15 years of age were conducted. The overall influenza vaccination coverage rate was 17.8%. In the elderly (>65 years) the rate was 32.1%, and the adjusted odds ratio of being vaccinated, compared to those not belonging to a high-risk group, was 3.8. Chronically ill persons and health care workers had adjusted odds ratios of 2.6 and 1.5, respectively, while chronically ill elderly persons had an odds ratio of vaccination of 7.0. Minimizing the risk of contracting influenza was the most frequent reason for getting vaccinated (35.2%), and a recommendation by the family doctor was perceived as the major encouraging factor for vaccination (46.4%). The main reason for not getting vaccinated was indifference (>50%). Vaccination coverage in Austria in 2006/07 was low and far behind WHO objectives.
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PMID:Influenza vaccination coverage rates in Austria in 2006/07 - a representative cross-sectional telephone survey. 1899 78

Argentina experienced a heavy burden of novel H1N1 influenza in austral winter 2009. In early July 2009, Argentina reported more than 1,500 cases and was confronting the highest per capita H1N1 mortality rate in the world. By September 2009, more than 500 people had died of H1N1 in Argentina. Unlike sister countries Chile and Mexico, Argentina's national authorities did not respond by implementing mitigation measures such as public gathering bans and school closures or by issuing broad-based messages about personal hygiene and disease prevention. Around the globe, many observers expressed dismay at this inaction. For example, The Economist scolded the country's leadership for its halting response and seeming apathy to an escalating health crisis. Why did Argentina, a middle-income country with a developed and, in many respects, sophisticated system of health and education, fall short in enacting a national pandemic plan during the 2009 H1N1 outbreak? What can we learn from Argentina's experiences about obstacles and opportunities during a pandemic crisis? This article, based on extensive qualitative research, including document capture, media analysis, and oral history interviews, assesses Argentina's mixed response to H1N1 during austral winter 2009, and adds to a growing body of studies focused on how governments and health systems in the Americas performed during the 2009-2010 H1N1 pandemic. When the first cases of novel H1N1 influenza were identified by the U.S. Centers for Disease Control and Prevention (CDC) in mid-April 2009, Argentina's national health ministry appeared to be prepared. Starting in 2002, primarily in response to the prospect of avian influenza, the health ministry had formulated a preparedness plan and, beginning in 2005, had conducted at least five pandemic simulation exercises. In April 2009, Argentina's health ministry activated its pandemic response plan, triggering the establishment of an executive-level situation room equipped with rapid communications and computer surveillance to track events as they unfolded. In addition, several expert committees were assembled to assess the situation and solicit input from health practitioners, academics, hospital staff, and allied professionals.
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PMID:Assessing Argentina's response to H1N1 in austral winter 2009: from presidential lethargy to local ingenuity. 2133 26

The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.
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PMID:Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors. 2873 75

Defective interfering particles (DIPs) of influenza virus are generated through incorporation of highly truncated forms of genome segments, mostly those coding polymerase complex proteins (PB2, PB1, PA). Such particles are able to replicate only in the presence of a virus with the complete genome, thus DIPs may alter the infection outcome by suppressing production of standard virus particles, but also by stimulating the immune response. In the present study we compared the clinical outcome, mortality and transmission in chickens and turkeys infected with the same infectious doses of H7N7 low pathogenic avian influenza virus containing different levels of defective gene segments (95/95(DVG-high) and 95/95(DVG-low)). No clinical signs, mortality or transmission were noted in SPF chickens inoculated with neither virus stock. Turkeys infected with 95/95(DVG-high) showed only slight clinical signs with no mortality, and the virus was transmitted only to birds in direct contact. In contrast, more severe disease, mortality and transmission to direct and indirect contact birds was observed in turkeys infected with 95/95(DVG-low). Apathy, lower water and food intake, respiratory system disorders and a total mortality of 60% were noted. Shedding patterns in contact turkeys indicated more efficient within- and between-host spread of the virus than in 95/95(DVG-high) group. Sequencing of virus genomes showed no mutations that could account for the observed differences in pathogenicity. The results suggest that the abundance of DIPs in the inoculum was the factor responsible for the mild course of infection and disrupted virus transmission.
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PMID:Low pathogenic avian influenza virus isolates with different levels of defective genome segments vary in pathogenicity and transmission efficiency. 3285 69

Background: The lockdown strategies adopted to limit the spread of COVID-19 infection may lead to adopt unhealthy lifestyles which may impact on the mental well-being and future risk of dementia. Older adults with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) may suffer important mental health consequences from measures of quarantine and confinement. Aims: The study aimed to explore the effects of COVID-19 and quarantine measures on lifestyles and mental health of elderly at increased risk of dementia. Methods: One hundred and twenty six community-dwelling seniors with MCI or SCD were phone-interviewed and assessed with questions regarding variables related to COVID-19 pandemic, lifestyle changes and scales validated for the assessment of depression, anxiety, and apathy. Results: The sample included 55.6% patients with MCI and 56 people with SCD. Over 1/3 of the sample reduced their physical activity and nearly 70% reported an increase in idle time. Adherence to the Mediterranean diet decreased in almost 1/3 of respondents and over 35% reported weight gain. Social activities were abolished and 1/6 of participants also decreased productive and mental-stimulating activities. 19.8% were depressed, 9.5% anxious, and 9.5% apathetic. A significant association existed between depression and living alone or having a poor relation with cohabitants and between anxiety and SCD, cold or flu symptoms, and reduction in productive leisure activities. Conclusions: Seniors with SCD and MCI underwent lifestyle changes that are potentially harmful to their future cognitive decline, even if, with the exception of leisure activities, they do not appear to be cross-sectionally associated with psychiatric symptoms.
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PMID:The Effects of COVID-19 and Quarantine Measures on the Lifestyles and Mental Health of People Over 60 at Increased Risk of Dementia. 3317 23