Beyond the control of the care home: A meta‐ethnography of qualitative studies of Infection Prevention and Control in residential and nursing homes for older people
AuthorsDaker‐White, Gavin; orcid: 0000-0002-3538-8805
Panagioti, Maria; orcid: 0000-0002-7153-5745; email: firstname.lastname@example.org
Blakeman, Thomas; orcid: 0000-0003-3298-8423
Moore, Victoria; orcid: 0000-0002-1349-3612
Hall, Alex; orcid: 0000-0002-8849-744X
Jones, Paul P.
Tyler, Natasha; orcid: 0000-0001-8257-1090
Campbell, Stephen; orcid: 0000-0002-2328-4136
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AbstractAbstract: Objective: This study aimed to develop interpretive insights concerning Infection Prevention and Control (IPC) in care homes for older people. Design: This study had a meta‐ethnography design. Data Sources: Six bibliographic databases were searched from inception to May 2020 to identify the relevant literature. Review Methods: A meta‐ethnography was performed. Results: Searches yielded 652 records; 15 were included. Findings were categorized into groups: The difficulties of enacting IPC measures in the care home environment; workload as an impediment to IPC practice; the tension between IPC and quality of life for care home residents; and problems dealing with medical services located outside the facility including diagnostics, general practice and pharmacy. Infection was revealed as something seen to lie ‘outside’ the control of the care home, whether according to origins or control measures. This could help explain the reported variability in IPC practice. Facilitators to IPC uptake involved repetitive training and professional development, although such opportunities can be constrained by the ways in which services are organized and delivered. Conclusions: Significant challenges were revealed in implementing IPC in care homes including staffing skills, education, workloads and work routines. These challenges cannot be properly addressed without resolving the tension between the objectives of maintaining resident quality of life while enacting IPC practice. Repetitive staff training and professional development with parallel organisational improvements have prospects to enhance IPC uptake in residential and nursing homes. Patient or Public Contribution: A carer of an older person joined study team meetings and was involved in writing a lay summary of the study findings.
DescriptionFrom Wiley via Jisc Publications Router
History: received 2021-04-29, rev-recd 2021-07-22, accepted 2021-08-04, pub-electronic 2021-08-21
Article version: VoR
Publication status: Published
Funder: NIHR Patient Safety Translational Research Centres; Id: http://dx.doi.org/10.13039/501100013235; Grant(s): PSTRC‐2016‐003
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No Difference in Penetrance between Truncating and Missense/Aberrant Splicing Pathogenic Variants in MLH1 and MSH2: A Prospective Lynch Syndrome Database StudyDominguez-Valentin, Mev; orcid: 0000-0001-7856-0057; email: Mev.Dominguez.Valentin@rr-research.no; Plazzer, John-Paul; orcid: 0000-0001-5114-4301; email: email@example.com; Sampson, Julian R.; email: Sampson@cardiff.ac.uk; Engel, Christoph; orcid: 0000-0002-7247-282X; email: firstname.lastname@example.org; Aretz, Stefan; orcid: 0000-0002-5228-1890; email: email@example.com; Jenkins, Mark A.; email: firstname.lastname@example.org; Sunde, Lone; email: email@example.com; Bernstein, Inge; email: firstname.lastname@example.org; Capella, Gabriel; orcid: 0000-0002-4669-7320; email: email@example.com; Balaguer, Francesc; orcid: 0000-0002-0206-0539; email: firstname.lastname@example.org; et al. (MDPI, 2021-06-28)Background. Lynch syndrome is the most common genetic predisposition for hereditary cancer. Carriers of pathogenic changes in mismatch repair (MMR) genes have an increased risk of developing colorectal (CRC), endometrial, ovarian, urinary tract, prostate, and other cancers, depending on which gene is malfunctioning. In Lynch syndrome, differences in cancer incidence (penetrance) according to the gene involved have led to the stratification of cancer surveillance. By contrast, any differences in penetrance determined by the type of pathogenic variant remain unknown. Objective. To determine cumulative incidences of cancer in carriers of truncating and missense or aberrant splicing pathogenic variants of the MLH1 and MSH2 genes. Methods. Carriers of pathogenic variants of MLH1 (path_MLH1) and MSH2 (path_MSH2) genes filed in the Prospective Lynch Syndrome Database (PLSD) were categorized as truncating or missense/aberrant splicing according to the InSiGHT criteria for pathogenicity. Results. Among 5199 carriers, 1045 had missense or aberrant splicing variants, and 3930 had truncating variants. Prospective observation years for the two groups were 8205 and 34,141 years, respectively, after which there were no significant differences in incidences for cancer overall or for colorectal cancer or endometrial cancers separately. Conclusion. Truncating and missense or aberrant splicing pathogenic variants were associated with similar average cumulative incidences of cancer in carriers of path MLH1 and path_MSH2.
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