The study discussed in this article describes the alcohol-related policies, practices, and problems experienced by a sample of 111 intermediate care facilities and homes for elderly people. Data were collected using a semi-structured telephone interview and indicate that alcohol use and associated problems among nursing home residents are common. Despite the problems reported, screening for alcohol problems among residents, treatment of identified problems, and training of staff were not found to be widespread. Ambiguity about the role of alcohol as a social beverage or as a psychoactive substance to be managed was identified. Challenges to social workers and social work education are identified.
Both meta-analysis and traditional literature or narrative reviews strive to compile a great deal of information in an accessible and succinct manner. In recent years, social work researchers have been turning toward meta-analysis to identify issues in large areas of research. In order for meta-analysis to be a rigorous and objective source of information there are a certain set of assumptions that must be met about how to carry out the process of including and excluding various studies. However, when these assumptions are not met, the information provided can be misleading. Traditional literature reviews continue to offer a valid and important way to identify existing patterns and gaps in social work research. In fact, because they draw not only on quantitative (as does meta-analysis) but also qualitative studies their reach may often be broader. This paper examines the strengths, weaknesses and utility of both practices in social work research today.
Systemic infections, especially in patients with chronic diseases, may result in sepsis: an explosive, uncoordinated immune response that can lead to multisystem organ failure with a high mortality rate. Patients with similar clinical phenotypes or sepsis biomarker expression upon diagnosis may have different outcomes, suggesting that the dynamics of sepsis is critical in disease progression. A within‐subject study of patients with Gram‐negative bacterial sepsis with surviving and fatal outcomes was designed and single‐cell transcriptomic analyses of peripheral blood mononuclear cells (PBMC) collected during the critical period between sepsis diagnosis and 6 h were performed. The single‐cell observations in the study are consistent with trends from public datasets but also identify dynamic effects in individual cell subsets that change within hours. It is shown that platelet and erythroid precursor responses are drivers of fatal sepsis, with transcriptional signatures that are shared with severe COVID‐19 disease. It is also shown that hypoxic stress is a driving factor in immune and metabolic dysfunction of monocytes and erythroid precursors. Last, the data support CD52 as a prognostic biomarker and therapeutic target for sepsis as its expression dynamically increases in lymphocytes and correlates with improved sepsis outcomes. In conclusion, this study describes the first single‐cell study that analyzed short‐term temporal changes in the immune cell populations and their characteristics in surviving or fatal sepsis. Tracking temporal expression changes in specific cell types could lead to more accurate predictions of sepsis outcomes and identify molecular biomarkers and pathways that could be therapeutically controlled to improve the sepsis trajectory toward better outcomes.
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