Do Socioeconomic Factors Influence Knowledge, Attitudes, and Representations of End-of-Life Practices? A Cross-Sectional Study.

OBJECTIVE: Access to palliative and end-of-life (EOL) care might be influenced by knowledge, attitudes, and representations of these practices. Socioeconomic factors might then affect what people know about EOL care practices, and how they perceive them. This study aims to compare knowledge, attitudes, and representations regarding EOL practices including assisted suicide, medical assistance in dying, and continuous palliative sedation of adults, according to socioeconomic variables. METHODS: A cross-sectional community-based questionnaire study featuring two evolving vignettes and five end-of-life practices was conducted in Quebec, Canada. Three sample subgroups were created according to the participants' perceived financial situation and three according to educational attainment. Descriptive analysis was used to compare levels of knowledge, attitudes, and representations between the subgroups. RESULTS: Nine hundred sixty-six (966) people completed the questionnaire. Two hundred and seventy participants (28.7%) had a high school diploma or less, and 42 participants (4.4%) were facing financial hardship. The majority of respondents supported all end-of-life options and the loosening of eligibility requirements for medical assistance in dying. Differences between subgroups were minor. While respondents in socioeconomically disadvantaged subgroups had less knowledge about EOL practices, those with lower educational attainment were more likely to be in favor of medical assistance in dying, and less likely to favor continuous palliative sedation. CONCLUSIONS: People living with situational social and economic vulnerabilities face multiple barriers in accessing health care. While they may have poorer knowledge about EOL practices, they have a positive attitude towards medical assistance in dying and assisted suicide, and a negative attitude towards continuous palliative sedation. This highlights the need for future research and interventions aimed at empowering this population and enhancing their access to EOL care.

How societal responses to COVID-19 could contribute to child neglect.

BACKGROUND: The ecosystemic approach to children's needs demands a cohesive response from societies, communities, and families. During the COVID-19 pandemic, the choices societies made to protect their community members from the virus could have created contexts of child neglect. With the closure of services and institutions, societies were no longer available to help meet the needs of children. OBJECTIVE: The purpose of this study is to examine parents' reports on the response their children received to their needs during the COVID-19 crisis. METHODS: During the period of the spring 2020 lockdown, 414 parents in the province of Quebec, Canada, completed an online questionnaire about the impact of the crisis on the response their children received to their needs. RESULTS: Compared to parents of younger children, parents of older children reported less fulfillment of their child's needs in three measured domains, namely cognitive and affective, security, and basic care needs. CONCLUSION: These results are discussed in light of the policies and the resources societies have put in place during the crisis to help families meet the needs of their children. Societies must learn from this crisis to put children at the top of their priorities in the face of a societal crisis. Thoughtful discussions and energy must be given to ensure that, while facing a crisis, the developmental trajectories of children are not sacrificed.

Effect of pH adjustment on the composition and rennet-gelation properties of milk concentrates made from ultrafiltration and reverse osmosis.

The objective of this work was to investigate the effect of pH adjustment (initial pH vs. pH 6.50) on the rennet-gelation properties of concentrates made by ultrafiltration (UF) and reverse osmosis (RO). Rennet-gelation kinetics were followed by dynamic rheology and κ-casein hydrolysis by reverse-phase HPLC. At initial pH, RO concentrates had better rennet-coagulation behavior than UF concentrates and skim milk, whereas adjusting the pH to 6.50 produced the opposite results. The kinetics of κ-casein hydrolysis were similar in skim milk, and both concentrates and were not affected by pH adjustment. Differences in rennet coagulation were then related to the extent of hydrolysis required to trigger casein micelle aggregation. Small pH adjustments (<0.2 pH unit) enabled the use of RO concentrate with similar rennet-gelation behavior to UF concentrate, despite major compositional differences. This study shows that pH adjustment of RO concentrates can be a simple approach to improve their coagulation properties; however, the mechanisms behind these improvements remain to be elucidated.

Prevalence and risk factors of child neglect in the general population.

OBJECTIVES: Child neglect is a major public health problem. It is the most frequently reported and substantiated form of maltreatment in youth protective services, and its effects are the most harmful to children. Yet, very few studies have documented its extent and risk factors in the general population. This study aims at documenting the annual prevalence and risk factors of child-neglect behaviours in the general population according to child age and parental gender. STUDY DESIGN: Cross-sectional population survey. METHODS: A sample consisting of 3298 mothers and 1104 fathers of children between six months and 15 years old responded to a telephone survey. The prevalence of neglect was documented using the short version of the Parent-Report Multidimensional Neglectful Behaviour Scale for three child-age categories. RESULTS: Annual prevalence rates vary between 20.6% (95% CI 18.2-23.1) and 29.4% (95% CI 26.6-32.4) depending on the children's age. Although statements do not vary by parent gender, the factors associated with neglect depend on whether they are reported by the mother or the father. Mothers present more mental health problems, while fathers struggle more commonly with difficulties related to their life context. CONCLUSIONS: Measuring neglect in the population presents numerous challenges. Nonetheless, this study made it possible to document the extent of neglectful behaviours in the general population. The results confirm that the risk factors related to neglectful behaviours are similar to those documented in studies concerning situations of neglect reported to the authorities. Other studies are needed to better understand how this phenomenon is manifested in the population.

Concentration of Giardia lamblia cysts, Legionella pneumophila, Clostridium perfringens, human enteric viruses, and coliphages from large volumes of drinking water, using a single filtration.

Poliovirus, coliphages, Giardia lamblia cysts, Clostridium perfringens spores, and Legionella pneumophila were concentrated simultaneously in a single pass by sequential filtration of large volumes of drinking water through 3- and 1-micron wound electronegative fiberglass cartridge filters (25.4 cm). Filtration was performed under acidic conditions (pH 3.5) in the presence of 0.001 M aluminum chloride to enhance adsorption. Elution of all the microorganisms entrapped or adsorbed to the filters was obtained by a slow backwash elution with a 1.5% beef extract solution, pH 9.75, containing 0.5% Tween 80. Tween 80 was shown to enhance recovery of the bacteriophages, bacteria, and parasites. Giardia cysts were efficiently eluted (71%) and could be reconcentrated by low-speed centrifugation and purified by sucrose density gradient flotation at a final recovery of 52%. Legionella pneumophila cells were eluted at 64% and were further concentrated by low-speed centrifugation at an overall recovery of 55%. C. perfringens spores and coliphages were eluted at efficiencies of 82 and 86%, respectively, and reconcentrated with minimal loss by a detergent - protein flotation method. Poliovirus was eluted at 93% and reconcentrated at 78% efficiency by organic flocculation.

Rapid detection and identification of Legionella pneumophila by a membrane immunoassay.

Legionella pneumophila was detected and identified by an immunoblot assay using a monoclonal antibody specific to serogroups 1 to 8. Samples containing L. pneumophila were plated on buffered charcoal yeast extract agar supplemented with glycine, vancomycin, and polymyxin B. After incubation at 35 degrees C for 3 days, colonies were transferred to nitrocellulose membranes by blotting. Simultaneous detection and identification of L. pneumophila were done by treating the membrane with the monoclonal antibody and a peroxidase conjugate to mouse immunoglobulins. A diffuse cross-reaction was observed with Pseudomonas fluorescens colonies, but this was a low-level reaction that could easily be differentiated from the strong specific reactions to L. pneumophila.

The rabbit mesenteric vein: a specific bioassay for substance P.

The anterior mesenteric vein of the rabbit responds to substance P with dose-dependent contractions and is among the vascular smooth muscles most sensitive to this peptide. In spite of its high sensitivity to numerous other agents, including angiotensin and bradykinin, the rabbit mesenteric vein can be made selective for substance P by the use of specific inhibitors that will prevent the myotropic effects of acetylcholine, catecholamines, histamine, 5-hydroxytryptamine, and of the two above-mentioned peptides, without modifying the contractions elicited by substance P. It appears that this peptide acts directly on specific receptors and not through the release of neurotransmitters. Interference by intramural prostaglandins is excluded because substance P is equally active on tissues pretreated with indomethacin or untreated. Dose-response curves obtained with substance P are close to the theoretical curves predicted by the mass action law. The rabbit mesenteric vein contains a new type of receptor for bradykinin, recently identified (REGOLI, D., MARCEAU, F., and BARABE, J. 1978. De novo formation of vascular receptors for bradykinin. Can, J. Physiol. Pharmacol. 56, in press.). The action of bradykinin on this receptor can be prevented with the use of specific and competitive inhibitors and, therefore, the mesenteric vein will distinguish between peptides of the kinins or of the substance P types.