Assessing the impact of COVID-19 on healthcare staff at a combined elderly care and specialist palliative care facility: A cross-sectional study.

BACKGROUND: In the pre-COVID-19 era, healthcare professionals experienced stress and burnout. The international literature confirms that COVID-19 placed significant additional burdens on healthcare workers. AIM: To describe and characterise the magnitude and variety of ways in which the COVID-19 pandemic affected the personal, social and professional lives of healthcare workers representing several multidisciplinary specialties in a fully-integrated palliative and elderly care service. DESIGN: All staff were invited to complete an anonymised standardised questionnaire evaluating the impact of COVID-19 across a diverse range of domains. The study was conducted over a 6-week period commencing 11 September 2020. SETTING: The setting incorporates two distinct but integrated services operating under a single management structure in Ireland: (i) Specialist palliative care across hospice (44 beds), community and hospitals and (ii) Elderly Care Service (long-term and respite care) delivered in a 63-bed inpatient unit. RESULTS: 250 respondents (69.8%) completed the questionnaire. Nurses and healthcare assistants comprised the majority of respondents (60%) and other disciplines were represented proportionately. 230 participants (92%) agreed that their personal workload had changed significantly in response to COVID-19 and 182 (72.8%) agreed that their responsibilities had increased. 196 (78.4%) reported greater work-related stress. Highest-rated sources of stress included fear of contracting COVID-19 or transmitting it to friends/family, interacting with isolated frail/dying patients, changes to workplace protocols and reduced social interaction with colleagues. CONCLUSIONS: This study demonstrates the profound impact of COVID-19 on personal and professional wellbeing of staff. The greatest burden was carried by those providing prolonged, direct and intimate patient care.

The anatomy and physiology of the venous foot pump.

The presence of a venous pumping mechanism in the foot may be significant for venous return in the lower extremities. However, there has been a lack of conclusive research in the area to date and controversy still exists over the detailed anatomy and physiologic mechanism of the venous foot pump. A full understanding of the anatomy and physiology of the venous foot pump is essential for designing effective interventions for the prevention, treatment, and management of venous disease in the lower limbs. This article highlights and discusses the relevant literature relating to the anatomy and physiology of the venous foot pump. In addition, the plantar aspects of 10 cadaveric feet were dissected. These dissections revealed the presence of a previously unreported secondary deep plantar arch and/or deep system of venous connections in the foot and facilitated a more detailed description of the patterns of doubling and branching of the primary veins of the foot. The results of these dissections are discussed within the context of previous work in the field with the aid of detailed diagrams of the dissected feet and may provide a backdrop for the physiology of the venous foot pump and its potential role in lower limb circulation. This is discussed in the last section of the article, which also highlights existing controversy regarding the role of weight bearing and muscular contraction as the dominant mechanisms for venous pumping in the foot.

Influences of Infant-Directed Speech on Early Word Recognition.

When addressing infants, many adults adopt a particular type of speech, known as infant-directed speech (IDS). IDS is characterized by exaggerated intonation, as well as reduced speech rate, shorter utterance duration, and grammatical simplification. It is commonly asserted that IDS serves in part to facilitate language learning. Although intuitively appealing, direct empirical tests of this claim are surprisingly scarce. Additionally, studies that have examined associations between IDS and language learning have measured learning within a single laboratory session rather than the type of long-term storage of information necessary for word learning. In this study, 7- and 8-month-old infants' long-term memory for words was assessed when words were spoken in IDS and adult-directed speech (ADS). Word recognition over the long term was successful for words introduced in IDS, but not for those introduced in ADS, regardless of the register in which recognition stimuli were produced. Findings are discussed in the context of the influence of particular input styles on emergent word knowledge in prelexical infants.

Overcoming the Effects of Variation in Infant Speech Segmentation: Influences of Word Familiarity.

Previous studies have shown that 7.5-month-olds can track and encode words in fluent speech, but they fail to equate instances of a word that contrast in talker gender, vocal affect, and fundamental frequency. By 10.5 months, they succeed at generalizing across such variability, marking a clear transition period during which infants' word recognition skills become qualitatively more mature. Here we explore the role of word familiarity in this critical transition and, in particular, whether words that occur frequently in a child's listening environment (i.e., "Mommy" and "Daddy") are more easily recognized when they differ in surface characteristics than those that infants have not previously encountered (termed nonwords). Results demonstrate that words are segmented from continuous speech in a more linguistically mature fashion than nonwords at 7.5 months, but at 10.5 months, both words and nonwords are segmented in a relatively mature fashion. These findings suggest that early word recognition is facilitated in cases where infants have had significant exposure to items, but at later stages, infants are able to segment items regardless of their presumed familiarity.