Vaccination of health care workers (HCWs) is recommended as a strategy for preventing influenza in elderly patients in long-term care. However, there have been no controlled studies to show whether this approach is effective. During the winter of 1994-1995, 1059 patients in 12 geriatric medical long-term-care sites, randomized for vaccination of HCWs, were studied. In hospitals where HCWs were offered vaccination, 653 (61%) of 1078 were vaccinated. Vaccination of HCWs was associated with reductions in total patient mortality from 17% to 10% (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.40-0.80) and in influenza-like illness (OR, 0.57; 95% CI, 0.34-0.94). Vaccination of patients was not associated with significant effects on mortality (OR, 1.15; 95% CI, 0.81-1.64). Results of this study support recommendations for vaccination against influenza of HCWs in long-term geriatric care. Vaccination of frail elderly long-term-care patients may not give clinically worthwhile benefits.

During infection, bacterial pathogens utilize a type III secretion system to inject effectors into the cytoplasm of a target cell where they disrupt the defense system of the host cell. Vibrio parahaemolyticus, a causative agent of gastroenteritis endemic in Southeast Asia, has a type III secretion system that encodes a novel member of the YopJ-like protein effector family, VopA (Vibrio outer protein A). Our studies revealed that Vibrio VopA encodes an evolutionarily conserved activity that is extremely potent and requires an intact catalytic site to abrogate signaling pathways in a manner distinct from that of other YopJ-like effectors. We observed that VopA efficiently inhibits the MAPK signaling pathways but not the NFB pathway in mammalian cells. When expressed in yeast, VopA induces a growth arrest phenotype and also blocks yeast MAPK signaling pathways. Our observations provide insight into the immense diversity of targets utilized by YopJ-like effectors to manipulate eukaryotic signaling machineries that are important for the response and survival of the host cell during infection and/or symbiosis.

Significant numbers of cats enter rescue and re-homing facilities each year, over half of which are relinquished directly by owners. Identifying the reasons why owners decide to give up their pet is an important step in the development of education strategies to encourage retention of cats by their owners. In addition, identifying why adopting owners fail to retain their new cats is important in the refinement of homing policies. Characteristics of 6,089 cats relinquished and returned to 11 rescue facilities in the UK were recorded over a year. In addition, information was collected on the reason why owners gave up, or brought back, their pet. Sixty percent of cats and kittens entering shelters were relinquished by owners, with 19% being due to owner circumstances, such as moving to rented accommodation or changes in family circumstances. Seven percent were for behavioral reasons, and 5% because of the occurrence of allergy or asthma in owners. Returned cats were significantly more likely to be older (Mann Whitney U, Z = -9.167, p < 0.001) and neutered (Pearson 2 = 110.0, df = 2, p < 0.001) than the general relinquished population. The reasons for original relinquishment and return of owned cats were also significantly different (Pearson 2 = 84.4, df = 6, p < 0.001), with 38% of cats being returned for behavioral reasons, and 18% because of allergy or asthma. The commonest behavioral reason for both relinquishment and return was aggression between cats in the household.

Undernutrition of long-stay hospital patients and those in surgical units is well documented. This study was designed to determine the extent of the problem in elderly people admitted to hospital with acute medical problems and to assess the relationship between nutritional status and course of hospital stay. Sixty-nine patients underwent a nutritional assessment on admission and at intervals throughout their hospital stay and episodes of sepsis were documented. Severely malnourished patients were identified using body mass index, BMI (22%) and corrected arm muscle area, CAMA (26%). Episodes of sepsis occurred significantly more often in the severely undernourished group (p < 0.04). The median length of stay of the group was 16 days (range 2-113): during this time there was no significant change in markers of nutritional status apart from actual muscle circumference (AMC), which showed a reduction in measurement between admission and discharge which was statistically significant (p < 0.0003). This study indicated that severe malnutrition is common in elderly medical admissions, and that it is associated with an increased risk of sepsis. Additional nutritional depletion may occur during hospital stay, and is not easily recognized unless anthropometry is undertaken.

Objectives: To determine whether routine oral and enteral nutritional supplementation can improve the weight, anthropometry, and survival of adult patients. Design: Systematic review of randomised controlled trials of oral or enteral protein supplementation in adults. Trials were identified from Medline (Silver Platter 3.11, 1966-96), reference lists of identified studies and review articles, and communication with feed manufacturers. Subjects: Randomised controlled trials comparing oral or enteral protein supplementation with no routine supplementation. All trials of adult subjects were included except those addressing nutrition in pregnancy. Main outcome measures: Change in body weight and anthropometry (mid-arm muscle circumference), and all cause case fatality recorded at the end of scheduled follow up. Body weight and anthropometry were analysed as the weighted mean difference and 95% confidence intervals of the percentage change in these variables. Case fatality was analysed with odds ratio and 95% confidence intervals.

Prescribing sip feed supplements in the medicine prescription chart during hospital stay reduces weight loss. Our data also support other evidence for a reduction in mortality noted in elderly patients on nutritional supplementation. There were suggestions of other clinical benefits.

The main aim of this study was to replicate methodology used to estimate the size of the UK pet cat and dog populations in 2006 and the proportion of households owning cats/dogs in 2007, to produce updated data to compare trends in ownership and population sizes. A cross-sectional study design was used to collect telephone interview data from 3155 households in the UK. 2011 UK human census data were used to predict the size of the cat and dog populations owned by households in the UK in 2011. Of the households, 23 per cent (714/3155) owned one or more cats and 30 per cent (940/3155) owned one or more dogs. There was some overlap in pet ownership with 7 per cent (210/3155) of households owning both one or more cats and one or more dogs. There was a small but significant decrease in the proportion of households that owned one or more cats in 2011 compared with 2007, with no change in the proportion owning dogs. However, overall, the total number of cats and dogs that were estimated to be owned by UK households did not change significantly between 2006 and 2011. The estimated size (and 95% CIs) of the pet cat and dog populations in the UK in 2011 was 10,114,764 cats (9,138,603-11,090,924) and 11,599,824 dogs (10,708,070-12,491,578).

Data were collected on 1260 cats owned by a random sample of UK households in 2007, by means of telephone questionnaires, which were completed by 33 per cent of the households contacted. Cats were owned by 26 per cent of these households, 42 per cent of which owned more than one cat. The owners of 622 female cats reported a total of 110 unplanned litters of kittens. Excluding cats with an unknown neutered status 92 per cent of the cats aged six months or more were neutered, but only 66 per cent of the cats aged six to 12 months were neutered. Multivariable logistic regression, based on data collected for one randomly selected cat aged four months or more in each cat-owning household, was used to identify factors affecting the cats' neutered status. Analysis of 48 sexually entire cats and 501 neutered cats showed that cats aged 10 months or more, with indoor access, that had been vaccinated within the last year or were currently registered with a veterinary practice, were more likely to be neutered than cats aged less than 10 months, without indoor access, that had been vaccinated more than one year ago or were not registered with a veterinary practice.