Search

Introduction: US home care (HC) aide visits to clients' homes typically involve cleaning and disinfecting (C&D) environmental surfaces, particularly in bathrooms. Some ingredients in C&D products are associated with respiratory illness: sodium hypochlorite (bleach), quaternary ammonium compounds (QACs), and volatile organic compounds (VOCs). This study assessed and compared aides' respiratory exposures to specific VOCs and QACs while using 2 conventional and 1 "green" household C&D spray products during bathroom cleaning. Measured exposures were compared to ingredients listed on publicly available sources., Methods: Three C&D products were selected with principal active disinfecting ingredients: 1% to 5% sodium hypochlorite by weight ("bleach-based"); 0.1% to 1% QACs ("QACs-based"); and 0.05% thymol ("green"). Twenty-two aides were recruited to perform C&D tasks in a simulated residential bathroom constructed in an environmental monitoring laboratory. A balanced experimental study design involved each aide visiting the lab 4 times to perform typical cleaning tasks with the 3 products and distilled water (as a control), randomly assigned across the 4 visits. Aides wore air sampling equipment for breathing zone samples: canisters to collect whole air for VOC analyses and filter cassettes for QACs analyses., Results: Aides performed 84 cleaning visits contributing approximately 20 air samples each for VOCs and QACs, for each of the 3 products and distilled water. In total, 38 unique VOCs were identified in the canister whole air samples: 20 in the QACs-based product samples, 15 in the bleach-based, and 10 in the green. Most VOCs were not listed in publicly available sources of cleaning product ingredients. Toxicity information was limited. Few VOCs had occupational exposure limits. The QACs-based product generated QACs aerosol: benzalkonium chloride (BAC)12 (geometric mean (GM) = 6.98 µg/m3), BAC14 (GM=2.97 µg/m3), BAC16 (GM=0.78 µg/m3); and the 3 QACs summed (GM=10.86 µg/m3)., Discussion: The use of C&D spray products for residential cleaning can generate respiratory exposures to complex mixtures of volatile and nonvolatile compounds. Notably, we measured aerosols containing QACs during the use of the QACs-based product. Dermal is usually considered the main route of exposure because QACs are nonvolatile salts. This study provides evidence that QACs inhalation exposure should be recognized and minimized in addition to the well-accepted dermal exposure routes. The green product generated the fewest VOCs. However, more toxicity information is needed on the health impacts of green C&D products. Spraying of C&D products, conventional and green, should be avoided., Conclusions: Aides' respiratory health should be protected from chemical exposures while performing C&D in home care., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Home care (HC) aides experience numerous safety hazards in clients' homes; many hazards also put clients at risk. We hypothesized that safety coaching led by nurse managers (NMs) during their initial HC needs assessment could prompt clients to improve safety conditions in their homes. Following a 2-arm proof-of-concept intervention study design, intervention NMs used motivational interviewing (MI), facilitated by a safety handbook and video, to coach clients on home safety improvements. Control arm NMs performed intake assessments with no changes to usual practices. Intervention effectiveness was assessed by NMs and aides. Three HC agencies and two elder services contributed 35 intervention and 23 control homes. NMs coached 97% of clients and reported that 94% were engaged; 63% implemented improvements. NMs' and aides' assessments were consistent; homes with clients reported by NMs as resistant to safety changes had higher aides' hazard scores. Client coaching can be effective for improving HC safety., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Assuring home care (HC) workers' safety is challenging because the work environment is a private home. This paper presents the process evaluation for a proof-of-concept safety intervention study to assess whether nurse-led safety coaching, using motivational interviewing and a safety handbook, could enable HC clients to improve safety in their homes. The process evaluation objectives were to (i) document the intervention's implementation progress and (ii) assess the intervention's dose delivery, dose reception, and fidelity. Five agencies employing liaisons ( n = 5) and nurse managers (NMs, n = 8) implemented this study's intervention and control arms. NMs assigned to the intervention arm ( n = 6) coached 34 clients. Process evaluation metrics were assessed with mixed-methods data from (i) surveys completed by NMs during the intervention, (ii) postintervention audio-recorded and transcribed interviews ( n = 6) with NMs and liaisons, and (iii) study progress tracking tools. The delivered dose efficiency was 85%, measured by the distribution of safety handbook copies to clients. About 94% of clients ( n = 32) were considered "engaged" or "maybe engaged" during the safety coaching. Most coached clients ( n = 30) were reachable for follow-up by NMs to assess intervention progress. Despite challenges, the intervention was implemented with good fidelity. Safety coaching can be applied in many HC contexts in larger populations.

With more efficient utilisation of dietary nutrients and energy, diversified production systems, modifications of diet composition with respect to feedstuffs included and the use of free amino acids, the negative impact of animal food production on the environment and climate can be reduced. Accurate requirements for nutrients and energy for animals with differing physiological needs, and the use of robust and accurate feed evaluation systems are key for more efficient feed utilisation. Data on CP and amino acid requirements in pigs and poultry indicate that it should be possible to implement indispensable amino acid-balanced diets with low- or reduced-protein content without any reduction in animal performance. Potential feed resources, not competing with human food security, can be derived from the traditional food- and agroindustry, such as various waste streams and co-products of different origins. In addition, novel feedstuffs emerging from aquaculture, biotechnology and innovative new technologies may have potential to provide the lack of indispensable amino acids in organic animal food production. High fibre content is a nutritional limitation of using waste streams and co-products as feed for monogastric animals as it is associated with decreased nutrient digestibility and reduced dietary energy values. However, minimum levels of dietary fibre are needed to maintain the normal physiological function of the gastro-intestinal tract. Moreover, there may be positive effects of fibre in the diet such as improved gut health, increased satiety, and an overall improvement of behaviour and well-being., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

The effects of early supplementation with oat β-glucan during the suckling period on piglet gut microbiota composition, concentrations of short-chain fatty acids, and gut physiological markers were assessed. Fifty piglets from five litters, balanced for sex and birth weight, were divided within litters into two treatment groups: β-glucan and control. Piglets in the β-glucan group received the supplement three times/week from day 7 of age until weaning. Rectal swab samples were collected from 10 piglets per treatment group (balanced across litters) from week 1 to week 4, and plasma samples were collected at 1, 3, and 4 weeks of age. Additional samples of intestinal tissues and jugular and portal vein plasma were collected from 10 animals at weaning (one per treatment group and litter). The concentrations of short-chain fatty acids in plasma and the microbiota composition in rectal swabs were mainly influenced by piglet age, rather than the supplement. There were significant differences in microbiota composition between litters and several correlations between concentrations of short-chain fatty acids in plasma and specific microbial taxa in rectal swabs. Overall, β-glucan supplementation did not have any clear impact on the gut environment in suckling piglets, whereas a clear age-related pattern emerged.

Retention of the home care (HC) aide workforce is essential to meet the needs of our aging population. Some studies suggest that improving HC safety could increase job retention. This study objective was to explore qualitatively the connection between aide and client safety and factors impacting this care relationship. Data consisted of audio-recorded, verbatim responses to open-ended questions of two focus groups with aides ( n = 10), two in-person interviews with HC agency managers, and 37 phone interviews with those working in (aides, n = 16; managers, n = 12) and receiving (clients, n = 9) HC. Clients reported home layout and accessibility as safety concerns. Aides and managers reported that client family members can make the care job more challenging. The aide-client connection was affected by communication style, family and HC agency support, allotted care time, and job task boundaries. Interventions that address the safety of both clients and aides can influence HC job satisfaction and retention.