4,231 research outputs found
Ambulatory assisted living fallers at greatest risk for head injury
No full textOBJECTIVES: To determine the relationship between head injuries sustained during each fall with various known high risk health and demographic factors predictive of falls.
DESIGN: Prospective cohort study conducted over 1 year
SETTING: Assisted living and skilled nursing units of a Continuing Care Retirement Community located in the northeastern United States.
PARTICIPANTS: Sixty nine OAs who fell.
MEASUREMENTS: Age, gender, diagnosis, high risk medication, functional, cognitive, ambulation/elimination status, mode of locomotion, fall related symptoms and the position of the fall, were analyzed using General Estimating Equations among elderly fallers with and without head injury.
RESULTS: A total of 173 falls (average of 2.9 times) were observed for 62 patients who had complete injury data. Injuries were recorded in 40.5% of falls, with 41.4% being head injuries. Head injuries were more likely to be hematomas than lacerations (66.7% vs. 14.7%) and among assisted living residents (p=0.04). Head injured patients were more likely to be walking at the time of the fall (69% vs. 36.1%) and less likely to have bowel incontinence (3.5% vs. 28.5%; p=0.04). None of the high risk diagnosis or medications associated with falls risk increased risk for head injury.
CONCLUSION: Those at greatest risk for head injury were ambulatory assisted living residents. None of the known clinical conditions predictive of risk to fall were predictive of head injury. For head injury prevention to be successful we need a closer examination of resident’s mobility, shoe-wear, health behavior with respect to ability to use assistive devices, and floor surface landing area. Future health policy implications include measures to ensure standard of care practices for head injured patients are in place.This is the peer reviewed version of the following article: Gray-Miceli, D. L., Ratcliffe, S. J. and Thomasson, A. (2013), Ambulatory Assisted Living Fallers at Greatest Risk for Head Injury. Journal of the American Geriatrics Society, 61: 1817–1819, which has been published in final form at https://dx.doi.org/10.1111/jgs.12467. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Peer reviewe
Teaching Strategies for Atypical Presentation of Illness in Older Adults
No full textAtypical presentation of illness is one of those phenomena where “seeing is believing”. Expert geriatric nurses and clinicians know all to well the early signs and symptoms of this frequent masquerader of bacterial infections, pain, acute myocardial infarction, heart failure or other serious medical ailments in older adults. Students however, as novices to clinical practice, require interactive learning approaches to reflect on the client’s illness presentations, help with developing the necessary skills to analyze and synthesize clinically relevant data, and to witness resolution of an atypical presentation when found and treated. We discuss various learner-centered, interactive approaches to teach students how to recognize an atypical presentation of illness using a real-life clinical case. Outlined are teaching strategies for faculty, drawn on visual, auditory, reading and kinesthetic modes of student learning. Use of the senses to teach nurses about care of patient’s is not entirely new or innovative, as reflected on by Florence Nightingale’s (1846) earliest writings of the "rules of nursing".Peer reviewe
Current Approaches to Post-fall Assessment in Nursing Homes
No full textFalls in nursing homes occur among a large percentage of residents. Their onset necessitates a postfall assessment (PFA) be performed by clinical staff to determine likely etiology. The absence of an empirically validated comprehensive postfall assessment tool has led to considerable variability in the types of PFAs performed. The purpose of this study was to examine the types of PFA tools available, their content, and to compare this with national recommendations for fall assessment in geriatric practice.Peer reviewe
Use of a comprehensive postfall assessment tool to prevent falls
No full textNursing research in fall prevention should not only identify etiologic risk factors to fall, but seek to identify underlying causes, whenever possible. Few studies have investigated the use of a comprehensive post fall assessment tool (PFAT) by nurses as an intervention for the prevention of recurrent falls, especially one that prompts nurses to consider all potential causes through a categorization scheme. This study tested use of a comprehensive PFAT as an intervention, prospectively, facility-wide for 1 year by RNs using a pre-post-test design. A 29.4% reduction in the fall rate (z=3.89; p <0.001), 27.6% decline in total falls experienced by all fallers (p<0.001) and a 34.0% decline for recurrent fallers (p = 0.025) from pre-intervention to intervention year was observed when trained nurses categorized falls according to perceived causes. These declines are likely due to consistent and rigorous use by trained nursing staff, prompting their critical examination of each fall.Peer reviewe
The representation of segmental information: an fMRI investigation of the consonant-vowel distinction
No full textRecent studies suggest that consonants and vowels are represented
separately in cognitive/neural space. Much of the evidence
comes from research on dysgraphia (for review, see Miceli & Capasso,
submitted). In the first place, letter substitution errors preserve
the consonant/vowel (CV) status of the target (e.g., cinema fi cirema
or cinoma, but not cintma). Second, there are reports of selective
impairment for consonants or vowels. Additional evidence comes
from disorders of phonology, demonstrating the dissociability between
consonants and vowels (Caramazza, Chialant, Capasso, &
Miceli, 2000). However, while neuropsychological observations
clearly support the C/V distinction, the anatomical correlates of such
distinction are still unknown. We investigated this issue by means of
an event-related fMRI experiment, with a grapheme verification
task
Improving the quality of geriatric nursing care: Enduring outcomes from the Geriatric Nursing Education Consortium
No full textThe nation's aging demographics, few nursing faculty with gero-expertise, and insufficient geriatric content in nursing programs has created a national imperative to increase the supply of nurses qualified to provide care for older adults. GNEC, the Geriatric Nursing Education Consortium, a collaborative program of the John A. Hartford Foundation, the American Association of Colleges of Nursing, and the NYU Nursing Hartford Institute for Geriatric Nursing was initiated to provide faculty with the necessary skills, knowledge, and competency to implement sustainable curricular innovations in care of older adults. This article describes the background, processes, and development of GNEC evidence-based curricular materials, and the dissemination of these materials through six, two and a half day national Faculty Development Institutes (FDIs). Eight hundred eight faculty, representing 418 schools of nursing, attended an FDI. A total of 479 individuals responded to an evaluation conducted by Baruch College that showed faculty feasibility to incorporate GNEC content into courses, confidence in teaching and incorporating content, and overall high rating of the GNEC materials. The impact of GNEC is discussed along with effects on faculty participants over two years. Administrative and faculty level recommendations to sustain and expand GNEC are highlighted.Peer reviewe
Effect of thermal treatments on vitality and physical characteristics of bean, chickpea and lentil
No full textThermal disinfestation treatments are relatively easy to apply, leave no chemical residues and may have some fungicidal activity. However, temperature and time combinations required to kill insect pests may meet or exceed those that reduce the viability of seeds, nutrients content, shelf life or technological characteristics. The aim of this study was to investigate the effect of thermal treatments (different temperature and time combinations) on physical and biological characteristics of bean, chickpea and lentil. Seed samples of common bean, chickpea and lentil were treated at low (12, 24 or 48 h at −18 °C) or high (30, 60 or 90 min at 60 °C) temperature. Seed germination, mean germination time, physical characteristics: solids loss, electrolytes leached and firmness after cooking, were determined. The use of thermal treatments for disinfesting seeds of bean, chickpea and lentil represent a physical technique of pest control that can be harmless for seeds destined for crop production (especially for organic farming) or to be stored in germplasm banks. Moreover, thermal treatments can be applied also to grain legumes used as food by humans, with no significant effect on lentils and with a reduction of cooking time for chickpeas. Beans should be treated only with cold treatments and for no more than 24 h
Effect of Nitrogen Fertilization on the Quality of Swiss Chard at Harvest and during Storage as Minimally Processed Produce
No full textThe effects of different levels of nitrogen fertilization (0-50-100-150-200 kg ha-1), minimal processing and cold storage (14 days at 4°C) on yield and quality of fresh-cut Swiss Chard (Beta vulgaris L. var. cicla L.) were evaluated. Increasing the level of nitrogen fertilization over 100 kg N ha-1, plants had a higher fresh weight, reduced their dry matter content and resulted taller and leafier. Total and marketable yield increased linearly as increasing nitrogen level. Both nitrate and ascorbic acid content at harvest increased as increasing nitrogen supply. Nitrogen fertilization negatively affected the yield of minimal processing. No effect on appearance and quality loss during cold storage was detected. Reducing nitrogen fertilization could lead to a more environmentally friendly product with no significant loss in yield and quality both for raw plant and fresh-cut Swiss chard. Minimal processing can improve nutritional quality lowering nitrates and increasing ascorbic acid content in fresh-cut produce
Prove preliminari per la valorizzazione della borragine (Borrago officinalis L.) come prodotto minimamente processato
No full textLa borragine (Borago officinalis L.) è una pianta erbacea annuale tomentosa della famiglia Boraginaceae originaria dell'Europa e del Nord Africa, ampiamente diffusa in molti paesi mediterranei. Questa pianta è coltivata in tutto il mondo ed è usata per scopi medicinali nonché per la preparazione di bevande e per essere consumata cruda o cotta. La coltivazione della borragine è principalmente orientata alla produzione di seme, mentre la coltura da ortaggio è molto limitata e spesso si ricorre alla raccolta delle piante spontanee per soddisfare le richieste di mercato. Al fine di valorizzare il potenziale orticolo di questa specie, la presente ricerca ha lo scopo di valutare la possibilità di coltivazione per la produzione di foglie di borragine minimamente processate. Dai risultati ottenuti nella presente ricerca, la borragine si è dimostrata una specie rustica, di facile coltivazione e con limitate esigenze idriche e nutritive. Pertanto risulta una specie interessante per diversificare la produzione orticola di pieno campo. Inoltre, le foglie di borragine hanno dimostrato una buona idoneità alla preparazione di prodotto di IV gamma, mantenendo sufficienti requisiti qualitativi durante 14 giorni di conservazione a 4°C. Ulteriori ricerche sono in corso per migliorare la produttività della coltura ed ottenere piante più pulite che consentano di ridurre le manipolazioni nelle operazioni di mondatura e lavaggio delle foglie per l’ottenimento di prodotto minimamente processato
Suitability of borago officinalis for minimal processing as fresh-cut produce
No full textBorage (Borago offcinalis L.) is a wild vegetable appreciated as a folk medicine and for culinary preparations. The introduction of borage as a specialized cultivation would allow for the diversification of vegetable crops and would widen the offerings of raw and minimally processed leafy vegetables. Thus, the aim of the research was to evaluate the quality and shelf-life of fresh-cut borage stored at different temperatures. Borage plants were grown during the autumn-winter season and immediately minimally processed after harvest. Fresh-cut borage leaves packed in sealed bags were stored at 2 or 6 °C for 21 d. Weight loss, total soluble solids (TSS), titratable acidity (TA), ascorbic acid, nitrates, leaf color characteristics and overall quality were determined through the storage period. Borage plants were deemed suitable for minimal processing. Storage temperature significantly influenced the rate of quality loss. Borage leaves had an initial nitrate content of 329.3 mg kg-1 FW that was not affected by temperature or storage. TSS and TA were higher in leaves stored at 6 °C. TSS, TA and ascorbic acid content increased during storage. Minimally processed borage leaves stored at 2 °C had lower weight loss and leaf color modifications during storage and a longer shelf life than those stored at 6 °C, so were still marketable after 21 d of storage
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