5,659 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
Gray family Christmas card [undated] "The Bowman Gray and Gordon Gray Boys"
No full textThis is a Christmas card that includes a group photograph of nine boys all sitting on an indoor stairway. The card indentifies them as "The Bowman Gray and Gordon Gray Boys". The author of the card is Nathalie Bernard
Correspondence Concerning Genealogical records Related to the Gray Family
No full textA typed letter addressed to Shirley Dye that explains the relationship of the author (Newton Roseborough) to the Gray Family, citing genealogical research and records; page 3
Correspondence Concerning Genealogical records Related to the Gray Family
No full textA typed letter addressed to Shirley Dye that explains the relationship of the author (Newton Roseborough) to the Gray Family, citing genealogical research and records; page 4
Correspondence Concerning Genealogical records Related to the Gray Family
No full textA typed letter addressed to Shirley Dye that explains the relationship of the author (Newton Roseborough) to the Gray Family, citing genealogical research and records; page 1
Correspondence Concerning Genealogical records Related to the Gray Family
No full textA typed letter addressed to Shirley Dye that explains the relationship of the author (Newton Roseborough) to the Gray Family, citing genealogical research and records; page 2
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
Thomas Gray Archive
No full textThe Thomas Gray Archive is a collaborative digital archive and research project devoted to eighteenth-century poet, letter-writer, and scholar Thomas Gray (1716-1771), author of the acclaimed "Elegy Written in a Country Churchyard" (1751). Founded in 2000, the Archive's mission is to facilitate and support the study, research, and teaching of Gray's life and works
Correspondence Concerning Genealogical records Related to the Gray Family
No full textA typed letter addressed to Shirley Dye that explains the relationship of the author (Newton Roseborough) to the Gray Family, citing genealogical research and records
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