2,052,783 research outputs found
Letter from E. C. Gray to his sister, Sarah T. Gray, November 16, 1863
No full textE. C. Gray is serving in the Confederate Army. He writes his sister of the capture of deserters from the Confederate Army and their execution
Other title: Inset title: Entrance to Mobile Bay
No full textCopyright, 1878, by O.W. Gray & Son; Bottom margin center: Philadelphia : O.W. Gray & Son; Right margin: 82, 83; Prime meridians: Washington and Greenwich.; Marked off in ranges and townships.; Relief shown by hachures and soundings.; Inset: Entrance to Mobile Bay, Scale 1:150,000.; Explanation shows symbols used on map.; Includes also: explanation of Division of public lands, historical notes, and population 1810-1880
Jeremiah Gray to Hannah Hughes Gray, correspondence, 1882-1884
No full textCorrespondence from Jeremiah Gray to Hannah Hughes Gray, 1882-1884. Included in the correspondence are a detailed sketch by Jeremiah Gray of his room in Philadelphia and a flier advertising "J.H. Gray, Teacher of Music.
Jeremiah Gray to Hannah Hughes Gray, correspondence, 1876-1879
No full textCorrespondence from Jeremiah Gray to Hannah Hughes Gray, 1876-1879. Includes two copies of a program for concert at which Jeremiah Gray was a headline performer
Jeremiah Gray to Hannah Hughes Gray, correspondence, 1885-1887
No full textCorrespondence from Jeremiah Gray to Hannah Hughes Gray, 1885-188
Jeremiah Gray to Hannah Hughes Gray, correspondence, 1880-1881
No full textCorrespondence from Jeremiah Gray to Hannah Hughes Gray, 1880 to 1881
Other title: Inset title: Entrance to Mobile Bay
No full textCopyright, 1878, by O.W. Gray & Son; Bottom margin center: Philadelphia : O.W. Gray & Son; Right margin: 94, 95.; Prime meridians: Washington and Greenwich.; Shows Mobile and Birmingham Railway, established 1887. Acquisition record dates the map 1889.; Marked off in ranges and townships.; Relief shown by hachures and soundings.; Inset: Entrance to Mobile Bay, Scale 1:150,000.; Explanation shows symbols used on map.; Includes also: explanation of Division of public lands, historical notes, and population 1810-1880
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
Other title: Inset title: City of New Orleans; Other title: Inset title: The Passes of the Mississippi River
No full textPrime meridians: Washington and Greenwich; Depth shown by soundings.; 102 and 103 in upper margin; Includes explanation of symbols and the method used to survey
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