9,599 research outputs found
Letter from Nicholas Gray to Alden Partridge, 1 April 1815.
No full textNicholas Gray informs Alden Partridge of an extension to his furlough.Transcription by Esme Rabin. Transcriptions may be subject to error
Letter from Nicholas Gray to Alden Partridge, 1 January 1814.
No full textNicholas Gray, Jr., reports himself at No. 15 Broadway, New York, to Alden Partridge.Transcription by Cameron Myette and Alison Horner. Transcriptions are subject to human error
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
A Community of Agents Maintaining Links in the World Wide Web (Preliminary Report)
No full textIn this paper we present an agent architecture to maintain link integrity in the World-Wide Web. It consists of a community of agents collaborating to provide services to users, authors and administrators. In summary, agents maintain link integrity when documents are updated, moved, or when WWW sites are reorganised. They also provide authors and administrators with usage information such as documents that are currently bookmarked or documents that are no longer accessed. The architecture is also able to advertise new versions of documents. At a low-level, we use a distributed garbage collection algorithm to trace links and maintain their integrity
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
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