2,060 research outputs found
Wpływ lizozymu na zmiany rozmiarów miceli kazeiny w mleku
No full textThe influence of lysozyme on changes in the dimensions of casein micelles in cow's milk was studied. Their size was determined by the fractionation of milk, applying the centrifugation technique as well as by measurements of light scattering. The dimensions of micelles were also determined with the use of an electron microscope. The conducted studies showed that the addition of lysozyme to milk caused certain modifications of casein properties and an increase in the dimensions of its micelles. The obtained results may be useful in an explanation of the method and suitability of milk for modification by this enzyme e.g. in production of baby food and in cheese manufacture.W badaniach podjęto próbę określenia wpływu dodatku lizozymu (0,5; 1,0 i 2,0 mg/cm³) na rozkład rozmiarów miceli kazeinowych w mleku. Wielkość miceli określano 3 różnymi metodami:
- pośrednio przez frakcjonowanie miceli metodą wirowania,
- przez pomiary rozproszenia światła,
- bezpośrednio za pomocą mikroskopu elektronowego.
Uzyskane wyniki wykazały, że ilości kazeiny odwirowanej w poszczególnych frakcjach z mleka modyfikowanego lizozymem były wyższe w porównaniu z odpowiadającymi im próbami kontrolnymi. Różnice te, a także charakterystyka fizykochemiczna odwirowanych frakcji wykazały, że lizozym powodował pewne zmiany w rozkładzie miceli kazeinowych w mleku (tab. 1 i 2). Wyniki pomiarów natężenia światła (I₉₀) oraz współczynnik zmętnienia (τ) roztworów mleka modyfikowanego lizozymem wykazały, że niezależnie od stężenia kazeiny roztwory mleka traktowanego lizozymem stanowiły ośrodki silniej rozpraszające światło (rys. 1 i 2). Wskazuje to pośrednio na zwiększenie rozmiarów cząsteczek kazeiny w mleku z lizozymem. Wniosek ten potwierdziły również obserwacje mikroskopowe preparatów mleka modyfikowanego lizozymem. Analiza uzyskanych elektronogramów wykazała, że enzym wpłynął na zmianę rozmiarów miceli kazeinowych (zdjęcie 1, 2, 3; tab. 3, rys. 3). Analiza statystyczna rozkładu tych wielkości wykazała różnice w przebiegu dystrybuanty próbek traktowanych lizozymem w porównaniu z próbkami kontrolnymi (rys. 3). Stwierdzono zmniejszenie procentowego udziału miceli małych o średnicy poniżej 60 nm na korzyść wzrostu ilości miceli o rozmiarach większych
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
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
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
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
A Stepwise Approach to a Comprehensive Post-Fall Assessment
No full textPost-fall assessment is an essential component of any fall prevention intervention. Typically, clinical practice recommendations for fall assessment are left to the discretion of each practitioner and miss many of the associated symptoms, situational contexts and pertinent elements required to reveal likely underlying determinants of a fall event. In order to elicit a comprehensive evaluation of a recent fall, a 5-step organizational approach is presented which allows for the consistent gathering of key information needed to determine possible underlying fall etiology while also addressing the patient’s perception of their fall. Several cases will be used to illustrate this comprehensive approach to fall assessment.Peer reviewe
„Rak toczący planetę”: Mountaintop removal (ścinanie szczytów górskich) i przestępstwa przeciwko środowisku w powieści Freedom Jonathana Franzena
No full textThe American novelist Jonathan Franzen has always shown a great interest for the environmental problems, mainly in his masterpiece Freedom (2011) and in the essay “My Bird Problem” (2005). Freedom, which recounts three decades of the Berglund family, sees its main character dealing with the environmental themes for his work. Walter is a lawyer who is actively engaged in environmental causes, but the one that occupies most of the novel, is the support of an organization called “Cerulean Mountain Trust”, which aims at saving the cerulean warblers, a small species of songbird, creating a “birds’ sanctuary” in West Virginia. The honorable cause is actually moved by Vin Haven, a Texan millionaire tycoon who wants to implement an extractive coal strip mining operation and afterwards build the birds’ sanctuary as a remedial move. The aim of this paper is to analyze the novel to extract Franzen’s fictional depiction of actual environmental crimes in order to shed light on harmful practices such as the mountaintop removal.Amerykański pisarz Jonathan Franzen zawsze wykazywał duże zainteresowanie problemami środowiskowymi, szczególnie w swoim arcydziele Freedom (2011) oraz w eseju „My Bird Problem” (2005). Powieść Freedom opowiada o dziejach rodziny Berglund, a swego głównego bohatera ukazuje jako szczególnie zaangażowanego w sprawy ochrony środowiska. Walter jest prawnikiem, który aktywnie angażuje się w sprawy środowiskowe. Większość powieści jednak koncentruje się na zagadnieniach wsparcia organizacji o nazwie „Cerulean Mountain Trust”, która ma na celu uratowanie lasówki niebieskiej (cerulean warblers), gatunku małego ptaka śpiewającego i w tym celu stara się stworzyć „rezerwat ptaków” w Zachodniej Wirginii. Przedstawiony został także Vin Haven, milioner z Teksasu, potentat naftowy, który pragnie wdrożyć odkrywkowe wydobycie węgla, a następnie stworzyć rezerwat ptaków jako środek naprawczy. Celem niniejszego artykułu jest przeprowadzenie analizy powieści w kierunku uwypuklenia sposobu przedstawienia przez Franzena rzeczywistych przestępstw przeciwko środowisku, aby rzucić światło na szkodliwe praktyki, takie jak górnictwo szczytów górskich
Orthostatic hypotension in elderly nursing home residents who fall: Are they dizzy?
No full textOrthostatic hypotension (OH) and symptoms of dizziness have been identified as key factors in falls among older adults; however, gaps in the research literature about the presence of asymptomatic OH and its association with falls exist and have prompted this study to determine if falls among nursing home residents are associated with orthostatic hypotension in the absence of dizziness. A secondary analysis was conducted on blood pressure data and symptom experience of 77 older adult residents who experienced a fall while residing in a continuing care retirement community (CCRC). Data of interest were extrapolated from the Post-Fall Index. Of the 77 individuals with 194 RN documented falls, the majority (n=89, 46%) did not meet the diagnostic criteria of OH; 18 (9%) met criteria, and 8 (4%) nearly met OH criteria. OH blood pressure determinations were incomplete or absent in 41% (n=79). Of the 18 residents who fell and met OH criteria, none experienced dizziness. Conclusion: We conclude older nursing home residents do not exhibit symptoms of dizziness prior to orthostatic drops in blood pressure resulting in a fall. Further study is indicated to identify reliable predictors, besides symptom experience of OH in this population.Peer reviewe
Sovereign wealth funds. Legitimacy, governance, and global power
No full textThis is a review on the book “Sovereign Wealth Funds. Legitimacy, Governance, and Global Power” by Clark,Dixon and Monk. The book sheds light on the forms and functions of Sovereign Wealth Funds mapping the global footprints of these institutions and examining their governance and the related issues of domestic and international legitimacy. The review evaluates its effectiveness
- …
