bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis, Characterization and Photocatalytic Activity of New Photocatalyst ZnBiSbO4 under Visible Light Irradiation
Authors: Luan Jingfei , Chen Mengjing , Hu Wenhua
Published: May 2014

In this paper, ZnBiSbO4 was synthesized by a solid-state reaction method for the first time. The structural and photocatalytic properties of ZnBiSbO4 had been characterized by X-ray diffraction, scanning electron microscopy, X-ray photoelectron spectroscopy, Fourier-transform infrared spectroscopy, transmission electron microscope and UV-visible spectrometer. ZnBiSbO4 crystallized with a pyrochlore-type structure and a tetragonal crystal system. The band gap of ZnBiSbO4 was estimated to be 2.49 eV. The photocatalytic degradation of indigo carmine was realized under visible light irradiation with ZnBiSbO4 as a catalyst compared with nitrogen-doped TiO2 (N-TiO2) and CdBiYO4. The results showed that ZnBiSbO4 owned higher photocatalytic activity compared with N-TiO2 or CdBiYO4 for the photocatalytic degradation of indigo carmine under visible light irradiation. The reduction of the total organic carbon, the formation of inorganic products, SO42− and NO3−, and the evolution of CO2 revealed the continuous mineralization of indigo carmine during the photocatalytic process. One possible photocatalytic degradation pathway of indigo carmine was obtained. The phytotoxicity of the photocatalytic-treated indigo carmine (IC) wastewater was detected by examining its effect on seed germination and growth.
Identification of Differentially Expressed miRNAs between White and Black Hair Follicles by RNA-Sequencing in the Goat (Capra hircus)
Authors: Wu Zhenyang , Fu Yuhua , Cao Jianhua , Yu Mei , Tang Xiaohui , Zhao Shuhong
Published: May 2014

MicroRNAs (miRNAs) play a key role in many biological processes by regulating gene expression at the post-transcriptional level. A number of miRNAs have been identified from livestock species. However, compared with other animals, such as pigs and cows, the number of miRNAs identified in goats is quite low, particularly in hair follicles. In this study, to investigate the functional roles of miRNAs in goat hair follicles of goats with different coat colors, we sequenced miRNAs from two hair follicles samples (white and black) using Solexa sequencing. A total of 35,604,016 reads were obtained, which included 30,878,637 clean reads (86.73%). MiRDeep2 software identified 214 miRNAs. Among them, 205 were conserved among species and nine were novel miRNAs. Furthermore, DESeq software identified six differentially expressed miRNAs. Quantitative PCR confirmed differential expression of two miRNAs, miR-10b and miR-211. KEGG pathways were analyzed using the DAVID website for the predicted target genes of the differentially expressed miRNAs. Several signaling pathways including Notch and MAPK pathways may affect the process of coat color formation. Our study showed that the identified miRNAs might play an essential role in black and white follicle formation in goats.
Nipple Discharge of CA15-3, CA125, CEA and TSGF as a New Biomarker Panel for Breast Cancer
Authors: Wang Gangping , Qin Yan , Zhang Junxi , Zhao Jinhui , Liang Yun'ai , Zhang Zuofeng , Qin Meihua , Sun Yanqing
Published: May 2014

Breast cancer is the second leading cause of cancer death in women. Serum biomarkers such as cancer antigen 15-3 (CA15-3), cancer antigen 125 (CA125), and carcinoembryonic antigen (CEA) can be used as diagnostic and prognostic factors and can also provide valuable information during follow-up. However, serum protein biomarkers show limited diagnostic sensitivity and specificity in stand-alone assays because their levels reflect tumor burden. To validate whether biomarkers in nipple discharge may serve as novel biomarkers for breast cancer, we composed a panel of potential cancer biomarkers, including CA15-3, CA125, CEA, and malignant tumor-specific growth factor (TSGF), and evaluated their expression in both serum and nipple discharge in order to explore the expression and significance of estrogen receptor (ER), progestrone receptor (PR), epidermal growth factor receptor type 2 (HER2/neu), CA15-3, CA125, CEA, and TSGF expression for their combined predictive value for breast cancer and in judging the prognosis of breast cancer. Univariate analysis revealed that combined detection of CA15-3, CA125, CEA, and TSGF in nipple discharge served as novel biomarkers for the diagnosis and prognosis of breast cancer, but in the multivariate analyses the adverse effects of the four biomarkers combination in nipple discharge positivity on overall survival were lost. Multivariate analysis revealed that the positivity of the combined detection of the four biomarkers in both nipple discharge and serum was significantly higher than that of other detection methods. Thus, the combined detection of these four biomarkers both in serum and nipple discharge was retained as an independent prognostic variable in breast cancer patients. Our results indicate that CA15-3, CA125, CEA, and TSGF in nipple discharge can serve as novel biomarkers in the diagnosis and prognosis of breast cancer.
New Coumarins and Anti-Inflammatory Constituents from the Fruits of Cnidium monnieri
Authors: Lee Tzong-Huei , Chen Yuan-Chih , Hwang Tsong-Long , Shu Chih-Wen , Sung Ping-Jyun , Lim Yun-Ping , Kuo Wen-Lung , Chen Jih-Jung
Published: May 2014

The fruit of Cnidium monnieri is commercially used as healthcare products for the improvement of impotence and skin diseases. Three new coumarins, 3'-O-methylmurraol (1), rel-(1'S,2'S)-1'-O-methylphlojodicarpin (2), and (1'S,2'S)-1'-O-methylvaginol (3), have been isolated from the fruits of C. monnieri, together with 14 known compounds (4–17). The structures of these new compounds were determined through spectroscopic and MS analyses. Compounds 1, 4–12, and 14–17 exhibited inhibition (IC50 ≤ 7.31 µg/mL) of superoxide anion generation by human neutrophils in response to formyl-l-methionyl-l-leucyl-l-phenylalanine/cytochalasin B (fMLP/CB). Compounds 7, 9–11, 15, and 17 inhibited fMLP/CB-induced elastase release with IC50 values ≤7.83 µg/mL. This investigation reveals that bioactive isolates (especially 6, 7, 14, and 17) could be further developed as potential candidates for the treatment or prevention of various inflammatory diseases.
Characterization of Nanoreinforcement Dispersion in Inorganic Nanocomposites: A Review
Authors: Saheb Nouari , Qadir Najam , Siddiqui Muhammad , Arif Abul , Akhtar Syed , Al-Aqeeli Nasser
Published: May 2014

Metal and ceramic matrix composites have been developed to enhance the stiffness and strength of metals and alloys, and improve the toughness of monolithic ceramics, respectively. It is possible to further improve their properties by using nanoreinforcement, which led to the development of metal and ceramic matrix nanocomposites, in which case, the dimension of the reinforcement is on the order of nanometer, typically less than 100 nm. However, in many cases, the properties measured experimentally remain far from those estimated theoretically. This is mainly due to the fact that the properties of nanocomposites depend not only on the properties of the individual constituents, i.e., the matrix and reinforcement as well as the interface between them, but also on the extent of nanoreinforcement dispersion. Therefore, obtaining a uniform dispersion of the nanoreinforcement in the matrix remains a key issue in the development of nanocomposites with the desired properties. The issue of nanoreinforcement dispersion was not fully addressed in review papers dedicated to processing, characterization, and properties of inorganic nanocomposites. In addition, characterization of nanoparticles dispersion, reported in literature, remains largely qualitative. The objective of this review is to provide a comprehensive description of characterization techniques used to evaluate the extent of nanoreinforcement dispersion in inorganic nanocomposites and critically review published work. Moreover, methodologies and techniques used to characterize reinforcement dispersion in conventional composites, which may be used for quantitative characterization of nanoreinforcement dispersion in nanocomposites, is also presented.
New Prenylxanthones from the Deep-Sea Derived Fungus Emericella sp. SCSIO 05240
Authors: Fredimoses Mangaladoss , Zhou Xuefeng , Lin Xiuping , Tian Xinpeng , Ai Wen , Wang Junfeng , Liao Shengrong , Liu Juan , Yang Bin , Yang Xianwen , Liu Yonghong
Published: May 2014

Four new prenylxanthones, emerixanthones A–D (1–4), together with six known analogues (5–10), were isolated from the culture of the deep-sea sediment derived fungus Emericella sp. SCSIO 05240, which was identified on the basis of morphology and ITS sequence analysis. The newstructures were determined by NMR (1H, 13C NMR, HSQC, HMBC, and 1H-1H COSY), MS, CD, and optical rotation analysis. The absolute configuration of prenylxanthone skeleton was also confirmed by the X-ray crystallographic analysis. Compounds 1and 3 showed weak antibacterial activities, and 4 displayed mild antifungal activities against agricultural pathogens.
Zn-Driven Discovery of a Hydrothermal Vent Fungal Metabolite Clavatustide C, and an Experimental Study of the Anti-Cancer Mechanism of Clavatustide B
Authors: Ye Panpan , Shen Ling , Jiang Wei , Ye Ying , Chen Chen-Tung , Wu Xiaodan , Wang Kuiwu , Wu Bin
Published: May 2014

A naturally new cyclopeptide, clavatustide C, was produced as a stress metabolite in response to abiotic stress elicitation by one of the hydrothermal vent fluid components Zn in the cultured mycelia of Aspergillus clavatus C2WU, which were isolated from Xenograpsus testudinatus. X. testudinatus lives at extreme, toxic habitat around the sulphur-rich hydrothermal vents in Taiwan Kueishantao. The known compound clavatustide B was also isolated and purified. This is the first example of a new hydrothermal vent microbial secondary metabolite produced in response to abiotic Zn treatment. The structures were established by spectroscopic means. The regulation of G1-S transition in hepatocellular carcinoma cell lines by clavatustide B was observed in our previous study. The purpose of the present study was to verify these results in other types of cancer cell lines and elucidate the possible molecular mechanism for the anti-cancer activities of clavatustide B. In different human cancer cell lines, including pancreatic cancer (Panc-1), gastric cancer (MGC-803), colorectal cancer (SW-480), retinoblastoma (WERI-Rb-1) and prostate cancer (PC3), clavatustide B efficiently suppressed cell proliferations in a dose-dependent manner. Although different cancer cell lines presented variety in Max effect dose and IC50 dose, all cancer cell lines showed a lower Max effect dose and IC50 dose compared with human fibroblasts (hFB) (p < 0.05). Moreover, significant accumulations in G1 phases and a reduction in S phases (p < 0.05) were observed under clavatustide B treatment. The expression levels of 2622 genes including 39 cell cycle-associated genes in HepG2 cells were significantly altered by the treatment with 15 μg/mL clavatustide B after 48 h. CCNE2 (cyclin E2) was proved to be the key regulator of clavatustide B-induced G1-S transition blocking in several cancer cell lines by using real-time PCR.
Phase Equilibria of the Ce-Mg-Zn Ternary System at 300 °C
Authors: Mostafa Ahmad , Medraj Mamoun
Published: May 2014

The isothermal section of the Ce-Mg-Zn system at 300 °C was experimentally established in the full composition range via diffusion multiple/couples and key alloys. Annealed key alloys were used to confirm the phase equilibria obtained by diffusion multiple/couples and to determine the solid solubility ranges. Spot analysis was carried out, using wavelength dispersive X-ray spectroscopy (WDS), to identify the composition of the observed phases. The composition profiles were obtained using WDS line-scans across the diffusion zones. X-ray diffraction (XRD) was performed to identify the phases in the annealed alloys and to confirm the WDS results. Eight ternary compounds, in the Ce-Mg-Zn isothermal section at 300 °C, were observed from 45–80 at.% Zn. These are: τ1 (Ce6Mg3Zn19), τ2 (CeMg29Zn25), τ3 (Ce2Mg3Zn3), τ4 (CeMg3Zn5), τ5 (CeMg7Zn12), τ6 (CeMg2.3−xZn12.8+x; 0 ≤ x ≤ 1.1), τ7 (CeMgZn4) and τ8 (Ce(Mg1−yZny)11; 0.096 ≤ y ≤ 0.43). The ternary solubility of Zn in the Ce-Mg compounds was found to increase with a decrease in Mg concentration. Accordingly, the ternary solid solubility of Zn in CeMg12 and CeMg3 was measured as 5.6 and 28.4 at.% Zn, respectively. Furthermore, the CeMg and CeZn showed a complete solid solubility. The complete solubility was confirmed by a diffusion couple made from alloys containing CeMg and CeZn compounds.
Novel Pseudo-Wavelet Function for MMG Signal Extraction during Dynamic Fatiguing Contractions
Authors: Al-Mulla Mohammed , Sepulveda Francisco
Published: May 2014

The purpose of this study was to develop an algorithm to classify muscle fatigue content in sports related scenarios. Mechanomyography (MMG) signals of the biceps muscle were recorded from thirteen subjects performing dynamic contractions until fatigue. For training and testing purposes, the signals were labeled in two classes (Non-Fatigue and Fatigue). A genetic algorithm was used to evolve a pseudo-wavelet function for optimizing the detection of muscle fatigue. Tuning of the generalized evolved pseudo-wavelet function was based on the decomposition of 70% of the conducted MMG trials. After completing 25 independent pseudo-wavelet evolution runs, the best run was selected and then tested on the remaining 30% of the data to measure the classification performance. Results show that the evolved pseudo-wavelet improved the classification rate of muscle fatigue by 4.70 percentage points to 16.61 percentage points when compared to other standard wavelet functions, giving an average correct classification of 80.63%, with statistical significance (p < 0:05).
Land-Development Offset Policies in the Quest for Sustainability: What Can China Learn from Germany?
Authors: Tan Rong , Wang Rongyu , Sedlin Thomas
Published: May 2014

Land-development offset policies consist of measures that require compensation to be made for the negative impact of land development on agricultural production, ecological and environmental conservation, and the sustainability of economic and social development. However, when such policies are inappropriately designed, unexpected problems can result. This paper describes certain land-development offset policies that have recently been implemented in China, with a particular emphasis on three such policies: the Balancing Policy, the Linkage Policy, and the Integrated Policy. These well-intentioned environmental policies have led to unexpected ecological, social, and cultural problems. This paper also describes the core of German land-development policy, which features a distinctive compensation system that has been employed since the 1970s, and compares Chinese and German land-development policies to highlight differences in three main areas: policy purposes, governance structures, and fundamental institutions. The comparisons might help explain the unexpected outcomes in China, and they also lead to land-development offset policy recommendations for China in the near future.
Ecological Econophysics for Degrowth
Authors: Pueyo Salvador
Published: May 2014

This paper outlines a synthesis of ecological economics with econophysics and other complexity approaches to economics. Arguably, the resulting “ecological econophysics” will be scientifically sounder than mainstream economics and much better suited to addressing a major challenge of our times: the development of democratically-based policies to reduce economic throughput to an environmentally sustainable level without triggering economic crises and without excluding part of the world’s population, i.e., to implement degrowth. Degrowth will need major structural changes, which leads us to question whether there are limits to the malleability of the economic system’s architecture. A fundamental limit will be encountered if, as suggested by the physics of complexity, long-lasting complex systems always occur midway between an ordered and a disordered state. There is much evidence that this hypothesis holds and that the current economic system satisfies this condition. However, this does not mean that the problems posed by this system should be unavoidable. Ecological econophysics gives clues to identifying alternative economic systems that would also function between order and chaos, but which would have radically different implications for environmental sustainability and social justice.
Des itinéraires de patrons atypiques, ou la place de “l'étranger”
Authors: Alter Norbert
Published: May 2014

Norbert Alter a écouté des patrons porteurs d’un stigmate les reléguant aux marges de la société pour comprendre comment ils ont réussi et sont désormais respectés. Il explique pourquoi la différence surmontée peut devenir une force.
O4CP : une entreprise pharmaceutique dédiée au marché pédiatrique
Authors: Grek Vincent
Published: May 2014

Vincent Grek a voulu lancer Only for Children Pharmaceuticals, O4CP, première entreprise pharmaceutique dédiée au marché pédiatrique, pour créer des médicaments adaptés aux enfants. Six ans plus tard, O4CP envisage d’entrer en Bourse.
Investissement socialement responsable et financement du développement durable : une expérience québécoise
Authors: Vendette Rosalie
Published: May 2014

Depuis les années 2000, l’investissement socialement responsable se développe, en visant à concilier performance économique et impact social et environnemental, en finançant les entreprises et les entités publiques qui contribuent au développement durable.
Une guerre économique d'une violence inédite
Authors: Dahan Michel
Published: May 2014

Les leaders d’internet se livrent une bataille de géants, en se battant à coup d’innovations pour se différencier. Comment lancer ou financer des innovations et des start-up dans un contexte aussi turbulent ?
IMPROVING SAFETY FOR HOSPITALIZED ELDERLY
Authors: Spellbring Ann Marie , Gannon Mary Ellen , Kleckner Thelma , Conway Kathleen
Published: May 2014

The nursing profession is responsible for continually expanding and improving its practices. The prevention of falls in geriatric patients must become a part of the health professionals' intervention strategies. Developing safety standards is important because these criteria serve as guidelines for nursing practice.
Promoting Independence
Authors: Penn Cathy
Published: May 2014

THE NURSE CAN COMMUNICATE AN UNDERSTANDING OF THE SELF-CARE DEFICIT, AND ELICIT THE CLIENT'S PERSPECTIVE OF THE DEFICIT AND ITS MEANING TO DAILY LIVING.
Impaired Skin Integrity
Authors: Iverson-Carpenter Martha S
Published: May 2014

ANYONE WHO STAYS IN ONE POSITION WITHOUT THE RELIEF OF PRESSURE ON BODY PROMINENCES CAN DEVELOP A PRESSURE SORE.
TREATING RECOVERING ALCOHOLICS
Authors: Burns Beatrice R
Published: May 2014

By the time the elderly alcoholic comes to the attention of treatment agencies, their support systems and resources are gone or seriously eroded.
PROPAC AND INFLUENCES OF PPS ON THE ELDERLY
Authors: Rumph Elizabeth
Published: May 2014

PROPAC has recognized the need for quality caiv of Medicare patients in this era of cost constraints. Such awareness is necessary to deal with the increasing needs of the geriatric population.
Inadvertent Hypothermia
Authors: Burkle Nancy L
Published: May 2014

Inadvertent hypothermia can be a common, yet underestimated, hazard of the elderly surgical patient.
MODEL OF SHARED CONTROL
Authors: Kohler Patricia
Published: May 2014

The desire and necessity of the elderly to assume more control and responsibility over their health status and health behaviors serve as the underlying factors in the interaction model. There are definite advantages for the health-care provider and client in mutually identifying problems, goals, needed actions for goal attainment and expected outcomes.
CARE OF THE DEMENTED CLIENT
Authors: Weiler Kay , Buckwalter Kathleen C
Published: May 2014

Gerontological nurses can be an invaluable and pivotal resource to these families through education, support, and case management
DEPRESSION ASSESSMENT AND INTERVENTIONS IN THE MEDICALLY ILL FRAIL ELDERLY
Authors: Dreyfus Joan K
Published: May 2014

Depression is a very common syndrome in the medically ill elderly. The symptoms of depression may be the cause of nursing care problems and decreased functional ability for the elderly patient.
ELDER CARE: ETHICAL DIMENSIONS
Authors: Job Sharon , Ariema Marion G
Published: May 2014

Nurses, when developing a care plan for a patient, must remember the family system needs to be included in the assessment. Including the system will assure success in achieving positive patient outcomes.
The Elderly and COPD
Authors: Johnson Ann Putnam
Published: May 2014

It is the nurse's responsibility to provide the client with COPD, the knowledge concerning self-care. The primary goal of education for the client with COPD is to allow a better quality lifestyle while staying within the limitations of the illness.
Self- Regulation Techniques in the Elderly
Authors: Bower Margaret E
Published: May 2014

Teaching needs to be adapted to the elderly.
An Aggressive Approach to Promoting Health Responsibility
Authors: Schafer Sandra L
Published: May 2014

Older adults want to stay well and maintain good health. The desire to stay well and maintain good health implies acceptance of responsibility for health.
Comfort and the HOSPITALIZED CHRONICALLY ILL
Authors: Hamilton Joan
Published: May 2014

Although comfort is a word nurses use in their daily practice to describe a nursing measure, an outcome, and a goal, its meaning remains vague and abstract from the patients perspective.
CIRCADIAN RHYTMS: Charting Oral Temperatures to Spot Abnormalities
Authors: Davis Connie , Lentz Martha J
Published: May 2014

The presence of regular circadian rhythms indicates normal health status.
CLINICAL NURSE PRACTITIONERS: Identifying Their Roles
Authors: Trella Rebecca Johnson
Published: May 2014

Many health professionals do not recognize the need for specialized care for the elderly, and therefore do not feel the need to consult with experts in this area.
MAKING A DIFFERENCE: THE GERONTOLOGICAL CNS
Authors: Beyerman Kathleen
Published: May 2014

There is a great deal in the literature that describes what the CNS does, but little about what this nurse achieves.
Providing Nursing Home Care for the Chronically Mentally Ill
Authors: Richter Judith M
Published: May 2014

The original purpose of the movement from mental institutions to nursing homes was to prevent psychosocial problems associated with institutional dependence.
Remember When . . . ?: Using Mnemonics to Boost Memory in the Elderly
Authors: Johnston Linda , Gueldner Sarah Hall
Published: May 2014

Mnemonics are learned skills that improve the efficiency of memory.
RECOGNIZING DEPRESSION IN THE ELDERLY
Authors: Keane Sarah McDermott , Sells Sharon
Published: May 2014

Depression in late life is treatable and frequently as chronic only because adequate therapeutic intervention is not initiated earlier.
The Ethnographic Approach: Characteristics and Uses in Gerontological Nursing
Authors: Cameron Cynthia
Published: May 2014

Nursing Theory Development
Oxygen Saturation Levels in the Well Elderly: Altitude Makes a Difference
Authors: Ogburn-Russell Lee , Johnson Julie E
Published: May 2014

Nurses must recognize that normal oxygen saturation levels are different for those over 65 years of age who reside at moderate altitude and those who live at low altitude.
Assessing Mental Status
Authors: Hogstel Mildred O
Published: May 2014

The first installment of "Clinical Outlook" presented "Whole Disease Care Planning." A process that staged the Alzheimer patient's disease and provided routines for case management. This installment of "Clinical Outlook" presents a tool for assessing levels of confusion in the well patient. The suggested flow sheet can become a valuable part of the well patient's record and provide baseline data. This flow sheet may also be helpful in the nursing care of the confused patient or patient with Alzheimer's Disease. The flow sheet can monitor the stage of the disease and thus act as a guideline for case management.
CLINICAL CONSIDERATIONS: Midlife Daughters and Their Aging Parents
Authors: Green Clarissa P
Published: May 2014

INTRODUCTION

It is fair to say that the graying of North America is shaping peoples* daily lives in a most profound way. As this century wears on, not only are the elderly becoming mòre vocal and visible, but also the ramifications of the changing demographics are being felt in family life, in the health-care industry, in architecture and city planning, and in social policy, to name a few arenas. Little will be left unaffected by the time the Senior's Boom peaks in 2030, when mere will be more seniors than ever before.

We need not wait until 2030 to pose the question of who will care for the increasing population of seniors; this is already a crucial concern. Although it is unclear who should assume responsibility and how much should be assumed, it is clear who is currently doing much of the work of elder care: the family. Specifically, it is the less frail spouse and midlife children.1·2 But it is not all midlife children; it is the daughter who becomes increasingly involved with her parents as their frailty increases and they need assistance in maintaining their independence in the community.3"5 In fact, it is likely that she is involved in elder care with her husband's parents as well as her own.
Urinary Incontinence : Nursing Home Staff Reaction Toward Residents
Authors: Yu Lucy C , Johnson Karen , Kaltreider D Lynne , Hu Teh-wei , Brannon Diane , Ory Marcia
Published: May 2014

Nurses usually feel guilty and inadequate when they are unable to meet all of the residents' needs.
Failure to Thrive: A Growing Concern in the Elderly
Authors: Newbern Virginia B
Published: May 2014

The term "failure to thrive" (FTT) was first used in the Ì890s by Holt (1 894) in describing malnourished infants. It has long been a key concept in the field of early childhood development (Bowlby, 1969; Harlow, 1969; Ribble, 1943; Spitz, 1945) as well as in pediatrics (Fischoff, 1971; Hopwood, 1984; Polit, 1976) and nursing (Durand, 1978; Rhymes, 1966; Suran, Ì975).

The early work on failure to thrive examined the behaviors of irthnh ?p? young children in relation to their environment. Ribble (1943), for example, noted that rejected infants either reacted with negativism or regression, and she labeled this reaction failure to thrive. The most extreme form she coiled marasmus: pronounced lethargy and lack of interest, deterioration of body reflexes, increased pallor, and atonicity.
CONSTIPATION: Proposed Natural Laxative Mixtures
Authors: Beverley Laurie , Travis Ivan
Published: May 2014

The treatment of constipation in the elderly is one of the most common problems encountered by the geriatric nurse practitioner (Aman, 1990; Brocklehurst, 1983; Shefts, 1984). Management of bowel habits with this age group is difficult often resulting in mismanagement and the need for invasive measures, such as suppositories and enemas. Yet, it is possible bowel habits for these patients might be regulated by maintaining their dietary, dentition, and mobility requirements so that the use of invasive measures as well as associated product costs are minimized.

A review of the literature revealed normal defecation ranges in frequency from three times a day to three times a week (Connel, 1965). As reported by Wright and Staats (1986), however, the "interval between bowel movements generally lengthens in debilitated older people."
A CENTURY OF PROGRESS: Today's Strategies for Responding to Wandering Behavior
Authors: Algase Donna L
Published: May 2014

Wandering is often a perplexing problem in providing care to persons with a dementing illness. Although restraints have long been presumed to provide a measure of safety for wanderers, they are not the best approach for responding to wandering behavior. In this article, promising strategies for assessing and intervening with wanderers are identified from current research on this puzzling behavior.
ELDERLY CARE Automatic Implantable Cardioverter Defibrillators
Authors: Arato Augusta , Biggs Anna J , Williams Jan
Published: May 2014

Mr J, 78 years old, will be returning to your adult day health-care program next week following his 2-month recovery from surgery to implant an automatic cardioverter defibrillator to treat the ventricular tachyrhythmia he developed following a myocardial infarction nearly 2 years ago. You wonder what care he will need related to this implanted device.

One of the new admissions in your home health-care agency case load is Ms P, age 67. She is to be dismissed home later this week to complete her recovery from a fractured hip sustained in an automobile accident last month. Her medical history indicates she has had an automatic implantable cardioverter defibrillator (AICD) for nearly 4 years, and nurses' notes indicate she is anxious to return to her faculty position in the sociology department of the nearby state college. As you schedule an appointment to meet with her primary care nurse at the local hospital, you wonder what care Ms P will need regarding her AICD.
URINARY RETENTION: In Hospitalized Elderly Women
Authors: Williams Marilyn P , Wallhagen Margaret , Dowling Glenna
Published: May 2014

Urinary retention has been proven to cause serious consequences in bladder function if left untreated. Yet the incidents described in this article suggest that urinary retention (UR) may be an under-recognized or overlooked clinical phenomenon in elderly hospitalized women. In each case, the work-up that documented UR was initiated only after appropriate nursing assessment. In each case, it became clear to the authors that there was little consensus on the accepted immediate management of UR. The purpose of this article is to define UR and its complications and risk factors, and to discuss assessment and immediate management of UR in the acute care setting.
PATIENT ASSESSMENT Infection in the Elderly
Authors: Fraser Dorothy
Published: May 2014

Infection in the elderly occurs more frequently than in the younger population, and it is associated with an increasing morbidity and mortality. Diagnosis is often hindered by atypical presentations, and treatment may be delayed. Decreasing immune competence, the presence of pathology, and increasing disability all increase within this population. This article will include a discussion of physiologic changes in aging that predispose this population to infection, clinical signs and symptoms with an emphasis on atypical presentations, and important nursing care measures for common infections.
CLINICAL MANIFESTATIONS Failure to Thrive in the Elderly
Authors: Osato Edith E , Stone Joyce Takana , Phillips Steven L , Winne Dianne M
Published: May 2014

This article is a report of a study conducted at two Department of Veterans Affairs (VA) medical centers to determine how the diagnosis of failure to thrive (FTT) was being applied to the geriatric population. Patient demographics, disease categories, symptoms, treatments, and outcomes were obtained from charts of patients diagnosed with FTT in an effort to help clarify and define the diagnosis as used in these institutions.
CREUTZFELDT-JAKOB DISEASE: Assessment and Management
Authors: Wallace Meredith
Published: May 2014

Creutzfeldt- Jakob Disease (OD) is a rare, slowly degenerating, viral disease that attacks the central nervous system. It affects primarily late middle-aged and elderly individuals, with a peak incidence occurring between the ages of 55 and 75 (Brown, 1989). GD was originally discussed by Jakob in 1921. Similar cases were documented by Creutzfeldt in the years 1920 through 1921 (Kirschbaum, 1968).
NUTRITIONAL INTAKE: Use of Touch and Verbal Cuing
Authors: Lange-Alberts Mary Ellen , Shott Susan
Published: May 2014

Many hospitalized elderly patients suffer from inadequate nutritional intake (Gupta, 1988; Infante-Rivard, 1986; Mobarhan, 1987, 1991; Morley, 1 986; Rudman, 1 989; Sandman, 1 987; Sullivan, 1 989). These patients may not eat properly because of pain, emotional stress, physical deficits, or inability to attend to the process of eating (Mobarhan, 1 991 ). Because poor nutrition affects healing, skin integrity, and psychological well-being, it is often partially responsible for extended hospitalization (Morley, 1 986). In addition, the cost of supplementing a patienfs diet to compensate for poor nutrition can range from a few dollars per day for noninvasive supplements to several hundred dollars per day for invasive procedures.
CLINICAL CONCERNS: AIDS in the Elderly
Authors: Schuerman Debra A
Published: May 2014

Acquired immunodeficiency syndrome (AIDS) in the elderly accounts for 10% of all AIDS cases (Centers for Disease Control [CDC], 1993). Although blood transfusion is thought to be the most likely mode of transmission in the elderly, AIDS acquired through sexual contact should not be overlooked (Whipple, 1 989).
CLINICAL CONCERNS: Management of Dry Skin
Authors: Frantz Rita A , Gardner Sue
Published: May 2014

Xerosis, or dry skin, is a common problem among elders. It has been reported that 59% to 80% of the elderly population experience dry skin (Frante, 1986; Parent, 1985; Tindall, 1963). Dry skin, with its itching, flaking, cracking and scaling, is a source of discomfort. Moreover, dry skin erodes the ability of the skin to perform its many functions. Nursing care is often directed toward supporting the elderly with activities of daily living, including skin care.
SKIN CARE STRATEGIES: In a Skilled Nursing Home
Authors: Burd Christine , Olson Bette , Langemo Diane , Hunter Susan , Hanson Darlene , Osowski Karen F , Sauvage Timothy
Published: May 2014

Pressure ulcers are of such clinical significance that guidelines have been developed by the Agency for Health Care Policy and Research (1992) for their prediction, prevention, ana* early treatment Predisposing factors that most frequently are associated with the development of pressure ulcers also are associated with being a resident in a long-term care setting. Common circumstances, such as increased age, incontinence, immobility, altered sensory perception, circulatory problems, and poor nutritional status create conditions of risk for pressure ulcer development (Gosnell, 1989; Lazzaro, 1991).
NURSES HELPING NURSES: Development of Internal Specialists in Long-Term Care
Authors: Smith Marianne , Mitchell Susan , Buckwalter Kathleen C
Published: May 2014

Because many long-term care (LTC) providers feel ill-prepared to cope with the high rate of patients with mental disorders and behavioral disturbances/ outside experts in the field of psychiatry often are sought. This may be only a stop gap measure. A collaborative approach to the care of mentally iII nursing home residents that educates, supports, and empowers nurses employed in these LTC facilities may help them become "internal specialists" on geriatric mental health topics within their own facilities.
HELPING SPOUSES with Chronic Sorrow Related to Multiple Sclerosis
Authors: Hainsworth Margaret A
Published: May 2014

This study was designed to examine chronic sorrow in spouse caregivers of individuals with multiple sclerosis. Chronic sorrow was defined as a pervasive sadness that is permanent, periodic, and progressive in nature. The sample comprised 10 participants: 5 males and 5 females. Data were collected through audiotaped, face-to-face interviews using the Burke/NCRCS Chronic Sorrow Questionnaire (Caregiver Version). The audiotapes were transcribed, and then analyzed by the researcher. Eighty percent of the caregivers were found to experience chronic sorrow. Milestones or events which caused the sorrow to recur were major themes. The participants also identified what was helpful and not helpful in coping with these feelings, gave practical advice for similar individuals, and offered suggestions for nurses and other caregivers.
INTERVENTIONS FOR Decreasing Agitation Behaviors in Persons with Dementia
Authors: Snyder Mariah , Egan Ellen C , Burns Kenneth R
Published: May 2014

Agitation behaviors in persons with dementia are a major problem for caregivers. Hall and Buckwalter (1987) hypothesized that an increase in agitation behaviors occur when persons experience high levels of stress, The purpose of this pilot study was to explore the efficacy of hand massage, therapeutic touch, and presence (control group) in producing relaxation and decreasing agitation behaviors in persons with dementia. An experimental crossover design was used to study the effects of these interventions in 17 residents on one AlzheimeKs Care Unit. Hand massage and therapeutic touch were administered once a day in late afternoon for 10 days while presence was administered for 5 days. Five days of observation were done before and after the administration of each intervention. Significant differences were found in the level of relaxation from pre- to post- intervention with the use of hand massage and therapeutic touch. However, no decrease in agitation behaviors was observed.
Long-Term Care: Providing For Those With Disability and Chronic Illness
Authors: Burggraf Virginia , Barry Richard
Published: May 2014

In 1 992 the American Nurses Association redefined long-term care to encompass all ages and groups needing health care over an extended period of time (ANA, 1 992). This definition would include children with disabilities, those with chronic illnesses, the elderly, and the mentally challenged. Long-term care encompasses the services that are needed for life-long health maintenance, and assisted care for acute and protracted illness and disability. Such services include physical, psychological, spiritual, social, and economic support. The number of persons requiring long-term care in the future will increase. The list of communicable diseases requiring long-term care now includes tuberculosis (TB), which is re-emerging. The number of children with AIDS is projected to increase. The past de-institutionalization of the mentally disabled has refashioned the way they are cared for: thousands now live in community dwellings. The number of homeless individuals has also increased, which opens an additional arena for illness (physical and emotional) to flourish. Long-term care requires the social and professional contributions of nurses, not only through the delivery of primary health care services, but also in health teaching and health promotion, prevention of illness, and the provision of rehabilitative services.
Identifying the Responsibilities & Needs of WORKING ADULTS WHO ARE PRIMARYCAREGIVERS
Authors: Krach Peg , Brooks Jo A
Published: May 2014

This descriptive study identified responsibilities and needs of working caregivers of older persons. A 30-item questionnaire was completed by 760 caregivers employed at a large midwestern university. Subjects had a mean age of 52, were female [66%), married [75%), and had children under the age of 18 (36%). Caregiving activities included completing household chores (61%) and personal care (18%), managing finances (40%), providing financial support (26%) and transportation (62%), and companionship (83%). Caregiving responsibilities interfered with activities related to family (56%), work (39%), leisure activities (52%), and rest [57%). Subjects experienced a variety of health problems, including headaches (32%), nervousness (29%), insomnia (29%), weight gain or loss (26%), and unusual drowsiness (22%). Forty-eight percent of subjects missed an average of 4 days of work over a 6-month period due to caregiving activities. The top ten educational needs of the subjects were information regarding community resources (80%), mental incapacities of older persons (79%), and stress management for caregivers [77%). Seventy-six percent of the sample wanted information about normal aging processes. Seventy percent of Hie subjects wanted information about physical care, home care, communication, and community resources. Subjects needed information regarding communication with physicians (69%), housing options (58%), and nursing homes [65%). Hie data stress the need for health care professionals to become more involved with program development, implementation, and evaluation of caregivers of older persons.
THE USE OF FUNCTIONAL CONSEQUENCES THEORY IN ACUTELY CONFUSED HOSPITALIZED ELDERLY
Authors: Kozak-Campbell Cindy , Hughes Anna Marie
Published: May 2014

ABSTRACT

Acute confusion is a common complication of hospitalization in the elderly that impacts on both the use of health care resources and the functional status of individuals. Providing optimum nursing care for these patients depends on three factors: 1) the nurse's ability to differentiate acute confusion from other common conditions in the hospitalized elderly, chiefly dementia or depression, 2) the nurse's ability to identify factors contributing to this condition, and 3) the implementation of interventions to minimize the effects of these factors on the patient. This article differentiates the clinical features of acute confusion from those of depression and dementia, and discusses the use of the Functional Consequences Theory, developed by Miller (1990), as a framework for nursing assessment and management of care for elderly patients with this condition. The functional consequences theory framework assists the nurse to identify risk factors associated with the development of acute confusion in the hospitalized elderly. Further it guides the development of interventions to minimize the effects of this condition in this population. The use of this framework in the clinical setting is illustrated through a case study.
EXEMPLARS FROM AN ACUTE CARE GERIATRIC PSYCHIATRY UNIT
Authors: Cutillo-Schmitter Terri A , Massara Emily Bradley , Wynne Pat , Martin Penny , Sliner Barbara J , Cunningham Frances , Bigdeli Sharie P
Published: May 2014

The exemplars in this article reflect caring contexts and creative nursing solutions to dementia, depression and addiction, common mental health problems afflicting elderly patients and for which inpatient evaluation and treatment are necessitated. Optimal functioning and quality of life for elderly individuals depend substantially upon both physical and mental capacity. The coexistence of mental and physical illness leads to rapid impairment of functioning and interrupts the individual's zest for living. Although in most cases dementia is irreversible, other treatable comorbid conditions like delirium can exacerbate suffering and decline. Conversely, mental disorders, like depression and addiction, can amplify the negative effects associated with other health conditions, causing excess disability and mortality, and are associated with older individuals having the highest suicide rate of any age group in the United States. Nurses are well positioned to identify mental health problems and humanely treat primary and secondary symptoms associated with these disorders in their elderly patients. A document to guide medical professionals' assessment of mental disorders is now available Spitzer et al., 1994). Remaining attentive to early identification of high-risk individuals and mobilizing resources in their behalf will substantially contribute to their wellbeing. There is ample research evidence on the benefits and efficacy of mental health interventions (Lebowitz, 1 994). Much of the challenge and hard work for nurses lies in getting to know the patient, grasping what is happening for the individual and determining which treatment interventions will be most effective given the present circumstances surrounding the illness episode (Benner, 1 984).
COMMUNICATION DIFFICULTIES OF NURSING HOME RESIDENTS: How Can Staff Help?
Authors: Kato Jill , Hickson Louise , Worrall Linda
Published: May 2014

ABSTRACT

Recent studies hove found a high prevalence of communication disorders in elderly residents of nursing homes. This study was undertaken to investigate staff attitudes to me communication problems and communicative needs of residents in their care. A questionnaire was administered to 32 staff members from one nursing home. Responses indicate little evidence of the negative staff attitudes previously reported in the literature. Staff wanted more time to spend communicating with residents and wanted to leam more about the residents' communication problems. Implications of the questionnaire responses for staff training are presented.
MANAGING AMBIGUOUS LOSS in Dementia and Terminal Illness
Authors: Cutillo-Schmitter Terri A
Published: May 2014

A universal family task centers on resolving losses threatening family solidarity. Loss such as death is definite; clearly tangible and visible. Other loss such as deterioration associated with terminal illness can be ambiguous; i.e., appearing less real because it is indefinite and less clear. Lingering, incurable illness, such as AlzheimeKs disease, is extremely painful and stressful for family members as they endure the progressive deterioration and eventual death of their loved one. In such cases, the essence of self, individual personality, ceases though the person physically remains alive (Dolca & Aber, 1989). Such an ambiguous loss may be more complicated for family members to grasp, and thereby begin to resolve. As a result, ambiguous loss may constrain relationships and hamper family connectedness and restructuring. This article encourages nurses to confront the reality of grief and isolation families undergoing ambiguous loss typically experience. Employing a systems perspective, it prescribes stress management strategies that nurses can utilize with families faced with ambiguous loss. In my own nursing practice, I attempt to help such families renew a sense of inner strength to cope more effectively with present circumstances and their future iourney together. My goal is to validate family members' grief while instilling hope that they can successfully manage the disease processes. To enable them to release grief and master developmental as well as caregiving tasks, my first step is to offer my presence, joining with them to support their getting in touch with the ambiguous nature of their loss. Following Walsh and McGoldrick's model (1991), I seek to foster healthy adaptation by facilitating two family tasks: 1 ) shared acknowledgment of the reality of the situation and shared experience of the loss; and 2) reorganization of the family unit and reinvestment in other relationships and life pursuits. To this end, I offer information and guidance, encouraging and coaching family members to share perceptions and explore beneficial solutions for meeting individual and collective needs. It is often difficult for families to accept the reality of psychological death when the person continues to be part of daily existence. Loss within the context of life does not allow space and time for emotional detachment, or pursuits outside the family. Often my role is more about "being with" and less about "doing far/ with the intent of fostering affectionate connections and competency among family members as they readjust to changing circumstances.
SELF-CARE IN NURSING HOME RESIDENTS
Authors: Brubaker Beryl H
Published: May 2014

ABSTRACT

The investigator observed four residents to explore the nature of selfcare in the nursing home. The three themes identified showed that residents performed self-care and acted assertively but not to their full potential. Timing of care events and whether nurse or resident performed them were unpredictable, and residents demonstrated lack of information about scheduling and other routines. Residents not only frequently waited for events to occur but (also) both nurses and residents provided clues that nurse permission was necessary before proceeding. Residents expressed frustration due to lack of control.