bluuebunny/crossref_metadata_2025 huggingface dataset:
L’étrange histoire de l’ordonnance de Villers-Cotterêts : force du passé, force des signes
Authors: Merlin-Kajman Hélène
Published: May 2014

Historians are fascinated by the famous “ Article 111” of the “ Ordonnance de Villers-Cotterêts” (1539), analyzing it from the point of view of its legal meaning, namely in terms of its referential value and the real changes in policy it proposes. What existing language is meant by «langage maternel francais » ? What con s traints, transformations, reactions did the use of the term bring about ? The present analysis touches upon another aspect of the Article : its monumental nature. Article 111 documents, in a temporal dimension which is not that of the legislative act but rather of the fictitious memory of an abstract entity being constructed (State, nation), the existence, potentially ficti tious, of a single language connected with a single kingdom, and not only its existence but its perpetual nature. The fact that even today the interpretation of the Article still causes passionate debates proves that we are still living in this nonevent-based (and ahistorical) period construed at a particular historical date, 1539. It is the historical paradox of the establishment of a transhistoric time period (perpetuity) which will be explored in this paper.
La philologie comme épopée : aspects de la tradition historiographique de l’indianisme en Allemagne au 19e s.
Authors: Rabault-Feuerhahn Pascale
Published: May 2014

The historiography of Indology begins with the birth of the field, at the dawn of the 19th century. It has remained a lively branch of activity and is essentially the result of work by indologists. Germany, an important center of Indology in Europe starting from the Romantic Period, made significant contributions to this tradition. Beyond their often repetitve and hagiographic nature, the texts often reveal both how actors in the field perceived Indology and its history, how they positioned themselves in relation to the field, and what image of the field they wan ted to transmit. German indologists of the 19th century, who were amateur philologists, pre sented their work in the same style as the ad ven tures of field explorers. This article analy zes how this epic stage-setting cemented the field, was used to promote it to political and uni versity powers, and served as an ambiguous ins trument of rivalry with the British colonial power.
Shape-selected nanocrystals for in situ spectro-electrochemistry studies on structurally well defined surfaces under controlled electrolyte transport: A combined in situ ATR-FTIR/online DEMS investigation of CO electrooxidation on Pt
Authors: Brimaud Sylvain , Jusys Zenonas , Behm R Jürgen
Published: May 2014

The suitability and potential of shape selected nanocrystals for in situ spectro-electrochemical and in particular spectro-electrocatalytic studies on structurally well defined electrodes under enforced and controlled electrolyte mass transport will be demonstrated, using Pt nanocrystals prepared by colloidal synthesis procedures and a flow cell set-up allowing simultaneous measurements of the Faradaic current, FTIR spectroscopy of adsorbed reaction intermediates and side products in an attenuated total reflection configuration (ATR-FTIRS) and differential electrochemical mass spectrometry (DEMS) measurements of volatile reaction products. Batches of shape-selected Pt nanocrystals with different shapes and hence different surface structures were prepared and structurally characterized by transmission electron microscopy (TEM) and electrochemical methods. The potential for in situ spectro-electrocatalytic studies is illustrated for COad oxidation on Pt nanocrystal surfaces, where we could separate contributions from two processes occurring simultaneously, oxidative COad removal and re-adsorption of (bi)sulfate anions, and reveal a distinct structure sensitivity in these processes and also in the structural implications of (bi)sulfate re-adsorption on the CO adlayer.
Tandem Cu-catalyzed ketenimine formation and intramolecular nucleophile capture: Synthesis of 1,2-dihydro-2-iminoquinolines from 1-(o-acetamidophenyl)propargyl alcohols
Authors: Kumar Gadi Ranjith , Kumar Yalla Kiran , Kant Ruchir , Reddy Maddi Sridhar
Published: May 2014

The copper-catalyzed ketenimine formation reaction of 1-(o-acetamidophenyl)propargyl alcohols with various sulfonyl azides is found to undergo a concomitant intramolecular nucleophile attack to generate 1,2-dihydro-2-iminoquinolines after aromatization (via elimination of acetyl and hydroxy groups) and tautomerization. The reaction produces 4-substituted and 3,4-unsubstituted title compounds in moderate to good yields under mild reaction conditions.
A NEW CAR-FOLLOWING MODEL CONSIDERING ACCELERATION OF LEAD VEHICLE
Authors: Sun Bingrong , Wu Na , Ge Ying-En , Kim Taewan , Zhang Hongjun Michael
Published: May 2014

For decades, the general motors (gm) car following model has received a great deal of attention and provided a basic framework to describe the interactions between vehicles on the road. It is based on the stimulus-response assumption that the following vehicle responds to the relative speed between the lead vehicle and itself. However, some of the empirical findings show that the assumption of gm model is not always true and need some modification. For example, the acceleration of the following vehicle is very sensitive to the sign of the relative speed and because of no term in the model that directly represents the leader’s acceleration, the follower’s response to the leader’s acceleration can be retarded. This paper offers a new car-following model that can be considered as a variant of the gm model that can better capture car following behavior. The new model treats the follower’s acceleration as a proportion of a weighted sum of the leader’s acceleration and the relative speed between the lead and following vehicles. This paper compares the new model with the original gm model numerically and the characteristics of the new parameters in the model are investigated. It is also shown that the new model overcomes the shortcomings of the original gm model identified in this paper and gives us more instruments to capture the real-world car-following behavior.
LANDSCAPE SPATIAL PATTERN INDICES AND SOUNDSCAPE PERCEPTION IN A MULTI-FUNCTIONAL URBAN AREA, GERMANY
Authors: Liu Jiang , Kang Jian , Behm Holger , Luo Tao
Published: May 2014

Soundscape research could provide more information about urban acoustic environment, which should be integrated into urban management. The aim of this study is to test how landscape spatial pattern could affect soundscape perception. Soundscape data on specifically defined spatial and temporal scales were observed and evaluated in a multi-functional urban area in Rostock, Germany. The results show that urban soundscapes were characterised by artificial sounds (human, mechanical and traffic sounds) overwhelming the natural ones (biological and geophysical sounds). Major sound categories were normally mutual exclusive and dynamic on temporal scale, and have different spatial distribution on spatial scale. However, biological and traffic sounds seem to be co-existing on both temporal and spatial scales. Significant relationships were found existing between perception of major sound categories and a number of landscape spatial pattern indices, among which vegetation density (NDVI), landscape shape index (LSI) and largest patch index (LPI) showed the most effective indicating ability. The research indicated that soundscape concepts could be applied into landscape and urban planning process through the quantitative landscape indices to achieve a better urban acoustic environment.
REMOVAL OF HEAVY METALS (CU, NI, ZN, PB, CD) FROM COMPOST BY MOLASSES HYDROLYSATE
Authors: ÖZBAŞ Emine Elmaslar , BALKAYA Nilgün
Published: May 2014

This study aimed to remove heavy metals (Cu, Ni, Zn, Pb, Cd) from composts using molasses hydrolysate, produced from molasses by-product of the sugar industry. Batch experiments were conducted to examine the effects of differing experimental conditions on the removal of heavy metals, according to contact time and solid–liquid ratio. Batch experiments achieved removal efficiencies of 66% for Cu(II), 52% for Ni(II), 57% for Zn(II), 51% for Pb (II), and 77% for Cd(II) at 60 minutes and 1:12.5 solid–liquid ratio. Column experiments achieved removal efficiencies of 91% for Cu, 86% for Ni, 99% for Zn, 61% for Pb, and 99% for Cd at 0.55 mL/minute flow rate and a solid–liquid ratio of 1:12.5 g/mL. Producing large quantities of highly acidic and heavy metal contaminated solution, compost with low pH, and decreasing some parameters’ concentrations of compost such as C, TKN, total P are the disadvantages of suggested technology.
Fulfilling Nutritional Requirements
Authors: Iverson-Carpenter Martha S , Haskins Debbie , Maas Meridean , Hardy Mary , Button Margaret
Published: May 2014

THE CRITICAL ROLE OF NUTRITION FOR THE WELL-BEING OF OLDER PERSONS MAKES IT IMPERATIVE FOR THE NURSE TO DIAGNOSE AND INTERVENE WITH NUTRITIONAL PROBLEMS.
FUNCTIONAL ASSESSMENT OF THE ELDERLY
Authors: Brown Margaret Dunphy
Published: May 2014

Screening tools are particularly helpful, not only in anticipating performance ability and potential fr caregiver stress, but also the allocation of equipment and support services.
Keeping Pace with Nursing Literature Through a Professional Gerontological Nursing Journal Club
Authors: Shelton Saran Elaine
Published: May 2014

Nurses often subscribe to professional journals and fail to set aside time, or have difficulty finding the time to read them during their busy schedules. The concept of a journal club offers a unique opportunity to develop specific skills in reading, comprehending and evaluating nursing literature.
Key to Healthy Aging: Exercise
Authors: Webster JoAnn A
Published: May 2014

Nurses can significantly impact the quality of life and disability associated with many chronic diseases of older adults by teaching their clients to begin a safe and effective exercise program.
Learning to Care About Gerontological Nursing
Authors: Collins Mary B , Brown Victoria M
Published: May 2014

The more students know about aging and nursing care of the aged, the more they can love it.
RELEASING RESTRAINTS a nursing dilemma
Authors: McHutchion Edna , Morse Janice M
Published: May 2014

The debate continues about the use of restraints as nurses wrestle with the dilemma of appropriate use of restraining devices.
Learned HELPLESSNESS
Authors: LeSage Joan , Slimmer Lynda W , Lopez Martita , Ellor Janet R
Published: May 2014

It is unclear whether passive and dependent behaviors in nursing home residents represent an adaptive response with an intact sense of personal autonomy, or the loss of control that leads to learned helplessness.
Elderly Male Spouses as Caregivers Toward an Understanding of Their Experience
Authors: Gregory David M , Peters Nettie , Cameron Cynthia F
Published: May 2014

The meaning of caregiving may be shaped by sex-role socialization, previous experience in the domestic realm, work-role behaviors, personality characteristics, and culture.
ENVIRONMENTAL INTERVENTIONS IN ASSAULTIVE BEHAVIOR
Authors: Negley Elaine Nelson , Manley Joanne T
Published: May 2014

Assaults without injures, or those with minor injuries not requiring medical attention, time lost from work, or compensation, were generally not reported.
Is There a Link Between Dementia and Phenylketonuria?
Authors: Maddox Marjorie A
Published: May 2014

A diet low in phenylalanine may help prevent some of the manifestations of dementia in the elderly.
Meta-Analysis Techniques
Authors: Graney Marshall J , Engle Veronica F
Published: May 2014

Nursing Theory Development
The Prevalence of Orthostatic Hypotension in high-risk ambulatory elders
Authors: Walczak Mary
Published: May 2014

Inactivity, underlying medical illness, medications, and even food ingestion may contribute to the prevalence of orthostatic hypotension.
CLINICAL OUTLOOK
Authors: Haight Barbara Kavanagh , Burnside Irene
Published: May 2014

Reminiscence and Life Review: Conducting the Processes
FEASIBLE WITHOUT SUBSIDY?: Overnight Respite for Alzheimer's
Authors: Rosenheimer Lilia , Francis Ettle M
Published: May 2014

Alzheimer's disease remains an incurable, progressive neurologic disease that lasts for many years (Office of Technology Assessment, 1987). The incidence of Alzheimer's rises significantly with increasing age. Alzheimer's disease accounts for about 50% of the dementias; other causes are multiple infarct dementia, alcoholism, and Parkinson's disease. The course of illness for an individual with Alzheimer's disease progresses from mild forgetfulness to being unable to handle activities of daily living, requiring total care over a 7-year to 10-year period. Many victims of this disease reside at home with the family serving as primary caregiver. This translates into a tremendous physical, emotional, social, and financial burden for the family (Office of Technology Assessment, 1990; Older Women's League, 1989). The alternative is placing the patient in a nursing home at a financial cost to the family and community (Sherman, 1990).
POSTMENOPAUSAL WOMEN: Factors in Osteoporosis Preventive Behaviors
Authors: Ali Nagia S , Bennett Susan J
Published: May 2014

Osteoporosis is a serious health hazard mainly affecting postmenopausal and elderly women. An estimated 200 million people worldwide have the disorder (Christiansen, 1990). Osteoporosis predisposes its victims to fractures of the spine, wrist, and hip with minimal or no trauma. In the United States each year, 250,000 people, 90% of whom are women over 70 years of age, suffer osteoporotic hip fractures (Bauer, 1991). Osteoporotic fractures are one of the leading causes of morbidity and death in the elderly population. About 20% of the individuals die from complications and 50% are permanently disabled (Christiansen, 1990).
GERONTOLOGICAL NURSING: Overcoming Barriers to Preparation and Practice
Authors: Manuel Patricia , Haussler Susan C
Published: May 2014

Because nurses are the principal managers of health care for the elderly, it is crucial to examine the barriers that affect educational programs that prepare nurses to practice as both clinicians and administrators in gerontology. Until the barriers are removed, it will be impossible for educational programs to provide the quality and quantity of nurses needed to practice in this specialty.

This article examines the barriers that prevent nurses from both practicing in the long-term care setting and pursuing graduate education in gerontology and long-term care. Additionally, strategies for change and collaboration between the service/practice setting and educational programs are discussed.
RESEARCH CONCERNS: Aging as Perceived by Saudi Elders
Authors: Mansour Ahlam , Laing Gail
Published: May 2014

The field of gerontology has been gaining importance in recent years. More and more people are living longer because of advances in medical technology and improved health care delivery systems. People in the health field are studying the theories of aging to better understand elderly people; these theories are being taught in universities throughout the world.
HOSPITAL RESOURCES FOR CARE OF ACUTELY ILL OLDER PERSONS
Authors: Hogstel Mildred O , Cox Marsha
Published: May 2014

ABSTRACT

Older patients in acute care hospitals are at high risk for problems. Care of older persons is further jeopardized by a shortage of physicians and nurses interested and prepared in gerontology and geriatrics, as shown in a survey of hospitals and staff in one southwestern state.
OBRA '87: Has It Resulted in Positive Change in Nursing Homes?
Authors: Marek Karen Dorman , Rantz Marilyn J , Fagin Claire M , Krejci Janet Wessel
Published: May 2014

This study examines perspectives of a broad group of nursing home employees, regulators, advocates, and professional associations to describe progress made since the 1 990 implementation of the Nursing Home Reform legislation (OBRA '87) and to determine whether the legislation is perceived as effecting positive change for nursing home residents. Interviews were conducted with 1 32 professional and non-professional staff in six states and 56 residents. Important issues about nursing home staffing and quality of care are explored. In general, OBRA '87 is viewed as positive, with all groups of respondents indicating that nursing staff or quality have not deteriorated; administrators, licensed nurses, and certified nursing assistants indicate the quality of nursing care provided and the nursing staffing levels have improved since OBRA '87 implementation. Regulators agree that quality of nursing care has improved, but nursing home advocates, regulators, and professional association staff indicate mostly no change or no opinion. There is a danger in interpreting that quality and staffing are adequate from these results. While both may have improved, they may not be adequate.
REPORTING ELDER MISTREATMENT
Authors: Capezuti Elizabeth , Brush Barbara L , Lawson Willam T
Published: May 2014

ABSTRACT: Elder mistreatment, defined as the abuse and neglect of older persons, includes physical, psychological, and sexual abuse, caregiver and self-neglect, and financial exploitation. Fifty states and the District of Columbia have passed legislation to establish adult protective service (APS) programs. State APS statutes authorize APS agencies to investigate cases of elder mistreatment. Some states fund services to alleviate the abusive or neglectful situation. This article analyzes the critical aspects of state-specific APS legislation affecting nursing practice with older adults and the nurse's role in reporting cases of elder mistreatment.
DETECTION AND CORRECTION of Underweight Problems in Nursing Home Residents
Authors: Gants Ruth
Published: May 2014

ABSTRACT

Subnormal weight in the elderly is a well-known phenomenon; the ramifications may result in illness and death. There are many reasons for weight loss, usually related to changes that accompany aging or against a background of acute or chronic illness.

Our goal in this study was to identify the underweight people living in our retirement facility at different functional levels and to plan and carry out nursing interventions in cooperation with the rest of the multidisciplinary team to increase their weight to within normal limits.

Of the 205 residents who live in the home, 48 (23.4%) were found to be under the lower limit of ideal weight tables. With the aid of individual care plans and calorie-rich, low-volume diets, we succeeded in increasing the weight of 29 residents to within the normal range within 2 to 12 months. Seven residents died during the experimental period, and three continuing to lose weight. The rest of the residents remained stable at their original low weight.
GENDER DIFFERENCES in Health and Health Actions Among Community-Dwelling Elders
Authors: Musil Carol M
Published: May 2014

ABSTRACT

This secondary analysis of data from a study of elders' health examined gender differences in the psychological and physical health and the health actions made in response to specific physical complaints in a random sample of 491 communitydwelling older adults (mean age of 75.3 years). Significant gender differences in anxiety, depression, and body awareness were found, although there were no differences in self -assessed health or total number of health problems reported. There were some gender differences in the types of health problems experienced. Subjects tended to use self-care actions, particularly overthe-counter medications and home remedies, more so than professional consultation. Different patterns of care emerged for women and men, with women somewhat more inclined to use self-care and men more likely to seek professional consultation.
Tuberculosis and the Elderly: A Community Health Perspective
Authors: Gubser Virginia L
Published: May 2014

ABSTRACT

Tuberculosis is an ancient disease which has had a resurgence in the United States. Many elderly clients were exposed to tuberculosis as children and young adults and are still carrying the infection today. This article describes tuberculosis as it affects the elderly client in community and nursing home settings. The history, etiology, clinical manifestations, treatment, and prevention of tuberculosis infection and disease are presented. Because nurses can be very instrumental in controlling tuberculosis in the elderly, gerontological nursing implications are discussed.
LIVING WITH DEMENTIA From the Patient's Perspective
Authors: Phinney Alison
Published: May 2014

ABSTRACT

This study describes the illness experience of dementia from the patient's perspective. Five people with Alzheimer's disease and their spouses were interviewed and observed during home visits. Thematic analysis revealed two themes: being unsure and trying to be normal. Being unsure describes people's fluctuating experience of symptoms that leaves them feeling unsure of themselves in a world that is increasingly unfamiliar. Trying to be normal describes people's efforts to counter the impact of dementia to maintain continuity in their lives. These findings point to the importance of taking into account the patient's perspective to better understand the experience of living with dementia and develop improved treatment and care practices.
Gerontological Nurses' WAYS OF KNOWING
Authors: Parke Belinda
Published: May 2014

Realizing the Presence of Pain in Cognitively Impaired Older Adults
USE OF MUSIC to Decrease Aggressive Behaviors in People With Dementia
Authors: Clark Michael E , Lipe Anne W , Bilbrey Melinda
Published: May 2014

ABSTRACT

The purpose of this study was to examine the effects of recorded, preferred music in decreasing occurrences of aggressive behavior among individuals with Alzheimer's type dementia during bathing episodes. Eighteen older adults, age 55 to 95, with severe levels of cognitive impairment, participated in the study. They were randomly scheduled for observation during bath time under either a control (no music) condition or an experimental condition in which recorded selections of preferred music were played via audiotape recorder during the bathing episode. Following a 2-week (10 episode) observation period, conditions were reversed. A total of 20 observations were recorded for each individual. Results indicated that during the music condition, decreases occurred in 12 of 15 identified aggressive behaviors. Decreases were significant (p < 0.05) for the total number of observed behaviors and for hitting behaviors. During the music condition, caregivers frequently reported improved affect and a general increase in cooperation with the bathing task. The implications of these findings for improving the overall quality of care for severely cognitively impaired older adults are discussed.
Identification of Alcohol-Related Problems in OLDER WOMEN
Authors: Eliason Michele J
Published: May 2014

ABSTRACT

The stereotype of an alcohol or drug abuser rarely elicits an image of an older woman. However, if an expanded definition of alcohol abuse is considered, many older women are at risk because of normal changes in the body due to aging and the high number of prescription and overthe-counter medications they use. This article reviews current knowledge about alcohol-related problems in older women.
Test of an Educational Brochure on Advance Directives Designed for Well-Elderly People
Authors: Husted Gladys L , Miller M Carroll , Brown Barbara
Published: May 2014

ABSTRACT

The aim of this study was to test an advance directive brochure designed especially for well-elderly people. The brochure was developed using information from literature on preparing educational materials ana from information gained from well-elderly focus groups. The information sought was in regard to what they knew and what they wanted to know about advance directives and what they found appealing in brochures on advance directives. Twenty well-elderly people participated in the study. Prior to data collection, the brochure was given to 10 nurses who were asked to evaluate it according to the Bernier Instructional Design Scale 2. Out of a possible 280 points, the brochure received 244. The participants in the study were asked to read the brochure and answer 15 questions about the content, user friendliness, and attractiveness of the brochure. The overall results were positive. The first five questions had to do with the appearance of the brochure. All 20 participants responded favorably to these questions. The next 10 questions had to do with understanding the content. A simple percentage was used to calculate the results. The participants understood 90.5% of the content. Based on these results, the brochure should be used in future intervention research and in discussions regarding the education of well-elderly people and the drafting of advance directives.
Measurement of Inappropriate Behavior Associated With Dementia
Authors: Cohen-Mansfield Jiska
Published: May 2014

Using direct observation, caregiver ratings, or technological devices for assessment to help understand causes of problem behavior.
CAREGIVER DISTRESS
Authors: Middleton Joan I , Stewart Norma J , Richardson J Steven
Published: May 2014

Related to Disruptive Behaviors on Special Care Units Versus Traditional Long-Term Care Units
A Standardized Assessment and Intervention Protocol for Managing Risk for Falls on a Geriatric Rehabilitation Unit
Authors: Patrick Louise , Leber Miriam , Scrim Carmel , Gendron Isabelle , Eisener-Parsche Pamela
Published: May 2014

Interdisciplinary team members determine levels of independence and teach behavioral compensatory strategies for physical or cognitive impairments.
Geriatric Mental Health Education in Canada SKIPs Into the 21st Century
Authors: Lusk Christine
Published: May 2014

This program teaches nurses the importance of advanced and current education in the field of geropsychiatric nursing.
Missed Depression in Elderly Individuals
Authors: Whall Ann L , Hoes-Gurevich M Linda
Published: May 2014

Why Is This a Problem?

Older adults often hide depression for fear of being labeled "weak" or "crazy," so health care workers must be thorough, understanding, and willing to follow through with treatments.
An Intervention Study to ENHANCE MEDICATION COMPLIANCE in Community-Dwelling Elderly Individuals
Authors: Fulmer Terry T , Feldman Penny Hollander , Kim Tae Sook , Carty Barbara , Beers Mark , Molina Maria , Putnam Margaret
Published: May 2014

ABSTRACT

Objective: To determine whether daily videotelephone or regular telephone reminders would increase the proportion of prescribed cardiac medications taken in a sample of elderly individuals who have congestive heart failure (CHF).

Methods: The authors recruited community-dwelling individuals age 65 and older who had the primary or secondary diagnosis of CHF into a randomized controlled trial of reminder calls designed to enhance medication compliance. There were three arms: a control group that received usual care; a group that received regular daily telephone call reminders; and a group that received daily videotelephone call reminders. Compliance was defined as the percent of therapeutic coverage as recorded by Medication Event Monitoring System (MEMS) caps. Subjects were recruited from 2 sources: a large urban home health care agency and a large urban ambulatory clinic of a major teaching hospital. Baseline and post-intervention MOS 36-ltem Short-Form Health Survey (SF-36) scores and Minnesota Living with Heart Failure (MLHF) scores were obtained.

Results: There was a significant time effect during the course of the study from baseline to post-intervention (F [2,34] = 4.08, ? < .05). Over the elderly individuals who were called, either by telephone or videotc phone, showed enhanced medication compliance relative to the cot group. There was a trend, but no significant difference between the intervention groups. Both SF-36 and MLHF scores improved from bé line to post-intervention for all groups. There was no significant ch« in the SF-36 scores for the sample, but there was a significant change the MLHF scores (p < .001). The control group had a significant fall in the medication compliance rate during the course of the study, drc ping from 81 % to 57%.

Conclusions: Telephone interventions are effective in enhancing medk tion compliance and may prove more cost effective than clinic vis preparation of pre-poured pill boxes in the home. Technologie advi which enable clinicians to monitor and enhance patient medication cc pliance may reduce costly and distressing hospitalization for elderly viduals with CHF.
Nursing Unit Meal Management Maintenance Program
Authors: Miceli Bernard Vincent
Published: May 2014

Continuation of Safe Swallowing and Feeding Beyond Skilled Therapeutic Intervention
Measuring Nursing Work in Long-Term Care
Authors: Leppa Carol J
Published: May 2014

The Reliability and Validity of the Leatt Measure of Nursing Technology

The Leatt instrument can be provide a basis for comparing the nature of long-term care nursing work - measured as uncertainty, instability, and variability - with other nursing environments.
The Lived Experience of BEING AT HOME
Authors: Hammer Rita M
Published: May 2014

A Penomenological Investigation

ABSTRACT

Objective: To describe the essential structure of the lived experience of feeling at home for older adults relocated to alternative care settings which provide some degree of supervision.

Methods: A purposive sample of 10 relocated older adults in three settings (i.e., one life care and two long-term care facilities) was studied using a qualitative design. Data were gathered through interviews and analyzed using Giorgi's (1985) method of phenomenology.

Findings: Fourteen themes existing in a dialectic of "at home" versus "not at home" emerged and were integrated into the essential structure of the phenomenon of home. Elders who felt at home had strong feelings of satisfaction with their lives, security, autonomy, and purpose. Those older adults who did not feel at home were anxious, angry, and depressed, and were consumed by a desire to be elsewhere.

Conclusions: Some individuals have great difficulty establishing a sense of home in alternative settings. Methods of assessing older adults and designing interventions that contribute to establishing a sense of home could prove valuable in enhancing the quality of life for those who must spend their remaining years in settings other than their traditional homes.
The World It Is A-Aging
Authors: Swanson Elizabeth
Published: May 2014

As the elderly population increases globally, gerontological nurses must learn to apply their expertise and promote health among different cultures.
Factors Associated With Referral of Elderly Individuals With Cardiac and Pulmonary Disorders for Home Care Services Following Hospital Discharge
Authors: Narsavage Georgia L , Naylor Mary D
Published: May 2014

ABSTRACT

Referrals for home care services initiated prior to hospital discharge may prevent or delay readmission or nursing home placement, especially for elderly individuals with multiple, chronic health problems. While multiple factors could justify the need for home follow-up after hospital discharge, little is known about those patient factors associated with clinicians' decisions to refer older adults with cardiac or pulmonary disorders. Increased understanding of factors that contribute to initiating a home care referral could enhance clinicians' decision-making and thus improve post-discharge outcomes for these patient groups. This study examined patient factors associated with and predictive of the decision to refer for home follow-up, using a sample of older adults hospitalized with chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF). Study findings suggest a model that includes patients diagnosed with both COPD and CHF, who are not married, need home health aides, and have a longer than average length of hospital stay may be helpful in predicting the need for home care referrals.
Heart Health and Older Women
Authors: Robinson Anne White , Sloan Helen L
Published: May 2014

Coronary heart disease, often considered a man's disease, has gender- and age-specific characteristics that nurses must address to help prevent it from developing in aging women.
Pressure Ulcer Risk ASSESSMENT in Long-Term Care Nursing
Authors: Vap Pamela W , Dunaye Thomas
Published: May 2014

ABSTRACT

The intent of this study was to determine whether the typical practice of using risk assessment tools in combination with the federally mandated Minimum Data Set (MDS) actually predict more cases of pressure ulcers (PUs) in long-term care facilities. Data in this study were collected from 555 resident charts in a sample of eight nursing homes. A total of 66 PUs were identified between September 1, 1996 and September 1, 1997 in a comparative test of the predictive abilities of the MDS versus the Braden Scale (BS) patient profiles.

As shown by a Chi square test, the MDS and the BS assesment tools were valid in finding factors that placed residents in jeopardy of developing pressure ulcers: MDS ?2 = 43.68, df= 1 , ? < .0001 and BS ?2 = 52.47, df = 1 , ? < .001 . However, a two-tailed t test, indicated results of the BS were significantly different than the MDS: t = 3.77, df= 97, ? < .003 and BS = ? = 3.77, df= 97, ? < .001.

Both the MDS and the BS identified patient factors: the MDS identified 311 at risk, resulting in accurate prediction of 62 of 66 PUs, while the BS found 172 at risk and predicted only 46 PUs accurately. Therefore, data indicate the BS did not make a significant difference in predicting the incidence of pressure ulcers in this sample of long-term care facilities. These unexpected findings would argue in favor of discontinuing the practice of using the BS for PU risk assessment simultaneously with the MDS, but rather at independent time frames such as immediately upon resident admission. This would continue to support the recommendations of the National Pressure Ulcer Advisory Panel (NPUAP), and at the same time, provide a more timely pressure ulcer risk assessment.
Healthy People 2010: Protecting the Health of Older Individuals
Authors: Burggraf Virginia , Barry Richard J
Published: May 2014

Building on initiatives pursued over the past 2 decades, the new objectives commit to promoting health and preventing illness, disability, and premature death.
Assessing Elderly Patients with Congestive Heart Failure via In-Home Interactive Telecommunication
Authors: Jenkins Ruth L , McSweeney Maryellen
Published: May 2014

ABSTRACT

The efficacy of telemedicine technology was tested for equivalence of nursing assessment with chronic congestive heart failure (CHF) home care patients (N = 28). The equivalence of nurses' physical assessment findings was estimated using an innovative two-way, telemedicine audiovisual system. Nurses were randomly assigned to a method of client assessment: on-site (real time) or telemedicine (monitor time). Each assessment was performed within 10 minutes of each other. Assessment variables compared were auscultation of lung sounds, heart sounds, rate and rhythm, blood pressure, weight, edema, respiratory effort, and client's face, lip, and nail color. Eighteen physiological parameters were analyzed, using either the Wilcoxon signed ranks test or the McNemar test. Results indicate few significant differences between the assessments of the real time and monitor time nurses. The monitor nurse was more likely to claim abnormality than the real nurse was when assessing the color of nails (p = .048). The real nurse picked up ankle edema (p = .024), pedal edema (p = .099), and inspiratory wheeze (p = .01) more frequently than did the monitor nurse. Kappa coefficients to determine the extent of agreement between nurse's assessments were significant. Nurses' comments were favorable, but they recommended altering the interview to elicit symptoms not easily observed by the monitor nurse such as diaphoresis. Exit interviews of the elderly patients revealed a favorable reaction to using the telemedicine monitor, citing a quick connection to a nurse and response to their concerns and questions. Both nurses and patients reported the need to have real nurse home visits along with telemedicine visits.
Long-Term Care for Older Adults: The Role of the Family
Authors: Janzen Wonita
Published: May 2014

ABSTRACT

Family members are involved in all aspects of a frail or ill older adult's care before, during, and after admission into a long-term care facility. However, their role within the facility is not always clearly defined. This article addresses issues regarding facility policies and staff attitudes toward family involvement, particularly whether the family member is seen as an integral part of the care system or peripheral to the care system. An emphasis is placed on the use of open communication to prevent misunderstandings and disagreements between staff and family and to promote good quality care and acceptable quality of life for the resident.
Studying Acute Confusion in Long-Term Care: Clinical Investigation or Secondary Data Analysis Using the Minimum Data Set?
Authors: Culp Kennith , Mentes Janet C , McConnell Eleanor S
Published: May 2014

ABSTRACT

Clinical investigations of acute confusion have largely been initiated in the acute care setting, where no uniform patient assessment exists. No reliable estimates of the prevalence of acute confusion in long-term care (LTC) residents have been reported. Delirium indicators are present in the nursing home Minimum Data Set (MDS), suggesting that MDS assessments could be used to facilitate studies of acute confusion in LTC. Methods to study acute confusion in LTC are discussed, with an emphasis on the advantages and disadvantages of using secondary analysis of MDS assessments as one research strategy.
RELOCATION Among Ethnic Elders: A REVIEW - Part 2
Authors: Johnson Rebecca A , Tripp-Reimer Toni
Published: May 2014

ABSTRACT

Relocation to more supportive housing is a potentially stressful life event for older adults. Under the best of circumstances, the older adult will be relatively healthy and able and willing to participate in relocation decisions. However, this is not always possible. Nurses have a critical role to play in helping families identify the most appropriate housing alternative, helping plan the relocation, and helping older adults adjust to their new homes. Relocation is particularly stressful for ethnic elders who may not understand the housing options available, or may fear prejudicial treatment and exclusion in the various settings. Nurses need to take time for careful assessment of the older adults' preferences, and to provide information needed to help them make relocation decisions within the context of their existing support networks.
The 20th Century: Looking Back at the Ambiance of Aging From the Perspective of Age-Specific Journals and Periodicals
Authors: Holkup Patricia A
Published: May 2014

ABSTRACT

The word "aging" is fraught with nuance, both positive and negative. The purpose of this article is to describe the results of a preliminary exploration of the ambiance of the concept of aging in the United States as seen from the perspective of periodical literature from the past century. A convenience sample of professional journals and lay periodicals concerned with aging and the issues of aging was selected as the focus for this investigation. Specifically, volume one, number one of the selected journals was examined with regard to the date of the first publication, the table of contents, and the first issue editorial or articles in the first volume describing the motivation for the introduction of the journal. Findings indicated that as the century progressed and the study of aging took form, the focus shifted from how to manage the problems of aging to: (a) how to promote healthier young adult lifestyles to increase the chances of a healthy old age, (b) how to continue to maintain older adults' health and therefore, increase the life expectancy for those people older than age 65, and (c) how older adults contribute to the well-being of society. The longevity of the human species, as well as the increasing size of the aging population is a new phenomenon, the ramifications of which are difficult to predict. However, as the emotional tone of the journals in the latter quarter of the century gradually became more positive, it was apparent that consideration was being given to the idea that this phenomenon could be a positive force in the collective growth of humanity.
DETECTION OF DELIRIUM USING THE CONFUSION ASSESSMENT METHOD
Authors: Laplante Johanne , Cole Martin G
Published: May 2014

Nurses are encouraged to initiate interventions and perform mental assessments routinely to prevent deterioration of mental state in older adults who are hospitalized.
The Effect of INDIVIDUALIZED ACTIVITIES ON THE SLEEP of Nursing Home Residents Who Are Cognitively Impaired: A PILOT STUDY
Authors: Richards Kathy Culpepper , Sullivan Sheila Cox , Phillips Robin L , Beck Cornelia K , Overton-McCoy Amy Leigh
Published: May 2014

ABSTRACT

This pilot study investigated a program of individualized activities designed to enhance nocturnal sleep in five cognitively impaired veterans residing in a dementia care unit. Actigraphy documented 24-hour sleep-wake patterns of the residents for 3 days. Those meeting the criteria for inclusion then participated in an Individualized Activity Intervention timed to occur during peak napping times for 14 days. During the 10th, 12th, and 14th days of intervention, actigraphy provided a repeat measure of sleep-wake patterns. The results indicated an increase in nocturnal sleep with increased efficiency, as well as a decrease in daytime napping. This pilot study encourages further investigation of this potential method for enhancing nocturnal sleep in cognitively impaired elderly adults.
Fall Occurrence in a Geriatric Psychiatry Setting Before and After a Fall Prevention Program
Authors: Savage Troy , Matheis-Kraft Carol
Published: May 2014

ABSTRACT

A fall prévention program providing staff education, quantitative assessment of gait and balance, risk factors assessment, and evidence- based interventions was introduced on two geriatric wards of a regional psychiatric hospital. A within -subjects comparison was made of fall occurrence during the 4-month preintervention phase and the 4-month post-intervention phase using Fisher's exact test. Among those (N = 23) who survived the duration of the study, significantly fewer falls occurred in the post- intervention time period than in the pre-intervention time period (p < 0.01). Comprehensive assessment, problem identification, and intervention planning by nurses may serve to reduce the number of fails among elderly individuals with severe psychiatric disorders.
When Your Patient Can No Longer Live Independently
Authors: Baldwin Kathleen , Shaul Muriel
Published: May 2014

A Cuide to Supporting the Patient and Family
Assisted Living: Strategies for Initiating an Advanced Practice Nurse Clinic
Authors: Bonnel Wanda Blaser
Published: May 2014

Advanced practice nurses have an opportunity to create a role combining the best of home health and acute and chronic care management skills while building client strengths to promote successful aging.
Helping Patients with Vision Impairment Adhere to a Medication Regime
Authors: Mowerson Lisa-Anne
Published: May 2014

An interdisciplinary team can help nurses implement simple strategies to help patients who are visually impaired become more independent and compliant in the management of their medication program.
RESIDENTS' AUTONOMY: Nursing Home Personnel's Perceptions
Authors: Mullins Larry C , Hartley Tina M
Published: May 2014

ABSTRACT

While delivering quality care, nursing home personnel may unintentionally adversely affect residents' sense of personal autonomy. Faced with the challenge of respecting resident autonomy and simultaneously adhering to nursing home standards, nursing home staff often experience a frustrating ethical conflict. This study examines the effects of sets of independent variables on six autonomy dimensions to examine nursing home personnel's perceptions of how care was provided in their facility. For each of six case studies, respondents were asked the following question: "If Mr. or Mrs. X were at your facility, what would have been decided?"
Coping Styles of OLDER ADULTS with Ostomies
Authors: Reynaud Sheila Normand , Meeker Bonnie Juve
Published: May 2014

ABSTRACT

Various clinical studies throughout the years have shown that individuals with ostomies are a unique group facing adjustment demands. One of the most important challenges for an individual with an ostomy is coping with the physiological and psychological changes. The purpose of this study was to describe coping styles of older adults after undergoing ostomy surgery and to explore its helpfulness in dealing with the Stressors related to having an'ostomy. Lazarus and Folkman's theory on stress and coping was used as the framework to guide this study. A sample of 27 participants ranging from age 5Q to 84 years was obtained from an ostomy association in southeastern Louisiana. Participants were asked to complete a demographic data form and the Revised Jalowiec Coping Scale. This revised scale measured eight coping styles related to Use and Effectiveness. Findings revealed significant differences existed among the means of the eight measures for both Use and Effectiveness at p < .01. Results demonstrated that the optimistic and self-reliant styles of coping were the most frequently used as effective styles for coping with an ostomy. This indicated a positive outlook and dependence on oneself rather than dependence on ethers when coping with the Stressors of having an ostomy. There were no statistically significant differences related to gender or ostomy type. Also, aging did not appear to be a factor when considering coping styles of older adults with ostomies. The nursing role should include assessment of the individual preoperatively to identify fears, concerns, and Stressors reJated to having an ostomy. Also, nurses can provide education on disease management, assist with identification of ineffective coping mechanisms, and promote effective coping skills and stress management techniques.
Why Older Adults with Light Care Needs: Enter and Remain in Nursing Homes
Authors: Grando Victoria T , Mehr David , Popejoy Lori , Maas Meridean , Rantz Marilyn , Wipketevis Deidre D , Westhoff Reghnald
Published: May 2014

ABSTRACT

Many patients in nursing homes receive limited services. In 1996, approximately 17% of the 1.6 million nursing home residents received assistance with two or less activities of daily living (ADL). This descriptive study addressed this issue by investigating why residents with light care needs enter and remain in nursing homes. Residents with light care needs (N = 20) identified by directors of nursing were interviewed to elicit why they entered and remain in nursing homes. Their care level was estimated using the Minimum Data Set (MDS) and Resource Utilization Groups, Version III (RUGIII). In this study, older adults with light care needs who decide to enter and remain in nursing homes were found to be influenced by a prior Hospitalization or a health event; the perceived inability to manage instrumental ADLs (IADLs), ADLs, or health monitoring at home; and lack of knowledge about alternatives to nursing home care. This study demonstrates the vital role nurse case managers can play in both acute care settings and nursing homes. They can help older adults with light care needs to make informed decisions about longterm care, seek out community options, and set in place assistive care systems that can help them age in the community.