bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Projects of Life Reflected in Autobiographies of Old Age
Authors: Ruth Jan-Erik , Birren James E. , Polkinghorne Donald E. 
Published: May 2019

AbstractThe present investigation was based on the analysis of twenty respondents, ten men and ten women, all retired. The written texts were obtained from the archives of one of the authors who gathered autobiographies using a guided method of assigned topics of life. The main objective for this analysis was to find those central life goals and dominant activities around which the projects of life were formed. Sorting of life projects was done according to the constant comparison method described by Glaser and Strauss in their Grounded Theory model. Five types of life projects were identified in the narratives:living is achieving, living is being social, living is loving, living is family life, living is struggling.Considerable gender differences appeared in the findings with women showing a broader participation and interpretation of life where family life, community work and job careers were important. The men tended to be more monothematic focusing either on a personal achievement or a career development in a more social context. The rhetoric in the discourse of life themes was quite different between the sexes reflecting the sex role scripts of the cohort studied. Only in some of the types was the class dimension clearly visible where the typeliving is achievingand to a certain extent evenliving is being socialreflected upper middle class and upper class occupations whileliving is lovingreflected middle class occupations. The positive narrative tone and the telling of well-managed life projects and success stories in most of the accounts were considered as American features in comparison to some Finnish life stories that contained more of the telling of hardships. The most gender bound accounts such as the masculineliving is achievingand the feminineliving is lovinglife projects showed the greatest resemblances between these two western cultures revealing comparable master scripts.
The Absent Body – A Social Gerontological Paradox
Authors: Öberg Peter 
Published: May 2019

AbstractThis contribution, which is mainly theoretical, focuses on the paradox that, to a considerable extent, the body has been absent from social gerontology, despite the fact that in our culture, ageing is presented both in terms of surface and body and is experienced via the body. This paradox is brought into the open and clarified using as a starting point the ontological dualism of the Platonic-Christian tradition in which body and soul are seen as hierarchical opposites. The article shows how this dualism penetrates society and science and is carried on into the construction of gerontological concepts and theories, e.g. the ‘ageless self’ concept. The article also illustrates what consequences this dualism has for the everyday understanding of ageing based on biographical interviews with elderly Finnish people.
Socioeconomic Factors and Behavioural Problems of the Elderly Population: A Study of Rural Areas of Eastern Uttar Pradesh
Authors: Yadava K. N. S. , Yadava Surendar S. , Sharma C. L. N. 
Published: May 2019

AbstractThis paper attempts to study the socioeconomic and demographic profile of the elderly population at a micro level based on data collected in a sample survey, entitled ‘Ageing and health conditions in rural areas - a sample survey 1990’, conducted in the eastern part of Uttar Pradesh, India. The distribution of the elderly population according to their work status, health problems and needs is also discussed. The views and actions of the younger family members toward the elderly members are examined and found to vary according to caste group, sex, and work status of the latter. It is noted that elderly females are usually relatively more dependent on their families than their male counterparts. The behaviour of the family members towards their elders is also significantly affected by the literacy and income levels of family members. Provision for an old-age pension is strongly recommended.
Constructing Familiarity and Managing the Self: Ways of Adapting to Life in Nursing and Residential Homes for Older People
Authors: Reed Jan , Payton Valerie Roskell 
Published: May 2019

AbstractThis paper reports on the analysis of data collected in a study looking at older people moving into nursing and residential homes. Using life history methodology, participants are interviewed before and after arrival at homes in order to determine the process of adapting to their new environment. Initial data analysis indicates that this process requires extensive social activity on the part of the new resident, involving negotiation of complex social conventions. The discussion focuses on two themes which have been identified from the data: constructing familiarity whereby participants use sometimes tenuous knowledge of people and places to make the home seem less strange, and managing the self, whereby familiarity is used as a means of permitting social conversation to take place without leaving residents open to the dangers of being intrusive. These two themes have relevance for the way in which new residents can be introduced to homes, and the way in which the social skills of older people are viewed.
Unemployment and the Older Worker in the Netherlands: Re-entry into the Labour Force or Resignation
Authors: Henkens Kène , Sprengers Maarten , Tazelaar Frits 
Published: May 2019

AbstractIn this article we present the results of a panel survey in which 242 men aged 40 to 55 were followed for approximately seven years after they became involuntarily unemployed. The study focused on reintegration probabilities of the older workers and on the question of their reaction to a situation of prolonged unemployment. The study shows that if policy is not changed, the probability of the reintegration of older, long-term unemployed persons into the labour force will remain extremely low. Re-entry via a ‘normally’ functioning labour market (formal application procedures and official job intermediaries) takes place almost exclusively during the first year after dismissal. If a new job is not found, a resigned feeling occurs among almost all of this older unemployed group. Most of the older people adjust to the new circumstances sooner or later. If one wishes to protect older persons from the trap of long-term unemployment (and in many cases total exclusion), more rapid interventions must be made, and reorientation and retraining efforts must be started sooner, before it is ‘too late’. From the employer’s point of view, there is not much interest in those who are still unemployed after one year.
Stories and Metaphors: Talking about the Past in a Psychotherapy Group for People with Dementia
Authors: Cheston Rik 
Published: May 2019

AbstractSocial constructionist approaches to the talk of older adults diagnosed as suffering from a dementing illness have emphasised the importance of analysing such talk in terms of its social function. Drawing on this work together with the increasing clinical impetus towards the development of psychotherapy in this area, this paper examines two sequences of stories produced during a psychotherapy group. These stories are seen as having two related functions: first, they enable individuals to explore the significance of their experiences and thus, it is argued, act as metaphors for the personal experience of having a dementing illness; and secondly they act as a means of creating a series of social identities. As such they serve as explanations of ‘what it is to lose one’s mind’ (Sutton 1994).
Is America Exporting Another New Social Idea?
Authors: Sheppard Harold L. , Myles John F. , Polivka Larry 
Published: May 2019

AbstractThe focus in the United States on ‘setting limits’ to the provision of such services as health care for old people may be spreading to Europe. This article points up the empirical deficiencies in some of the unexamined assumptions in such proposals, especially the belief that an inordinate share of medical expenditures occur in the final weeks or months of elderly patients. The setting-limits doctrine is viewed as a subset of broader socio-political-ideological thrusts aimed at (or resulting in) anti-elderly, intergenerational-conflict policy proposals. Such proposals should be evaluated in terms of their social constructionist, partially contrived, and historically distorted bases. Apocalyptic gerontology needs to be weighed in terms of its moral implications.
The Effect of Respirator Training on the Ability of Healthcare Workers to Pass a Qualitative Fit Test
Authors: Hannum Donna , Cycan Kerrie , Jones Linda , Stewart Melinda , Morris Steve , Markowitz Sheldon M. , Wong Edward S. 
Published: May 2019

AbstractObjectives:To determine the effect of different methods of training on the ability of hospital workers to wear respirators and pass a qualitative fit test, and to compare the direct cost of the training.Design:179 hospital employees were recruited for study and were stratified into three groups based on the type of training they received in the use of respirators. Employees in Group A received one-on-one training by the hospital's industrial hygienist and were fit tested as part of this training. Employees in Group B received classroom instruction and demonstration by infection control nurses in the proper use of respirators, but were not fit tested as part of training. Employees in Group C received no formal training. Each participant in our study underwent a subsequent qualitative fit test using irritant smoke to check for the employee's ability to adjust correctly the fit and seal of the respirator. The direct cost of each method of training was determined by accounting for the cost of trainers and the cost of employee-hours lost during training.Setting:775-bed Veterans' Affairs hospital.Results:94% of Group A participants (49 of 52) passed the qualitative fit test, compared to 91% of Group B participants (58 of 64) and 79% of Group C participants (50 of 63; P=.036, 2 × 3 chi-square). Group A had a significantly higher pass rate than Group C (P=.043), but Group B did not differ significantly from Group A or Group C. Location or professional status did not affect pass rate, but prior experience wearing respirators did. When the study groups were compared after stratifying for prior experience, we found no difference in pass rates, except when Groups A and B (those with any training) were combined and compared with Group C (107 of 116 versus 50 of 63, P=.05, Mantel-Haenszel chi-square).We estimate that the method of training involving individual instruction followed by fit testing took 20 minutes per employee to complete, compared to 10 minutes per six employee class for the method of classroom demonstration. The difference in direct cost between the two methods, applied to the training of 1,200 employees at our hospital, would be approximately $19,000 per year.Conclusion:Our study indicates that training in the proper use of respirators is important, but the method of training may not be, as the two methods we evaluated were nearly equivalent in their pass rates on fit testing (94% versus 91%). Fit testing as part of training may have enhanced the performance of our participants marginally, but was more time consuming and accounted for most of the excess cost.
Prevention of Nosocomial Influenza
Authors: Adal Karim A. , Flowers Richard H. , Anglim Anne M. , Hayden Frederick G. , Titus Maureen G. , Coyner Betty J. , Farr Barry M. 
Published: May 2019

AbstractObjective:To study compliance with preventive strategies at a university hospital during an outbreak of nosocomial influenza A during the winter of 1988, and the rates of vaccination of healthcare workers and of nosocomial influenza following changes in vaccine practices after the outbreak.Design:Retrospective review of employee health, hospital epidemiology, hospital computing, and clinical microbiology records.Setting:A university hospital.Interventions:Unvaccinated personnel with exposure within the previous 72 hours to an unisolated case of influenza were offered influenza vaccine and 14 days of amantadine hydrochloride prophylaxis. Personnel with exposure more than 72 hours before evaluation were offered vaccine. A mobile cart was introduced for vaccinating personnel after the 1988 outbreak.Results:An outbreak of influenza with 10 nosocomial cases occurred in 1988. Only 4% of exposed employees had been vaccinated previously and 23% of exposed, unvaccinated employees agreed to take vaccine, amantadine, or both. A mobile-cart vaccination program was instituted, and annual vaccination rates steadily increased from 26.3% in 1989 to 1990 to 38% in 1993 to 1994 (P<.0001). The relative frequency of documented cases of influenza in employees with symptoms of influenza decreased significantly during this period (P=.025), but nosocomial influenza rates among patients did not change significantly.Conclusion:A mobile-cart influenza vaccination program was associated with a significant increase in compliance among healthcare workers, but a majority still remained unvaccinated. The rate of nosocomial influenza among patients was not reduced by the modest increase in the vaccination rate, but influenza rates remained acceptably low, perhaps due to respiratory isolation of patients and furlough of employees with influenza.
Colonization byStaphylococcus AureusResistant to Methicillin and Ciprofloxacin During 20 Months' Surveillance in a Private Skilled Nursing Facility
Authors: Lee Yee-Lean , Gupta Geeta , Cesario Thomas , Lee Richard , Nothvogel Sandra , Nassar James , Flionis Leo , Thrupp Lauri 
Published: May 2019

AbstractObjective:To evaluate endemic colonization withStaphylococcus aureusresistant to methicillin, ciprofloxacin, or both among patients of a private skilled nursing facility, with regard to colonization rate and site, and relation to infection and prior antibiotic use.Design:Prospective quarterly culture surveillance of nares and rectal specimens over 20 months' observation.Results:The mean prevalence was 3.8% in new admissions and 5.4% for in-house patients; cumulatively, 7.5% of the patients were colonized during the study period. The colonization rate remained stable during the study period. Screening of rectal, as well as nares, specimens detected substantially more colonized patients than would have been detected by nasal cultures alone. Five to seven percent of the colonized patients developed later infection with methicillin-ciprofloxacin-resistantS aureus. Colonized patients did not differ significantly from the noncolonized group in prior use of quinolones, but the colonized group was exposed significantly more frequently to other antibiotics than the noncolonized group. Eighty-three percent of methicillin-resistantS aureus(MRSA) isolated from infections and 89% from colonization were also ciprofloxacin resistant.Conclusion:Although all infecting and most colonizing isolates of MRSA were resistant to quinolones, the overall rate of colonization remained low and stable despite the continued use of quinolones. The findings suggest that good infection control practice has prevented broader spread of such strains in this facility.
Monitoring Persistence of Coagulase-Negative Staphylococci in a Hematology Department Using Phenotypic and Genotypic Strategies
Authors: van Belkum Alex , Kluijtmans Jan , van Leeuwen Willem , Goessens Wil , ter Averst Ellen , Wielenga Jenne , Verbrugh Henri 
Published: May 2019

AbstractObjective:To determine persistence of coagulase-negative staphylococci (CNS) on a hematology-oncology ward and to determine the value of phenotypic and genotypic procedures for establishing clonality among CNS isolates.Design:Strains of CNS isolated from bacteremic patients (n=139) were typed by biochemical reactivity, antibiotic susceptibility, DNA macrorestriction analysis by pulsed-field gel electrophoresis (PFGE), and arbitrary primed polymerase chain reaction (AP PCR). Coagulase-negative staphylococci were subgrouped in a random collection (n=20) used for the evaluation of the typing procedures and a collection of 119 CNS isolates from hematologic patients displaying multiple bacteremic episodes.Results:Analysis of the reference collection demonstrated the usefulness of the DNA typing procedures, indicating that AP PCR and PFGE can be used for epidemiologic typing of CNS in a concordant fashion. Certain strains appeared to be permanent colonizers of the hematology ward or ward-related personnel. In individual patients, persistent colonization by a single type was demonstrated. However, a number of patients also experienced bacteremic episodes caused by CNS belonging to different types.Conclusion:We conclude that monitoring of CNS infections on a hematology ward by various genotypic techniques provides insight into nosocomial epidemiology and elucidates the complexity of the infections taking place. DNA typing is preferred over phenotypic procedures and can identify persistent CNS strains in a given location.
Plasmid Analysis of 26 Staphylococcal Species by a Rapid Microscale Technique
Authors: Herchline Thomas , Maher William 
Published: May 2019

AbstractObjective:Evaluate a plasmid typing technique for a diverse group of staphylococci.Design:In vitro testing on known isolates.Setting:University hospital.Intervention:The plasmid content of 195 isolates representing 26 staphylococcal species was analyzed by agarose gel electrophoresis following lysostaphin-alkaline-SDS lysis, with and without acetone treatment.Results:Isolates yielded plasmid profiles with 0 to 7 extra-chromosomal bands (median, 1; 1.5); 171 (88%) had a profile with at least 1 band. Species with more than one isolate available for testing showed considerable diversity of plasmid profiles, except forStaphylococcus haemolyticus.Conclusions:The ease of the procedure and the diversity of plasmid profiles within each species examined suggests that plasmid profiling is an accessible and useful epidemiologic tool applicable to most staphylococcal species by epidemiologic units or clinical laboratories.
Prevention and Control of Varicella-Zoster Infections in Healthcare Facilities
Authors: Weber David J. , Rutala William A. , Hamilton Holli 
Published: May 2019

AbstractVaricella-zoster virus (VZV) is the causative agent of two diseases: varicella (chickenpox) and zoster (shingles). Although varicella generally is a mild disease in children, serious morbidity and mortality are common if infection occurs in neonates, pregnant women, adults, or immunocompromised patients. For this reason, the Centers for Disease Control and Prevention recommends that all the hospitals institute control measures. Healthcare workers should be screened for VZV immunity and, if susceptible, should receive the recently licensed Oka/Merck vaccine (unless contraindicated). This article reviews nosocomial outbreaks associated with VZV and provides detailed algorithms for preexposure immunization and postexposure management of healthcare workers exposed to VZV.
Development of Mupirocin Resistance Among Methicillin-ResistantStaphylococcus aureusAfter Widespread Use of Nasal Mupirocin Ointment
Authors: Miller Mark A. , Dascal Andre , Portnoy Joseph , Mendelson Jack 
Published: May 2019

AbstractAll methicillin-resistantStaphylococcus aureus(MRSA) strains isolated from colonized or infected patients in a 625-bed public teaching hospital during an epidemic, and for 3 years thereafter, underwent susceptibility testing to mupirocin. Mupirocin resistance among MRSA increased markedly over this period (1990, 2.7%; 1991, 8.0%; 1992, 61.5%; 1993, 65%) in association with increased use of mupirocin ointment as an adjunct to infection control measures.
Bladder Management and Urinary Tract Infections in Danish Hospitals, Nursing Homes, and Home Care: A National Prevalence Study
Authors: Zimakoff Jette , Stickler David J. , Pontoppidan Birgitte , Larsen Severin O. 
Published: May 2019

AbstractObjective:To establish the prevalence of urinary tract infection in patients undergoing various forms of bladder management.Design:A nationwide descriptive point-prevalence survey with logistic regression analysis of the data relating infection to bladder management.Setting:Fifteen hospitals, 21 nursing homes, and 13 home care districts throughout Denmark.Patients:Information was collected on 3,665 patients. On the day of the study, 349 patients had indwelling catheters and 1,150 were using external urine drainage systems (condoms or diapers) for bladder management.Results:The prevalence of urinary tract infections in catheterized patients and those using external drainage systems was 13.2% and 8.1%, respectively. The prevalence of hospital-acquired urinary tract infection (4.2%) had not changed from that reported in 1978. The proportion of these infections related to the indwelling catheter, however, had reduced from 66% to 30%. Logistic regression analysis confirmed that, when corrected for the patient-related confounders (female gender, age >60 years, incontinence, immobility, and stay in hospital for longer than 15 days), condoms (odds ratio [OR], 5.94; 95% confidence interval [CI95], 2.8 to 12.5), indwelling catheters (OR, 3.3; CI95, 2.3 to 4.8), and diapers (OR, 1.5; CI95, 1.1 to 2.1) were significantly (P<.001, P<.001, and P=.008, respectively) related to infection.Conclusions:Prevalence surveys have revealed that over the period 1978 to 1991, during which efforts have been made to restrict the use of indwelling catheters and to encourage the care of catheterized patients according to guidelines recommended by the Danish National Centre for Hospital Hygiene, the percentage of hospital-acquired urinary tract infections associated with indwelling catheters has been halved. External urine drainage systems, however, have emerged as significant risk factors for urinary tract infection.
Loss of Antimicrobial Susceptibility in Aerobic Gram-Negative Bacilli Repeatedly Isolated From Patients in Intensive-Care Units
Authors: Manian Farrin A. , Meyer Lynn , Jenne Joane , Owen Amy , Taff Terry 
Published: May 2019

AbstractObjective:To study the loss of antimicrobial susceptibility in repeat (same patient, same bacterial species, and same site) aerobic gram-negative bacilli (AGNB) isolated from individual patients during their stay in the intensive-care unit (ICU).Setting:A 792-bed, tertiary-care community hospital with a total of 107 adult, pediatric, and neonatal ICU beds. METHOD: An obser vational prospective study performed November 1992 through mid-July 1993.Results:Of 594 consecutive AGNB from 287 ICU patients, 117 isolates (20%) from 55 patients (19%) were repeat isolates, with the majority obtained from respiratory secretions (83%). Pseudomonas aeruginosa and Enterobacter species accounted for 61% of the isolates. Forty-two (36%) of the repeat isolates from 24 patients (44%) had >4-fold increase in minimum inhibitory concentration to at least one antibiotic and no longer were considered fully susceptible based on National Committee on Clinical Laboratory Standards criteria. Loss of antimicrobial susceptibility often developed within several (median 8) days and was associated only infrequently with simultaneous transition from colonization to infection in the individual patient. Use of certain β-lactam antibiotics was associated with increasing resistance to several other antibiotics in the same class. Concurrent use of β-lactams and aminoglycosides did not prevent loss of antimicrobial susceptibility to the former in repeat isolates.Conclusion:We conclude that loss of antimicrobial susceptibility in repeat AGNB isolated from ICU patients is common, usually is not associated with transition from colonization to infection, and often is associated with prior use of antibiotics. Minimizing antibiotic use in ICU patients should help reduce the risk of antimicrobial resistance in repeat AGNB isolates.