Health Problems of Institutionalized Elderly

Introduction: human aging is marked by a decrease in the performance of some daily tasks, some even considered banal and imperceptibly when this limitation is followed by chronic diseases, the elderly becomes a source of concern for the family. Objective: identifying the health problems of the elderly living in long-stay institutions from self-reported diseases. This is a descriptive and quantitative study, conducted in northeastern Brazil capital, involving 138 elderly. For data collection we used a questionnaire containing demographic variables, institutional and related to self-reported health problems. Data were evaluated using bivariate analysis and association chi-square. Results: predominance of women was found (61.6%), aged 60-69 years old (39.1%), coming from the state capital (51.4%), and institutional permanence time between 1-5 years (77.5%). The most frequent diseases were related to the cardiovascular system (15.9%) and endocrine, nutritional and metabolic diseases (9.4%). It showed a significant association between self-reported diseases and the age of the elderly (p=0.047). Conclusion: it is expected to raise awareness among health professionals to provide a better assistance to the institutionalized elderly focusing on the real needs of these persons.

Survival models of community tenure and length of hospital stay for the seriously mentally ill : a 10-year perspective

Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982-1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.

Uplift Resistance of Long Pipelines in the Presence of Seismic Forces

The vertical uplift resistance of long pipes buried in sands and subjected to pseudostatic seismic forces has been computed by using the lower-bound theorem of the limit analysis in conjunction with finite elements and nonlinear optimization. The soil mass is assumed to follow the Mohr-Coulomb failure criterion and an associated flow rule. The failure load is expressed in the form of a nondimensional uplift factor F-gamma. The variation of F-gamma is plotted as a function of the embedment ratio of the pipe, horizontal seismic acceleration coefficient (k(h)), and soil friction angle (phi). The magnitude of F-gamma is found to decrease continuously with an increase in the horizontal seismic acceleration coefficient. The reduction in the uplift resistance becomes quite significant, especially for greater values of embedment ratios and lower values of friction angle. The predicted uplift resistance was found to compare well with the existing results reported from the literature. (C) 2014 American Society of Civil Engineers.

Lectures on the philosophy and practice of slavery [electronic resource] : as exhibited in the institution of domestic slavery in the United States: with the duties of masters to slaves. /

Electronic text and image data.

Delay in development and implementation of medical assistance for the aged program, District of Columbia Government;

Cover title.

Musai Seatonianae: a complete collection of the Cambridge prize poems, from the first institution of that premium by the Reverend Thomas Seaton, in 1750, to the year 1806.

Perhaps edited by Isaac Reed, who collected the edition of 1773.

The nature and objects of the Royal Institution of Great Britain for the promotion, diffusion, and extension of science and of useful knowledge ...

Mode of access: Internet.

Area of residence is associated with Australian women’s uptake of long-acting contraception

Objective: Several new types of contraception became available in Australia over the last twelve years (the implant in 2001, progestogen intra-uterine device (IUD) in 2003, and vaginal contraceptive ring in 2007). Most methods of contraception require access to health services. Permanent sterilisation and the insertion of an implant or IUD involve a surgical procedure. Access to health professionals providing these specialised services may be more difficult in rural areas. This paper examines uptake of permanent or long-acting reversible contraception (LARCs) among Australian women in rural areas compared to women in urban areas. Method: Participants in the Australian Longitudinal Study on Women's Health born in 1973-78 reported on their contraceptive use at three surveys: 2003, 2006 and 2009. Contraceptive methods included permanent sterilisation (tubal ligation, vasectomy), non-daily or LARC methods (implant, IUD, injection, vaginal ring), and other methods including daily, barrier or "natural" methods (oral contraceptive pills, condoms, withdrawal, safe period). Sociodemographic, reproductive history and health service use factors associated with using permanent, LARC or other methods were examined using a multivariable logistic regression analysis. Results: Of 9,081 women aged 25-30 in 2003, 3% used permanent methods and 4% used LARCs. Six years later in 2009, of 8,200 women (aged 31-36), 11% used permanent methods and 9% used LARCs. The fully adjusted parsimonious regression model showed that the likelihood of a woman using LARCs and permanent methods increased with number of children. Women whose youngest child was school-age were more likely to use LARCs (OR=1.83, 95%CI 1.43-2.33) or permanent methods (OR=4.39, 95%CI 3.54-5.46) compared to women with pre-school children. Compared to women living in major cities, women in inner regional areas were more likely to use LARCs (OR=1.26, 95%CI 1.03-1.55) or permanent methods (OR=1.43, 95%CI 1.17-1.76). Women living in outer regional and remote areas were more likely than women living in cities to use LARCs (OR=1.65, 95%CI 1.31-2.08) or permanent methods (OR=1.69, 95%CI 1.43-2.14). Women with poorer access to GPs were more likely to use permanent methods (OR=1.27, 95%CI 1.07-1.52). Conclusions: Location of residence and access to health services are important factors in women's choices about long-acting contraception in addition to the number and age of their children. There is a low level of uptake of non-daily, long-acting methods of contraception among Australian women in their mid-thirties.

The prospectus, charter, ordinances and bye-laws of the Royal Institution of Great Britain : together with lists of proprietors and subscribers, and an appendix.

With society's device on p. [iii]

Papers from the Department of Marine Biology of the Carnegie Institution of Washington.

Vols. 10, 14, 15, 17, 20 and 21 issued without series title.

Annotated record of the detailed examination of Mn deposits from the LUSIAD Expedition stations

The cores and dredges described in this report were taken on the LUSIAD Expedition from May 1962 until August 1963 by the Scripps Institution of Oceanography from both the R/V Argo and the R/V Horizon. A total of 310 cores and dredges were recovered and are available at Scripps for sampling and study.

Transmission Easement and Adverse Possession of Transmission Easement in the Polish Law

The object of analysis in the text are the issues concerned with the transmission easement and the adverse possession thereof on the grounds of the Polish law. The text features: (1) a historical outline of the solutions concerned with easements in the Polish law following 1945, (2) the institution of transmission easement introduced in 2008 and the solutions concerned with the claims for the establishment thereof at court, (3) the institution of adverse possession of transmission easement pursuant to civil law regulations, judicature and the legal doctrine. On account of the need to elaborate the wide-ranging legal issues concerned with the transmission easement in this text, the analysis embraces two research questions giving rise to the following conclusions: (1) What function is performed by the institution of transmission easement in the system of civil-law relations in the Polish law? The legislator in the articles introducing a transmission easement ossified the solutions functioning in the judicature of the Polish courts before 2008. The legal interpretation took a turn for clarification, that is for the establishment of a norm in the situation where its comprehension was dubious. It is noteworthy that in the period prior to 2008, the law provided for easement appurtenant, and on account of the usual course of judicial decisions also for easement appurtenant with the content corresponding to transmission easement. In 2008 these two “legal existences” were supplemented with a transmission easement, which nevertheless failed to resolve all the legal problems; nay, this gave rise to even more problems, e.g. the one of non-establishment of interpolar norms which would address the issues arising in connection with the use of various easement institutions in legal transactions. While amending the civil law, the legislator aimed to bring order to legal transactions by streamlining the unregulated actual state of easement in relation to transmission infrastructure, but also in relation to the situations where an easement was yet to be established and a facility yet to be constructed. Thus, such action is intended to regulate the disorderly legislation in force as well as to safeguard investment processes. This is of particular significance, for example, for energy companies which are burdened with statutory public-law obligations as regards securing energy supplies and providing for the development of energy infrastructure. Hence, the de facto introduced civil-law solutions indirectly served to realise the principles of the doctrine of easement in the public interest. (2) What legal problems in the civil-law relations does the application of the institution of transmission easement by adverse possession entail? On account of the functioning of various institutions of easement, that is (1) an easement appurtenant, (2) an easement appurtenant with the content corresponding to a transmission easement, and as of 2008 (3) a transmission easement, a problem arose as to which of the given easements companies exercised in particular periods, all the more so because before 1989 the State Treasury owned them and many of the transmission facilities were put in place by virtue of administrative decisions. The commonly held belief is that in the period of “society-oriented economy” as well as up to 2008 infrastructure companies could exercise an easement appurtenant which corresponded to the content of a transmission easement. Therefore, in such a case the running of the prescriptive period should allow for the general rules laid down for an easement appurtenant. Apart from the problem of the relation of a capacity to exercise a right to property and the free development of civil-law relations before 1989, the recognition of the running of prescriptive periods – given the functioning of the three various easements as legal institutions – became a significant legal problem. By way of illustration, the recognition – against the period of exercising transmission easement – of the period required for the acquisition thereof by adverse possession, whereby before 3 August 2008 the real estate featured the legal state corresponding to the content of this right, is debatable. One cannot recognise that within that period a transmission easement was exercised, because such a right was not in existence as yet. Therefore, the institution that might be employed is the running of the period as regards the adverse possession in relation to an easement appurtenant with the content of a transmission easement. Still, the problem remains as to whether the period of the exercise of the easement appurtenant with the content corresponding to a transmission easement can be recognised against the period of possession required for the adverse possession of a transmission easement pursuant to the regulations introduced in 2008. One might incline to the position whereby in such a case it would be right to fully recognise – against the period of exercising a transmission easement – the period of exercising an easement appurtenant corresponding thereto in respect of its content. That being so, the adverse possession of a transmission easement might ensue in such a situation on 3 August 2008 at the earliest, that is the moment the regulations governing this right come into effect. Conversely, if the prescriptive period expires before that date, the entrepreneur would acquire an easement appurtenant with the content corresponding to the transmission easement. Such an interpretation is aligned with the purpose intended by the legislator, which is to bring order to the actual state of the broadest scope with the aid of a new legal instrument. The text, while analysing the issue of a transmission easement and an adverse possession thereof as a institution of the civil law, presents only some selected problems. Hence, the analysis does not include, for example, the issues concerned with claims for remuneration (for usufruct without contractual basis or usufruct fees), or claims for compensation (redress or amends). Furthermore, the text does not conduct a more profound analysis of the relation between the provisions regulating public-law relations (e.g. acts of law introducing the institution of dispossession) and the provisions regulating civil-law relations (the easements in question).