Translating and testing the Alberta Context Tool for use among nurses in Swedish elder care

Background. There is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and Canadian health care have similarities in terms of organisational and professional aspects, suggesting that the ACT could be used for measuring context in Sweden. This paper reports on the translation of the ACT to Swedish and a testing of preliminary aspects of its validity, acceptability and reliability in Swedish elder care. Methods. The ACT was translated into Swedish and back-translated into English before being pilot tested in ten elder care facilities for response processes validity, acceptability and reliability (Cronbach’s alpha). Subsequently, further modification was performed. Results. In the pilot test, the nurses found the questions easy to respond to (52%) and relevant (65%), yet the questions’ clarity were mainly considered ‘neither clear nor unclear’ (52%). Missing data varied between 0 (0%) and 19 (12%) per item, the most common being 1 missing case per item (15 items). Internal consistency (Cronbach’s Alpha > .70) was reached for 5 out of 8 contextual concepts. Translation and back translation identified 21 linguistic- and semantic related issues and 3 context related deviations, resolved by developers and translators. Conclusion. Modifying an instrument is a detailed process, requiring time and consideration of the linguistic and semantic aspects of the instrument, and understanding of the context where the instrument was developed and where it is to be applied. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation. This study suggests preliminary validity, reliability and acceptability evidence for the ACT when used with nurses in Swedish elder care.

Developing and Integrating the Management of Elder Abuse in Primary Practice: A Case Study Using A Web-Based CME Course Format

Introduction: As the population in the United States continues to age, more attention in primary practice settings is now devoted toward managing the care of the elderly. The occurrence of elder abuse is a growing problem. It is a condition many professionals in primary care may be ill prepared with the knowledge or resources to identify and manage. [See PDF for complete abstract]

Factors associated with hospital admission of elder cardiovascular patients in an emergency center

Context. Healthcare utilization of elder cardiovascular patients in United States will increase in near future, due to an aging population. This trend could burden urban emergency centers, which have become a source of primary care. ^ Objective. The objective of this study was to determine the association of age, gender, ethnicity, insurance and other presenting variables on hospital admission in an emergency center for elder cardiovascular patients. ^ Design, setting and participants. An anonymous retrospective review of emergency center patient login records of an urban emergency center in the years 2004 and 2005 was conducted. Elder patients (age ≥ 65 years) with cardiovascular disease (ICD91 390-459) were included. Multivariate logistic regression analysis was used to identify independent factors for hospital admission. Four major cardiovascular reasons for hospitalisation – ischemic heart disease, heart failure, hypertensive disorders and stroke were analysed separately. ^ Results. The number of elder patients in the emergency center is increasing, the most common reason for their visit was hypertension. Majority (59%) of the 12,306 elder patients were female. Forty five percent were uninsured and 1,973 patients had cardiovascular disease. Older age (OR 1.10; CI 1.02-1.19) was associated with a marginal increase in hospital admission in elder stroke patients. Elder females compared to elder males were more likely to be hospitalised for ischemic heart disease (OR 2.71; CI 1.22-6.00) and heart failure (OR 1.58; CI 1.001-2.52). Furthermore, insured elder heart failure patients (OR 0.54; CI 0.31-0.93) and elder African American heart failure patients (OR 0.32; CI 0.13-0.75) were less likely to be hospitalised. Ambulance use was associated with greater hospital admissions in elder cardiovascular patients studied, except for stroke. ^ Conclusion. Appropriate health care distribution policies are needed for elder patients, particularly elder females, uninsured, and racial/ethnic minorities. These findings could help triage nurse evaluations in emergency centers to identify patients who were more likely to be hospitalised to offer urgent care and schedule appointments in primary care clinics. In addition, health care plans could be formulated to improve elder primary care, decrease overcrowding in emergency centers, and decrease elder healthcare costs in the future. ^

Physical activity quantification in elder women

Cuantificación de la actividad física en mujeres mayores.

Cover to be unveiled : how meaning is revealed with sheer veils in paintings by Lucas Cranach The Elder

While scholars have questioned the meaning of Lucas Cranach the Elder’s sheer veils when associated with sensual nude figures, research about sheer veils adorning women in a religious context in his paintings has not yet been developed. Through a primarily iconographical approach, I explore who dons each type of veil, and when, to better understand why the same sheer veil is worn differently by various individuals and what that could mean relative to Cranach’s body of work. These veils exhibit artistic prowess, but analysis of their placement on individual figures also reveals how Cranach’s repeated use of sheer veils in his paintings trains the eye on underlying messages, unlocking meanings of these works for Cranach and his patrons and broader themes present in sixteenth century visual culture. My paper initiates this important discussion about how sheer veils – often overlooked in Cranach’s works – are used in both religious and secular contexts.

Country cottages and week-end homes, by J. H. Elder-Duncan ... with numerous illustrations and plans of cottages by well-known architects.

Plates in black and white printed on both sides.

Religious communism : a lecture by F.W. Evans (Shaker) of Mount Lebanon, Columbia Co., New York, U.S.A. : delivered in St. George's Hall, London, Sunday evening, August 6th, 1871 : with introductory remarks by the chairman of the meeting, Mr. Hepworth Dixon : also some account of the extent of the Shaker communities, and a narrative of the visit of Elder Evans to England ; an abstract of a lecture by Rev. J.M. Peebles, and his testimony in regard to the Shakers.

"Can any good come out of Nazareth? Abstract of J. M. Peeble's lecture on Sunday evening, July 30, in Cleveland Hall, London.": p. 30-32.

Autobiography by Elder Giles B. Avery, of Mount Lebanon, N.Y. : also an account of the funeral service which was held at Watervliet, N.Y., December 30, 1890 : together with testimonials of respect from his many kind friends.

Hymn "The angels are coming" with music on p. 34.

The great iron wheel examined; or, its false spokes extracted, and an exhibition of Elder Graves, its builder.

Mode of access: Internet.

English parsing: comprising the rules of syntax, exemplified by appropriate lessons under each rule, with an index, containing all the parts of speech in the different lessons unparsed, for the use of schools, private teachers, and elder students.

Mode of access: Internet.

Elder Northfield's home; or, Sacrificed on the Mormon altar; a story of the blighting curse of polygamy.

Wright III, 5347.