857 resultados para Older Sub-acute ED Presentations


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This paper discusses research into familiarity amongst younger and older adults. It explains the relevance of familiarity in product interactions. An experiment is discussed which investigates differences in familiarity between younger and older adults. A comprehensive coding scheme was developed to help analyse the data collected. This paper discusses the results and findings from the observational data. The results indicate that there is a negative relationship between age and familiarity. Also older adults are less likely to demonstrate familiarity though verbalisation than their younger counterparts.

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The middle years of schooling are increasingly recognised as a crucial stage in students' lives, one that has significant consequences for ongoing educational success. International research indicates that young adolescents benefit from programs designed especially for their needs. Teaching Middle Years offers a systematic overview of the philosophy, principles and issues in middle schooling. It includes contributions from academics and school-based practitioners on intellectual and emotional development in early adolescence, pedagogy, curriculum and assessment of middle years students. This second edition is fully revised to reflect the latest research findings. It includes new chapters on students with diverse needs, school partnerships with families and community, and effective team teaching. Also new to this edition is a chapter that brings middle schooling concepts to life by providing real examples of reform in action.

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The middle years of schooling are increasingly recognised as a crucial stage in students' lives, one that has significant consequences for ongoing educational success. International research indicates that young adolescents benefit from programs designed especially for their needs, and the middle years have become an important reform issue for education systems. Teaching Middle Years offers a systematic overview of the philosophy, principles and issues in middle schooling. It includes contributions from academics and school-based practitioners on intellectual and emotional development in early adolescence, pedagogy, curriculum and assessment of middle years students. Written for teachers, student teachers, education leaders and policy makers, Teaching Middle Years is an essential resource for anyone involved in educating young adolescents. Teaching Middle Years is the first comprehensive Australian book to match and surpass the quality of many overseas publications.'

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BACKGROUND:Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance.METHODS:Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated.RESULTS:GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable.CONCLUSION:A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.

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Objective: To investigate the acute effects of isolated eccentric and concentric calf muscle exercise on Achilles tendon sagittal thickness. ---------- Design: Within-subject, counterbalanced, mixed design. ---------- Setting: Institutional. ---------- Participants: 11 healthy, recreationally active male adults. ---------- Interventions: Participants performed an exercise protocol, which involved isolated eccentric loading of the Achilles tendon of a single limb and isolated concentric loading of the contralateral, both with the addition of 20% bodyweight. ---------- Main outcome measurements: Sagittal sonograms were acquired prior to, immediately following and 3, 6, 12 and 24 h after exercise. Tendon thickness was measured 2 cm proximal to the superior aspect of the calcaneus. ---------- Results: Both loading conditions resulted in an immediate decrease in normalised Achilles tendon thickness. Eccentric loading induced a significantly greater decrease than concentric loading despite a similar impulse (−0.21 vs −0.05, p<0.05). Post-exercise, eccentrically loaded tendons recovered exponentially, with a recovery time constant of 2.5 h. The same exponential function did not adequately model changes in tendon thickness resulting from concentric loading. Even so, recovery pathways subsequent to the 3 h time point were comparable. Regardless of the exercise protocol, full tendon thickness recovery was not observed until 24 h. ---------- Conclusions: Eccentric loading invokes a greater reduction in Achilles tendon thickness immediately after exercise but appears to recover fully in a similar time frame to concentric loading.

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The aim of this research was to establish Taiwanese undergraduate nursing students’ attitudes toward older people. This study involved a cross-sectional survey of 362 nursing students in a university in southern Taiwan. Overall, the results showed that nursing students had positive attitudes toward older people. Moreover, the findings suggested that nursing students’ intention to work with older people and gender were important factors influencing their attitudes toward older people. The findings of this study indicate that efforts are required to maintain these positive attitudes. In addition, provision of nursing courses related to older people that place greater emphasis on attitudes about aging and that take into account students’ working experience and career intention will lead to higher quality of care for older people.

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This naturalistic study investigated the mechanisms of change in measures of negative thinking and in 24-h urinary metabolites of noradrenaline (norepinephrine), dopamine and serotonin in a sample of 43 depressed hospital patients attending an eight-session group cognitive behavior therapy program. Most participants (91%) were taking antidepressant medication throughout the therapy period according to their treating Psychiatrists' prescriptions. The sample was divided into outcome categories (19 Responders and 24 Non-responders) on the basis of a clinically reliable change index [Jacobson, N.S., & Truax, P., 1991. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.] applied to the Beck Depression Inventory scores at the end of the therapy. Results of repeated measures analysis of variance [ANOVA] analyses of variance indicated that all measures of negative thinking improved significantly during therapy, and significantly more so in the Responders as expected. The treatment had a significant impact on urinary adrenaline and metadrenaline excretion however, these changes occurred in both Responders and Non-responders. Acute treatment did not significantly influence the six other monoamine metabolites. In summary, changes in urinary monoamine levels during combined treatment for depression were not associated with self-reported changes in mood symptoms.

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Principal Topic: For forward thinking companies, the environment may represent the ''biggest opportunity for enterprise and invention the industrial world has ever seen'' (Cairncross 1990). Increasing awareness of environmental and sustainability issues through media including the promotion of Al Gore's ''An Inconvenient Truth'' has seen increased awareness of environmental and sustainability issues and increased demand for business processes that reduce detrimental environmental impacts of global development (Dean & McMullen 2007). The increased demand for more environmentally sensitive products and services represents an opportunity for the development of ventures that seek to satisfy this demand through entrepreneurial action. As a consequence, increasing recent market developments in renewable energy, carbon emissions, fuel cells, green building, and other sectors suggest an increasing importance of opportunities for environmental entrepreneurship (Dean and McMullen 2007) and increasingly important area of business activity (Schaper 2005). In the last decade in particular, big business has sought to develop a more ''sustainability/ green friendly'' orientation as a response to public pressure and increased government legislation and policy to improve environmental performance (Cohen and Winn 2007). Whilst much of the literature and media is littered with examples of sustainability practices of large firms, nascent and young sustainability firms have only recently begun generating strong research and policy interest (Shepherd, Kuskova and Patzelt 2009): not only for their potential to generate above average financial performance and returns owing to a greater popularity and demand towards sustainability products and services offerings, but also for their intent to lessen environmental impacts, and to provide a more accurate reflection of the ''true cost'' of market offerings taking into account carbon and environmental impacts. More specifically, researchers have suggested that although the previous focus has been on large firms and their impact on the environment, the estimated collective impact of entries and exits of nascent and young firms in development is substantial and could outweigh the combined environmental impact of large companies (Hillary, 2000). Therefore, it may be argued that greater attention should be paid to nascent and young firms and researching sustainability practices, for both their impact in reducing environmental impacts and potential higher financial performance. Whilst acknowledging this research only uses the first wave of a four year longitudinal study of nascent and young firms, it can still begin to provide initial analysis on which to continue further research. The aim of this paper therefore is to provide an overview of the emerging literature in sustainable entrepreneurship and to present some selected preliminary results from the first wave of the data collection, with comparison, where appropriate, of sustainable and firms that do not fulfil this criteria. ''One of the key challenges in evaluating sustainability entrepreneurship is the lack of agreement in how it is defined'' (Schaper, 2005: 10). Some evaluate sustainable entrepreneurs simply as one category of entrepreneurs with little difference between them and traditional entrepreneurs (Dees, 1998). Other research recognises values-based sustainable enterprises requiring a unique perspective (Parrish, 2005). Some see the environmental or sustainable entrepreneurship is a subset of social entrepreneurship (Cohen & Winn, 2007; Dean & McMullen, 2007) whilst others see it as a separate, distinct theory (Archer 2009). Following one of the first definitions of sustainability developed by the Brundtland Commission (1987) we define sustainable entrepreneurship as firms which ''seek to meet the needs and aspirations of the present without compromising the ability to meet those of the future''. ---------- Methodology/Key Propositions: In this exploratory paper we investigate sustainable entrepreneurship using Cohen et al.'s (2008) framework to identify strategies of nascent and young entrepreneurial firms. We use data from The Comprehensive Australian Study of Entrepreneurial Emergence (CAUSEE). This study shares the general empirical approach with PSED studies in the US (Reynolds et al 1994; Reynolds & Curtin 2008). The overall study uses samples of 727 nascent (not yet operational) firms and another 674 young firms, the latter being in an operational stage but less than four years old. To generate the sub sample of sustainability firms, we used content analysis techniques on firm titles, descriptions and product descriptions provided by respondents. Two independent coders used a predefined codebook developed from our review of the sustainability entrepreneurship literature (Cohen et al. 2009) to evaluate the content based on terms such as ''sustainable'' ''eco-friendly'' ''renewable energy'' ''environment'' amongst others. The inter-rater reliability was checked and the Kappa's co-efficient was found to be within the acceptable range (0.746). 85 firms fulfilled the criteria given for inclusion in the sustainability cohort. ---------- Results and Implications: The results for this paper are based on Wave one of the CAUSEE survey which has been completed and the data is available for analysis. It is expected that the findings will assist in beginning to develop an understanding of nascent and young firms that are driven to contribute to a society which is sustainable, not just from an economic perspective (Cohen et al 2008), but from an environmental and social perspective as well. The CAUSEE study provides an opportunity to compare the characteristics of sustainability entrepreneurs with entrepreneurial firms without a stated environmental purpose, which constitutes the majority of the new firms created each year, using a large scale novel longitudinal dataset. The results have implications for Government in the design of better conditions for the creation of new business, firms who assist sustainability in developing better advice programs in line with a better understanding of their needs and requirements, individuals who may be considering becoming entrepreneurs in high potential arenas and existing entrepreneurs make better decisions.

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National Seniors Australia (2008) acknowledged the huge contributions that older people have made to Australian society in its policy statement, AdvantAGE Australia. National Seniors Australia commissioned this study to find out more about the extent of these contributions and the factors that influence these contributions. The key outcome of this study is a framework or ‘Chart of Accounts’ that allows users to a) track the participation of older Australians in paid and unpaid work; and b) estimate the value of economic and social contributions by older Australians as well as the value of losses for not utilising the knowledge and skills that older Australians have built up over a lifetime. Users can also make predictions of future contributions and participation in paid and unpaid work by using existing data as the baseline.

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In this short communication we wanted to find out what is the analgesic effect of single dose oral Ibuprofen for adults with postoperative pain? Ibuprofen at 200mg and 400mg are effective in producing at least 50% pain relief in patients with moderate to severe postoperative pain (at least 30mm on a VAS). They are safe to use without common adverse effects. The use of Ibuprofen 200mg or 400mg should be considered as standard practice or protocol for pain relief in post-operative settings. Clinicians should consider a range of factors before prescribing or administering Ibuprofen for acute post-operative pain, including but not limited to, the duration of pain relief with Ibuprofen of different doses, Ibuprofen formulation, cost and patient preference.

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Part I of this book covers the commercial and contractual background to technology licensing agreements. Part II discusses the European Community's new regime on the application and enforcement of Article 81 to technology licensing agreements. EC Council Regulation 1/2003 replaced the Council Regulation 17/1962 and repealed the system under which restrictive agreements and practices could be notified to the EC Commission. A new Commission regulation on technology transfer agreements, Regulation 772/2004. These two enactments required consequential amendments to the chapters in Part III where the usual terms of technology licensing agreements are analysed and exemplified by reference to decided cases.

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BACKGROUND: Western studies have suggested that emotional stress and distress impacted on the morbidity and mortality in people following acute coronary events. Symptoms of anxiety and depression have been associated with re-infarction and death, prolonged recovery and disability and depression may precipitate the client's low self-esteem. This study examined perceived anxiety, depression and self-esteem of Hong Kong Chinese clients diagnosed with acute coronary syndrome (ACS) over a 6-month period following hospital admission. OBJECTIVES: To examine: DESIGN: A prospective, repeated measures design with measures taken on two occasions over a 6-month period; (1) within the 1st week of hospital admission following the onset of ACS and (2) at 6 months follow up. SETTING AND PARTICIPANTS: Convenient sample of 182 voluntary consented clients admitted with ACS to a major public hospital in Hong Kong who could communicate in Chinese, complete questionnaires, cognitive intact, and were haemodynamically stable and free from acute chest pain at the time of interview. METHODS: Baseline data were obtained within 1 week after hospital admission. The follow-up data was collected 6 months after hospital discharge. The Chinese version of the Hospital Anxiety and Depression Scale (HADS), State Self-esteem Scale (SSES), and Rosenberg's Self-Esteem Scale (RSES) were used to assess anxiety and depression, state self-esteem, and trait self-esteem, respectively. RESULTS: Findings suggested gender differences in clients' perception in anxiety, depression and self-esteem. Improvements in clients' perception of these variables were evident over the 6-month period following their acute coronary events. CONCLUSION: The study confirmed the western notion that psychosocial problems are common among coronary clients and this also applies to Hong Kong Chinese diagnosed with ACS. Further studies to explore effective interventions to address these psychosocial issues are recommended.

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Within contemporary inpatient mental health nursing practice, the psychodynamic model of care considered previously to be central to the nurse-patient relationship now seems a radical concept. It appears to exist only within primary care facilities and public health care practice settings. This naturalistic inquiry aimed to explicate mental health nurses' perspectives and expectations of providing psychodynamic therapeutic care in acute inpatient psychiatric facilities. Ten registered nurses working in acute inpatient mental health facilities were interviewed. Five themes emerged: a career for life, relating in a psychodynamic manner, swimming against the current, adopting a position of difference, and hopeful expectancy.

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Objectives: To assess the validity of the Waterlow screening tool in a cohort of internal medicine patients and to identify factors contributing to pressure injury. Design: Longitudinal cohort study Setting: A tertiary hospital in Brisbane, Australia Participants: 274 patients admitted through the Emergency Department or outpatient clinics and expected to remain in hospital for at least three days were included in the study. The mean age was 65.3 years. Interventions: Patients were screened on admission using the Waterlow screening tool. Every second day, their pressure ulcer status was monitored and recorded. Main outcome measures: Pressure ulcer incidence Results: Fifteen participants (5.5%) had an existing pressure ulcer and a further 12 (4.4%) developed a pressure ulcer during their hospital stay. Sensitivity of the Waterlow scale was 0.67, (95% CI: 0.35 to 0.88); specificity 0.79, (95% CI: 0.73 to 0.85); PPV 0.13, (95% CI: 0.07 to 0.24); NPV 0.98, (95% CI: 0.94 to 0.99). Conclusion: This study provides further evidence of the poor predictive validity of the Waterlow scale. A suitably powered randomised controlled trial is urgently needed to provide definitive evidence about the usefulness of the Waterlow scale compared with other screening tools and with clinical judgement.

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The effects of exercise and breakfast manipulations on mood and motivation to eat were assessed in 11 healthy females who were regular exercisers and habitual breakfast eaters. The study involved a two by two repeated-measures design, with exercise (or no exercise) and a high-energy breakfast (or low-energy breakfast) as the repeated measures. The exercise or no-exercise session (0800 h) was followed by consumption of the low- or high-energy breakfast (0900 h). An ad libitum lunch test meal was provided 4 hours after the beginning of the exercise session (1200 h). Mood and motivation to eat were continuously tracked from 0800 until 1700 h by an electronic appetite ratings system (EARS). In general, morning subjective mood states (e.g., contentment) were significantly lower in the low-energy breakfast condition, but exercise reversed this effect. Exercise also significantly decreased feelings of lethargy, independent of the breakfast condition. Desire-to-eat and fullness ratings were significantly increased in the low-energy breakfast and high-energy breakfast conditions, respectively. Impairments of mood disappeared in the afternoon after consumption of an ad libitum lunch. In these healthy young adults, the condition inducing the largest energy deficit (exercise and low-energy breakfast) was not associated with the lowest mental states.