Delirium upon admission to Swiss nursing homes: a cross-sectional study.

QUESTIONS UNDER STUDY: We wished to investigate the prevalence of delirium in patients upon admission to nursing homes and whether or not the previous place of residence predicts delirium. METHODS: The Resident Assessment Instrument Minimum Data Set (RAI-MDS) and the Nursing Home Confusion Assessment Method (NHCAM) were used to determine whether the previous place of residence (community, nursing home, acute care, psychiatric, rehabilitation hospital) predicted the prevalence of sub-syndromal or full delirium in nursing home residents in three Swiss cantons (n = 11745). RESULTS: 39.7% had sub-syndromal and 6.5% had full delirium. Lower cognitive performance and increased depressive symptoms were significant predictors of higher NHCAM values independent of previous residence. Age, civil status, continence, newly introduced drugs, and basic activities of daily living were predictors in some resident groups. The variance of NHCAM scores explained varied between 25.1% and 32.3% depending on previous residence. CONCLUSIONS: Sub-syndromal and full delirium are common upon nursing home admission. Increased dependence and depression are consistently associated with higher NHCAM scores. Patients from psychiatric settings have an increased risk of delirium. Although factors associated with delirium depend on a patient's previous residence, all patients must be carefully screened for sub-syndromal and full delirium.

Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: A survival analysis.

Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents.

Desempenho de índices quantitativos de seca na estimativa da produtividade de arroz de terras altas

O objetivo deste trabalho foi caracterizar a intensidade e a ocorrência de seca pelo uso de índices quantitativos, e avaliar a relação entre esses índices e os dados da série histórica da produtividade ajustada do arroz de terras altas da microrregião de Goiânia, GO. O ajuste da série histórica foi realizado para minimizar os efeitos da variabilidade climática da região e dos avanços tecnológicos sobre a produtividade. Foram avaliados os seguintes índices: severidade de seca de Palmer (PDSI); Z de Palmer (Z-index); o de anomalia de chuva (RAI); e o padronizado de precipitação (SPI). Os índices de seca foram analisados com uso da correlação de Pearson, número e frequência de ocorrência da seca e percentual de acerto dos índices em relação à produtividade ajustada. O RAI quantificou o maior número de eventos extremos de seca, enquanto o PDSI não estimou nenhum caso. O Z-index apresentou o maior percentual de acerto, em relação às variações ocorridas na produtividade ajustada. Em períodos com variações da produtividade ajustada maior que 300 kg ha-1, Z-index, RAI e SPI apresentaram 78, 78 e 67% de percentuais de acerto, respectivamente. O Z-index teve o melhor desempenho na estimação da produtividade ajustada de arroz de terras altas.

Talonpoika ja varis

Suomalainen kansanlaulu.

Tammerkosken sillalla

Suomalainen kansanlaulu.

Tukkipoika

Merikannon kansanlaulusovitusta on tässä sovitettu edelleen.

Tavaritshin svobodaseikkailut

Kansansävelmä.

Milloin raukka onnen saan

Soitinnus: lauluääni, piano.

Koivun valitus 2

Sanat: Kalevala, runo 44: 169- 334: "Uuden kanteleen veisto".

N:o 1: Morning

Soitinnus: orkesteri.

Eveliina-polkka

Trad.

Masuska

Masurkka.

O Jesulein süss, o Jesulein mild

Soitinnus: lauluääni, urut.

Kahvikeittäjä-juttu 1

äänitetty 19.5.1931, [Tukholma].