The risk of nursing home admission in three communities

Beginning in 1982, the 3-year incidence of nursing home admission was determined for community-dwelling residents aged 65 and over in East Boston, Massachusetts (4%); New Haven, Connecticut (9%); and Iowa and Washington Counties, Iowa (12%). A common methodology was used to collect baseline risk factor and follow-up data on nursing home admissions among persons in each community as part of the National Institute on Aging's Established Populations for Epidemiologic Studies of the Elderly. A multivariate logistic regression model of baseline risk factors that included the participant's age, race, sex, history of prior admission, ADL limitations, cognitive function, living arrangements, and level of income predicted 80% of the users in each community.     

Developing critical analysis skills in academic writing

Students may often feel confused about what is expected of their work at different academic levels. This article aims to demystify the skill of critical analysis in academic writing.     

Cooling strategies for patients with severe cerebral insult in ICU (Part 2)

Critically ill patients who have sustained a severe cerebral insult will be actively cooled should they develop an elevated body core temperature. Patients who require therapeutic hypothermia for neuroprotection may require the same cooling strategies. A literature review suggested limited evidence to support cooling strategies currently used within one intensive care unit. An experimental approach was used to examine the effects of paracetamol and four external cooling strategies on patients with severe cerebral insult It is suggested that paracetamol is effective in reducing body core temperature and that fans may not. However, data obtained from the study of the four external cooling strategies were inconclusive.     

Clinical and laboratory features of patients with chronic renal disease at the start of dialysis

We examined clinical and laboratory features retrospectively in 402 patients at the start of chronic hemodialysis in order to define better the "uremic syndrome" in the dialysis era. The information gathered included demographic data, renal diagnoses, uremic symptoms, biochemical values, and prevalences of hypertension (69%), diabetes mellitus (23%) and ischemic heart disease (16%). Unexpected findings were the wide ranges of serum creatinine levels (3.5 to 35 mg/dl) and blood urea nitrogen levels (35 to 345 mg/dl), and the frequency of hyponatremia (27%), hypoalbuminemia (52%), and anion gaps above 25 mg/dl (5%). There were higher hematocrits in males and diabetics, lower serum creatinine levels in females, diabetics and older patients, and lower blood urea nitrogen levels in blacks. The time interval from diagnosis of diabetes mellitus to initiation of dialysis in patients with diabetic nephropathy due to juvenile-onset diabetes mellitus (20.6 +/- 6.8 years) was twice that in adult onset diabetes mellitus (10.3 +/- 8.3 years).     

Cutting cardiovascular risk in barbershops

BackgroundRacial and ethnic minorities have lower cardiovascular disease (CVD) risk factor control and lower awareness of their CVD risk status despite being at higher risk for the disease. We sought to understand the reach and potential impact of delivering a CVD risk reduction program by Community Health Workers (CHW) in 15 Denver, Colorado barbershops.MethodsThis mixed-methods study analyzed data from CVD screenings of 1674 barbershop clients and from semi-structured interviews with barbershop owners.ResultsIn 2 years, two CHWs screened a total of 1674 clients in barbershops for cardiovascular risk, nearly 80% of whom were African American. Screening results indicated that clients visiting barbershops are at risk for CVD and other health conditions. One third of clients had medium or high Framingham risk scores, one-quarter had mildly to severely high blood pressure, 45% had borderline high or high cholesterol, with 75% of clients considered overweight or obese according to BMI. Importantly, 41% of screened clients reported having no prior knowledge of their CVD risk before the screening. Barbershop owners reported many benefits of this screening program on their businesses, clients and personal health.ConclusionsBarbershops represent a promising venue for reaching primarily male, African American populations at risk for cardiovascular disease. © 2009 WPMH gmbH. Published by Elsevier Ireland Ltd.     

Administration of oxygen therapy

This article aims to increase nurses' knowledge of the safe administration of oxygen therapy in acute care. The administration and potential complications associated with delivery of oxygen to patients with chronic obstructive pulmonary disease (COPD) and type II respiratory failure are discussed.