Health care needs and quality of life of elderly in home care in Reykjavik, 1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: It is increasingly emphasized that the elderly should be supported to live at home as long as possible. The purpose of this study was to describe the health and conditions of people in home care. Material and methods: Individuals who received home care in the Reykjavik area in autumn of 1997 were assessed with the Minimum Data Set-Resident Assessment Instrument for Home Care, MDS-RAI HC. Results: The study evaluated 257 individuals at four primary care health centers. The mean age was 82.7 years, women were 78.6%, living alone were 62.5%, and they had received home care on average of 2.4 years. Almost all were independent in primary activities of daily living, ADL, but about half needed help with instrumental activities of daily living (IADL). Impaired cognition was observed in 40% of individuals, depressive symptoms in 18%, daily pain was noted in 47% and 47% assessed their health as poor. Loneliness was expressed by 21%, 18% had not gone out doors in over 30 days and 27% were always alone during the day. The mean number of hours during two weeks was 3.5 hours in nursing care and 9.5 hours in home help. Thirty-four percent took 9 or more medications. Conclusion: Individuals in home care were independent in ADL but needed assistance with IADL. There are important quality of life issues that are of concern. Further research is needed in home care with particular emphasis on improvement of well being.Tilgangur: Vaxandi áhersla er lögð á að aldraðir geti búið heima sem lengst, en rannsóknir á högum aldraðra Íslendinga sem njóta þjónustu í heimahúsum eru takmarkaðar. Markmið rannsóknarinnar var að lýsa heilsufari, líðan og aðstæðum fólks í heimaþjónustu. Aðferð: Einstaklingarnir sem nutu heimaþjónustu heilsugæslunnar á Reykjavíkursvæðinu haustið 1997 voru metnir með MDS-RAI HC (Minimum Data Set-Resident Assessment Instrument for Home Care) mælitækinu. Niðurstöður: Metnir voru 257 einstaklingar á fjórum heilsugæslustöðvum. Meðalaldur var 82,7 ár, 62,5% bjuggu einir, og höfðu þeir notið heimaþjónustu að meðaltali í 2,4 ár. Konur voru 78,6%. Nær allir voru sjálfbjarga með persónulegar athafnir daglegs lífs (ADL), en 53% þurftu aðstoð við böðun. Um helmingur þurftu mikla aðstoð við almennar athafnir daglegs lífs (IADL). Skert minni var hjá tæplega 40% einstaklinganna en dapurt yfirbragð hjá 18%. Átján prósent höfðu aldrei farið út úr húsi á 30 daga tímabili, 27% voru alltaf einir yfir daginn, en 21% tjáði sig um einmanaleika. Daglegir verkir greindust hjá 47% einstaklinganna og 47% töldu heilsufar sitt vera lélegt. Á 14 dögum var meðalfjöldi klukkustunda á skjólstæðing í heimahjúkrun 3,5 klukkustundir og heimilishjálp 9,5 klukkustundir. Lyfjanotkun var mikil og voru 34% á níu lyfjum eða fleiri. Ályktun: Einstaklingar í heimahjúkrun eru sjálfbjarga með ADL en þeir þurfa aðstoð við almenn dagleg verk og böðun. Ýmis atriði sem snerta lífsgæði þyrfti að skoða nánar með hliðsjón af því hvort bæta megi líðan þeirra sem njóta þjónustunna

The population genomic legacy of the second plague pandemic

SummaryHuman populations have been shaped by catastrophes that may have left long-lasting signatures in their genomes. One notable example is the second plague pandemic that entered Europe in ca. 1,347 CE and repeatedly returned for over 300 years, with typical village and town mortality estimated at 10%–40%.1 It is assumed that this high mortality affected the gene pools of these populations. First, local population crashes reduced genetic diversity. Second, a change in frequency is expected for sequence variants that may have affected survival or susceptibility to the etiologic agent (Yersinia pestis).2 Third, mass mortality might alter the local gene pools through its impact on subsequent migration patterns. We explored these factors using the Norwegian city of Trondheim as a model, by sequencing 54 genomes spanning three time periods: (1) prior to the plague striking Trondheim in 1,349 CE, (2) the 17th–19th century, and (3) the present. We find that the pandemic period shaped the gene pool by reducing long distance immigration, in particular from the British Isles, and inducing a bottleneck that reduced genetic diversity. Although we also observe an excess of large FST values at multiple loci in the genome, these are shaped by reference biases introduced by mapping our relatively low genome coverage degraded DNA to the reference genome. This implies that attempts to detect selection using ancient DNA (aDNA) datasets that vary by read length and depth of sequencing coverage may be particularly challenging until methods have been developed to account for the impact of differential reference bias on test statistics.Results and discussion STAR★Method

Tephrochronology

Tephrochronology is the use of primary, characterized tephras or cryptotephras as chronostratigraphic marker beds to connect and synchronize geological, paleoenvironmental, or archaeological sequences or events, or soils/paleosols, and, uniquely, to transfer relative or numerical ages or dates to them using stratigraphic and age information together with mineralogical and geochemical compositional data, especially from individual glass-shard analyses, obtained for the tephra/cryptotephra deposits. To function as an age-equivalent correlation and chronostratigraphic dating tool, tephrochronology may be undertaken in three steps: (i) mapping and describing tephras and determining their stratigraphic relationships, (ii) characterizing tephras or cryptotephras in the laboratory, and (iii) dating them using a wide range of geochronological methods. Tephrochronology is also an important tool in volcanology, informing studies on volcanic petrology, volcano eruption histories and hazards, and volcano-climate forcing. Although limitations and challenges remain, multidisciplinary applications of tephrochronology continue to grow markedly

Finite element modelling of the femur bone of a subject suffering from motor neuron lesion subjected to electrical stimulation

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Bone loss and a decrease in bone mineral density is frequently seen in patients with motor neuron lesion due to lack of mechanical stimulation. This causes weakening of the bones and a greater risk of fracture. By using functional electrical stimulation it is possible to activate muscles in the body to produce the necessary muscle force to stimulate muscle growth and potentially decrease the rate of bone loss. A longitudinal study was carried out on a single patient undergoing electrical stimulation over a 6 year period. The patient underwent a CT scan each year and a full three dimensional finite element model for each year was created using Mimics (Materialise) and Abaqus (Simulia) to calculate the risk of fracture under physiologically relevant loading conditions. Using empirical formulas connecting the bone mineral density to the stiffness and ultimate tensile stress of the bone, each element was assigned a unique material property, based on its density. The risk of fracture was estimated by calculating the ratio between the predicted stress and the ultimate tensile stress, should it exceed unity, failure was assumed. The results showed that the number of elements that were predicted to be at risk of failure varied between years

Assessment of health and caring needs in nursing homes. The Resident Assessment Instrument, its development and some pilot study results

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThose elderly living in institutions have multiple social, health and mental problems, in addition to loss of function. The Resident Assessment Instrument assesses the individual in detail and his caring needs. Resident Assessment Protocols come with the instrument and a handbook that describes how to evaluate specific problems further. Quality indicators allow comparisons between institutions and thus the quality of care can be assessed in comparable groups of residents. The elderly can be put into defined resource utilisation groups and an average cost calculated per unit or nursing home. A pilot study was conducted in Iceland in 1994 to examine the utility of the instrument. It was shown that most of the residents were viewed as competent according to documents, even if about half of them had considerable cognitive dysfunction. Dementia was the most common diagnosis. One fourth of the residents took antidepressant medications and 54-62% took sedatives or hypnotic drugs. Eight out of 10 had dentures and one third had difficulty chewing. Many more interesting findings showed up that are described in a special report.Aldraðir sem dvelja á stofnunum búa við margvíslegan félagslegan, heilsufarslegan og andlegan vanda, auk færnitaps. Lýst er RAI mælitækinu (Resident Assessment Instrument) sem metur ítarlega heilsufar og aðbúnað aldraðra á stofnunum. Mælitækinu fylgja matslyklar og leiðbeiningarhandbók sem lýsa viðbrögðum við greindum vandamálum. Gæðavísar gera kleift að meta gæði þeirrar umönnunar sem veitt er á einstökum stofnunum. Jafnframt er hægt að reikna út svokallaða þyngdarstuðla sem gefa til kynna kostnað við að annast mismunandi hópa aldraðra innan elli- og hjúkrunarheimilanna. Forkönnun var gerð á notagildi RAI mælitækisins á Íslandi árið 1994. í þeirri könnun kom meðal annars fram að nær allir vistmenn voru skráðir sjálfráða, enda þótt um það bil helmingur hafi haft einhvers konar vitræna skerðingu. Heilabilun var ein algengasta sjúkdómsgreiningin. Fjórðungur allra tók geðdeyfðarlyf og 54-62% íbúanna tóku róandi lyf og svefnlyf. Átta af hverjum 10 voru með gervitennur og um þriðjungur átti erfitt með að tyggja. Margar fleiri athyglisverðar niðurstöður komu fram og er þeim lýst í sérstakri skýrslu

Main Street, Yeppoon, Queensland, ca. 1920 [picture] /

Accompanied by photographic print.; Clara Pullar and children holidayed in Yeppoon for three months each summer; .; Glass negative no. 323.; Part of the Gordon Cumming Pullar collection of glass negatives of Clermont, Yeppoon and nearby locations, Queensland, ca. 1905-1932.; Photograph no. 74 in the book A shifting town : glass-plate images of Clermont and its people.; Condition: Emulsion lift, Scratched, Dirty.; Also available in an electronic version via the internet at: http://nla.gov.au/nla.pic-vn4192054; Published in: A shifting town : glass-plate images of Clermont and its people / by G.C. Pullar ; compiled by Richard and Marguerite Stringer ; text by Marguerite Stringer. St. Lucia, Qld. : University of Queensland Press, 1986

Health care needs and quality of life of elderly in home care in Reykjavik, 1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: It is increasingly emphasized that the elderly should be supported to live at home as long as possible. The purpose of this study was to describe the health and conditions of people in home care. Material and methods: Individuals who received home care in the Reykjavik area in autumn of 1997 were assessed with the Minimum Data Set-Resident Assessment Instrument for Home Care, MDS-RAI HC. Results: The study evaluated 257 individuals at four primary care health centers. The mean age was 82.7 years, women were 78.6%, living alone were 62.5%, and they had received home care on average of 2.4 years. Almost all were independent in primary activities of daily living, ADL, but about half needed help with instrumental activities of daily living (IADL). Impaired cognition was observed in 40% of individuals, depressive symptoms in 18%, daily pain was noted in 47% and 47% assessed their health as poor. Loneliness was expressed by 21%, 18% had not gone out doors in over 30 days and 27% were always alone during the day. The mean number of hours during two weeks was 3.5 hours in nursing care and 9.5 hours in home help. Thirty-four percent took 9 or more medications. Conclusion: Individuals in home care were independent in ADL but needed assistance with IADL. There are important quality of life issues that are of concern. Further research is needed in home care with particular emphasis on improvement of well being.Tilgangur: Vaxandi áhersla er lögð á að aldraðir geti búið heima sem lengst, en rannsóknir á högum aldraðra Íslendinga sem njóta þjónustu í heimahúsum eru takmarkaðar. Markmið rannsóknarinnar var að lýsa heilsufari, líðan og aðstæðum fólks í heimaþjónustu. Aðferð: Einstaklingarnir sem nutu heimaþjónustu heilsugæslunnar á Reykjavíkursvæðinu haustið 1997 voru metnir með MDS-RAI HC (Minimum Data Set-Resident Assessment Instrument for Home Care) mælitækinu. Niðurstöður: Metnir voru 257 einstaklingar á fjórum heilsugæslustöðvum. Meðalaldur var 82,7 ár, 62,5% bjuggu einir, og höfðu þeir notið heimaþjónustu að meðaltali í 2,4 ár. Konur voru 78,6%. Nær allir voru sjálfbjarga með persónulegar athafnir daglegs lífs (ADL), en 53% þurftu aðstoð við böðun. Um helmingur þurftu mikla aðstoð við almennar athafnir daglegs lífs (IADL). Skert minni var hjá tæplega 40% einstaklinganna en dapurt yfirbragð hjá 18%. Átján prósent höfðu aldrei farið út úr húsi á 30 daga tímabili, 27% voru alltaf einir yfir daginn, en 21% tjáði sig um einmanaleika. Daglegir verkir greindust hjá 47% einstaklinganna og 47% töldu heilsufar sitt vera lélegt. Á 14 dögum var meðalfjöldi klukkustunda á skjólstæðing í heimahjúkrun 3,5 klukkustundir og heimilishjálp 9,5 klukkustundir. Lyfjanotkun var mikil og voru 34% á níu lyfjum eða fleiri. Ályktun: Einstaklingar í heimahjúkrun eru sjálfbjarga með ADL en þeir þurfa aðstoð við almenn dagleg verk og böðun. Ýmis atriði sem snerta lífsgæði þyrfti að skoða nánar með hliðsjón af því hvort bæta megi líðan þeirra sem njóta þjónustunna