Preventive home care of frail older people: a review of recent case management studies.

Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal caregiver's strain and satisfaction

Using tephrochronology to date temperate ice: correlation between ice tephras on Livingston Island and eruptive units on Deception Island volcano (South Shetland Islands, Antarctica)

Tephra layers are interstratified in the ice caps of the South Shetland Islands. Although previously poorly investigated, they are potential targets for the application of tephrochronology and, hence, may provide temporal constraints on glaciological models for the region. Several tephra layers crop out in the coastal ice-cliffs and ablation ramps of Livingston Island. Using stratigraphical position, granulometry and bulk sample geochemistry, the tephra layers can be divided into three groups (TPH1, TPH2 and TPH3, from top to base). The source for all of the tephras is unequivocally identified as Deception Island, a large active volcano in Bransfield Strait, situated about 35 km south of Livingston Island. TPH1 (a single layer) is strongly correlated compositionally with tephra erupted in 1970 from centres close to Telefon Bay. This is the first time it has been possible to correlate a distal tephra with a pyroclastic unit in the source volcano in the Antarctic Peninsula region. TPH2 (usually two layers, sometimes only one) was probably erupted from a tuff cone centre within the Crater Lake cluster of vents. From historical accounts, it is deduced that the numerous co-eruptive Crater Lake vents were active prior to 1829 and, from their relatively fresh appearance, an eighteen-century age for the eruptions is possible. TPH3 comprises at least four discrete tephra layers with a much wider compositional range than either TPH1 or TPH2. It may have been erupted during successive months or years. Compositional comparisons of TPH3 with possible source vents on Deception Island are ambiguous, but there is a reasonably good similarity with tephras erupted at Wensleydale Beacon and/or Vapour Col. However, it is also conceivable that the source(s) for TPH3 are no longer preserved on Deception Island. The age of the TPH3 eruptions is unknown but it must be prior to 1829 and is unlikely to be more than a few centuries

Avaliação da condutividade hidraulica do solo saturada utilizando dois métodos de laboratório numa topossequência com diferentes coberturas vegetais no Baixo Amazonas Evaluation of the saturated hydraulic conductivity using two laboratory methods in a topossequence with different vegetation cover in the lower Amazon

O objetivo desse trabalho foi avaliar dois métodos de laboratório para a determinação da condutividade hidráulica do solo saturada (Ko) conhecidos como Permeâmetro de carga constante (PCC) e Permeâmetro de carga decrescente (PCD), com o intuito de verificar sua aplicabilidade e variabilidade em solos amazônicos. Coletaram-se 125 amostras de solo com estrutura indeformada, através de amostrador tipo Uhland, com anéis volumétricos, de 0,072 m de altura e 0,069 m de diâmetro, devido à variabilidade apresentada pelas determinações de tal parâmetro. Nos mesmos pontos de amostragens da Ko, procedeu-se coleta de anéis volumétricos para a determinação da porosidade do solo. Ainda nesses pontos foram coletadas amostras com estrutura deformada para análises físicas e químicas. Os resultados obtidos demonstram que o método do PCC foi o mais apropriado para a classe dos Latossolos estudados, apresentando os menores coeficientes de variação e desvio padrão ao longo da topossequência. Os valores de Ko estiveram distribuídos entre P1(2,65 à 3,34 cm dia-1), P2(2,85 à 3,38 cm dia-1), P3(2,86 à 3,63 cm dia-1), P4(2,75 à 3,49 cm dia-1), P5(2,38 à 3,83 cm dia-1) e P6 (2,47 à 3,52 cm dia-1); havendo uma tendência para maiores valores de Ko na superficie. A utilização de Ko como parâmetro de análise hídrica em solos porosos na superfície e muito argilosos em profundidade, como os amazônicos, necessita ser realizada com precaução, evitando a interrupção da continuidade dos poros e compactação da amostra. Mudanças na condutividade hidráulica saturada estiveram mais relacionadas a alterações nas propriedades físicas do solo e posição no relevo do que nas alterações das coberturas vegetais ao longo da topossequência.<br>The objective of this work was to evaluate two different laboratory methods for determining the saturated hydraulic conductivity (Ko), namely, the constant head permeameter method (PCC) and the falling decreasing head permeameter method (PCD) and their applicability and variability to Amazon soils. 125 undisturbed soil samples were collected with an Uhland soil sampler using volumetric rings of 0,072 m height and 0,069 m in diameter. Soil porosity was also estimated by volumetric ring samples collected at the same spots where Ko was evaluated. Disturbed soil samples were also collected for chemical and particle size analysis at the same spots. The results showed that the PCC method was more appropriate for the studied soils Oxisols, leading to the lowest coefficient of variation and standard deviation throughout the topographic sequence. The Ko values were distributed among P1(2,65 to 3,34 cm day-1), P2(2,85 to 3,38 cm day-1), P3(2,86 to 3,63 cm day-1), P4(2,75 to 3,49 cm day-1), P5(2,38 to 3,83 cm day-1) and P6 (2,47 to 3,52 cm day-1); having a tendency to show higher Ko values at soil surface. The use of Ko as a parameter for hydraulic analysis in soils with high porosity in the surface layer and high clay content in the subsoil, as is the case in the Amazon, must be undertaken with caution to avoid compacting the sample and porous discontinuities. Throughout the studied topographic sequence, changes of saturated hydraulic conductivity were more related to changes in soil physical properties than to changes in vegetation cover throughout the studied topographic sequence