Implementation of a Deconditioning Prevention Program: Getting Dressed Makes a Difference

Implementation of a Deconditioning Prevention Program: Getting Dressed Makes a Difference Seleem R. Choudhury MSN, MBA, RN, CEN, FAEN Purpose. Deconditioning by immobility or bed rest affects essential body systems and diminishes functional capacity. Individuals age 65 and older have more hospital stays than any other age group. they also account for one out of three hospital admissions costing healthcare over $330 Billion annually. Numerous studies demonstrate this age group often struggle to get back to normal level of activity. . Empowering patients to dress and wear their own clothes can prevent deconditioning. Benefits to hospitals include reduced cost through admissions, improved patient flow by reducing their length of stay (LOS) which can lead to timelier admissions for other patients. A longer LOS also raises the probability of a hospital-acquired condition (HAC), which is an undesirable situation or condition that affects a patient during a hospital stay. Finally, patients who get dressed may feel more satisfied with the care they receive. Methods. To prevent deconditioning through the development of promoting activity by getting patients dressed which reduces the risk of deconditioning as measured by three outcomes: 1) LOS, 2) HAC, 3)Patient Satisfaction. LOS and HAC data were collected from chart review. Patient satisfaction was evaluated by HCAHPS metrics. Results. Three months of data were analyzed and compared in 2016 and 2017. The data were also segregated into age groups to analyze any benefit to over 65-year-olds. The comparison did not demonstrate clear correlation that the deconditioning program impacted the LOS and Patient Satisfaction. LOS comparison (n-832) showed improvement in month three in ages 18-59 and over 75. The ages 55-74 showed no decrease in LOS however recalculating the data from median versus mean showed all age groups LOS did decrease. Patient Satisfaction metrics (n-207) showed no clear inference or consistent pattern that deconditioning program improved satisfaction. Scores stayed comparable to previous years, especially among 18-54 age group. The 75 plus age group did see a decline in scores. Hospital Acquired Complications (HAC) was not a reliable indicator with only one incident in a two-year period. Methodological flaws in unreliable data and insufficient ability to separate variables within the electronic health record confounded comparison. Finally, the multi-faceted nature of discharges limited all of the indicators’ validity. Conclusions. The importance of being active is universally understood, yet hospitals struggle to implement this action. Data of 1-year mortalities of over 65 support that hospitals need to do more to improve this outcome. A simple program of getting dressed everyday has the potential to reduce LOS and with further study, improve 1-year mortality. This study also showed that whilst patient satisfaction is not increased, it also does not significantly decrease therefore it’s possible to assume that our patients want hospital staff to be assertive with preventing Deconditioning Syndrome. Finally, whilst not supported in this study future work, could analyze staff’s perception of patient readiness for discharge alongside data gradually demonstrating a decrease of LOS of 75-year old

Development of vertical diffusion solar stills utilizing folded sheets technology

Fresh water shortage is now a global problem the world is facing, and solar stills address a sustainable solution towards such crisis. This study entails the importance of desalination, specifically solar distillation. Diffusion stills have been effective in water desalination. This work presents a model of the distillation process using vertical single-effect diffusion stills. In the provided models, two geometry patterns have been utilized: the flat sheets and the folded sheets. This study aims to evaluate the applicability of utilizing folded sheets on the performance of the still using wick and without wick. A semi-analytical model utilizing the flat sheet and the folded sheet have been developed to analyze the diffusion process. Furthermore, a software computer code using Engineering Equation Solver (EES) issued to solve the equations of the developed semi-analytical model. An experimental test rig has been constructed, and used for the validation of the semi-analytical model to find its best range of validity. Also, it is validated against former literature results. A good agreement is reached with feed rates of flow up to 0.0211 kg/m2-s. Moreover, a parametric study for the still utilizing flat sheets model is carried out to assess the performance of the still; it is found that the controllable parameters are:(i) hot plate temperature; (ii) cold plate temperature;(iii) diffusion gap thickness;(iv)feed water temperature; and (v) feed rate of flow; have an impact on the still’s productivity. The most dominant parameters that influence the productivity of the still are the hot plate temperature that ranges from (55- 90 °C), the diffusion gap thickness in range of (5-10 mm), the feed water temperature (20-50 °C), and the feed flow rate in range of (0.00694-0.0211 kg/m2-s). The experimental work utilizing folded-chevron pattern sheets, both with wick and wickless, have been carried out and have been compared to the flat sheets to assess still’s productivity. A comparative analysis has been conducted to evaluate the productivity; it is found that the folded sheet with wick has a higher productivity among other sheets. It indicates the superiority of the wicked folded over the wickless folded and the flat sheet. The folded pattern showed a higher performance by an average increase in the condensate to feed ratio by 27 % through the operating hot plate temperature that ranges from 60 to 90°C

A corpus analysis of stance marker use in international and Egyptian medical research articles

The need for stance expression and making the position of the writers clear about what they are reporting is well documented in the literature (Biber, 2006; Kelly & Bazerman, 2003; Hyland, 2005; 2008; Molino, 2010; Myers, 1989; Williams, 2006). Even hard knowledge disciplines that were traditionally expected to sound objective and detached employ stance projection strategies by which researchers express their opinions, degree of certainty or ownership of the different claims that are stated in their work (Harwood, 2005 ; Hyland, 2005). Authors of research who are writing in English as their second language (L2) are reported to find difficulty in making their voice heard in their research articles (RAs) (Flowerdew, 2001). Differences in the frequency and the accuracy of using stance markers in RAs written by L2 writers of research and native speakers (NSs) have been detected in numerous studies (Hendersson & Barr, 2010; Hyland, 2002; Jafarpour & Taki, 2012; Maurannen, 1993 ; Molino, 2010 ; Orta, 2010). Meeting the needs of almost 30% of research producers at Cairo University, this study detects the differences between stance markers in Egyptian RAs compared to internationally published RAs in the field of medicine. Differences are diagnosed and patterns of the “acceptable use of stance markers are listed in order to help Egyptian doctors write more professionally and gain acceptance in international publishing. In this corpus-based study, 47 RAs published in local Egyptian medical journals representing different medical schools and institutions across the country were examined and compared to the Corpus of Contemporary American English (COCA). The use of direct self-reference using first person pronouns I, me, my, we us and our compared to the more impersonal “it ‚ that structure was examined in both corpora. The study showed a tendency in the Egyptian RAs to sound more distant and cautious. The use of first person pronouns in Egyptian RAs was generally less frequent. Egyptian medical researchers avoided using the singular first person pronoun in their RAs but they sometimes directly referred to themselves when they wrote in a group. Egyptian researchers also showed higher frequency of the more mitigated and impersonal structures such as “it , that structures, the passive structure and doubt adverbs. On the other hand, Egyptian researchers showed awareness with the preferred verb tenses collocating with the first person pronoun we as well as an awareness of the different structures of the “it , that structures despite its complexity. The Egyptian Medical Research Articles corpus (EMRA) showed a lack of variety in some of the lexical collocates of the first person pronouns as well as “it , that structures

Transition metal complexes of an isatinic quinolyl hydrazone

<p>Abstract</p> <p>Background</p> <p>The importance of the isatinic quinolyl hydrazones arises from incorporating the quinoline ring with the indole ring in the same compound. Quinoline ring has therapeutic and biological activities. On the other hand, isatin (1H-indole-2,3-dione) and its derivatives exhibit a wide range of biological activities. Also, the indole ring occurs in Jasmine flowers and Orange blossoms. Recently, the physiological and biological activities of quinolyl hydrazones arise from their tendency to form metal chelates with transition metal ions. In this context, we have reported to isolate, characterize and study the biological activity of some transition metal complexes of an isatinic quinolyl hydrazone; 3-[2-(4-methyl quinolin-2-yl)hydrazono] indolin-2-one.</p> <p>Results</p> <p>Mono- and binuclear as well as dimeric chelates were obtained from the reaction of a new isatinic quinolyl hydrazone with Fe(III), Co(II), Ni(II), Cu(II), VO(II) and Pd(II) ions. The ligand showed a variety of modes of bonding <it>viz</it>. (NNO)^2-, (NO)^-and (NO) per each metal ion supporting its ambidentate and flexidentate characters. The mode of bonding and basicity of the ligand depend mainly on the type of the metal cation and its counter anion. All the obtained Pd(II)- complexes have the preferable square planar geometry (D_4h- symmetry) and depend mainly on the mole ratio (M:L).</p> <p>Conclusion</p> <p>The effect of the type of the metal ion for the same anion (Cl^-) is obvious from either structural diversity of the isolated complexes (O_h, T_dand D_4h) or the various modes of bonding. The isatinic hydrazone uses its lactim form in all complexes (Cl^-) except complex <b>5 </b>(SO₄^2-) in which it uses its lactam form. The obtained Pd(II)- complexes (dimeric, mono- and binuclear) are affected by the mole ratio (M:L) and have the square planar (D_4h) geometry. Also, the antimicrobial activity is highly influenced by the nature of the metal ion and the order for <it>S. aureus </it>bacteria is as follows: Nickel(II) > Vanadyl(II) > Cobalt(II) > Copper(II) ≈ Palladium(II) >> Iron(III).</p

A Contrastive Analytical Study of Cohesive Devices in Dickens' A Tale of Two Cities and its Translation into Arabic

تهدف هذه الدراسة إلى معرفة كيفية ترجمة أدوات تماسك مُختارة من اللغة الإنجليزية إلى اللغة العربية في رواية ديكنز "قصة مدينتين". الترجمة العربية لرواية ديكنز المعتمدة في هذه الدراسة هي ترجمة منير البعلبكي. تُقدم هذه الدراسة مقارنة بين تراكيب أدوات التماسك المتنوعة في اللغتين الانجليزية والعربية بترجمتها من لغة المصدر (الانجليزية) إلى اللغة المستهدفة (العربية). يُمكن لهذه الدراسة أن تُبين عبر المقارنة أوجه الاختلاف والتشابه بين هاتين اللغتين بخصوص موضوع التماسك في الأعمال الأدبية، وعلى وجه التحديد الرواية الإنجليزية المُعتمدة في هذه الدراسة وترجمتها العربية. أجريت هذه الدراسة بالاعتماد على المنهج الوصفي والنوعي للكشف عن أدوات تماسك مُختارة في اللغة الانجليزية‘ وعلى وجه الخصوص، الرواية الإنجليزية وترجمتها العربية. وتتبنى هذه الدراسة تحليل ترجمة أربعة أنواع من أدوات التماسك: الإشارة، الإستبدال‘ الحذف‘ والتماسك المعجمي متضمناً التكرار والمترادفات. وخلص الباحث الى أنه من المهم دراسة ترجمة أدوات التماسك في الأعمال الأدبية لما لها من أدوارٍ متنوعةٍ في اللغة بالإضافة الى تدريس الأعمال الأدبية على مستوى البكالوريوس.The aim of this study is to deal with the translation of selected English cohesive devices into Arabic in Dickens' A Tale of Two Cities. The Arabic translation of Dickens' novel that is adopted in this study is Munir al-Baalbaki's translation. This study presents a comparison of various cohesive devices in English and Arabic through examining its translation from the source language (English) into the target language (Arabic). Adopting this comparison, this study intends to show differences and similarities between these two languages concerning the matter of cohesion in literary works, precisely the novel adopted and its Arabic translation. This research is achieved using descriptive and qualitative method so as to uncover selected cohesive devices utilized in English, particularly, the English novel and its Arabic translation. The translation of four types of cohesive devices: reference, substitution, ellipsis, and lexical cohesion including repetition and synonymy are to be analyzed here. The researcher concludes that it is important to study the translation of cohesive devices in literary works because they have diverse parts in language and the literary works are taught at the undergraduate level as well

The ligational behavior of an isatinic quinolyl hydrazone towards copper(II)- ions

<p>Abstract</p> <p>Background</p> <p>The importance of the isatinic quinolyl hydrazones arises from incorporating the quinoline ring with the indole ring. Quinoline ring has therapeutic and biological activities whereas, the indole ring occurs in Jasmine flowers and Orange blossoms. As a ligand, the isatin moiety is potentially ambidentate and can coordinate the metal ions either through its lactam or lactim forms. In a previous study, the ligational behavior of a phenolic quinolyl hydrazone towards copper(II)- ions has been studied. As continuation of our interest, the present study is planned to check the ligational behavior of an isatinic quinolyl hydrazone.</p> <p>Results</p> <p>New homo- and heteroleptic copper(II)- complexes were obtained from the reaction of an isatinic quinolyl hydrazone (HL) with several copper(II)- salts <it>viz. </it>Clˉ, Brˉ, NO₃ˉ, ClO₄^-, SO₄^2-and AcO^-. The obtained complexes have O_h, T_dand D_4h- symmetry and fulfill the strong coordinating ability of Clˉ, Brˉ, NO₃ˉ and SO₄^2-anions. Depending on the type of the anion, the ligand coordinates the copper(II)- ions either through its lactam (NO₃ˉ and ClO₄^-) or lactim (the others) forms.</p> <p>Conclusion</p> <p>The effect of anion for the same metal ion is obvious from either the geometry of the isolated complexes (O_h, T_dand D_4h) or the various modes of bonding. Also, the obtained complexes fulfill the strong coordinating ability of Clˉ, Brˉ, NO₃ˉ and SO₄^2-anions in consistency with the donor ability of the anions. In case of copper(II)- acetate, a unique homoleptic complex (<b>5</b>) was obtained in which the AcO^-anion acts as a base enough to quantitatively deprotonate the hydrazone. The isatinic hydrazone uses its lactim form in most complexes.</p

Functional Neuroimaging Techniques to Examine Falls and Cognition in Older Adults: A Systematic Review

Falls in older adults have been attributed to impaired cognition. There is potential for neuroimaging techniques to understand the biological components that are involved in the cognitive processes pertaining to falls. Therefore, the purpose of this systematic review was to analyze how functional neuroimaging can be used to examine the relationship between falls and cognition among older adults. The following five electronic databases were selected to identify peer-reviewed articles in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: 1) Medline (via OVID), 2) PsycINFO (via OVID), 3) CINAHL (via EBSCO), 4) EMBASE (via OVID), and 5) Pubmed. From the search, 9 articles were included that fit the inclusion criteria. The articles suggest that functional neuroimaging techniques can be efficacious for predicting falls in older adults

Efficacy of Short Novel Antimicrobial and Anti-Inflammatory Peptides in a Mouse Model of Methicillin-Resistant Staphylococcus aureus (MRSA) Skin Infection

The therapeutic efficacy of two novel short antimicrobial and anti-inflammatory peptides (RR and RRIKA) was evaluated in a mouse model of staphylococcal skin infection. RR (2%) and RRIKA (2%) significantly reduced the bacterial counts and the levels of proinflammatory cytokines, tumor necrosis factor (TNF)-α, and interleukin (IL)-6, in methicillin-resistant Staphylococcus aureusUSA 300-0114 skin lesions. Furthermore, the combined therapy of RRIKA (1%) and lysostaphin (0.5%) had significantly higher antistaphylococcal and anti-inflammatory activity compared to monotherapy. This study supports the potential use of these peptides for topical treatment of methicillin-resistant Staphylococcus aureus skin infections

In Vitro Evaluation Of Antifungal Activity Of Monolaurin Against Candida Albicans Biofilms

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Monolaurin (also known as glycerol monolaurate) is a natural compound found in coconut oil and is known for its protective biological activities as an antimicrobial agent, The nature of oral candidiasis and the increased antifungal resistance demand the search for novel antifungal therapeutic agents. In this study, we examine the antifungal activity of monolaurin against Candida albicans biofilms (strain ATCC:SC5314/MYA2876) in vitro and investigate whether monolaurin can alter gene expression of host inflammatory cytoknes, IL-1 alpha and IL-1 beta. In a co-culture model, oral fibroblast cells were cultured simultaneously with C. albicans for 24 hrs followed by the exposure to treatments of monolaurin (3.9-2,500 mu M), positive control fluconazole (32,2 mu M), and vehicle control group (1% ethanol), which was a model used to evaluate the cytotoxicity of monolaurin on fibroblasts as well as to analyze morphological characteristics of biofilms through fluorescence microscopy. In addition, the co-culture model was used for RNA extraction of oral fibroblasts to assess gene expression of host inflammatory cytokines, using quantitative rea-time PCR. Our results showed the MIC and MFC of monolaurin were in the range 62,5-125 mu M and 125-250 mu M, respectively, Biofilm antifungal assay showed significant reduction in Log (CFU/ml) of biofilms treated with 1,250 and 2,500 mu M of 1-monolaurin when compared to the control groups. There was also a significant down-regulation of IL-1 alpha and IL-1 beta in the co-culture treated with monolaurin. It can be concluded that monolaurin has a potential antifungal activity against C. albicans and can modulate the pro-inflammatory response of the host.4National Center for Complementary and Integrative Health of the National Institutes of Health [R00AT006507]Brazilian Federal Agency under CAPES [2317/2014-01]NIH/NIDCR [T90DE021982]Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Repurposing Celecoxib as a Topical Antimicrobial Agent

There is an urgent need for new antibiotics and alternative strategies to combat multidrug-resistant bacterial pathogens, which are a growing clinical issue. Repurposing existing approved drugs with known pharmacology and toxicology is an alternative strategy to accelerate antimicrobial research and development. In this study, we show that celecoxib, a marketed inhibitor of cyclooxygenase-2, exhibits broad-spectrum antimicrobial activity against Gram-positive pathogens from a variety of genera, including Staphylococcus, Streptococcus, Listeria, Bacillus, and Mycobacterium, but not against Gram-negative pathogens. However, celecoxib is active against all of the Gram-negative bacteria tested, including strains of, Acinetobacter, and Pseudomonas, when their intrinsic resistance is artificially compromised by outer membrane permeabilizing agents such as colistin. The effect of celecoxib on incorporation of radioactive precursors into macromolecules in Staphylococcus aureus was examined. The primary antimicrobial mechanism of action of celecoxib was the dose-dependent inhibition of RNA, DNA, and protein synthesis. Further, we demonstrate the in vivo efficacy of celecoxib in a methicillin-resistant S. aureus (MRSA) infected Caenorhabditis elegans whole animal model. Topical application of celecoxib (1 and 2%) significantly reduced the mean bacterial count in a mouse model of MRSA skin infection. Further, celecoxib decreased the levels of all inflammatory cytokines tested, including tumor necrosis factor-α, interleukin-6, interleukin-1 beta, and monocyte chemo attractant protein-1 in wounds caused by MRSA infection. Celecoxib also exhibited synergy with many conventional antimicrobials when tested against four clinical isolates of S. aureus. Collectively, these results demonstrate that celecoxib alone, or in combination with traditional antimicrobials, has a potential to use as a topical drug for the treatment of bacterial skin infections