589 research outputs found

    Perceived Readiness for Hospital Discharge in Adult Medical-Surgical Patients

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    Purpose: The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients\u27 perceptions of their readiness for hospital discharge. Design: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables. Setting: Midwestern tertiary medical center. Sample: 147 adult medical-surgical patients. Methods: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services. Findings: Living alone, discharge teaching (amount of content received and nurses\u27 skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions. Conclusions: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis\u27 transitions theory as a useful model for conceptualizing and investigating the discharge transition. Implications for Practice: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes

    North Dakota Economic-Demographic Assessment Model (NEDAM): Technical Description

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    This report describes the logic, structure, data bases, and operational procedures of the North Dakota model.Research Methods/ Statistical Methods,

    Country and gender differences in the association between violence and cigarette smoking among youth

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    Background: Exposure to violence in youth may be associated with substance use and other adverse health effects. This study examined cigarette smoking in two middle-income areas with different levels and types of exposure to violence. Methods: Association of exposure to verbal and physical violence with cigarette smoking in the West Bank oPt (2008) and in Jujuy Argentina (2006) was examined using cross-sectional surveys of 14 to 17-year old youth in 7th to 10th grade using probabilistic sampling. Results: Violence exposure rates were more than double for Palestinian girls (99.6% vs. 41.2%) and boys (98.7% vs. 41.1%) compared with Argentinians. The rate of current cigarette smoking was significantly higher among Argentinian girls compared with Palestinian girls (33.1% vs. 7.1%, p < 0.001). Exposure to verbal violence from family and to physical violence increased the odds of current cigarette smoking, respectively, among Argentinian girls (aOR = 1.3, 95% CI = 1.0–1.7; aOR = 2.5, 95%CI = 1.7–3.8), Palestinian girls (aOR 2.2, 95%CI = 1.1–2.4; aOR = 2.0, 95%CI = 1.1–3.6) and Argentinian boys (aOR = 1.5, 95%CI = 1.1–2.0; aOR = 2.2, 95%CI = 1.6–3.0), but not among Palestinian boys. Conclusion: Findings highlight the importance of producing context and gender specific evidence from exposure to violence, to inform and increase the impact of targeted smoking prevention strategies.Fil: Abu Rmeileh, Niveen M. E.. Birzeit University; Palestina (ANP)Fil: Alderete, Ethel del Carmen. Universidad Nacional de Jujuy; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades. Universidad Nacional de Jujuy. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades; Argentina. Instituto de Ciencia y Tecnología Regional; ArgentinaFil: Husseini, Abdullatif. Birzeit University; Palestina (ANP)Fil: Livaudais Toman, Jennifer. University of California; Estados UnidosFil: Pérez Stable, Eliseo J.. National Institutes of Health; Estados Unido

    Youth working in tobacco farming: effects on smoking behavior and association with health status

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    Background: Cultivation of tobacco raises concerns about detrimental health and social consequences for youth, but tobacco producing countries only highlight economic benefits. We compared sociodemographic and health-related characteristics of school-age youth who worked and did not work in tobacco farming and assessed the effects on smoking behavior and health at 1 year. Methods: We used existing data collected in the province of Jujuy, Argentina where 3188 youth 13 to 17 years of age from a random middle school sample responded to longitudinal questionnaires in 2005 and 2006. Multivariate logistic regression models predicted association of tobacco farming work with health status and smoking behavior at 1 year. Results: 22.8% of youth in the tobacco growing areas of the province were involved in tobacco farming. The mean age of initiation to tobacco farming was 12.6 years. Youth working in farming had higher rates of fair or poor versus good or excellent self-perceived health (30.3% vs. 19.0%), having a serious injury (48.5% vs. 38.5%), being injured accidentally by someone else (7.5% vs. 4.6%), being assaulted (5.5% vs. 2.6%), and being poisoned by exposure to chemicals (2.5% vs. 0.7%). Youth working in tobacco farming also had higher prevalence of ever (67.9% vs. 55.2%), current (48.0% vs. 32.6%) and established smoking (17.8% vs. 9.9%). In multivariate logistic regression models tobacco farming in 2005 was associated with significant increased reporting of serious injury (OR = 1.4; 95%CI 1.1-2.0), accidental injury by someone else (OR = 1.5; 95% 1.0-2.1), assault (OR = 2.2; 95% CI 1.3-3.8), and poisoning by exposure to chemicals (OR = 2.5; 95% CI 1.2-5.4). Tobacco farming in 2005 predicted established smoking 1 year later (OR = 1.5; 95% CI 1.1-2.0). Conclusion: Youth who work in tobacco faming face a challenging burden of adversities that increase their vulnerability. Risk assessments should guide public policies to protect underage youth working in tobacco farming. (298 words).Fil: Alderete, Ethel del Carmen. Consejo Nacional de Investigaciones CientĂ­ficas y TĂ©cnicas. Centro CientĂ­fico TecnolĂłgico Conicet - Salta. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades. Universidad Nacional de Jujuy. Unidad Ejecutora en Ciencias Sociales Regionales y Humanidades; ArgentinaFil: Livaudais Toman, Jennifer. University of California; Estados UnidosFil: Kaplan, Celia. University of California; Estados UnidosFil: Gregorich, Steven E.. University of California; Estados UnidosFil: MejĂ­a, RaĂşl. Centro de Estudios de Estado y Sociedad; ArgentinaFil: PĂ©rez Stable, Eliseo J.. National Institutes of Health; Estados Unido

    Protostellar collapse: rotation and disk formation

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    We present some important conclusions from recent calculations pertaining to the collapse of rotating molecular cloud cores with axial symmetry, corresponding to evolution of young stellar objects through classes 0 and begin of class I. Three main issues have been addressed: (1) The typical timescale for building up a preplanetary disk - once more it turned out that it is of the order of one free-fall time which is decisively shorter than the widely assumed timescale related to the so-called 'inside-out collapse'; (2) Redistribution of angular momentum and the accompanying dissipation of kinetic (rotational) energy - together these processes govern the mechanical and thermal evolution of the protostellar core to a large extent; (3) The origin of calcium-aluminium-rich inclusions (CAIs) - due to the specific pattern of the accretion flow, material that has undergone substantial chemical and mineralogical modifications in the hot (exceeding 900 K) interior of the protostellar core may have a good chance to be advectively transported outward into the cooler remote parts (beyond 4 AU, say) of the growing disk and to survive there until it is incorporated into a meteoritic body.Comment: 4 pages, 4 figure

    Differential transactivation of sphingosine-1-phosphate receptors modulates NGF-induced neurite extension

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    The process of neurite extension after activation of the TrkA tyrosine kinase receptor by nerve growth factor (NGF) involves complex signaling pathways. Stimulation of sphingosine kinase 1 (SphK1), the enzyme that phosphorylates sphingosine to form sphingosine-1-phosphate (S1P), is part of the functional TrkA signaling repertoire. In this paper, we report that in PC12 cells and dorsal root ganglion neurons, NGF translocates SphK1 to the plasma membrane and differentially activates the S1P receptors S1P1 and S1P2 in a SphK1-dependent manner, as determined with specific inhibitors and small interfering RNA targeted to SphK1. NGF-induced neurite extension was suppressed by down-regulation of S1P1 expression with antisense RNA. Conversely, when overexpressed in PC12 cells, transactivation of S1P1 by NGF markedly enhanced neurite extension and stimulation of the small GTPase Rac, important for the cytoskeletal changes required for neurite extension. Concomitantly, differentiation down-regulated expression of S1P2 whose activation would stimulate Rho and inhibit neurite extension. Thus, differential transactivation of S1P receptors by NGF regulates antagonistic signaling pathways that modulate neurite extension

    Gravitational Waves from the Dynamical Bar Instability in a Rapidly Rotating Star

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    A rapidly rotating, axisymmetric star can be dynamically unstable to an m=2 "bar" mode that transforms the star from a disk shape to an elongated bar. The fate of such a bar-shaped star is uncertain. Some previous numerical studies indicate that the bar is short lived, lasting for only a few bar-rotation periods, while other studies suggest that the bar is relatively long lived. This paper contains the results of a numerical simulation of a rapidly rotating gamma=5/3 fluid star. The simulation shows that the bar shape is long lived: once the bar is established, the star retains this shape for more than 10 bar-rotation periods, through the end of the simulation. The results are consistent with the conjecture that a star will retain its bar shape indefinitely on a dynamical time scale, as long as its rotation rate exceeds the threshold for secular bar instability. The results are described in terms of a low density neutron star, but can be scaled to represent, for example, a burned-out stellar core that is prevented from complete collapse by centrifugal forces. Estimates for the gravitational-wave signal indicate that a dynamically unstable neutron star in our galaxy can be detected easily by the first generation of ground based gravitational-wave detectors. The signal for an unstable neutron star in the Virgo cluster might be seen by the planned advanced detectors. The Newtonian/quadrupole approximation is used throughout this work.Comment: Expanded version to be published in Phys. Rev. D: 13 pages, REVTeX, 13 figures, 9 TeX input file
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