Treatment of anxiety in elderly housebound patients

Anxiety disorders are common amongst elderly housebound clients and are undertreated with detrimental effects to this population. Effective treatment for anxiety includes access to a talking therapy. Cognitive behavioural therapy (CBT) for anxiety is proven to be successful and has a low r elapse rate. Elderly housebound clients have poor access to talking therapies which compounds existing health inequalities. District and community nurses could be instrumental in enabling elderly housebound clients to have access to CBT approaches for the treatment of anxiety at an early stage, which could gr eatly improve outcomes

The use of motivational interviewing in community nursing

While lifestyle-related conditions such as heart diseas, obesity and diabetes are on the rise, district nurse numbers are falling. At the same time, traditional methods for providing lifestyle advice on factors such as smoking, alcohol intake and exercise have proven to be ineffective. This article examines how a technique called motivational interviewing, which seeks to build a partnership with the client, can promote positive change by strengthening the person's own motivation to change

American Indian and Alaska Native Grandfamilies: The Impact on Child Development

Traditionally, grandparents and other family members have assumed integral roles in raising children within American Indian/Alaska Native communities. The existence of an extensive support system assisted parents in passing on to their children the knowledge of customs, culture, and language essential to community survival and well-being. An increasing number of children are now being raised in “grandfamilies,” a type of family constellation where grandparents take on the role of sole or primary caregiver for their grandchildren under eighteen years of age

The Acute Effect of Piretanide upon Serum and Urinary Calcium in Normal Subjects

We gave piretanide, a new diuretic, at two dose levels to six normal subjects. Sodium excretion increased six to eightfold in the first two hours, and diuresis was completed within four hours. There was a simultaneous increase in the excretion of calcium which exceeded the amount present In the mobilized extracellular fluid. The resulting deficit of calcium produced a small but significant fall in serum calcium corrected for protein. After diuresis ended, calcium was retained but not sodium, when compared to basal values on the previous day. The fall in urinary calcium and the failure to correct the sodium deficit may both have resulted from increased secretion of parathyroid hormone (PTH), which increases calcium reabsorption and decreases sodium reabsorption. The role of PTH in the long-term effects of diuretics on sodium and calcium excretion requires further study

Use of Pyrolysis GC/MS for Predicting Emission Byproducts from the Incineration of Double-Base Propellant

Gas chromatography/mass spectrometry was used to analyze the pyrolytic byproducts from an Army-unique propellant compound (AA2) that is composed of predominantly nitrocellulose and nitroglycerin. Compounds produced by AA2 pyrolysis were compared to compounds detected in the gaseous effluent from AA2 incineration. The light permanent gases and most of the higher molecular weight byproducts produced by AA2 incineration are replicated by laboratory pyrolysis on AA2. The reverse case also holds whereby 18 out of 24 high molecular weight AA2 pyrolytic byproducts are found in the incinerator emissions. Poor matching, however, was obtained between the two processes for the volatile, water-soluble species. None of these low molecular weight compounds produced under pyrolytic conditions were detected in the AA2 incinerator samples, likely indicating inefficient capture of these compounds from the effluent stream. Separate pyrolytic degradation of the individual components of AA2 provides evidence that nearly all of the incomplete combustion products detected during incineration originate not from the prevalent energetic ingredients but rather from the minor and trace additives in AA2. In addition, pyrolysis successfully identified the AA2 components capable of surviving the incineration process intact. This work illustrates the potential of bench-scale pyrolysis for predicting incineration behavior

Self-neglect: a case study and implications for clinical practice

Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses

The Harvest of Beluga Whales in Canada's Western Arctic: Hunter-based Monitoring of the Size and Composition of the Catch

Hunter-based beluga monitoring programs, in place in the Mackenzie Delta since 1973 and in the Paulatuk, Northwest Territories, area since 1989, have resulted in collection of data on the number of whales harvested and on the efficiency of the hunts. Since 1980, data on the standard length, fluke width, sex, and age of the landed whales have also been collected. The number of belugas landed each year averaged 131.8 (SD 26.5, n = 1337) between 1970 and 1979, 124.0 (SD 23.3, n = 1240) between 1980 and 1989, and 111.0 (SD 19.0, n = 1110) between 1990 and 1999. The human population increased during this same period. Removal of belugas from the Beaufort Sea stock, including landed whales taken in the Alaskan harvests, is estimated at 189 per year. The sex ratio of landed belugas from the Mackenzie Estuary was 2.3 males:1 female. Median ages were 23.5 yr (47 growth layer groups [GLG]) for females (n = 80) and 24 yr (48 GLG) for males (n = 286). More than 92% of an aged sample (n = 368) from the harvest consisted of whales 10 or more years old (20 GLG). The rate of removal is small in relation to the expected maximum net productivity rate of this stock. The continued availability of large, old individuals after centuries of harvesting and the apparent lack of change in the size and age structure of the catch in recent years also support a conclusion that the present level of harvest is sustainable.Des programmes de surveillance du bélouga gérés par les chasseurs et mis en oeuvre dans le delta du Mackenzie depuis 1973 et dans la région de Paulatuk (Territoires du Nord-Ouest) depuis 1989, ont abouti à la collecte de données sur le nombre de baleines blanches prélevées et sur l'efficacité des expéditions de chasse. Depuis 1980, on a également collecté des données sur la longueur standard, la largeur de la nageoire caudale, le sexe et l'âge des bélougas ramenés à terre. Le nombre moyen de bélougas ramenés à terre chaque année était de 131,8 (écart-type 26,5, n = 1337) entre 1970 et 1979, de 124,0 (écart-type 23,3, n = 1240) entre 1980 et 1989, et de 111,0 (écart-type 19,0, n = 1110) entre 1990 et 1999. La population humaine s'est accrue durant cette même période. On estime à 189 le nombre annuel de bélougas prélevés sur le stock de la mer de Beaufort, y compris ceux ramenés à terre qui font partie des récoltes de l'Alaska. Le rapport des sexes des bélougas ramenés à terre depuis l'estuaire du Mackenzie était de 2,3 mâles pour 1 femelle. La moyenne d'âge était de 23,5 (47 groupes de couches de croissance [GCC]) pour les femelles (n = 80) et 24 (48 GCC) pour les mâles (n = 286). Plus de 92 p. cent d'un échantillonnage (n = 368) prélevé sur la récolte et dont l'âge avait été déterminé, consistait en des baleines blanches de 10 ans ou plus (20 GCC). Le taux de retrait est faible par rapport à la productivité maximale nette à laquelle on peut s'attendre de ce stock particulier. La présence continue d'individus âgés et de grande taille après des siècles de prélèvements, et le manque apparent de changements dans le nombre des prises et leur distribution d'âge au cours des dernières années permettent de conclure que le niveau actuel des prélèvements est durable