Motorized cart driver safety in assisted living.

When a group of residents at a life care facility purchased motorized carts to move around the 350,000-square-foot facility, staff members were faced with the need to ensure the safety of both drivers and pedestrians. This article describes a safety assessment procedure developed for cart drivers who lived in the assisted living area of the community. Five performance criteria were selected for the safety assessment: the ability to safely moving into and out of the vehicle, demonstrate safe reaction times, take appropriate evasive action to sudden obstructions in the driver's path, turn the vehicle around safely, and park the vehicle without hitting walls or other objects.

Hospitalization patterns and palliation in the last year of life among residents in long-term care.

PURPOSE: This study compared patterns of care, including hospitalization, during the last year of life for a group of residents in institutional long-term care. These subjects were either implicitly or explicitly in palliative care modes versus those who remained in active treatment or blended care. DESIGN AND METHODS: The study used a retrospective chart review and both quantitative and qualitative methods of data collection and analysis to examine indepth the end-of-life experiences of 41 nursing home residents who died in the nursing care unit of one large continuing care retirement community during an 18-month period. RESULTS: Most residents die in palliative care modes, but their movement into palliation with comfort care and symptom management is often slowed by indecision or inaction on the part of key decision makers, interrupted by aggressive acute care, or delayed until the last few days of life. IMPLICATIONS: Transitions from active curative care to palliative care are important for residents in permanent long-term care placements. Improved end-of-life care requires more attention to these transitions and to the decisions that residents, their families, and care teams are called upon to make.

Detraining from total body exercise ergometry in individuals with spinal cord injury.

This study was designed to investigate the effects of detraining that occurred during an 8 week period of muscular inactivity following a 12 week training program of artificial computerized functional electrical stimulation cycle ergometry (CFES LE) and arm ergometry. Six spinal cord injured male individuals were followed through an 8 week detraining period that was preceded by a 12 week exercise program including CFES LE and arm ergometry. Maximal graded exercise tests were completed and measurements of peak oxygen consumption (VO2), heart rate (HR), ventilation (VE) workload, and creatine kinase were taken. Testing occurred at initial training (0T), after 12 weeks of training (12T), and after 8 weeks of detraining (DT). After the training program, peak VO2 increased significantly from 0.562 +/- 0.126 (0T) to 1.021 +/- 0.247 l/min (12T, P < 0.05). After DT, peak VO2 decreased to 0.791 +/- 0.216 l/min, which was lower than 12T (P < 0.05), yet higher than 0T (P < 0.05). After DT, peak workoad had decreased from 0.675 +/- 0.203 (12T) to 0.32 +/- 0.203 kp (P < 0.05), which was not different than 0T. Creatine kinase levels were significantly lower both at 12T and DT compared to 0T (P < 0.05). In addition, this training program induced linear increases in both VO2 and HR with workload, which were retained after DT. These increases did not reach statistical significance. however. No apparent relationship existed between these values at baseline. There were no significant differences in submaximal or peak HR of VE between the three testing periods. The results indicate that both peripheral muscular adaptations and central distribution adaptations in SCI individuals are partially maintained following 8 weeks of DT from CFES LE and arm ergometry.

Phobic response factors from the fear survey schedule.

A Phobic Response Scale was factored from responses to the Fear Survey Schedule. Subjects were 137 male and 168 female college students. A six factor solution extracted 41.78% of the trace. The factors were as follows: I (Hostile-Dependence), II(Body assult), III (Developmental Fears), IV (Performance and Evaluation), V (Death Evasion), and VI (Nuisance Animals). An analysis of sex differences by item and scale generally supported and extended previous research. Some conceptual ties were made by scale to traditional phobic response styles and diagnostic categories.

Uricotelism and low evaporative water loss in a South American frog.

A South American anuran (Phyllomedusa sauvagii) produced large amounts of semisolid urate when it was maintained on a diet of insects. Rates of evaporative water loss in Phyllomedusa sauvagii were only about 5 to 10 percent of those other anurans tested and were similar to those of lizards of comparable size.