Delirium: a very common problem you may not recognize

Older adults with multiple pre-existing conditions are admitted to hospitals with acute illnesses and injuries every day. Delirium is not recognized by clinicians across health care settings. With awareness of risk factors and knowledge of delirium, nurses can play a pivotal role in the early identification, treatment, and, most important, prevention of delirium in older adults. Nurses often display a lack of knowledge related to delirium and the complex symptoms that appear differently in the presence of other complicating co-morbid conditions in aging adults. Nurses play a crucial role in keeping patients safe and ensuring optimal outcomes, regardless of the setting. With the growing population of older adults and the expected increases in chronic illness and dementia, delirium is a problem nurses are likely to experience in all practice settings. Knowing what to look for facilitates recognizing the risk and acting early to minimize (or even prevent) delirium.     

Approaches used by employee assistance programs to address perpetration of intimate partner violence

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.     

Links between childhood physical abuse and intimate partner aggression: the mediating role of anger expression

Research linking childhood physical abuse (CPA) and adult intimate partner aggression (IPA) has focused on individuals without sufficient attention to couple processes. In this study, 109 couples reported on histories of CPA, IPA, and anger expression. Actor-partner interdependence model (APIM) was used to examine links between CPA and revictimization and perpetration of IPA, with anger suppression as a potential mediator. Women's CPA histories were associated with more physical aggression towards and more revictimization by partners. Men's CPA histories were only associated at the trend level with their revictimization. Anger suppression fully mediated the link between women's CPA and both revictimization and perpetration of IPA. Findings suggest that women with CPA histories are more prone to suppress anger, which leaves them at greater risk for revictimization and perpetration of IPA.     

"It's your badge of inclusion": The Red Hat Society as a gendered subculture of aging

Although studies document the health-enhancing effects of social engagement, they reveal little about the underlying mechanisms operating within specific organizational contexts. Limited attention is given to the role of inequality - particularly age and gender - in shaping either the organizations to which we belong or their consequences for our well-being. We address this issue by examining the Red Hat Society, a social organization for middle-aged and older women. Interviews with members (n=52) illustrate how age and gender inequality interact to shape the organization, which can be viewed as a gendered subculture of aging. Drawing on this framework, we discuss four processes through which participation generates benefits for older women involved in age- and gender-segregated organizations: enhancing social networks, countering invisibility, creating positive frames for aging experiences, and promoting youthful identities.     

政府旅游开发方式评析——以土耳其为例

提起旅游,人们脑海里首先浮现的必然是"阳光与海滩"。土耳其是地中海地区的一个主要国家,在历史、文化、自然风光、美食、民俗等方面都具有巨大潜力,并且土耳其人民也非常热情友善。土耳其拥有21世纪的游客所寻求的异国风情。为使土耳其的这种潜力在继续服务于旅游业的同时保持其延续性,就需要认真的自省与科学的研究和规划。旅游业对于一国的社会福利和经济发展有着举足轻重的影响,但也存在毁灭当地资源的可能。理性运用旅游资产、增加游客数量和提高旅游收入,这些都可以通过有效的旅游规划来实现。在此问题上,中央政府、地方政府和非政府组织在相互协作的框架下各司其职显得至关重要。本文通过揭示当前土耳其旅游业的现状,对中央和地方政府扮演的角色做出评析,希望从国家管理的风格和方式角度出发,使土耳其的旅游规划和政策取得实际效果。     

1918—1932年苏联石油出口和石油工业

十月革命胜利后国外武装干涉和国内反动势力严重威胁着新生的布尔什维克政权。1918年起土耳其和英国军队先后占领巴库等石油产区,至1921年初苏俄石油出口量几乎为零。苏维埃政权稳固之后决定以出口石油换取外国设备和其他工业必需品,但收效不大。1923—1925年间西方大石油公司购买苏联石油产品的数量猛增并意欲控制苏联石油产品的出口和销售,苏联政府顺势而为,通过不断努力在世界石油市场上获得了一席之地。1926—1928年间英国等西欧国家在世界市场上排挤苏联石油,苏联遂与美国石油公司建立起伙伴关系,利用美国公司的营销网络与英国分庭抗礼。1929—1932年间英国停止抵制苏联石油产品,意味着英国要求苏联政府补偿企业国有化损失的方案落空,苏联获得了在世界市场上销售石油的合法权利。     

Raising awareness of psychosocial factors in the occurrence of low back symptoms in developing countries

Although there is strong evidence that single physical, psychosocial and organisational risk factors are each independent predictors of low back symptoms (LBS), little is known about their combination/interaction, particularly in those working in developing countries. A total of 1294 Indonesian coal mining industry workers reported information about physical, psychosocial, and organisational factors using self-reported questionnaires and were placed into one of four combination exposure groups: 1) high physical (working with bent trunk; whole body vibration exposure; lifting) and high psychosocial (high effort; low reward; work stress), 2) high physical and low psychosocial, 3) low physical and high psychosocial, and 4) low physical and low psychosocial (as the reference group). The odds of LBS in the high physical and high psychosocial group was 5.15 times (95% confidence interval 2.69-9.86) that of the reference group. Psychosocial factors played a more important role than physical factors in increasing the likelihood of reporting LBS. Permanent and night shift workers were more likely to report LBS. These findings imply that efforts to reduce LBS in this workplace should address both psychosocial and physical factors but psychosocial factors should be the priority, with a special focus on permanent and night shift workers.     

Physical variation in low-load work - physiological effects during exposure & recovery

Trends in industry are leaning towards jobs that are more stereotyped at lower workloads. Physical variation is a potential ergonomic intervention. However, little is known of physiological response to different kinds of variation. To investigate this issue, three kinds of isometric contraction patterns with the same mean amplitude, cycle time, and duty cycle were compared. Fatigue responses were measured by multiple biomechanical and physiological approaches. In exercise, sustained and intermittent contractions with zero force had a greater number of statistically significant differences in fatigue responses. Intermittent contractions with amplitude ? and 1? of mean force had effects intermediate but close to the sustained contraction. In recovery, sustained contractions led to decreased twitch forces 24 hours post-exercise whereas both intermittent contractions recovered within 60 minutes. This suggests that time varying forces, even without complete muscular rest, may be a useful intervention to reduce local and perceived fatigue in workers performing low-load tasks.