Heart Ed 101

Cardiovascular disease is the leading cause of death for men and women in the United States. Risk factors and health behaviors combine over time to contribute to the disease process. College communities provide a unique environment for health promotion, risk reduction, and primary intervention. Heart health should be an integral part of college health.     

College and University Compliance With a Required Meningococcal Vaccination Law

Objective: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. Participants: The authors surveyed 32 college/university administrators via a self-administered questionnaire. Methods: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. Results: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. Conclusions: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

Does Self-Neglect Occur Among Older Adults With Dementia When Unsupervised in Assisted Living? An Exploratory,Observational Study

The phenomenon of older adults with dementia who develop behavioral expressions when they are unsupervised in assisted living residences is understudied. This qualitative study aimed to bridge this gap in the literature by focusing on 12 residents in various stages of dementia. Grounded Theory was followed to guide data collection and analysis. Data were collected in two special care units of an assisted living residence for 10 months. Participant observation was the primary data collection strategy. Semistructured interviews with staff and managers and review of clinical records augmented the observation data. While unsupervised, residents exhibited a wide spectrum of negative emotional states, behavioral expressions, functional difficulties, wayfinding difficulties, serious hygiene problems, and safety risks. More than half of the identified incidents represented self-neglectful behaviors. The study highlights the need for enhanced supervision and targeted interventions for residents with dementia who are susceptible to self-neglect.     

Weighing the Success of a National Alzheimer's Disease Service Demonstration

Summary

As the need for long-term care services within the United States has grown dramatically, Congress has consistently deflected the primary responsibility for such care to state governments, local organizations, and, ultimately, the family. This paper examines the impact of the Alzheimer's Disease Demonstration Grants to States (ADDGS) program, a small federally funded initiative within the context of this trend. Although the demonstration can be deemed a huge success relative to the goals of creating new services for an underserved target population, questions are raised about the merits of the program relative to the exploding need for an effective network of long-term care services.     

扩能运输对朔黄铁路桥梁的影响及维管对策研究

随着朔黄铁路扩能运输的快速推进,单元列车轴重从21 t逐步提升到25 t,年运量即将突破2亿t,荷载与疲劳效应的增加对既有铁路桥梁特别是中小跨径桥梁的安全运营要求越来越高。分析重载运输对桥梁的主要影响因素,采取桥梁检查、安全状态评估、快速维修加固、加强维修质量验收相结合等系列应对措施,提出桥梁科学维管的对策,为建立桥梁安全运营保障体系奠定基础。     

Multimedia Biographies: A Reminiscence and Social Stimulus Tool for Persons with Cognitive Impairment

The multimedia biography tells the story of the life of an elderly person with a cognitive impairment in motion picture format. The multimedia biography combines family photographs, film clips, audio narration, and music. It is intended to be screened on an ongoing basis to provide spaces for reminiscence and communication between cognitively impaired persons and their families. Using a production process in which we collaborated with family caregivers, we created 12 multimedia biographies for persons having Alzheimer's disease or mild cognitive impairment. This article describes our production and screening processes. We also share lessons learned from the multimedia biography research to assist practitioners, families, or researchers who wish to use similar technologies and processes for eliciting and sharing life stories.     

The Role of Appraisal and Expressive Support in Mediating Strain and Gain in Hispanic Alzheimer's Disease Caregivers

Abstract

The purpose of this study was to examine how appraisal of burden and satisfaction, and perception of expressive support mediate the effects of caregiving on depression, somatic complaints, life satisfaction and personal gain with a sample of Hispanic Alzheimer's disease (AD) primary caregivers. A purposive-snowball sampling technique was used to identify 103 Hispanic caregivers, who completed a self-report questionnaire. A translation-back-translation process was used to translate the instruments into Spanish. Translated instruments were then pilot tested prior to being administered to the participants. Appraisal of burden was found to mediate the effects of caregiving on depression and somatic complaints and had significant direct effects on life satisfaction. Appraisal of satisfaction did not have a mediating effect on any of the measures, but did have a direct effect on depression and personal gain. Expressive support did have a mediating effect on depression, as well as direct effects on somatic complaints and life satisfaction. These findings suggest a need for improving outreach to older minorities and developing culturally sensitive interventions that can improve caregivers' understanding of problematic behavior, thereby altering appraisal of the situation, as well as developing extended systems of support.     

新型城镇化与经济转型:反思与借鉴

目前,我国已开始步入工业化中期阶段,城镇化也迈入了从传统城镇化向新型城镇化转变的关键时期。城镇化发展具有一般规律性,即阶段性、要素集聚与扩散以及经济发展水平决定规律。我国城镇化发展过程中伴随的是掠夺式扩张和线性发展模式,土地和政府助推了城镇化的粗放发展模式。因此,对我国现阶段新型城镇化过程进行反思,并借鉴国外城镇化的成功经验,创新城镇化发展战略与路径模式,对于推进我国现代化、实现富民强国具有重大现实意义。     

Tracking Transformations in Health Movement Organisations: Alzheimer's Disease Organisations and their Changing ‘Cause Regimes’

In this paper, we aim to contribute to the elaboration of a framework for the systematic periodisation of health social movement organisations (HSMOs). Drawing on historical and contemporaneous data on two organisations that identify as Alzheimer's disease movement organisations (the Alzheimer's Society in Britain and the Alzheimer Society of Ireland), we consider transformations in these organisations' ‘cause regimes’. By cause regime, we refer to who and what an HSMO is fighting for, as articulated in its public self-identifications; to the broader framing of the cause and to how organisations' public self-identifications of their cause can govern or regulate their operation, including their interactions with and representations of those on whose behalf they advocate. We show that the transformation of HSMOs' cause regime can give rise to a series of organisational tensions and challenges, including the alignment of the public identification of its cause with the patient identities it promotes, or its day-to-day ‘patient identity work’.     

Eight Years of Data on Residents in Small Dementia-Care Settings Suggest Functional Performance Is Maintained

Eight years of data analysis on residents’ status from three small Alzheimer care centers suggest notable stability in function. Individuals’ functional ability was best in their first year, but their year-to-year decline was mostly not significant. Cognitive abilities also were best in the resident's first year, but first-, second-, and third-year cognitive scores were not significantly different. We compared the residents’ dementia progression rate to the true rate of natural disease progression. This study, like others on small homelike settings, suggests that appropriate homelike environments maintain persons with dementia at an optimum level longer.