The sense of home of nursing home residents is a multifactorial phenomenon which is important for the quality of living. This purpose of this study is to investigate the factors influencing the sense ...of home of older adults residing in the nursing home from the perspective of residents, relatives and care professionals.
A total of 78 participants (n = 24 residents, n = 18 relatives and n = 26 care professionals) from 4 nursing homes in the Netherlands engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews and focus groups. The data were analyzed based on open ended coding, axial coding and selective coding.
The sense of home of nursing home residents is influenced by a number of jointly identified factors, including the building and interior design; eating and drinking; autonomy and control; involvement of relatives; engagement with others and activities; quality of care are shared themes. Residents and relatives stressed the importance of having a connection with nature and the outdoors, as well as coping strategies. Relatives and care professionals emphasized the role the organization of facilitation of care played, as well as making residents feel like they still matter.
The sense of home of nursing home residents is influenced by a multitude of factors related to the psychology of the residents, and the social and built environmental contexts. A holistic understanding of which factors influence the sense of home of residents can lead to strategies to optimize this sense of home. This study also indicated that the nursing home has a dual nature as a place of residence and a place where people are supported through numerous care strategies.
To investigate the use of the European SCORE model in a dental setting by exploring the frequency of a 'high' and 'very high' 10-year CVD mortality risk in patients with and without periodontitis. ...The secondary aim was to investigate the association of SCORE with various periodontitis parameters adjusting for remaining potential confounders.
In this study, we recruited periodontitis patients and non-periodontitis controls, all aged ≥40 years. We determined the 10-year CVD mortality risk per individual with the European Systematic Coronary Risk Evaluation (SCORE) model by using certain patient characteristics and biochemical analyses from blood by finger stick sampling.
In total, 105 periodontitis patients (61 localized, 44 generalized stage III/IV) and 88 non-periodontitis controls were included (mean age: 54.4 years). The frequency of a 'high' and 'very high' 10-year CVD mortality risk was 43.8% in all periodontitis patients and 30.7% in controls (
= .061). In total, 29.5% generalized periodontitis patients had a 'very high' 10-year CVD mortality risk, compared to 16.4% in localized periodontitis patients and 9.1% in controls (
= .003). After adjustment for potential confounders, the total periodontitis group (OR 3.31; 95% CI 1.35-8.13), generalized periodontitis group (OR 5.32; 95% CI 1.90-14.90), lower number of teeth (OR .83; 95% CI .73-1.00) and higher number of teeth with radiographic bone loss ≥33% (OR 1.06; 95% CI 1.00-1.12) were associated with a "very high" SCORE category. In addition, various biochemical risk markers for CVD were more frequently elevated in periodontitis compared to controls (e.g., total cholesterol, triglycerides, C-reactive protein).
The periodontitis group as well as the control group had a sizable frequency of a 'high' and 'very high' 10-year CVD mortality risk. The presence and extent of periodontitis, lower number of teeth and higher number of teeth with bone loss ≥33% are significant risk indicators for a 'very high' 10-year CVD mortality risk. Therefore, SCORE in a dental setting can be a very useful tool to employ for primary and secondary prevention of CVD, especially among the dental attenders who have periodontitis.
Abstract
Forest edges can be important strongholds for biodiversity and play a crucial role in the protection of forest interiors against edge effects. However, their potential to host biodiversity ...is dependent on the structure of the forest: Abrupt edges often fail to realise this potential. Yet, methods to accurately characterise and quantify forest edge abruptness are currently lacking. Here, we combine three‐dimensional forest structural data with biodiversity monitoring to assess the influence of forest edge structure on habitat suitability. We derived several structural metrics to determine forest edge abruptness using terrestrial laser scanning and applied these to six forest edge transects in Belgium. The local soundscapes were captured using audio recording devices (Audiomoths) and quantified using acoustic indices (AIs) (metrics on the soundscape characteristics). In each transect, the dawn choruses were recorded over a period of a week, both at the edge and the interior of the forest. No correlation between the AIs and bird species richness was found. There were clear differences between transects in the structural metrics and the recorded soundscapes. Some possible relations between both were found. In this proof of concept, we demonstrated innovative techniques to semi‐automatically classify forest structure and rapidly quantify soundscape characteristics and found a weak effect of forest edge structure on bird biophony.
Purpose
Positional (supine dependent) obstructive sleep apnea (POSA) affects about 55% of adults with obstructive sleep apnea (OSA). We aimed to study the prevalence and risk factors for POSA in ...children.
Methods
Cross-sectional analysis of data obtained in 171 children with moderate to severe OSA confirmed by polysomnography (PSG) performed over a 2-year period. POSA is defined by an obstructive apnea–hypopnea index (oAHI) in the supine position ≥ 2× oAHI in the non-supine position.
Results
The overall prevalence of POSA was 18.7%. Children with POSA were significantly older (
p
< 0.001), had a higher prevalence of obesity (
p
= 0.04), a lower tonsil score (
p
= 0.049), and less severe OSA (lower oAHI) (
p
= 0.02) compared to children without POSA, while age was the only significant independent predictor of POSA. The ratio AHI supine to AHI non-supine was not significantly higher during REM than during NREM sleep in children with POSA.
Conclusions
POSA is less common in children compared to adults and the prevalence of POSA increases with age. Although OSA worsens during REM sleep, this was not observed for POSA. Future studies should investigate the prevalence of POSA in specific subgroups and upper airway characteristics of POSA in children.
Intraconal hybrid neurofibroma ‐ schwannoma of the orbit Verhelst, E.; Lauwers, N.; Siozopoulou, V. ...
Acta ophthalmologica (Oxford, England),
September 2017, 2017-09-00, 20170901, Letnik:
95, Številka:
S259
Journal Article
Recenzirano
Purpose
Among peripheral nerve sheet tumors, an orbital hybrid neurofibroma‐schwannoma has been described twice. We describe a third case of orbital tumor with features of both a neurofibroma and a ...schwannoma.
Methods
Case report. A 39 year old man presents with diplopia and decreased vision (0.6) in the left eye. He has a proptosis of 7 mm, with mechanical restriction of elevation and horizontal eye movements. MRI shows a well‐defined lesion (2,5 x 1,9 x 2,3 cm) in the superotemporal intraconal space, displacing the globe, optic nerve and superior and lateral rectus muscles. The tumor demonstrates heterogeneous contrast enhancement, and is diagnosed as a probable cavernous hemangioma. Through a transconjunctival approach a red‐blueish lesion was found with a thin capsule and without lateral adhesions. The tumor could be extracted in 2 parts and consisted of a yellow/white coherent soft mass.
Results
Patient had complete recovery of visual acuity, and only diplopia in extreme lateral gaze. The pathology revealed a tumor composed of small spindle cells arranged in fascicles. The cells showed no atypia and there was no mitotic activity. There were also less cellular areas with a myxoid component. At places we could recognize a fibrous capsule surrounding the tumor. The tumor cells were strongly and diffuse positive with S100. In a few enclosed axons there was focal reactivity with neurofilament. The image is that of a neural tumor with features of both a neurofibroma and a Schwannoma.
Conclusions
This is the third reported orbital hybrid neurofibroma‐schwannoma. Although this type of tumor elsewhere in the body is often associated with schwannomatosis and neurofibromatosis, our patient did not show signs of systemic involvement.
Dynamic lighting systems (DLS) are an innovative way to improve the behavioural symptoms of older people with dementia residing in nursing homes. The use of such systems by care professionals and ...underlying beliefs of these professionals are essential in the successful implementation of DLS. Therefore, this study investigated the beliefs of staff of nursing homes in relation to the use of DLS. Through focus group sessions and interviews, a number of beliefs emerged which influence the use of DLS in practice. The intention to use is influenced by the control options of the system, and the way DLS is embedded in care routines. The most important factor impacting the use of DLS is the creation of homelike living conditions. The identified factors can help in the implementation and design of DLS in psychogeriatric nursing home wards.
•This study is the first to investigate the beliefs of staff of nursing homes towards the use of dynamic lighting systems.•The available control options influence the intention to use dynamic lighting systems.•Too often, lighting systems are not incorporated into care routines andnot used properly.•The desire to create homelike living conditions for residents is a main reason not to use the lighting.•The identified factors can help in the implementation and design of lighting for nursing homes.
Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned ...the exploration and generation of innovative environmental enrichment scenarios for bed-ridden residents. This exploration was conducted through a combination of participatory action research with user-centred design involving 56 professional stakeholders in interactive work sessions. This study identified numerous design solutions, both concepts and products that are available on the marketplace and that on a higher level relate to improvements in resident autonomy and the supply of technological items and architectural features. The methodology chosen can be used to explore the creative potential of stakeholders from the domain of healthcare in product innovation.
Purpose of the Study: To describe the differential diagnosis and management of a rare conjunctival malignancy. Procedures: A 79-year-old man presented with a conjunctival mass at the limbus. ...Excisional biopsy revealed a malignant mesenchymal tumor with myogenic differentiation. Six months later, three suspect lesions developed at the border of the previous excision. Pathological diagnosis pointed to a leiomyosarcoma. Adjuvant radiotherapy with strontium-90 brachytherapy was applied. After 3 years, there was neither recurrence nor distant metastases. A literature review revealed 11 cases of conjunctival leiomyosarcoma. Results: All 12 cases seemed to originate at the limbal conjunctiva. Scleral invasion was found only in one patient with multiple previous resections. Corneal invasion was reported in two patients. Four patients had a globe-sparing resection. In two of them, margins were not tumor free and additional brachytherapy gave a tumor-free follow-up of 1 and 3 years. Four cases underwent an exenteration. Conclusion and Message: Primary conjunctival leiomyosarcoma is a rare tumor with a favorable prognosis due to early detection and consequently limited size. Diagnosis involves histopathological investigation including immunohistochemistry. If possible, complete resection has the best prognosis. Adjunctive radiotherapy can be effective when the margins are not free and should be considered.
There is an increasing call in society for the improvement of well-being for nursing home residents and the support of care professionals through a wide array of architectural and technological ...solutions that are available in modern nursing homes. This study investigated which of these solutions are considered essential by stakeholders from healthcare and technology. Data were gathered via 22 simultaneously held multidisciplinary mind map sessions with 97 stakeholders, resulting in 43 mind maps. These, in turn, were grouped into a single mind map of the nursing home in general, the private rooms for residents with somatic or psychogeriatric health problems, and the group living room. A prioritization of solutions was added. The contents of the mind maps reflect a Dutch consensus on the necessary architectural and technological features for the design of nursing homes.
•A total of 22 multidisciplinary mind map sessions were held with 97 stakeholders.•Mind maps were made of four spaces in the nursing home.•The results reflect a consensus on the necessary architectural and technological features for the design of nursing homes.
To determine the possibility of screening for the risk for Obstructive Sleep Apnea (OSA) in periodontitis patients.
Periodontitis patients and non-periodontitis controls were recruited and asked to ...complete a validated screening questionnaire to calculate individual probabilities (%) of OSA. Also, for both groups, the risk for OSA was classified as low, medium and high.
Seventy periodontitis patients (49% male) and 77 controls (60% male) were included and both had an average age of 54 years. There was no statistically significant difference in the probability of the risk of OSA between periodontitis patients and controls, 38.6% ± 29.7%, and 34.2% ± 23.3%, respectively (p = 0.31). After sub-grouping individuals in "not high risk" (low plus intermediate) and "high OSA risk" categories, we observed statistically significantly more periodontitis patients than controls in the "high risk" category for OSA (21% vs 9%, p = 0.041, OR 2.73 95% CI = 1.04 - 7.15).
These findings suggest that screening for OSA among periodontitis patients may help in early recognition of a "high risk" of OSA, but further research is needed.
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