Evolución clínica y funcional de los pacientes que ingresan en residencias tras una fractura de cadera. Implementación de un programa de intervención multinivel

Background and objectiveThe aim of this study was to determine the clinical and functional outcomes of patients discharged to nursing homes after a hip fracture.MethodsThe study included all patients admitted to a group of nursing homes after a hip fracture in 2016. A geriatric assessment protocol was applied, and patients were treated with a specific protocol for 90 days. They were assessed for nutritional status (Mini-Nutritional Assessment and Body Mass Index), pain (Visual Analogue Scale, and the PAINAD Scale), the presence of pressure ulcers, blood test (D vitamin, haemoglobin, proteins), and functional status (Barthel index and Functional Assessment Categories).ResultsOut of a total of 175 patients, 116 (75%) met the inclusion criteria. The mean age was 84.9 years old (±6.7 SD), and 91 (78.4%) were women. At admission, 73.8% of 65 residents had anaemia, 76.7% hypovitaminosis D, 88% malnutrition or «at risk of malnutrition», and 15.3% had pressure ulcers. After 90 days, the moderate-severe functional status (Barthel index < 60) was reduced from 90.4 to 39.6%, dependence due to gait from 97.3 to 36.1%, and moderate-severe pain from 88.9 to 14.4%. Most of the pressure ulcers healed (94.4%).ConclusionsPatients admitted to nursing homes after a hip fracture had poor clinical and functional status. This study shows that after 90 days from admission these patients had positive outcomes in terms of functionality, gait, pain control, and pressure ulcers healing.     

Diagnostic Measures of Influence for s2

We present three intuitive diagnostic measures for judging the influence that single or multiple observations exert on the estimate s², the mean square error. The three measures are shown to be equivalent statistics. We discuss distributional properties of these measures and conclude with an example.     

Fine-scale distribution of treeline trees and the nurse plant facilitation on the eastern Tibetan Plateau

Above-average climate warming occurred during the 20th century in high altitude regions, and alpine treelines are believed to be an early indicator to respond to these warming-related changes. However, empirical investigations on treeline dynamics showed diverse results. The main objectives of this study are: (1) to investigate if treeline position shifted and if tree recruitment changed along with climate warming, and (2) to test if adult trees have “nursing effect” on tree establishment at treelines. We investigated two Balfour spruce (Picea balfouriana Rehd. et Wils.) treelines in Chang Niang (CNT) and Dang Dui (DDT), Dingqing county, Changdu prefecture, eastern Tibet. At each treeline site, three replicate plots with a size 30 m × 50 m were established. The coordinates of each tree within the plots were recorded and the age of each tree was identified by dendrochronological method. The changes in treeline position and tree recruitment were examined from spatially fine-scale distribution of trees and their age structure. The spatial patterns of individual trees were analyzed to infer the neighborhood effects. Results indicate that plots CNT2, CNT3, DDT1 and DDT2 showed stable treeline position during the last century, whereas plots CNT1 and DDT3 showed treeline advancing movement. Tree recruitments in all the six plots were enhanced during the 20th century, with two peaks occurring in the 1890–1910s and the 1950–1990s. Seedlings and saplings showed a general clustered distribution in all the six plots. The diverse pattern of treeline movement and episodic regeneration suggest that the treeline activity is not merely a result of climate change. “Nursing effects” from adult trees may play an important role in shaping the treeline activities on the eastern Tibetan Plateau. Our findings reveal diverse patterns in treeline dynamics at a local scale and highlight the importance of incorporating biotic interactions into species distribution modeling approaches.     

人工栽培铁皮石斛菌根的细胞学研究

从细胞学水平上研究了人工栽培铁皮石斛的菌根特征。结果表明:真菌与铁皮石斛根成功地形成了菌根,真菌菌丝穿透根被细胞,并在根被的某个细胞中定殖,然后经由外皮层的通道细胞进入皮层薄壁细胞;皮层薄壁细胞层正是真菌与植物体相互作用的活跃部位;真菌侵染大多数的皮层薄壁细胞,并不能侵染内皮层及中柱细胞,从而使根仍然保持生活力。     

猪瘟病毒感染性cDNA克隆的构建及其致病性

为了建立研究猪瘟病毒的技术平台,利用RT-PCR技术构建了猪瘟病毒中国石门株(Shimen)的全长有感染性cDNA克隆pT7SM。通过体外转录线性化的pT7SM并将转录的RNA转染至PK-15细胞中,获得了猪瘟病毒粒子。再用间接免疫荧光法测定了其生长曲线,通过电镜观察到重组病毒呈球形,具有囊膜结构。进一步把获得的猪瘟病毒粒子感染非免疫实验猪,结果子代病毒与石门株类似,对非免疫实验猪有强烈的致病性,证明该全长cDNA克隆可靠稳定,忠实地保留了石门株病毒的感染性和致病特征。由此为进一步探讨猪瘟病毒的致弱机制及病毒与机体相互作用的机制打下了良好的基础。     

周氏闭壳龟人工饲养下的观察资料

1997～2005年3月,先后对2只周氏闭壳龟进行人工饲养,介绍了周氏闭壳龟的一般活动、行为、食性、冬眠、繁殖、生长和疾病资料.测量了12只活体和5只标本的身体量度.     

Extending a Model of Shift‐Work Tolerance

The present study contributes to theory and practice through the development of a model of shift‐work tolerance with the potential to indicate interventions that reduce nurses' intention toward turnover and increase job satisfaction in hospital‐based settings. Survey data from 1257 nurses were used to conduct structural equation modeling that examine the direct and indirect effects of supervisor and colleague support, team identity, team climate, and control over working environment on time‐based work/life conflict, psychological well‐being, physical symptoms, job satisfaction, and turnover intention. The analysis of the proposed model revealed a good fit The chi‐square difference test was non‐significant (χ²(26)=338.56), the fit indices were high (CFI=.923, NFI=.918, and NNFI=.868), the distribution of residuals was symmetric and approached zero, the average standardized residual was low (AASR=.04), and the standardized RMR was. 072. In terms of the predictor variable, the final model explained 48% of the variance in turnover intention. The data revealed considerable evidence of both direct effects on adjustment and complex indirect links between levels of adjustment and work‐related social support, team identity, team climate, and control. Nurses with high supervisor and coworker support experienced more positive team climates, identified more strongly with their team, and increased their perceptions of control over their work environment. This in turn lowered their appraisals of their time‐based work/life conflict, which consequently increased their psychological well‐being and job satisfaction and reduced their physical health symptoms and turnover intention. The type of shift schedule worked by the nurses influenced levels of turnover intention, control over work environment, time‐based work/life conflict, and physical symptoms.