A national abhorrence of physical restraint.

Publications such as those from the RCN and the CSCI, together with media scrutiny and the increased involvement of the legal system, are highlighting what has been a long-standing issue for many health and social care staff. The difficulties still facing staff are that every situation is unique and staff members are themselves individuals.

Planning for end-of-life care: findings from the Canadian Study of Health and Aging.

Steps involved in formalizing end-of-life care preferences and factors related to these steps are unclear in the literature. Using data from the third wave of the Canadian Study of Health and Aging (CSHA-3), we examined the relations between demographic and health predictors, on the one hand, and three outcomes, on the other (whether participants had thought about, discussed , or formalized their end-of-life preferences), and considered, as well, whether relations existed among the three outcomes. Canadian region of residence, female gender, and more years of education predicted having thought about preferences; region of residence, female gender, and lack of cognitive impairment predicted discussion of preferences; and region of residence and not being married predicted whether formal documents were in place.

Impact of transit training and free bus pass on public transportation use by older drivers.

Purpose: The present pilot study examines the impact of group transit training for older adults in Victoria, British Columbia, Canada, between 2005 and 2006.

Methods: Data were collected from 41 participants, randomly assigned to three groups: 1) a control group that received no group transit training or free bus pass, 2) a group receiving group transit training only, and 3) a group receiving group transit training and a free bus pass. Participants were followed longitudinally for 1 year.

The Diabetes Ten City Challenge: interim clinical and humanistic outcomes of a multisite community pharmacy diabetes care program.

Objective: To assess clinical and humanistic outcomes 1 year after initiating the Diabetes Ten City Challenge (DTCC), a multisite community pharmacy health management program for patients with diabetes.

Design: Interim observational analysis of deidentified aggregate data from participating employer clients.

Setting: 29 employers at 10 distinct geographic sites contracting for patient care services with pharmacy providers in the community setting.

Impact of antiretroviral therapy on the incidence of tuberculosis: the Brazilian experience, 1995-2001.

Background: The human immunodeficiency virus (HIV) fuels tuberculosis (TB) epidemics. In controlled clinical trials, antiretroviral therapy (ART) reduces TB incidence in HIV-infected patients. In this study we determine if, under programmatic conditions, Brazil's policy of universal ART access has impacted TB incidence among HIV-infected patients.

Neurocognitive markers of cognitive impairment: exploring the roles of speed and inconsistency.

A well-known challenge for research in the cognitive neuropsychology of aging is to distinguish between the deficits and changes associated with normal aging and those indicative of early cognitive impairment. In a series of 2 studies, the authors explored whether 2 neurocognitive markers, speed (mean level) and inconsistency (intraindividual variability), distinguished between age groups (64-73 and 74-90+ years) and cognitive status groups (nonimpaired, mildly impaired, and moderately impaired). Study 1 (n = 416) showed that both level and inconsistency distinguished between the age and 2 cognitive status (not impaired, mildly impaired) groups, with a modest tendency for inconsistency to predict group membership over and above mean level.

A prospective randomized single-blind comparison of three methods of bowel preparation for outpatient flexible sigmoidoscopy.

Background: Preparation for outpatient flexible sigmoidoscopy using a self-administered phosphate enema is the standard practice in our unit, but it provides acceptable bowel preparation in only 80% of patients. This study compared two methods of bowel preparation with the current standard in an attempt to improve efficacy and acceptability.

Methods: From January to September 2003, patients scheduled for out-patient flexible sigmoidoscopy were prospectively randomized to 3 groups: group 1: one Fleet enema 2 h pre-procedure; group 2: two Fleet enemas, one on the evening prior to sigmoidoscopy and one 2 h pre-procedure; group 3: lactulose 30 ml orally 48 and 24 h prior to sigmoidoscopy, plus a single Fleet enema 2 h pre-procedure.

Microscale patterning of organic films on carbon surfaces using electrochemistry and soft lithography.

We have demonstrated three simple strategies employing poly(dimethylsiloxane) (PDMS) molds for patterning carbon surfaces with two different modifiers in an 18 microm line pattern. The PDMS molds are patterned with microfluidic channels (approximately 22 microm wide and 49 microm deep) and form a reversible, conformal seal to the pyrolyzed photoresist film (PPF) and modified PPF surfaces. Modifiers are electrochemically grafted to the PPF surface by the reduction of aryl diazonium salts and the oxidation of primary amines.

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My hopes for continuing care eligibility criteria stretch far beyond the pragmatic needs of national criteria with clarity and an attached budget to a publicity programme that develops understanding and avoids distress amongst the general population, and those involved with older people particularly.

Waterborne toxoplasmosis, Brazil, from field to gene.

Water was the suspected vehicle of Toxoplasma gondii dissemination in a toxoplasmosis outbreak in Brazil. A case-control study and geographic mapping of cases were performed. T.

A multicenter evaluation of tuberculin skin test positivity and conversion among health care workers in Brazilian hospitals.

Setting: Four general Brazilian hospitals.

Objective: To assess the occupational risk of Mycobacterium tuberculosis (TB) in participating hospitals.

Design: In phase one of this longitudinal study, a cross-sectional survey documented baseline tuberculin skin test (TST) positivity rates.

TST reversion in a BCG-revaccinated population of nursing and medical students, São Paulo, Brazil, 1997-2000.

Setting: A major university in São Paulo, Brazil, where vaccination against tuberculosis (TB) with bacille Calmette-Guerin (BCG) was routinely offered to first-year medical and nursing students.

Objectives: To estimate the probability of negative tuberculin skin test (TST) results over a 4-year period following BCG revaccination, and to evaluate the effect of factors associated with reversion.

Design: Students were enrolled in 1997, initially given a two-step TST, and were retested annually or biannually for the duration of the study.

Patient self-management program for diabetes: first-year clinical, humanistic, and economic outcomes.

Objective: To assess the outcomes for the first year following the initiation of a multisite community pharmacy care services (PCS) program for patients with diabetes.

Design: Quasi-experimental, pre-post cohort study.

Setting: 80 community pharmacy providers with diabetes certificate program training who were reimbursed for PCS by employers in Greensboro, N.

Impact of a community-based multiple risk factor intervention on cardiovascular risk in black families with a history of premature coronary disease.

Background: Black subjects with a family history of premature coronary heart disease (CHD) have a marked excess risk, yet barriers prevent effective risk reduction. We tested a community-based multiple risk factor intervention (community-based care [CBC]) and compared it with "enhanced" primary care (EPC) to reduce CHD risk in high-risk black families.

Methods And Results: Black 30- to 59-year-old siblings of a proband with CHD aged <60 years were randomized for care of BP > or =140/90 mm Hg, LDL cholesterol > or =3.

Accumulation and retention of micellar beta-carotene and lutein by Caco-2 human intestinal cells.

Despite the interest in the diverse roles of dietary carotenoids in human health, little is known about the transfer of these plant pigments from foods to micelles during digestion and their subsequent transfer across the intestinal epithelium. We conducted this study to characterize the intestinal uptake of micellarized carotenoids using monolayers of differentiated Caco-2 human intestinal cells. Crystalline beta-carotene (BC) and lutein (LUT), solubilized in mixed micelles for delivery to cells, were stable in a tissue culture environment for 20 hours.