Gerontology
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Community-acquired pneumonia is a common disease of the elderly and involves a high mortality risk. Demographic developments are creating new challenges for acute medical treatment strategies in geriatric patients with their underlying multimorbidity. In addition to the diagnostic parameters recorded on hospital admission, such as white cell count and C-reactive protein, procalcitonin, more than the risk scores CRB- and CURB-65 evaluated to date, appears to be a promising parameter for assessing the severity of pneumonia in elderly patients to allow early detection of severe courses and initiation of suitable treatment. The decisive factor is the dynamic course of the procalcitonin values over 3 consecutive days, as demonstrated in this case series.
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Hurricanes Katrina and Rita exposed significant flaws in US preparedness for catastrophic events and the nation's capacity to respond to them. These flaws were especially evident in the affected disaster areas' nursing homes, which house a particularly vulnerable population of frail older adults. Although evacuation of a healthcare facility is a key preparedness activity, there is limited research on factors that lead to effective evacuation. ⋯ We need to better understand how disaster plans can be adapted to meet the needs of frail elders and other residents in nursing homes. Moreover, we must address identified gaps in the scientific literature with respect to health outcomes by tracking outcomes over time. Information on health outcomes would allow administrators and others to more appropriately weigh the balance of risks and benefits associated with evacuation. Without this understanding of the relationship between evacuation and health outcomes, it is not possible to develop effective response plans that are tailored to meet the needs of nursing home residents.
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Biomedical signal monitoring systems have rapidly advanced in recent years, propelled by significant advances in electronic and information technologies. Brain-computer interface (BCI) is one of the important research branches and has become a hot topic in the study of neural engineering, rehabilitation, and brain science. Traditionally, most BCI systems use bulky, wired laboratory-oriented sensing equipments to measure brain activity under well-controlled conditions within a confined space. ⋯ Furthermore, owing to large data volumes, signal processing of BCI systems is often performed off-line using high-end personal computers, hindering the applications of BCI in real-world environments. To be practical for routine use by unconstrained, freely-moving users, BCI systems must be noninvasive, nonintrusive, lightweight and capable of online signal processing. This work reviews recent online BCI systems, focusing especially on wearable, wireless and real-time systems.
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Mummies are human remains with preservation of non-bony tissue. Mummification by natural influences results in so-called natural mummies, while mummification induced by active (human) intervention results in so-called artificial mummies, although many cultures practiced burial rites which to some degree involved both natural and artificial mummification. Since they are so uniquely well-preserved, mummies may give many insights into mortuary practices and burial rites. ⋯ Indeed, the development of commercially available CT scanners in the 1970s meant that for the first time the 3D internal structure of mummies and bog bodies could be studied non-destructively. This article describes the history of mummy radiography and CT scanning, and some of the problems and opportunities involved in applying these techniques, derived for clinical use, on naturally and artificially preserved ancient human bodies. Unless severely degraded, bone is quite readily visualized, but accurate imaging of preserved soft tissues, and pathological lesions therein, may require considerable post-image capture processing of CT data.
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Frail, old patients with and without cognitive impairment are at high risk of falls and associated medical and psychosocial issues. The lack of adequate, validated instruments has partly hindered research in this field. So far no questionnaire documenting fall-related self-efficacy/fear of falling has been validated for older persons with cognitive impairment or for different administration methods such as self-report or interview. ⋯ Both the FES as well as the FES-I showed good to excellent measurement properties in persons with and without moderate cognitive impairment. In frail older persons, especially in persons with cognitive impairment, an interview-based administration method is recommended.