An expressive-arts-based life-death education program for the elderly: A qualitative study.

This study endeavors to investigate how healthcare workers, equipped with expressive arts methods, could foster life-death education for the elderly. Forty-nine older adults aged 60 or above joined a 10-session expressive arts-based life-death education program that was led by social workers equipped with expressive arts methods. An ethnographic research approach, with a post-treatment focus group (n = 17), was conducted with the participants. The results showed that expressive arts methods could enhance reorganization of life experiences, promote dealing with ambivalent emotion regarding life-death issues, improve communicating life-death issues with family members, and induce ideas to prepare for death.

End-of-life (EoL) mobile phone management in Hong Kong households.

A questionnaire survey and interviews were conducted in households and end-of-life (EoL) mobile phone business centres in Hong Kong. Widespread Internet use, combined with the rapid evolution of modern social networks, has resulted in the more rapid obsolescence of mobile phones, and thus a tremendous increase in the number of obsolete phones. In 2013, the volume of EoL mobile phones generated in Hong Kong totalled at least 330 tonnes, and the amount is rising. Approximately 80% of electronic waste is exported to Africa and developing countries such as mainland China or Pakistan for recycling. However, the material flow of the large number of obsolete phones generated by the territory's households remains unclear. Hence, the flow of EoL mobile phones in those households was analysed, with the average lifespan of a mobile phone in Hong Kong found to be just under two years (nearly 23 months). Most EoL mobile phones are transferred to mainland China for disposal. Current recycling methods are neither environmentally friendly nor sustainable, with serious implications for the environment and human health. The results of this analysis provide useful information for planning the collection system and facilities needed in Hong Kong and mainland China to better manage EoL mobile phones in the future.

Selective area tuberculosis surveys in Singapore 1978.

A random population sample survey in Singapore 1975 revealed that a relatively high proportion of active pulmonary tuberculosis patients remained undiagnosed, mainly in the older age groups. Previous studies disclosed the cause to the lack of symptoms of concern in these patients. A new programme was devised to discover hidden elderly patients by mass chest X-ray screening of population aged 45 years and older living in areas with known high incidence of tuberculosis. The yield of cases was less than expected mainly due to the dislocation and dispersion of population from recent extensive urban re-development in Singapore. Nevertheless the results were comparable to the most productive case finding programme carried out in this department.

Pseudoascites in the clinical setting: avoiding unwarranted and futile paracenteses.

Ascites is diagnosed on physical exam by findings of abdominal distension, bulging flanks, shifting dullness and a prominent fluid wave. However, as the following cases demonstrate, these signs may also be positive in pseudoascites due to thick layers of adipose tissue in the abdomen. A history of recent food binging and a lack of a prolonged prothrombin time should raise the index of suspicion for pseudoascites in a patient with a protuberant abdomen. In light of equivocal physical signs, physicians may employ ultrasonography to prevent patients with pseudoascites from suffering multiple futile attempts at paracentesis.

Transport, fate and speciation of heavy metals (Pb, Zn, Cu, Cd) in mine drainage: geochemical modeling and anodic stripping voltammetric analysis.

The maximum concentrations (ppb) of heavy metals in the mine drainage (pH: down to 3.3) of Chonam-ri creek in the abandoned Kwangyang gold-silver mine, South Korea, are 22600 Zn, 2810 Cu, 182 Cd, and 109 Pb. A small, limestone-infused retention pond, about 440 meters downstream from the waste dump, plays an important role in the removal of heavy metals: the factors of reduction for Zn, Cu, Cd, and Pb are 12, 24, 14, and 14, respectively. This is due to the pH increase (up to >5.4) accompanying adsorption onto and/or coprecipitation with Fe- and Al-hydroxides (goethite and gibbsite). From the waste dump to the pond, heavy metal concentrations also progressively decrease due to pH increase. Geochemical modeling (using the computer code WATEQ4F) predicts that free aqueous metal ions are dominant (mostly >70% for Cu and Zn, and >60% for Pb and Cd) in samples collected upstream from the pond, whereas complexing with sulfate, carbonate and hydroxyl ions becomes important in the samples collected downstream. The comparison between the concentrations of electrochemically labile species (determined by Anodic Stripping Voltammetry) and the result of computer modeling shows that Cd and Zn are present predominantly as labile inorganic species throughout the whole range of the creek. However, Cu and Pb in the samples collected downstream from the pond largely form electrochemically inert species (possibly, metal-organic complexes). The above results indicate that the retention pond is effective in reducing the toxicity of heavy metals, especially Cu and Pb.

[ECG evaluation by the computer using the USPHS program (author's transl)]. / Die Computer-EKG-Auswertung nach dem USPHS-Programm

The efficiency of ECG evaluation by the computer has definitely increased owing to the current improvement of the program. Applying the USPHS program in our material, a wrong diagnosis was made in 14% of the pathological tracings and in 25% of the normal tracings under investigation. These results are certainly encouraging, considering that dissimilar diagnoses are established by different cardiologists in about 20% of the cases. However, we deem the number of wrong diagnoses both in pathological and in normal cases still too high and, therefore, further improvement should be made before applying ECG diagnosis by the computer in practice.

[Clinical pictures of hemiblock and fascicular block. Diagnosis and clinical significance]. / Hemiblock und faszikuläre Blockbilder Diagnostik und klinische Bedeutung

In intraventricular conducting defects distal the bundle of His we see different forms, i.e. left anterior and left posterior hemiblock, left bundle branch block and right bundle branch block. The left anterior hemiblock is electrocardiographically responsible for a left axis deviation, the left posteriof hemiblock for a vertical axis or right axis deviation. If there is in addition to a hemiblock a right bundle branch block, it is called a bifascicular block. Are at the same time all three fascicles concerned, there will be a trifascicular block, i.e. a complete atrioventricular block, the so-called peripheral form. The common cause of fascicular blocks is coronary heart disease. Because of the possible progressing of the disease patients need further surveillance and eventually therapy.

[Short PQ interval with particular reference to the Lown-Ganong-Levine syndrome (author's transl)]. / Kurze PQ-Zeit unter besonderer Berücksichtigung des Lown-Ganong-Levine-Syndroms

The ST length and T wave were investigated electrocardiographically and clinically in 200 patients with a short PQ interval in the electrocardiogram, independent of the length and shape of the QRS complex. In group A (Lown-Ganong-Syndrome LGL), we often found a narrow, pointed, positive P wave and a narrow QRS complex in the electrocardiogram in addition to the short PQ interval, and also a tendency to respiratory arrhythmia. Clinically this was frequently a matter of young women with a tendency to paroxysmal tachycardia and autonomic dystonia. A James bundle or even a short AV conduction pathway with a small heart might be considered as the origin of this LGL syndrome. A particular classification of patients with short PQ intervals and S-T deformation (Group B) in organic heart disease has not yet been described in the literature to our knowledge. The results of our investigations in group C (WPW syndrome) correspond in the main to those given in the literature.

[Treatment of bradycardiac arrhythmias with depot-orciprenaline (author's transl)]. / Behandlung bradykarder Rhythmusstörungen mit Depot-orciprenalin

24 patients with bradycardiac arrhythmias of various origin were treated with a new depot preparation of orciprenaline. The special galenical preparation guarantees effectiveness ofr 8-10 hours. In 21 patients (87%), therefore, one dragee morning and evening was sufficient to obtain a mean rise in frequency of 57%. The preparation had to be discontinued in 3 cases because of side effects such as increase in ventricular extrasystoles, anginal complaints and critical rise of blood pressure in hypertension. Because of its trouble-free administration in a depot form the preparation not only offers a practical advantage over the short-acting commercial preparations, but also shows a reliable efficacy. It can therefore be given under regular supervision in all forms of bradycardiac arrhythmias with stable ventricular frequency and satisfactory cardiac output.

[Early arteriosclerosis with increased thrombocyte aggregation (author's transl)]. / Frühzeitige Arteriosklerose bei erhöhter Thrombozytenaggregation.

The importance of thrombocyte function in atherogenesis is discussed in the light of experimental and clinical results. Adhesion and aggregation of thrombocytes on an intact or injured artery wall may be the first step to atherosclerotic plaque. In vitro measurements of aggregation, in vivo measurements of thrombocytic survival time and microscopic and histological examinations are all consistent in showing a rise in aggregation of thrombocytes in the early stages of arteriosclerosis. The measurement of thrombocyte function is therefore recommended in addition to the known risk factors in patients with a greater risk of arteriosclerosis.

Vectorcardiographic findings in Friedreich's ataxia.

Cardiac manifestations in Friedreich's ataxia occur frequently. We have studied 17 cases of Friedreich's ataxia, of which 94% showed a disturbance of the repolarization in the scalar ECG, 29% showed evidence of left ventricular hypertrophy. These changes are not specific but typical of Friedreich's ataxia. Vectorcardiograms were taken with the Frank-system. The vectorcardiographic findings showed not only the same changes as seen in the sclar ECG, but furthermore an atypical configuration of the QRS-loop was evident, which was not recognized in the scalar ECG. According to our experience compared with the scalar ECT, the vectorcardiographic investigations can be considered a more useful method in the diagnosis of Friedreich's ataxia.

[Electrocardiographic changes in electrolyte inbalance. Part 2: Alterations in serum calcium (author's transl)]. / Elektrokardiographische Untersuchungen bei Elektrolytstörungen

74 patients (hypocalcemia: 41 patients, hypercalcemia 13 patients, 20 patients as control) without heart disease were examined. A prolongation of the relative QT-interval was found in 90% and a flat or inverted T-wave in 25% of the patients with hypocalcemia. In 77% of the patients with hypercalcemia the QT-interval was shortened. A good, clinically useful correlation between the QT-interval and the serumcalcium-concentration could be established in patients with hypo- and hyper-calcemia.

[Electrocardiographic changes in electrolyte imbalance. Part 1: Alterations in serum potassium (author's transl)]. / Elektrokardiographische Untersuchungen bei Elektrolytstörungen. Teil 1: Kaliumstoffwechselstörungen

163 patients (95 hypokalemic, 48 hyperkalemic, 20 healthy) were examined. Electrocardiographic patterns of hypokalemia were evident in 46 p.c. of all patients with serum potassium less than 3,5 mval/l. Patients without cardiac disease showed signs of hypokalemia in the ECG in 68 p.c., those cases with extremly low serum potassium (less than 2,5 mval/l) in 81 p.c. In patients without cardiac disease a good correlation could be observed between ST depression and T wave inversion on one side and serum potassium level below 3,5 mval/l on the other side. The T/U ratio was found to be below unity in only 9 p.c. in mild hypokalemia, but in 82 p.c. in severe hypokalemia. ECG pattern of hyperkalemia could be found in 29 p.c. of all patients with serum potassium levels greater than 5,1 mval/l. These signs were evident in patients without cardiac disease in 29 p.c. in mild hyperkalemia, but in 75 p.c. in severe hyperkalemia. Patients suffering from cardiac disease, however showed the correspondive ECG changes of hyperkalemia only in 5 p.c. There is a good correlation between the P, and T-wave-amplitude and the serum potassium level greater than 5,1 mval/l. According to our findings it can be stated, that the ECG changes in patients with cardiac disease tend to hide the correspondive changes of potassium disorder.