Associations among fluid intake, cognitive function, and length of stay in psychogeriatric inpatients.

PURPOSE: The purpose of this study was to examine differences, interactions, and associations among cognition, fluid intake, and demographic variables that may affect length of stay (LOS) for psychogeriatric inpatients aged 65 years or older. DESIGN AND METHODS: Descriptive, comparative, correlational secondary analysis of data from a primary study of 202 inpatients. FINDINGS: Older adults with and without cognitive impairment had different fluid intake over time (F = 3.50; p = .03), but had no difference in LOS in relation to cognitive functioning (p = .23); additional factors may predict LOS. PRACTICE IMPLICATIONS: Care providers must monitor the fluid intake of elderly patients with and without cognitive impairment throughout their hospitalization.

HLA typing by direct DNA sequencing.

Sequencing-based typing is a high resolution method for the identification of HLA polymorphisms. The majority of HLA Class I alleles can be discriminated by their exon 2 and 3 sequence, and for Class II alleles, exon 2 is generally sufficient. There are polymorphic positions in other exons which may require additional sequencing to exclude certain alleles with differences outside exon 2 and 3, depending on the clinical requirement and relevant accredition guidelines. The process involves selective amplification of target alleles by PCR, agarose gel electrophoresis of the PCR products to assess the quantity and quality, followed by purification of PCR amplicons to remove excess primer and dNTPs. Cycle sequencing reactions using Applied Biosystems™ BigDye(®) Terminator Ready Reaction v1.1 or v3.1 Kit are performed, then purification of sequence reactions before electrophoresing using Applied Biosystems™ 3730 or 3730XL Genetic Analyser (or similar). Data is processed by specialised software packages, which compare the sample sequence to the sequences of all possible theoretical allele combinations to assign an accurate genotype. Examination of all nucleotides, both at conserved and polymorphic positions enables the direct identification of new alleles, which may not be possible with techniques such as SSP and SSO typing.

Hydration status of geriatric patients in a psychiatric hospital.

Dehydration negatively impacts geriatric hospitalization outcomes. The purpose of this study was to investigate the hydration status of psychogeriatric inpatients and explore possible factors for dehydration. A descriptive, retrospective chart review of patients discharged from a psychogeriatric unit was completed. Clinical and biochemical information was collected at three time points (admission, mid-point, and discharge). Results were consistent with clinical observations that less hydrated patients seem to do worse clinically. It is important to closely monitor hydration status in psychogeriatric inpatients to reduce morbidity. Further studies are needed to develop strategies to prevent dehydration and its complications in this population.

Turning points and protective processes in the lives of people with chronic disabilities.

In this qualitative study, the authors examined the nature of resilience in people with chronic disabilities. Fifteen people with disabilities identified the factors that helped or hindered them at major turning points, and the triggers and resolutions to these turning points. Turning points were emotionally compelling experiences and realizations that involved meaning acquired through the routes of belonging, doing, or understanding the self or the world. The major protective factors were social support, traits such as perseverance and determination, and spiritual beliefs. Three new protective processes were identified: replacing a loss with a gain (transcending), recognizing new things about oneself (self-understanding), and making decisions about relinquishing something in life (accommodating). These protective factors, processes, and ways in which people with disabilities draw sense and meaning in life have important implications for service delivery.