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Biomedical subjects

T L Beck

Publications and source records attributed to T L Beck.

9 recordsLinked to original sources
PubMed2005

Mild cognitive impairment in different functional domains and incident Alzheimer's disease.

BACKGROUND: Little is known about factors that predict transition from mild cognitive impairment to Alzheimer's disease (AD). OBJECTIVE: To examine the relation of impairment in different cognitive systems to risk of developing AD in persons with mild cognitive impairment. METHODS: Participants are 218 older Catholic clergy members from the Religious Orders Study. At baseline, they met criteria for mild cognitive impairment based on a uniform clinical evaluation that included detailed cognitive testing. Evaluations were repeated annually for up to 10 years. Analyses were controlled for age, sex, and education. RESULTS: Eighty two persons (37.6%) developed AD. In separate analyses, episodic memory, semantic memory, working memory, and perceptual speed, but not visuospatial ability, were associated with risk of AD, but when analysed together only episodic memory and perceptual speed were associated with AD incidence, with the effect for episodic memory especially strong. Overall, those with impaired episodic memory were more than twice as likely to develop AD as those with impairment in other cognitive domains (relative risk (RR) = 2.45; 95% confidence interval (CI): 1.53 to 3.92), and they experienced more rapid cognitive decline. Lower episodic memory performance was associated with increased risk of AD throughout the observation period, whereas impairment in other cognitive domains was primarily associated with risk during the following year but not thereafter. CONCLUSION: Among persons with mild cognitive impairment, episodic memory impairment is associated with a substantial and persistent elevation in risk of developing AD compared to impairment in other cognitive systems.

Aged↗
PubMed2004

Influence of behavioral symptoms on rates of institutionalization for persons with Alzheimer's disease.

BACKGROUND: Recent studies indicate that behavioral symptoms may play a key role in decisions to institutionalize persons with Alzheimer's disease (AD), but the specific types of behavior that contribute to this increased risk have not been reliably identified. The relationship between behavioral symptoms and time to institutionalization was evaluated in a 4-year longitudinal study. METHOD: A total of 410 persons with the clinical diagnosis of AD completed annual clinical evaluations to assess cognitive impairment, functional limitations, delusions, hallucinations, depressive symptoms and physical aggression. Participation rates among survivors exceeded 90% for four follow-up evaluations with complete ascertainment of mortality and institutionalization. Time to institutionalization was evaluated using proportional hazards regression models in relation to time-varying clinical features. RESULTS: In multivariate models, adjusted for demographic and social variables, four clinical features emerged as the predominant predictors of institutionalization: cognitive impairment level, physical aggression, hallucinations and depressive symptoms. These associations were virtually unchanged in analyses controlling for mortality. CONCLUSIONS: Specific behavioral symptoms are important independent risk factors for institutionalization in persons with AD. Because behavioral symptoms are susceptible to therapy, efforts to modify or prevent these symptoms deserve careful consideration as a means to delay institutionalization for persons with this disease.

Aged↗
PubMed1997

Caregiver safety.

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Caregivers↗
PubMed1994

Plantar dislocation of the metatarsophalangeal joint: case report.

Dislocations of lesser metatarsophalangeal joints are rare and are almost always dorsal hyperextension injuries. The patient reported sustained plantar dislocations of the second and third metatarsophalangeal joints in a motor vehicle accident; the mechanism of injury was hyperflexion. Closed reduction was not possible, and at the time of open reduction, the extensor digitorum longus and brevis tendons to the third toe were trapped beneath the plantar aspect of the third metatarsal head. Once the tendons were retracted dorsomedially, the joint was easily reduced. Fixation with a Kirschner wire was necessary because of joint instability.

Adult↗
PubMed1993

Phase transitions of reversed-phase stationary phases. Cause and effects in the mechanism of retention.

We provide a somewhat historical perspective on the work that has been accomplished that supports the suggestion of phase transitions in reversed-phase liquid chromatographic bonded phases. In addition to this general review, we consider from both a practical and theoretical viewpoint the implications of such transitions in the rational design of improved reversed-phase separations. Analytical theory and molecular simulation approaches to chromatographic stationary phases and related systems are reviewed. Initial results are presented on the temperature, density and chain length dependences of stationary phase properties. The role of computer simulation in analyzing transition behavior and retention processes is discussed.

Chemical Phenomena↗
PubMed1993

Health, income, and postretirement employment of older adults.

After a poor response to advertisements for employment for older adults, a community health nursing agency surveyed 216 individuals ranging in age from 60 to 96 years to examine their attitudes toward postretirement work, perceptions of barriers to and facilitators of employment, and the influence of perceived health status and income on these factors related to labor force participation. The findings are consistent with continuity theory of aging, and underscore the need for public policies aimed at supporting the decision of older persons to work or retire.

Aged↗
PubMed1992

Promoting the community health clinical nurse specialist.

The role of the community health nurse clinical specialist (CHNCS) has been clearly delineated by the profession as having a responsibility to the community as client. The need for this specialist has escalated as communities try to address health problems that are preventable and overwhelming their resources. Yet, a survey conducted in New Jersey and counsel from the Rutgers College of Nursing Community Health Nursing Advisory Committee suggest that nurses and agencies may not be aware of the role of the CHNCS and how to use this advanced practitioner most effectively. This article discusses the role of the CHNCS as described by the American Nurses' Association, the need for the CHNCS, a survey of the perceived need for Master's-prepared community health nurses, the role of a CHNCS in a New Jersey community health nursing agency (MCOSS, Inc.), and recommendations for promoting the role of the CHNCS.

Community Health Nursing↗
PubMed1991

A comparison of the health status of residents of sheltered care facilities in Monmouth County, New Jersey.

In the past 20 to 30 years the number of sheltered care facilities in the United States has risen dramatically. Serving what many consider to be marginal populations, they are often poorly regulated or unregulated, with little or no attention to the health of residents. A retrospective record review of 647 clients residing in boarding homes, rooming houses, a homeless shelter, and residential facilities in Monmouth County, New Jersey, suggested that whereas some differences exist among facilities in terms of clients' physical and psychosocial health problems, these differences may not be meaningful. Since New Jersey regulations require some minimal health supervision to be provided by residential facilities but not by the others, these results suggest that regulations of the other facilities should be revised to reflect better the needs and problems of the populations they serve.

Adult↗