Driving self-restriction and age: A study of emergency department patients

BACKGROUND: Driving self-restriction is well-documented among older drivers but might also occur among younger drivers. Little is known about the driving patterns of emergency department (ED) patients, who may be a high-risk population for motor vehicle crashes (MVCs). We sought to compare the driving patterns and MVCs of younger and older adult ED patients in order to inform development of injury prevention interventions in EDs. METHODS: We surveyed English-speaking younger adult (age 25–64) and older adult (age ≥65) ED patients, excluding non-drivers and those who were cognitively-impaired or too sick to participate. We compared drivers by age group and used logistic regression with adjustment for driving frequency to examine factors associated with driving self-restriction. RESULTS: Of those eligible, 82% (n = 178) of younger adult and 91% (n = 134) of older adult patients participated; approximately half were women. Similar proportions of younger and older adult patients reported driving everyday/almost everyday (80%) but also self-restricting driving in inclimate weather (48%), heavy traffic (27%), in unfamiliar places (21%), when travelling with passengers (1.6%) or when alone (1.3%). Fewer younger adult than older adult patients avoided driving at night (22% versus 49%) or on highways (6.7% versus 26%). In multivariable logistic regression, factors significantly associated self-imposed driving restriction in ≥1 driving situation were female gender (Odds Ratio [OR] 2.40; 95% CI 1.42-4.05) and ever feeling “confused, nervous or uncomfortable” while driving (OR 1.87; 95% CI 1.03-3.39). There was a non-significant trend for differences in proportions between younger adult (11%) and older adult (6.8%) drivers reporting ≥1 MVC as a driver in the past 12 months. CONCLUSIONS: Similar proportions of younger and older adult ED patients self-restrict driving, albeit in different situations, which has implications for behavioral interventions for injury prevention and for education of patients and medical providers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40621-014-0018-z) contains supplementary material, which is available to authorized users

Nurses\u27 Alumnae Association Bulletin, May 1960

Accreditation of Programs in Nursing Alumnae Meetings, 1959 Committee Reports Greetings from the President Highlights from first issue of Alumnae Bulletin Living in the new nurses residence Lost Members Marriages Necrology New Arrivals Notices Personal Items of Interest Report of the School of Nursing and Nursing Services Staff Nurses Association Student Activities Year of tremendous growth and expansio

Mobile health solutions for atrial fibrillation detection and management: a systematic review

AimWe aimed to systematically review the available literature on mobile Health (mHealth) solutions, including handheld and wearable devices, implantable loop recorders (ILRs), as well as mobile platforms and support systems in atrial fibrillation (AF) detection and management.MethodsThis systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The electronic databases PubMed (NCBI), Embase (Ovid), and Cochrane were searched for articles published until 10 February 2021, inclusive. Given that the included studies varied widely in their design, interventions, comparators, and outcomes, no synthesis was undertaken, and we undertook a narrative review.ResultsWe found 208 studies, which were deemed potentially relevant. Of these studies included, 82, 46, and 49 studies aimed at validating handheld devices, wearables, and ILRs for AF detection and/or management, respectively, while 34 studies assessed mobile platforms/support systems. The diagnostic accuracy of mHealth solutions differs with respect to the type (handheld devices vs wearables vs ILRs) and technology used (electrocardiography vs photoplethysmography), as well as application setting (intermittent vs continuous, spot vs longitudinal assessment), and study population.ConclusionWhile the use of mHealth solutions in the detection and management of AF is becoming increasingly popular, its clinical implications merit further investigation and several barriers to widespread mHealth adaption in healthcare systems need to be overcome

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Grammar and *Interaction: Syntactic Pivots in German Conversation

362 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2007.Chapter 1 situates the phenomenon within the fields of Interactional Linguistics and CA. Chapter 2 reviews relevant aspects of spoken German and outlines different types of syntactic pivot constructions. Chapter 3 discusses the systematic use of pivots in the environment of overlap, where they serve as a resource for managing the distributions of speakership in interaction. Chapter 4 discusses pivots employed to bridge sequential/topical junctures. I show that speakers use these structures to effectively steer the direction of the current topic or manage the transition between a subsidiary activity and the main activity. In Chapter 5, I explore the role of sentence-level resources in the organization of word searches. Pivot constructions are used at different points in the organization of searches (during/at the end of/after a search) and their interactional functions differ with their placement. Chapter 6 focuses on pivots used to carry out embedded self-correction. In the pivot turns analyzed, speakers accomplish a change in the action format or a modification of the stance conveyed and thereby orient to problems in alignment in an 'embedded' way. To conclude, I address implications for the field of Linguistics, point to limitations of my study, and provide avenues of future research. This dissertation shows that spoken syntactic constructions and their functions can only be grasped if we acknowledge the temporality of spoken language and view grammar as usage-based and negotiable.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

Indexing Priority of Position: Eben as Response Particle in German

Response particles manage intersubjectivity. This conversation analytic study describes German eben (“exactly”). With eben, speaker A locally agrees with the immediately prior turn of B (the “confirmable”) and establishes a second indexical link: A relates B’s confirmable to a position A herself had already displayed (the “anchor”). Through claiming temporal priority, eben speakers treat a just-formulated position as self-evident and mark independence. Further evidence for the three-part structure “anchor-confirmable-eben” that eben sets in motion retrospectively comes from instances where eben speakers supply a missing/opaque anchor via a postpositioned display of independent access. Data are in German with English translation

OKAY in responding and claiming understanding

OKAY originates from English, but it is increasingly used across languages. This chapter presents data from 13 languages, illustrating the spectrum of possible uses of OKAY in responding and claiming understanding in contexts of informings. Drawing on a wide range of interaction types from both informal and institutional contexts, including those crucially involving embodied practices, we show how OKAY can be used to (i) claim sufficient understanding, (ii) mark understanding of the prior informing as preliminary or not complete, and (iii) index discrepancy of expectation

Doing more than confirming: expanded responses to requests for confirmation in German talk-in-interaction

While requests for confirmation (RfCs) make a yes/no-response relevant, recipients often produce more than a mere confirmation. Our paper explores expanded responses to RfCs in German talk-in-interaction. We focus on responses consisting of a confirmation and an additional TCU/action. Drawing on video data from mundane and institutional settings, we demonstrate how expanded responses are designed and fit the sequential environments in which they occur. We show four different functions fulfilled with expanded responses: (i) specifying and elaborating on the topic introduced in the RfC, (ii) accounting for the intelligibility of the speaker’s prior actions, (iii) resisting the terms of the RfC, and (iv) challenging a RfC by referring to the recipient’s pre-existing knowledge. Finally, we summarize interactional features relevant for the occurrence of expanded responses in our data. In addition, we discuss the implications of our results for future cross linguistic research

Coordination of OKAY, nods, and gaze in claiming understanding and closing topics

Our paper examines how bodily behavior contributes to the local meaning of OKAY. We explore the interplay between OKAY as response to informings and narratives and accompanying multimodal resources in German multi-party interaction. Based on informal and institutional conversations, we describe three different uses of OKAY with falling intonation and the recurrent multimodal patterns that are associated with them and that can be characterized as ‘multimodal gestalts’. We show that: 1. OKAY as a claim to sufficient understanding is typically accompanied by upward nodding; 2. OKAY after change-of-state tokens exhibits a recurrent pattern of up- and downward nodding with distinctive timing; and 3. OKAY closing larger activities is associated with gaze-aversion from the prior speaker