Race and Sex Differences in Correlates of Systolic Blood Pressure in Community-Dwelling Older Adults

Objectives: To describe correlates of measured systolic blood pressure (SBP) among community-dwelling older African American and White Medicare beneficiaries. Methods: Participants completed an in-home assessment and factors significantly correlated with SBP were tested using multivariable models. Results: Among the 958 participants (mean age= 75.3 [SD = 6.8]; 49% African American; 49% female; 52% rural) African Americans were more often diagnosed with hypertension, more likely on anti-hypertensives, and on more anti-hypertensive medications. SBP was 2.7 mmHg higher in African Americans than Whites (p=.03). SBP was higher in women than men. Multivariable models revealed differences in the factors associated with SBP by race/sex specific groups. Having a history of smoking and reports of being relaxed and free of tension were associated with higher SBP among African American men. Discussion: Although more likely prescribed anti-hypertensives, mean SBP was higher for older African Americans than Whites. Results support the hypothesis that behavioral and psychosocial factors are more important correlates of SBP levels among older African Americans than among Whites

Perceived Adaptive Capacity and Natural Disasters: A Fisheries Case Study

Fishermen may be increasingly impacted by natural disasters, given sea level rise and the likely increased frequency and severity of storms associated with climate change. Planning for resiliency in the face of these disasters requires understanding the factors that influence fishermen’s capacity to adapt. The paper examines perceptions of adaptive capacity of New York and New Jersey commercial and for-hire fishermen one year after Hurricane Sandy. Subjective adaptive capacity to changes in the fishery in general and those caused by natural disasters was assessed. A comparison between commercial and for-hire fishermen revealed important differences and similarities with regard to attributes influencing their perceived adaptive capacity. While both groups show high levels of coping capacity in general, for-hire fishermen presented more confidence in their ability to obtain work and income outside the fishery while commercial fishermen were more confident in their ability to remain in fishing. For both groups, those that suffered more intense impacts from the storm had more negative levels of perceived adaptive capacity. Understanding the perceived adaptive capacity of commercial and for-hire fishermen can help researchers and policy makers better understand and address each sector’s response to impacts of future natural disasters and human driven changes

Social Bonds and Recovery: An Analysis of Hurricane Sandy in the First Year after Landfall

Hurricane Sandy was one of the most devastating hurricanes to hit US shores. The brunt of the impact was felt in New York and New Jersey, especially among coastal towns such as fishing communities. A survey of these two states assessed social and economic impacts to 958 commercial and recreational fishermen and fishing-related business owners 12 months post-storm. Many businesses and communities were still struggling, due to heavy infrastructure damages and revenue losses with low insurance coverage, but also to disrupted fishing patterns for some species. Social bonds were credited by many as a key aid to recovery. Social bonds (sometimes called bonding social capital) have been shown to be critical for evacuation and recovery in other disasters. However, few studies examine social bonds and disasters within the context of fisheries. This paper expands upon that topic

Toward a Model for Fisheries Social Impact Assessment

This paper presents a model for Fisheries Social Impact Assessment (SIA) that lays the groundwork for development of fisheries-focused, quantitative social assessments with a clear conceptual model. The usefulness of current fisheries SIA’s has been called into question by some as incompatible with approaches taken by fisheries biologists and economists when assessing potential effects of management actions. Our model’s approach is closer to the economists’ and biologists’ assessments and is therefore more useful for Fishery Management Council members. The paper was developed by anthropologists initially brought together in 2004 for an SIA Modeling Workshop by the National Marine Fisheries Service, NOAA. Opinions and conclusions expressed or implied are solely those of the authors and do not necessarily reflect the views or policy of the National Marine Fisheries Service, NOAA

Teaching at the Bedside: Maximal impact in Minimal Time

Academic physicians encounter many demands on their time including patient care, quality and performance requirements, research, and education. In an era when patient volume is prioritized and competition for research funding is intense, there is a risk that medical education will become marginalized. Bedside teaching, a responsibility of academic physicians regardless of professional track, is challenged in particular out of concern that it generates inefficiency, and distractions from direct patient care, and can distort physician–patient relationships. At the same time, the bedside is a powerful location for teaching as learners more easily engage with educational content when they can directly see its practical relevance for patient care. Also, bedside teaching enables patients and family members to engage directly in the educational process. Successful bedside teaching can be aided by consideration of four factors: climate, attention, reasoning, and evaluation. Creating a safe environment for learning and patient care is essential. We recommend that educators set expectations about use of medical jargon and engagement of the patient and family before they enter the patient room with trainees. Keep learners focused by asking relevant questions of all members of the team and by maintaining a collective leadership style. Assess and model clinical reasoning through a hypothesis-driven approach that explores the rationale for clinical decisions. Focused, specific, real-time feedback is essential for the learner to modify behaviors for future patient encounters. Together, these strategies may alleviate challenges associated with bedside teaching and ensure it remains a part of physician practice in academic medicine

The global oscillation network group site survey. II. Results

The Global Oscillation Network Group (GONG) Project will place a network of instruments around the world to observe solar oscillations as continuously as possible for three years. The Project has now chosen the six network sites based on analysis of survey data from fifteen sites around the world. The chosen sites are: Big Bear Solar Observatory, California; Mauna Loa Solar Observatory, Hawaii; Learmonth Solar Observatory, Australia; Udaipur Solar Observatory, India; Observatorio del Teide, Tenerife; and Cerro Tololo Interamerican Observatory, Chile. Total solar intensity at each site yields information on local cloud cover, extinction coefficient, and transparency fluctuations. In addition, the performance of 192 reasonable components analysis. An accompanying paper describes the analysis methods in detail; here we present the results of both the network and individual site analyses. The selected network has a duty cycle of 93.3%, in good agreement with numerical simulations. The power spectrum of the network observing window shows a first diurnal sidelobe height of 3 × 10⁻⁴ with respect to the central component, an improvement of a factor of 1300 over a single site. The background level of the network spectrum is lower by a factor of 50 compared to a single-site spectrum

Tricks and treats: designing technology to support mobility assistance dogs

Assistance dogs are a key intervention to support the autonomy of people with tetraplegia. Previous research on assistive technologies have investigated ways to, ultimately, replace their labour using technology, for instance through the design of smart home environments. However, both the disability studies literature and our interviews suggest there is an immediate need to support these relationships, both in terms of training and bonding. Through a case study of an accessible dog treats dispenser, we investigate a technological intervention responding to these needs, detailing an appropriate design methodology and contributing insights into user requirements and preferences