Ageism in Consent? In a decision-making capable geriatric orthopaedic trauma patient population, does increased age impact who physicians consent for surgical fixation?

Introduction: Persistent misconceptions of frailty and dementia in geriatric patients impact physician-patient communication and leave patients vulnerable to disempowerment. Our study examines the consenting process in an orthogeriatric trauma patient population to determine if there is a relationship between increased age at presentation and utilization of health care proxies (HCPs) for surgical procedure consent. Methods: We retrospectively reviewed medical records of patients aged 65 and older admitted for an operative fracture between 2013 and 2016. Patients were considered decision-making capable if there was absence of history of cognitive impairment prior to surgical consent and if the patients screened negative in a pre-surgical Confusion Assessment Method (CAM) and Mini-Cog Assessment. Data was analyzed via chi-squared and t-test analysis in SPSS. Results: 510 patients were included, and 276 (54.1%) patients were deemed capable of consent. 27 (9.8%) decision-making capable patients had HCPs consent for surgery. 20 of the 27 (74.1%) were 80 years of age or older and 7 patients between 70 and 79 had HCP consent. (p=0.07). HCP consent was significant for age (p\u3c0.001), income level (p=0.03), and HCP physically present at consult (p\u3c0.001). Additionally, language other than English was found to be a significant predictor of HCP consent (p=0.035). Conclusion: It is concerning that cognitively intact geriatric orthopaedic trauma patients are not always consented for their own surgical procedures. Factors including age, income, and language contribute to increased risk of HCP consent. Increased physician vigilance and adoption of institutional consenting guidelines can reinforce appropriate respect of geriatric patients’ consenting capacity

The Impact of Poor Health on Education: New Evidence Using Genetic Markers

This paper examines the influence of health conditions on academic performance during adolescence. To account for the endogeneity of health outcomes and their interactions with risky behaviors we exploit natural variation within a set of genetic markers across individuals. We present strong evidence that these genetic markers serve as valid instruments with good statistical properties for ADHD, depression and obesity. They help to reveal a new dynamism from poor health to lower academic achievement with substantial heterogeneity in their impacts across genders. Our investigation further exposes the considerable challenges in identifying health impacts due to the prevalence of comorbid health conditions and endogenous health behaviors.

Late-glacial marine invertebrate macrofossils from Point Lepreau, New Brunswick

A late-glacial shell fauna from Point Lepreau, New Brunswick produced a radiocarbon date of 13,500 years B.P. The assemblage contained well-preserved subarctic to boreal molluscs and barnacles typical of late Pleistocene marine deposits from the region. Rare specimens of sea urchin, crab and brittlestar may be the oldest recorded occurrence of these animals in the late-glacial Bay of Fundy. The assemblage fits into a previously defined Zone 3, late-glacial marine invertebrate assemblage in the Bay of Fundy-Gulf of Maine region, characterized as a Diverse Arctic assemblage. RÉSUMÉ La datation par le radiocarbone a situé à 13 500 ans BP une faune invertébéie tardiglaciaire de la pointe Lepreau, ou Nouveau-Brunswick. L'assemblage renferme des mollusques et des bernacles subarctiques à boréaux bien conservés caractéristiques des dépôts marins du Pléistocène tardif de la région. Les spècimens rares d'oursins, de crabes et d'ophiures pourraient constituer les manifestations les plus anciennes de la présence de ces animaux relevées dans la région tardiglaciaire de la baie de Fundy. L'assemblage se situé à l’intérieur de l'assemblage d'invertébrés marins tardiglaciaires de la zone 3 antérieurement défini dans la région de la baie de Fundy et du golfe du Maine, caractérisé en tant qu'assemblage arctique hétéiogene. [Traduit par la rédaction

Schubert calculus of Richardson varieties stable under spherical Levi subgroups

We observe that the expansion in the basis of Schubert cycles for $H^*(G/B)$ of the class of a Richardson variety stable under a spherical Levi subgroup is described by a theorem of Brion. Using this observation, along with a combinatorial model of the poset of certain symmetric subgroup orbit closures, we give positive combinatorial descriptions of certain Schubert structure constants on the full flag variety in type $A$. Namely, we describe $c_{u,v}^w$ when $u$ and $v$ are inverse to Grassmannian permutations with unique descents at $p$ and $q$, respectively. We offer some conjectures for similar rules in types $B$ and $D$, associated to Richardson varieties stable under spherical Levi subgroups of SO(2n+1,\C) and SO(2n,\C), respectively.Comment: Section 4 significantly shortened, and other minor changes made as suggested by referees. Final version, to appear in Journal of Algebraic Combinatoric

Counting atoms in a deep optical microtrap

We demonstrate a method to count small numbers of atoms held in a deep, microscopic optical dipole trap by collecting fluorescence from atoms exposed to a standing wave of light that is blue detuned from resonance. While scattering photons, the atoms are also cooled by a Sisyphus mechanism that results from the spatial variation in light intensity. The use of a small blue detuning limits the losses due to light assisted collisions, thereby making the method suitable for counting several atoms in a microscopic volume