Olfactory Preferences in Human Females

The purpose of this study was to determine if a relationship existed between olfactory preferences and sexual orientation in Heterosexual, Entire Life lesbian, and Adopted Lifestyle lesbian women. Research in the area of olfaction and sexual behavior was reviewed and, on the basis of the literature, it was hypothesized that Heterosexual women would prefer male odors, Entire Life lesbian women would prefer female odors, and Adopted Lifestyle lesbian women would prefer male odors more than Entire Life lesbians. The design involved having female subjects sniff male and female odors and indicate a preference for either the male or female odor. The odor samples were human apocrine gland secretions obtained by having odor donors wear gauze pads in their armpits. The odor collected on the pads was then stabilized through applications of alcohol and subsequent freezing

Talking about obesity with clients: preferred terms and communication styles of UK pre-registration dieticians, doctors and nurses

Objective To describe trainee healthcare professionals’ preferred terms when talking about obesity, their beliefs about initiating discussions about weight, and their confidence about consulting with obese people. Methods A self-completed questionnaire collected data on demographics, preferred terms, beliefs about initiation of discussions, confidence and training needs from 1036 pre-registration dieticians, nurses and doctors. Results Participants’ preferred terms when raising the issue of obesity with clients were BMI (mean=.96), weight (mean=.71) and unhealthy BMI (mean=.43). When defining a client's bodyweight, students endorsed the euphemism ‘your weight may be damaging your health’ (67.6%). A proactive, collaborative communication style was preferred by 34.9% of participants. 58.2% of participants felt confident about discussing obesity with clients and 95.1% felt that that more training would be useful. Conclusion It is reassuring that UK trainee healthcare professionals avoid value-laden terms and broadly endorse words preferred by people with obesity. It is, however, concerning that the majority of participants did not favor a proactive, collaborative communication style. Practice implications Educators of tomorrow's healthcare professionals could take advantage of students’ desire for more training on how to effectively talk to clients with obesity about their weight. Such training would, however, require the development of clear guidelines on terminology and communication styles

The Patient Centered Medical Home: Mental Models and Practice Culture Driving the Transformation Process

The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. The PCMH model is a departure from more traditional models of healthcare delivery and requires significant transformation to be realized. To describe factors shaping mental models and practice culture driving the PCMH transformation process in a large multi-payer PCMH demonstration project. Individual interviews were conducted at 17 primary care practices in South Eastern Pennsylvania. A total of 118 individual interviews were conducted with clinicians (N = 47), patient educators (N = 4), office administrators (N = 12), medical assistants (N = 26), front office staff (N = 7), nurses (N = 4), care managers (N = 11), social workers (N = 4), and other stakeholders (N = 3). A multi-disciplinary research team used a grounded theory approach to develop the key constructs describing factors shaping successful practice transformation. Three central themes emerged from the data related to changes in practice culture and mental models necessary for PCMH practice transformation: 1) shifting practice perspectives towards proactive, population-oriented care based in practice-patient partnerships; 2) creating a culture of self-examination; and 3) challenges to developing new roles within the practice through distribution of responsibilities and team-based care. The most tension in shifting the required mental models was displayed between clinician and medical assistant participants, revealing significant barriers towards moving away from clinician-centric care. Key factors driving the PCMH transformation process require shifting mental models at the individual level and culture change at the practice level. Transformation is based upon structural and process changes that support orientation of practice mental models towards perceptions of population health, self-assessment, and the development of shared decision-making. Staff buy-in to the new roles and responsibilities driving PCMH transformation was described as central to making sustainable change at the practice level; however, key barriers related to clinician autonomy appeared to interfere with the formation of team-based care