The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients

There is growing evidence that the outcomes of health care for seniors are dependent not only upon patients’ physical health status and the administration of care for their biomedical needs, but also upon care for patients’ psychosocial needs and attention to their social, economic, cultural, and psychological vulnerabilities. Even when older patients have appropriate access to medical services, they also need effective and empathic communication as an essential part of their treatment. Older patients who are socially isolated, emotionally vulnerable, and economically disadvantaged are particularly in need of the social, emotional, and practical support that sensitive provider-patient communication can provide. In this review paper, we examine the complexities of communication between physicians and their older patients, and consider some of the particular challenges that manifest in providers’ interactions with their older patients, particularly those who are socially isolated, suffering from depression, or of minority status or low income. This review offers guidelines for improved physician-older patient communication in medical practice, and examines interventions to coordinate care for older patients on multiple dimensions of a biopsychosocial model of health care

Stress indicators in steers at slaughtering

This work aimed to assess the blood modifications of some slaughtering-linked stress hormones in cattle subject to butcher standardized procedures. The blood samples of 20 Limousine 12-13 months old steers have been collected before slaughtering, during lairage, and after stunning by captive bolt gun, during exsanguination. The plasma level of epinephrine, norepinephrine, cortisol and beta-endorphin have been assayed by EIA. The data indicate that catecholamines, cortisol and beta-endorphin did not significantly increase after stunning in these animals

Pig, F1 (wild boar x pig) and wild boar meat quality

Sixteen carcasses of wild boars, pigs, hybrids F1 (wild boar x pig) and reared wild boar have been examined to study the meat quality and the fatty acid composition. Four carcasses came from hunted wild boars and twelve from animals reared in outdoor pens till nine months of age. The meat produced by the hunted wild animals, although not marketable, offers the best quality and nutritional characteristics. The use of hybrids reared in outdoor pens can approximate or equalize the hunted wild boars meat traits. Reared wild boar meat has, in the complex, better compositional characters than hybrids and domestic groups, but acidic quality of fat is not particularly useful for human feeding

Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study.

BACKGROUND\ud \ud Prompt access to artemesinin-combination therapy (ACT) is not adequate unless the drug is taken according to treatment guidelines. Adherence to the treatment schedule is important to preserve efficacy of the drug. Although some community based studies have reported fairly high levels of adherence, data on factors influencing adherence to artemether-lumefantrine (AL) treatment schedule remain inadequate. This study was carried-out to explore the provider's instructions to caretakers, caretakers' understanding of the instructions and how that understanding was likely to influence their practice with regard to adhering to AL treatment schedule.\ud \ud METHODS\ud \ud A qualitative study was conducted in five villages in Kilosa district, Tanzania. In-depth interviews were held with providers that included prescribers and dispensers; and caretakers whose children had just received AL treatment. Information was collected on providers' instructions to caretakers regarding dose timing and how to administer AL; and caretakers' understanding of providers' instructions.\ud \ud RESULTS\ud \ud Mismatch was found on providers' instructions as regards to dose timing. Some providers' (dogmatists) instructions were based on strict hourly schedule (conventional) which was likely to lead to administering some doses in awkward hours and completing treatment several hours before the scheduled time. Other providers (pragmatists) based their instruction on the existing circumstances (contextual) which was likely to lead to delays in administering the initial dose with serious treatment outcomes. Findings suggest that, the national treatment guidelines do not provide explicit information on how to address the various scenarios found in the field. A communication gap was also noted in which some important instructions on how to administer the doses were sometimes not provided or were given with false reasons.\ud \ud CONCLUSIONS\ud \ud There is need for a review of the national malaria treatment guidelines to address local context. In the review, emphasis should be put on on-the-job training to address practical problems faced by providers in the course of their work. Further research is needed to determine the implication of completing AL treatment prior to scheduled time

New experimental limit on the Pauli Exclusion Principle violation by electrons

The Pauli Exclusion Principle (PEP) is one of the basic principles of modern physics and, even if there are no compelling reasons to doubt its validity, it is still debated today because an intuitive, elementary explanation is still missing, and because of its unique stand among the basic symmetries of physics. The present paper reports a new limit on the probability that PEP is violated by electrons, in a search for a shifted K$_\alpha$ line in copper: the presence of this line in the soft X-ray copper fluorescence would signal a transition to a ground state already occupied by 2 electrons. The obtained value, ${1/2} \beta^{2} \leq 4.5\times 10^{-28}$, improves the existing limit by almost two orders of magnitude.Comment: submitted to Phys. Lett.

Neutrino transport in accretion disks

We test approximate approaches to solving a neutrino transport problem that presents itself in the analysis of some accretion-disk models. Approximation #1 consists of replacing the full, angular- dependent, distribution function by a two-stream simulation, where the streams are respectively outwardly and inwardly directed, with angles $\cos \theta=\pm 1/\sqrt{3}$ to the vertical. In this approximation the full energy dependence of the distribution function is retained, as are the energy and temperature dependences of the scattering rates. Approximation #2, used in recent works on the subject, replaces the distribution function by an intensity function and the scattering rates by temperature-energy-averaged quantities. We compare the approximations to the results of solving the full Boltzmann equation. Under some interesting conditions, approximation #1 passes the test; approximation #2 does not. We utilize the results of our analysis to construct a toy model of a disc at a temperature and density such that relativistic particles are more abundant than nucleons, and dominate both the opacity and pressure. The nucleons will still provide most of the energy density. In the toy model we take the rate of heat generation (which drives the radiative transfer problem) to be proportional to the nucleon density. The model allows the simultaneous solution of the neutrino transport and hydrostatic equilibrium problems in a disk in which the nucleon density decreases approximately linearly as one moves from the median plane of the disk upwards, reaching zero on the upper boundary.Comment: 8 pages, 5 figures Parentheses added in eqs. 10-1

Corrosione sotto sforzo su conserve di tonno sott’olio in banda stagnata

Nel presente lavoro sono stati analizzati alcuni casi di corrosione sotto sforzo (Stress Corrosion Cracking, SCC)su scatolette metalliche in banda stagnata per la conserva di tonno sott’olio. I contenitori metalliciprovenivano da due diversi fabbricanti di barattoli, con carni di diversi operatori del settore alimentare.In entrambi i casi sono state osservate microcricche fini e ramificate da SCC a ridosso delle regioni disaldatura. Dalle analisi chimiche del liquido associato ai prodotti sono state rilevate quantità sensibili di faseacquosa ed elevate concentrazioni di fosfati e cloruri, assieme a concentrazioni minori di bicarbonati e solfati.Gli esami in microscopia elettronica in scansione (SEM/EDS) hanno evidenziato all’interno delle lesionila presenza di prodotti di corrosione dell’acciaio frammisti a quantità sensibili soprattutto di fosfati.Tra i fattori scatenanti l’innesco della SCC hanno sicuramente importanza la separazione di fase acquosae le autotensioni in regione di saldatura. Occorre però anche una specificità dell’accoppiamento metalloambientee, in tal senso, l’ipotesi più probabile è l’abbondante presenza di fosfati in un ambiente acquosopraticamente deaerato. Da quanto osservato, questi anioni sembrano indurre anche inversione di polaritàtra acciaio al carbonio e deposito di stagno. Nel lavoro sono infine dati suggerimenti per minimizzarel’insorgenza di tali danneggiamenti