Physical Therapists’ Nonverbal Communication Predicts Geriatric Patients’ Health Outcomes

Two studies explored the link between health care providers' patterns of nonverbal communication and therapeutic efficacy. In Study 1, physical therapists were videotaped during a session with a client. Brief samples of therapists' nonverbal behavior were rated by naive judges. Judges' ratings were then correlated with clients' physical, cognitive, and psychological functioning at admission, at discharge, and at 3 months following discharge. Therapists' distancing behavior was strongly correlated with short- and long-term decreases in their clients' physical and cognitive functioning. Distancing was expressed through a pattern of not smiling and looking away from the client. In contrast, facial expressiveness, as revealed through smiling, nodding, and frowning, was associated with short- and long-term improvements in functioning. In Study 2, elderly subjects perceived distancing behaviors of therapists more negatively than positive behaviors.Psycholog

Functional outcomes of acute medical illness and hospitalization in older persons

BACKGROUND: Short-stay hospitalization in older patients is frequently associated with a loss of function, which can lead to a need for postdischarge assistance and longer-term institutionalization. Because little is known about this adverse outcome of hospitalization, this study was conducted to (1) determine the discharge and 3-month postdischarge functional outcomes for a large cohort of older persons hospitalized for medical illness, (2) determine the extent to which patients were able to recover to preadmission levels of functioning after hospital discharge, and (3) identify the patient factors associated with an increased risk of developing disability associated with acute illness and hospitalization. METHODS: A total of 1279 community-dwelling patients, aged 70 years and older, hospitalized for acute medical illness were enrolled in this multicenter, prospective cohort study. Functional measurements obtained at discharge (Activities of Daily Living) and at 3 months after discharge (Activities of Daily Living and Instrumental Activities of Daily Living) were compared with a preadmission baseline level of functioning to document loss and recovery of functioning. RESULTS: At discharge, 59% of the study population reported no change, 10% improved, and 31% declined in Activities of Daily Living when compared with the preadmission baseline. At the 3-month follow-up, 51% of the original study population, for whom postdischarge data were available (n=1206), were found to have died (11%) or to report new Activities of Daily Living and/or Instrumental Activities of Daily Living disabilities (40%) when compared with the preadmission baseline. Among survivors, 19% reported a new Activities of Daily Living and 40% reported a new Instrumental Activities of Daily Living disability at follow-up. The 3-month outcomes were the result of the loss of function during the index hospitalization, the failure of many patients to recover after discharge, and the development of new postdischarge disabilities. Patients at greatest risk of adverse functional outcomes at follow-up were older, had preadmission Instrumental Activities of Daily Living disabilities and lower mental status scores on admission, and had been rehospitalized. CONCLUSION: This study documents a high incidence of functional decline after hospitalization for acute medial illness. Although there are several potential explanations for these findings, this study suggests a need to reexamine current inpatient and postdischarge practices that might influence the functioning of older patients

Auditory generalization gradients for response latency in the monkey

Two monkeys were trained to press and hold a response key in the presence of a light and to release it at the onset of a pure tone. Initially, all responses with latencies shorter than 1 sec were reinforced without regard to the frequency of the pure tone, and the intensity of the pure tone that resulted in equal latencies at each frequency was determined. The second stage of the experiment consisted of discrimination training, during which releases to one pure-tone frequency (positive stimulus) were reinforced and releases to a second frequency (negative stimulus) were extinguished. Median latencies to the negative stimulus slowly increased as did the variability of the latency distribution for the negative stimulus. There was no evidence of a concurrent decrease in latencies to the positive stimulus indicative of behavioral contrast. The third part of the experiment consisted of determining maintained generalization gradients by increasing the number of nonreinforcement stimuli. The gradients that eventually resulted showed approximately equal latencies to all frequencies of the negative stimulus and shorter latencies to the positive stimulus frequency

Pilot Analysis Of Global Ecosystems

This report is also available at http://www.wri.org/wr2000 and http://www.ifpri.org iv Pilot Analysis of Global Ecosystems Pilot Analysis of Global Ecosystems (PAGE) A series of five technical reports, available in print and on-line at http://www.wri.org/wr200