Effectiveness of the Travelers Summer Research Fellowship Program in Preparing Premedical Students for a Career in Medicine

This study measured the effectiveness of the Travelers Summer Research Fellowship (T-SRF) Program for Premedical Students. No in-depth study has been conducted on the impact of its activities. A program-oriented qualitative summative evaluation approach and a logic model design were used to analyze survey responses for participants from four program years randomly chosen from 2000 to 2015, medical school enrollment records for participants from 1969 to 2015, physician practice locations for participants from 1969 to 2009, and interviews with a purposeful random sample of 10 physicians who were program participants from 2004 to 2008. Narrative inquiry consisted of audio recording, transcription, and analysis of individual accounts and participant experiences. The study revealed that participants valued interactions with physicians from backgrounds underrepresented in medicine. Talks on careers in medicine increased participants’ knowledge, and research projects helped develop skills. Cardiovascular physiology lectures introduced participants to the medical school learning experience and increased their confidence to apply to medical school successfully. T-SRF enhanced participants’ medical school applications and sharpened interviewing skills; 83% matriculated into medical school, 90% graduated, and 45% practice in HPSAs, MUAs/Ps, and rural areas. Recommendations included improving program orientation, making the cardiovascular physiology lectures and examinations more valuable experiences, re-evaluating the study skills curriculum, providing more clinical experiences, increasing the weekly stipend, improving maintenance of the alumni database, formally partnering admissions with the T-SRF program, helping alumni return to Weill Cornell as residents or fellows, and considering other ways to measure social concern. Further studies of T-SRF should be undertaken

Interventions to reduce the adverse psychosocial impact of driving cessation on older adults

As a result of our aging population, the coming years will see increasing numbers of older adults faced with the prospect of giving up driving due to poor health or functional limitations. Driving cessation has been associated with negative psychosocial outcomes for older adults including restricted mobility and depression. While several studies report evaluations of interventions designed to help older adults to drive safely for longer, there is a paucity of published research concerned with the design or implementation of intervention programs intended to reduce the negative consequences of driving cessation. This paper reviews cognitive and educational interventions designed to promote older driver safety, and discusses possible approaches to the design and implementation of clinical interventions for older adults who have ceased driving. A broad framework for adaptable interventions based on the theoretical tenets of social cognitive theory, with an emphasis on planning for cessation, problem-solving and the involvement of friends and family members is proposed

The origins of early modern experimental philosophy

This paper argues that early modern experimental philosophy emerged as the dominant member of a pair of methods in natural philosophy, the speculative versus the experimental, and that this pairing derives from an overarching distinction between speculative and operative philosophy that can be ultimately traced back to Aristotle. The paper examines the traditional classification of natural philosophy as a speculative discipline from the Stagirite to the seventeenth century; medieval and early modern attempts to articulate a scientia experimentalis; and the tensions in the classification of natural magic and mechanics that led to the introduction of an operative part of natural philosophy in the writings of Francis Bacon and John Johnston. The paper concludes with a summary of the salient discontinuities between the experimental/speculative distinction of the mid-seventeenth century and its predecessors and a statement of the developments that led to the ascendance of experimental philosophy from the 1660s

Co-morbidity of depression and anxiety in common age-related eye diseases: a population-based study of 662 adults

This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment.NHMRC (National Health and Medical Research Council of Australia

Incidence of self-reported brain injury and the relationship with substance abuse: findings from a longitudinal community survey

BACKGROUND: Traumatic or serious brain injury (BI) has persistent and well documented adverse outcomes, yet 'mild' or 'moderate' BI, which often does not result in hospital treatment, accounts for half the total days of disability attributed to BI. There are currently few data available from community samples on the incidence and correlates of these injuries. Therefore, the study aimed to assess the 1) incidence of self-reported mild (not requiring hospital admission) and moderate (admitted to hospital)) brain injury (BI), 2) causes of injury 3) physical health scores and 4) relationship between BI and problematic alcohol or marijuana use. METHODS: An Australian community sequential-cohort study (cohorts aged 20-24, 40-44 and 60-64 years at wave one) used a survey methodology to assess BI and substance use at baseline and four years later. RESULTS: Of the 7485 wave one participants, 89.7% were re-interviewed at wave two. There were 56 mild (230.8/100000 person-years) and 44 moderate BI (180.5/100000 person-years) reported between waves one and two. Males and those in the 20-24 year cohort had increased risk of BI. Sports injury was the most frequent cause of BI (40/100) with traffic accidents being a greater proportion of moderate (27%) than mild (7%) BI. Neither alcohol nor marijuana problems at wave one were predictors of BI. BI was not a predictor of developing substance use problems by wave two. CONCLUSIONS: BI were prevalent in this community sample, though the incidence declined with age. Factors associated with BI in community samples differ from those reported in clinical samples (e.g. typically traumatic brain injury with traffic accidents the predominate cause). Further, detailed evaluation of the health consequences of these injuries is warranted

DEVELOPMENT OF A HOLISTIC APPROACH TO ASSISTING FAMILIES WITH AN ALZHEIMER ' S SUFFERER

Alzheimer's is an irreversible degenerative disease in which brain cells die and are not replaced . It re sults in progressive impairment of memory, declining cognitive abilities, emotional distress and eventually, death. From an eco-systemic perspective the patient in an illness such as Alzheimer's Disease (AD) is the family rather than the sufferer alone. An intense period of suffering is experienced by all in the caring network as a sufferer progressively loses mental faculties,. emotional balance and motor abilities. This demands a more holistic response than simply medical management of the patient. Doctors, however, are often the first professionals to become aware of a patient's declining capacities, and possibly as much through reports by family members as from direct assessment of the patient. Within the evolution of a comprehensive response to AD, then, medical practitioners occupy a gatekeeper role. In tracking the evolution of support services for AD sufferers over a period of time in the Nelson Mandela Metropole, this article gives particular attention to a survey of general practitioners and physicians as well as psychiatrists and neurologists who explored, inter alia, their knowledge and use of support groups as part of treatment plans and their attitude to a holistic treatment approach

Is exposure to secondhand smoke associated with cognitive parameters of children and adolescents?—a systematic literature review

PURPOSE: Despite the known association of second hand smoke (SHS) with increased risk of ill health and mortality, the effects of SHS exposure on cognitive functioning in children and adolescents are unclear. Through a critical review of the literature we sought to determine whether a relationship exists between these variables. METHODS: The authors systematically reviewed articles (dated 1989–2012) that investigated the association between SHS exposure (including in utero due to SHS exposure by pregnant women) and performance on neurocognitive and academic tests. Eligible studies were identified from searches of Web of Knowledge, MEDLINE, Science Direct, Google Scholar, CINAHL, EMBASE, Zetoc, and Clinicaltrials.gov. RESULTS: Fifteen articles were identified, of which 12 showed inverse relationships between SHS and cognitive parameters. Prenatal SHS exposure was inversely associated with neurodevelopmental outcomes in young children, whereas postnatal SHS exposure was associated with poor academic achievement and neurocognitive performance in older children and adolescents. Furthermore, SHS exposure was associated with an increased risk of neurodevelopmental delay. CONCLUSIONS: Recommendations should be made to the public to avoid sources of SHS and future research should investigate interactions between SHS exposure and other risk factors for delayed neurodevelopment and poor cognitive performance

Intraindividual variability is a fundamental phenomenon of aging: Evidence from an 8-year longitudinal study across young, middle and older adulthood

Moment-to-moment intraindividual variability (IIV) in cognitive speed is a sensitive behavioural indicator of the integrity of the aging brain and brain damage, but little information is known about how IIV changes from being relatively low in young adulthood to substantially higher in older adulthood. We evaluated possible age group, sex, and task differences in IIV across adulthood using a large, neurologically normal, population-based sample evaluated thrice over 8 years. Multilevel modeling controlling for education, diabetes, hypertension, and anxiety and depressive symptoms showed expected age group differences in baseline IIV across the adult lifespan. Increase in IIV was not found until older adulthood on simple tasks, but was apparent even in the 40s on a more complex task. Females were more variable than males, but only at baseline. IIV in cognitive speed is a fundamental behavioural characteristic associated with growing older, even among healthy adults

The choice of self-rated health measures matter when predicting mortality: evidence from 10 years follow-up of the Australian longitudinal study of ageing

BACKGROUND Self-rated health (SRH) measures with different wording and reference points are often used as equivalent health indicators in public health surveys estimating health outcomes such as healthy life expectancies and mortality for older adults. Whilst the robust relationship between SRH and mortality is well established, it is not known how comparable different SRH items are in their relationship to mortality over time. We used a dynamic evaluation model to investigate the sensitivity of time-varying SRH measures with different reference points to predict mortality in older adults over time. METHODS We used seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004; N = 1733, 52.6% males). Cox regression analysis was used to evaluate the relationship between three time-varying SRH measures (global, age-comparative and self-comparative reference point) with mortality in older adults (65+ years). RESULTS After accounting for other mortality risk factors, poor global SRH ratings increased mortality risk by 2.83 times compared to excellent ratings. In contrast, the mortality relationship with age-comparative and self-comparative SRH was moderated by age, revealing that these comparative SRH measures did not independently predict mortality for adults over 75 years of age in adjusted models. CONCLUSIONS We found that a global measure of SRH not referenced to age or self is the best predictor of mortality, and is the most reliable measure of self-perceived health for longitudinal research and population health estimates of healthy life expectancy in older adults. Findings emphasize that the SRH measures are not equivalent measures of health status.This study was funded by the South Australian Health Commission, the Australian Rotary Health Research Fund, the US National Institute of Health (Grant No. AG 08523-02) and the National Health and Medical Research Council (NHMRC; Grant No.229936). KJA is supported by NHMRC Fellowship No.366756

Structuring social group work to assist socioeconomically deprived pupils with study behaviours

Thesis (B.A. Hons.(Social Work))--University of the Witwatersrand, Faculty of Arts, 197