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

Measuring the Educational Benefits of Diversity in Engineering Education: A Multi-Institutional Survey Analysis of Women and Underrepresented Minorities

Changing demographics of the U.S. population drive growing emphases on diversity in engineering education. Still, questions persist about the educational benefits of race and gender diversity within the student population, despite decades of supportive research. The present study sought to estimate the educational benefits that accrue to undergraduate engineering students who interact with diverse peers and perspectives. Furthermore, differences across gender and race were explored. Multi-institutional survey data were analyzed for over 100 undergraduate engineering students using a 2007 administration of the National Survey of Student Engagement (NSSE). Findings show that encouraging contact among students from different economic, social, or racial/ethnic backgrounds can produce greater perceived learning gains amongst engineering students

The Influence of Rejection Episodes in Recipients of Bilateral Corneal Grafts

Author version made available in accordance with Publisher copyright policy.We investigated whether a rejection episode in one graft was associated with rejection in the other graft, in recipients with bilateral corneal transplants. In a prospectively maintained, national register of 14 865 followed corneal grafts, 1476 patients with bilateral penetrating corneal grafts were identified. Occurrence of rejection was a risk factor for graft failure (p < 0.0001). Logistic regression was used to calculate the adjusted odds ratio for rejection in one eye following rejection in the other eye. In the subset of 1118 patients with bilateral grafts but no history of previous grafts or rejections in either eye, the adjusted odds ratio for a rejection episode in the first eye following rejection in the second was 3.27 (95% confidence interval, CI 1.85, 5.79; p < 0.001). The adjusted odds ratio was 2.04 (95% CI 1.07, 3.91; p = 0.03) for rejection in the second eye following rejection in the first. The median time between the first rejection episode in one eye and the first rejection episode in the other eye was 15 months. Patients with bilateral corneal grafts who suffer a graft rejection episode in one eye are at significantly greater odds of suffering a rejection episode in the other corneal transplant

The Australian Corneal Graft Registry 2007 Report

The Australian Corneal Graft Registry opened in May 1985 and thus has now been in operation for over 22 years. The census date for this report was 01/09/2006. Over the years, we have collected data on more than 18,500 corneal grafts. The majority of corneal grafts registered have been penetrating, but increasing numbers of lamellar and limbal grafts have also been registered over recent years, as patterns of surgical practice change. At registration, we seek information on the recipient, the donor, the eye bank practices and the operative procedure. Follow-up then occurs at approximately yearly intervals for an indefinite period, and ceases upon loss of the graft, or the death or loss-to-follow-up of the patient. At each round of follow-up, we request information on the graft and visual outcome, and upon relevant post-operative events and treatments. The data are entered into an Access database and checked for consistency. Descriptive, univariate and multivariate analyses are subsequently performed using SPSS and Stata software, and the report is eventually collated.This report was published with assistance from The Commonwealth Department of Health and Ageing

A Comparison of Arch Height Index Measures Between Collegiate Basketball and National Basketball Association Players

The rate of game related basketball injuries is 2xs greater in professionals than collegiate players and the most common injuries occur in the lower extremity. Arch mechanics are often cited as a related factor and the Arch Height Index Measurement System (AHIMS) is a reliable and valid system for quantifying mobility. However, normative or comparative values for basketball athletes have not been reported.https://ecommons.udayton.edu/dpt_symposium/1028/thumbnail.jp

Job Satisfaction and Burnout Among VA and Community Mental Health Workers

Building on two independent studies, we compared burnout and job satisfaction of 66 VA staff and 86 community mental health center staff in the same city. VA staff reported significantly greater job satisfaction and accomplishment, less emotional exhaustion and lower likelihood of leaving their job. Sources of work satisfaction were similar (primarily working with clients, helping/witnessing change). VA staff reported fewer challenges with job-related aspects (e.g. flexibility, pay) but more challenges with administration. Community mental health administrators and policymakers may need to address job-related concerns (e.g. pay) whereas VA administrators may focus on reducing, and helping workers navigate, administrative policies

Vegetation and peat characteristics of restiad bogs on Chatham Island (Rekohu), New Zealand

Restiad bogs dominated by Sporadanthus traversii on Chatham Island, New Zealand, were sampled to correlate vegetation patterns and peat properties, and to compare with restiad systems dominated by Sporadanthus ferrugineus and Empodisma minus in the Waikato region, North Island, New Zealand. Classification and ordination resulted in five groups that reflected a disturbance gradient. The largest S. traversii group, which comprised plots from central, relatively intact bogs, had the lowest levels of total nitrogen (mean 1.20 mg cm-3), total phosphorus (mean 0.057 mg cm-3), total potassium (mean 0.083 mg cm-3), and available phosphorus (mean 18.6 μg cm-3). Modification by drainage, stock, and fires resulted in a decline of S. traversii and an increase of Gleichenia dicarpa fern cover, together with elevated peat nutrient levels and higher bulk density. Compared with peat dominated by Sporadanthus ferrugineus or Empodisma minus in relatively unmodified Waikato restiad bogs, Chatham Island peat under S. traversii has significantly higher total potassium, total nitrogen, available phosphorus, bulk density, and von Post decomposition indices, and significantly lower pH. Sporadanthus traversii and Empodisma minus have similar ecological roles in restiad bog development, occupying a relatively wide nutrient range, and regenerating readily from seed after fire. Despite differences in root morphology, S. traversii and E. minus are the major peat formers in raised restiad bogs on Chatham Island and in Waikato, respectively, and could be regarded as ecological equivalents