Predictors of health care provider anticipatory guidance provision for older drivers

Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs.

Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265).

Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults.

Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study.     

Inflammation biomarkers associated with arsenic exposure by drinking water and respiratory outcomes in indigenous children from three Yaqui villages in southern Sonora,México

Environmental Science and Pollution Research - Environmental arsenic exposure in adults and children has been associated with a reduction in the expression of club cell secretory protein (CC16) and...     

The impact of climate change on three indicator Galliformes species in the northern highlands of Pakistan

The rise in global temperature is one of the main threats of extinction to many vulnerable species by the twenty-first century. The negative impacts of climate change on the northern highlands of Pakistan (NHP) could change the species composition. Range shifts and range reduction in the forested landscapes will dramatically affect the distribution of forest-dwelling species, including the Galliformes (ground birds). Three Galliformes (e.g., Lophophorus impejanus, Pucrasia macrolopha, and Tragopan melanocephalus) are indicator species of the environment and currently distributed in NHP. For this study, we used Maximum Entropy Model (MaxEnt) to simulate the current (average for 1960–1990) and future (in 2050 and 2070) distributions of the species using three General Circulation Models (GCMs) and two climate change scenarios, i.e., RCP4.5 (moderate carbon emission scenario) and RCP8.5 (peak carbon emission scenario). Our results indicated that (i) under all three climate scenarios, species distribution was predicted to both reduce and shift towards higher altitudes. (ii) Across the provinces in the NHP, the species were predicted to average lose around one-third (35%) in 2050 and one-half (47%) by 2070 of the current suitable habitat. (iii) The maximum area of climate refugia was projected between the altitudinal range of 2000 to 4000 m and predicted to shift towards higher altitudes primarily?>?3000 m in the future. Our results help inform management plans and conservation strategies for mitigating the impacts of climate change on three indicator Galliforms species in the NHP.

     

Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

A review of medical error taxonomies: A human factors perspective

Although a large number of medical error taxonomies have been published, there is little evidence to suggest that these taxonomies have been systematically compared. This paper describes a study comparing 26 medical error taxonomies using a human factors perspective. The taxonomies were examined to determine if they classified systemic factors of medical errors and if they utilized theoretical error concepts in their classifications. Scope of classification was also examined. It was found that two-thirds of the taxonomies classified systemic factors of medical errors and only a third utilized theoretical error concepts. Medical error taxonomies based on theoretical error concepts were more likely to be generic in applicability and also more likely to classify systemic factors and psychological error mechanisms of medical errors. In addition to terminology, the medical error taxonomies also varied in terms of domain-specificity, granularity, and developmental process. Different medical error taxonomies provide different information; how these differences affect medical error management needs to be investigated.     

Ecological impacts on the limpet Lottia gigantea populations: human pressure over a broad scale on island and mainland intertidal zones

Here long-term monitoring data taken at 33 sites in southern and central California coast and islands were used to evaluate the size structure of the large intertidal limpet, Lottia gigantea in restricted-access and in easily accessible intertidal zones that encompass a wide range of ecological variables. Using multi-dimensional analysis of population size structures, we found that sites on islands and strictly protected mainland sites have significantly larger median limpet sizes and a greater range of limpet sizes than unprotected mainland sites, while no pattern occurs in latitudinal or regional comparison of sites. Although intertidal predators such as oystercatchers were not the primary focus of the monitoring efforts, extensive natural history notes taken during sampling visits support the argument that predation was not a primary cause for the size structure differences. Finally, substratum differences were determined not to have biased the observation of larger limpets in protected sites. In regard to human interactions with limpets, we conclude that the degree of enforcement against poaching is the better predictor of limpet size structure than proximity to population centers or visitation to intertidal sites.     

Colony size affects division of labour in the ponerine ant<Emphasis Type="Italic"> Rhytidoponera metallica</Emphasis>

In theory, larger colonies of social insects should have greater colony organisation. While inter-specific comparative studies provide support for this idea, there is little direct intra-specific evidence. We investigated differences in task specialisation between large (>450 workers) and small (<80 workers) colonies of the ponerine ant Rhytidoponera metallica. Observations of individually marked young or old workers revealed greater task specialisation in large colonies. Age polyethism was detected in large but not small colonies. In large colonies, old workers spent significantly more time foraging than young workers did, while young workers spent more time caring for brood. In small colonies, young and old workers spent a similar amount of time foraging and caring for brood. This difference in task allocation patterns in large and small colonies was associated with a difference in contact rates between workers. Workers in small colonies have a lower contact rate between nestmates and a greater variability in time between contacts than workers from large colonies.     

Vegetation Placement for Summer Built Surface Temperature Moderation in an Urban Microclimate

Urban vegetation can mitigate increases in summer air temperature by reducing the solar gain received by buildings. To quantify the temperature-moderating influence of city trees and vine-covered buildings, a total of 13 pairs of temperature loggers were installed on the surfaces of eight buildings in downtown Toronto, Canada, for 6 months during the summer of 2008. One logger in each pair was shaded by vegetation while the other measured built surface temperature in full sunlight. We investigated the temperature-moderating benefits of solitary mature trees, clusters of trees, and perennial vines using a linear-mixed model and a multiple regression analysis of degree hour difference. We then assessed the temperature-moderating effect of leaf area, plant size and proximity to building, and plant location relative to solar path. During a period of high solar intensity, we measured an average temperature differential of 11.7 °C, with as many as 10–12 h of sustained cooler built surface temperatures. Vegetation on the west-facing aspect of built structures provided the greatest temperature moderation, with maximum benefit (peak temperature difference) occurring late in the afternoon. Large mature trees growing within 5 m of buildings showed the greatest ability to moderate built surface temperature, with those growing in clusters delivering limited additional benefit compared with isolated trees. Perennial vines proved as effective as trees at moderating rise in built surface temperature to the south and west sides of buildings, providing an attractive alternative to shade trees where soil volume and space are limited.     

Quantifying iridescent coloration in animals: a method for improving repeatability

Quantification of animal colors is important to a variety of fields of research, especially those dealing with visual communication and sexual selection. Most animal colors are easily measured using well-established spectrophotometric techniques. However, the unique characteristics of iridescent colors present particular challenges and opportunities to quantify novel color metrics. Due to the fine-scale angle dependence of iridescent coloration, color metrics, such as hue and brightness, must be measured using methods that allow for repeatable comparison across individuals (e.g., by carefully controlling and measuring viewing geometry). Here, we explain how the optical characteristics of iridescent colors should be considered when developing measurement techniques, describe the pitfalls of some commonly used techniques, and recommend improved methods and metrics (angular degree of color change and breadth of reflectance) for quantifying iridescent color. In particular, most studies of iridescent birds to date have used less than ideal procedures and have not provided repeatability estimates for their methods. For example, we demonstrate here that measuring coloration from overlapping patches of iridescent feathers may be problematic, and we argue against methods that do not carefully control viewing geometry. We recommend measuring iridescence at maximal reflectance angles using an apparatus that allows for sample rotation, and we compare this technique to some other commonly used methods using iridescent gorget and crown feathers from Anna’s hummingbirds (Calypte anna). Our apparatus allows for the quantification of angular color change, and we found that maximal reflectance measurements using single feathers are highly repeatable both within feather samples and among samples within an individual.     

A protein signal triggers sexual reproduction in Brachionus plicatilis (Rotifera)

The defining feature of the life cycle in monogonont rotifers such as Brachionus plicatilis (Muller) is alternation of asexual and sexual reproduction (mixis). Why sex is maintained in such life cycles is an important unsolved evolutionary question and one especially amenable to experimental analysis. Mixis is induced by a chemical signal produced by the rotifers which accumulates to threshold levels at high population densities. The chemical features of this signal were characterized using size exclusion, enzymatic degradation, protease protection assays, selective binding to anion ion exchange and C3 reversed phase HPLC columns, and the sequence of 17 N-terminal amino acids. These studies were carried out over two years beginning in 2003 using B. plicatilis Russian strain. When rotifer-conditioned medium was treated with proteinase K, its mixis-inducing ability was reduced by 70%. Proteinase K was added to medium auto-conditioned by 1 female ml⁻¹ where typically 17% of daughters became mictic and mixis was reduced to 1%. A cocktail of protease inhibitors added to conditioned medium significantly reduced degradation of the mixis signal by natural proteases. Conditioned medium subjected to ultrafiltration retained mixis-inducing activity in the >10 kDa fraction, but the <10 kDa fraction had no significant activity. The putative mixis signal bound to an anion exchange column, eluting off at 0.72 M NaCl. These fractions were further separated on a C3 reversed phase HPLC column and mixis-inducing activity was associated with a 39 kDa protein. Seventeen amino acids from the N-terminus have strong similarity to a steroidogenesis-inducing protein isolated from human ovarian follicular fluid. The 39 kDa protein is an excellent candidate for the rotifer mixis induction signal.