Use of palliative care and hospice among surgical and medical specialties in the Veterans Health Administration.

Importance: Many hospitals have undertaken initiatives to improve care during the end of life, recognizing that some individuals have unique needs that are often not met in acute inpatient care settings. Studies of surgical patients have shown this population to receive palliative care at reduced rates in comparison with medical patients.

Objective: To determine differences in the use of palliative care and hospice between surgical and medical patients in an integrated health care system.

NEUROPSYCHOLOGICAL PREDICTORS OF SAFETY IN URBAN LEFT-TURN SCENARIOS.

Left turns at urban intersections can be dangerous, especially when views are obstructed or pedestrians are present. Impairments in driver vision, motor, and cognition functions may further increase left-turn risk. We examined this problem in a simulated environment that included left-turn scenarios to study the driving behaviors of 28 drivers, ages 37 to 88 years, six of whom had "Useful Field of View" (UFOV) impairments.

Effect of pH on surface characteristics of switchgrass-derived biochars produced by fast pyrolysis.

Surface properties of switchgrass-derived biochars produced at fast pyrolysis temperatures of 450, 600 and 800 °C were characterized at different solution pHs in order to determine the structural and chemical changes of artificially-weathered biochars when incorporated into soil. As biochars were acidified from pH 7 to 3, crystalline minerals dissolved slowly releasing nutrients; however, residual minerals were still detected in biochars produced at higher pyrolysis temperatures after pH treatment. Moreover, the amount of exchangeable bases and other inorganic compounds released from the biochars increased when pH decreased.

Reported experiences with prenatal care: is there a difference in patient satisfaction based on racial and ethnic background?

Pregnant women were queried to determine if racial and ethnic disparities exist in prenatal care by assessing their satisfaction in private and clinic practices. An anonymous survey was distributed in both English and Spanish and focused on demographics, satisfaction and cultural sensitivity. A total of 273 surveys were collected.

Neuropsychological assessment of driving safety risk in older adults with and without neurologic disease.

Decline in cognitive abilities can be an important contributor to the driving problems encountered by older adults, and neuropsychological assessment may provide a practical approach to evaluating this aspect of driving safety risk. The purpose of the present study was to evaluate several commonly used neuropsychological tests in the assessment of driving safety risk in older adults with and without neurological disease. A further goal of this study was to identify brief combinations of neuropsychological tests that sample performances in key functional domains and thus could be used to efficiently assess driving safety risk.

Barriers to breastfeeding in a resident clinic.

Despite the known health benefits for mother and infant, compliance with exclusive breastfeeding continues to challenge many healthcare providers. In an ongoing attempt to maintain the goals of the Healthy People 2010 initiative, our institution set out to identify patients with suboptimal breastfeeding rates in order to recognize potential barriers. Review of breastfeeding rates at the time of discharge noted significantly lower participation by clinic patients.

Differential contribution of dendritic cell CD1d to NKT cell-enhanced humoral immunity and CD8+ T cell activation.

CD1d-restricted type I NKT cells provide help for specific antibody production. B cells, which have captured and presented a T-dependent, antigen-derived peptide on MHC class II and CD1d-binding glycolipid α-GC on CD1d, respectively, activate Th and NKT cells to elicit B cell help. However, the role of the DC CD1d in humoral immunity remains unknown.

Distracted driving in elderly and middle-aged drivers.

Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention.

Predictors of driving outcomes in advancing age.

This study aimed to develop predictive models for real-life driving outcomes in older drivers. Demographics, driving history, on-road driving errors, and performance on visual, motor, and neuropsychological test scores at baseline were assessed in 100 older drivers (ages 65-89 years [72.7]).

Cognitive functioning predicts driver safety on road tests 1 and 2 years later.

Objectives: To describe longitudinal changes in mean level and evaluate rank-order stability in potential predictors of driving safety (visual sensory, motor, visual attention, and cognitive functioning) and safety errors during an 18-mile on-road driving test in older adults and to evaluate the relative predictive power of earlier visual sensory, motor, visual attention, and cognitive functioning on future safety errors, controlling for earlier driving capacity.

Design: Three-year longitudinal observational study.

Setting: Large teaching hospital in the Midwest.

Global biogeography and quantitative seasonal dynamics of Gemmatimonadetes in soil.

Bacteria belonging to phylum Gemmatimonadetes comprise approximately 2% of soil bacterial communities. However, little is known of their ecology due to a lack of cultured representation. Here we present evidence from biogeographical analyses and seasonal quantification of Gemmatimonadetes in soils, which suggests an adaptation to low soil moisture.

Reduction of CD1d expression in vivo minimally affects NKT-enhanced antibody production but boosts B-cell memory.

The CD1d-binding glycolipid α-galactosylceramide exerts potent adjuvant effects on T-dependent humoral immunity. The mechanism is driven by cognate interaction between CD1d-expressing B cells and TCR-expressing type I CD1d-restricted NKT cells. Thus, far positive effects of alpha-galactosylceramide have been observed on initial and sustained antibody titers as well as B-cell memory.

Neuropsychological predictors of driving errors in older adults.

Objectives: To identify neuropsychological factors associated with driving errors in older adults.

Design: Cross-sectional observational study.

Setting: Neuropsychological assessment laboratory and an instrumented vehicle on a 35-mile route on urban and rural roads.

ASCERTAINMENT OF ON-ROAD SAFETY ERRORS BASED ON VIDEO REVIEW.

Using an instrumented vehicle, we have studied several aspects of the on-road performance of healthy and diseased elderly drivers. One goal from such studies is to ascertain the type and frequency of driving safety errors. Because the judgment of such errors is somewhat subjective, we applied a taxonomy system of 15 general safety error categories and 76 specific safety error types.

Gender preferences in ObGyn clinic vs private patients.

Purpose: To determine whether clinic patients, compared to private practice patients, are more likely to prefer seeing a female physician.

Method: Connecticut women were surveyed from August through September 2001, inclusive, about the attributes they desire in an ObGyn provider. Clinic patient responses were analyzed in comparison to private patients.

Qualities and attributes desired in menopause clinicians.

Objective: To assess the qualities and attributes desired in menopause clinicians.

Design: Women > or =45 years of age (n=72) were surveyed about the qualities and attributes desired in their physician. Surveys were performed in physician waiting rooms in Connecticut.

Do women prefer care from female or male obstetrician-gynecologists? A study of patient gender preference.

Objective: To determine whether men should be encouraged to enter the medical specialty of obstetrics and gynecology.

Methods: A self-administered survey was designed for and distributed to patients (N=264) in 13 obstetrics and gynecology waiting rooms in Connecticut. The survey was used to determine whether there were any patient preferences with regard to the gender of physicians providing obstetric and gynecologic care within this population.

Predicted impact and evaluation of North Carolina's phosphorus indexing tool.

Increased concern about potential losses of phosphorus (P) from agricultural fields receiving animal waste has resulted in the implementation of new state and federal regulations related to nutrient management. In response to strengthened nutrient management standards that require consideration of P, North Carolina has developed a site-specific P indexing system called the Phosphorus Loss Assessment Tool (PLAT) to predict relative amounts of potential P loss from agricultural fields. The purpose of this study was to apply the PLAT index on farms throughout North Carolina in an attempt to predict the percentage and types of farms that will be forced to change management practices due to implementation of new regulations.