Changes in medical stability upon admission to a rehabilitation unit

The implementation of Medicare's prospective payment system in acute care has coincided with a steady increase in medically unstable admissions to our freestanding rehabilitation facility. We investigated the consequences of these admissions by collecting medical information regarding transfers beginning in 1983. Patients requiring transfer back to the acute setting within 1 day of admission were considered medically unstable and their charts were reviewed. The number of patients requiring transfer back within 1 day increased from 1.5% of all first admissions to 3.1% in 1988 (Mantel - Haenszel chi 2 = 8.03, (df = 1), p < .01), but the increase among Medicare patients alone was not significant. This progressive increase was most pronounced in the cerebrovascular accident and spinal cord injury populations. Beginning in 1988, an intensified preadmission evaluation program was implemented, resulting in a significant decline in unstable patient transfers from hospitals where our consultants were on staff. Physiatric consultations at referral institutions decreased the number of unstable patients at admission.     

Family practice physicians' firearm safety counseling beliefs and behaviors

The purpose of this study was to identify family physicians' firearm safety counseling beliefs and behaviors. A survey was mailed to a random sample of 600 members of the American Academy of Family Physicians. A three wave mailing technique was used to maximize the response rate and yielded 271 usable surveys (55% response rate). Outcome measures included training experience in firearm safety counseling, the prevalence of firearm safety counseling by family physicians, and their perceptions regarding such counseling. The majority (78%) of family physicians lacked formal training on how to counsel patients about firearm safety and 49% believed more time should be spent in residency programs on firearm safety counseling. The majority (84%) of respondents never or rarely counseled patients on firearm safety and 50% believed firearm safety counseling should be a low priority in their delivery of primary care. The majority of respondents did not regularly counsel patients about firearm safety, did not believe firearm safety counseling should be a priority, and did not believe firearm safety counseling would be effective in reducing firearm-related trauma.     

Resection of the right middle lobe and lingula for mycobacterial infection

BACKGROUND: In a series of 229 patients infected with mycobacterial organisms, we noted a specific female phenotype that involves isolated infections of the middle lobe and lingula. METHODS: Thirteen patients were found to have infections of the middle lobe, lingula, or both. All of them were infected with Mycobacterium other then Mycobacterium tuberculosis, all were women, 12 of the 13 were slender, and most had variable combinations of skeletal abnormalities. All underwent resection of the middle lobe, lingula, or both. RESULTS: There were no operative deaths. Only 2 patients have had reactivation requiring additional antibiotic therapy. All patients have had a decreased number of pulmonary infections in the postoperative period. Anatomic findings at operation included a complete major fissure and at least a partially complete minor fissure with middle lobe resections or an elongated lingula. CONCLUSIONS: Mycobacterial infection of the middle lobe and lingula is primarily a disease of asthenic women and is often associated with skeletal abnormalities and complete fissures or an elongated lingula. We recommend that surgical intervention be performed early once the condition is identified.     

Planning prompts and indexed terms in textbook search tasks.

Text search is a type of strategic reading that involves locating specific goal-relevant information. Previous research has indicated that college and high school students often exhibit inefficient or unsuccessful text-search performance. Consequently, the effects of 2 manipulations on text-search performance were investigated: (1) the presence of indexed terms in a text-search task and (2) the use of a planning prompt before beginning a task. 34 college students engaged in 6 text-search tasks. Half of these tasks contained terms that could be used in an index; half required that a search term be generated. Half of the subjects were randomly assigned to a prompt condition in which they were prompted to plan their search before beginning each task. The results indicated that a planning prompt raised the success level of search performance, as did the presence of terms that were searchable in the textbook's index. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding community receptivity to water re-use: Ku-ring-gai Council case study.

This social research project investigated community receptivity to using rainwater and greywater as alternative domestic water sources. It was focused in the Ku-ring-gai local government area in northern Sydney, and involved a household questionnaire followed by community leader interviews and resident focus groups. Trends, such as a prolonged drought and increasing population, compound the current crisis and concern facing Sydney's available water supply. Substitution of domestic potable water has been promoted as part of the solution. The research results revealed that community receptivity was highest for external uses, such as watering gardens and flushing toilets, and progressively decreased with increasing personal contact. Receptivity to greywater reuse fell more rapidly with the community believing there was a higher health risk associated with its use. Gender and cultural background were revealed as significant variables and give insight into the design of strategies to target these demographic groups. This evidence provides a reliable stocktake of current receptivity revealing that the community has good awareness and positive association with water reuse for many household activities. This now needs to be harnessed through programs targeted at developing skills, resources and motivation for new water reuse practices and technologies across diverse social groupings.     

A Profile of Psychologists' Views of Critical Risk Factors for Completed Suicide in Older Adults.

The ability to accurately and reliably predict whether an older adult will commit suicide has eluded clinicians and researchers. A random national sample of psychologists who work with older adults was surveyed regarding their perception of 36 risk factors for completed suicide and indirect self-destructive behavior in older adults. This study produced a profile of psychologists' assessment and treatment practices when working with suicidal older adults. Determining what psychologists consider to be the most salient risk factors for completed suicide is important in identifying a minimum standard that clinicians should follow when assessing older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Successful Aging

This issue's Works in Progress department presents six abstracts for projects that are developing interesting solutions to the elderly's quality of life challenges. The first two abstracts discuss projects that will help provide the elderly with freedom and independence by instrumenting their environments with supportive technology. The next two abstracts discuss projects building specialized user interfaces for addressing some of the challenges associated with aging, such as vision impairment. The final two abstracts present projects that will aid independence for the elderly by providing remote monitoring and assistance.     

Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults.

The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The history of wireless power transmission

The history of wireless power transmission at microwave frequencies is reviewed with emphasis upon the time period starting with the post World War II efforts to use the new microwave technology developed during the war. A nationally televised demonstration of a microwave powered helicopter at the Spencer Laboratory of the Raytheon Co., in 1964 was the result of these early efforts and broadly introduced the concept of wireless power transmission to scientific and engineering communities and to the public. Subsequent development efforts centered on improving the efficiency of the interconversion of d.c. and microwave power at the ends of the system to reach a demonstrated overall d.c. to d.c. system efficiency of 54% in 1974. The response to the requirements of applications such as the Solar Power Satellite and high altitude microwave powered aircraft have changed the direction of technology development and greatly expanded the technology base. Recent and current efforts are centered on examining the use of higher frequencies than the baseline 2.45 GHz, and in reducing the system costs at 2.45 GHz.