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

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

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

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

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

Invalid party wall awards and how to avoid them

Considers the reasons for the invalidity of party wall awards. Examines decided cases under earlier party wall legislation in the context of the Party Wall etc. Act 1996. Explains invalidity on the basis of an excess of the surveyors’ statutory authority. Defines this authority in terms of jurisdiction and power. Demonstrates the limits of the surveyors’ authority and emphasises the importance of strict compliance with statutory procedures. Concludes that surveyors should adopt an inquisitive and analytical approach to the scope of their authority to avoid the possibility of invalid awards. Echoes John Anstey’s earlier warning that surveyors should avoid a broad-brush approach to their duties which will only leave them “covered in soot”