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Communication crossroads: Exploring generational dynamics in nursing from the bedside to the boardroom.

Nurses have up to four times more patient contact than physicians, positioning them as central drivers of communication in health care. Effective communication directly influences patient outcomes, teamwork, staff engagement, and the overall care experience. Today's nurses operate within a highly diverse environment that includes four generations in the workforce and up to eight generations of patients, each with distinct values, expectations, and communication preferences. This article examines how generational differences shape communication across three key relational domains: peer-to-peer, nurse-to-patient, and nurse-to-leader interactions, and offers insights to strengthen collaboration, engagement, and quality of care.

Humans

Intergenerational studies of human birthweight from the 1958 birth cohort. II. Do parents who were twins have babies as heavy as those born to singletons?

OBJECTIVE: To ascertain whether maternal twinning influences the previously described association between the birthweight of singleton mothers and their infants. DESIGN AND SUBJECTS: The association between the birthweight of singleton parents and their offspring and that between twin parents and their offspring was compared using data from the 23-year-old sample of the 1958 British national birth cohort. The numbers available for full comparison were 1027 female and 611 male singleton cohort members, and 26 female and 17 male twin cohort members and their first singleton livebirths. RESULTS: Of the mothers who had been twins, half had been of low birthweight, and overall their mean weight was 700 g less than that of their singleton counterparts. Nevertheless, the mean birthweight of babies of twin mothers was 133 g, and of twin fathers 94 g, greater than of babies of corresponding singletons. For female, but not male, parents this difference persisted after adjustment for confounding variables. CONCLUSIONS: We suggest two possible reasons for the difference between the weight of babies of twin and singleton mothers. Firstly, the growth of twins becomes retarded late in pregnancy, possibly after a period critical in determining long-term reproductive effects. Secondly, the twin survivors were of higher birthweight than the original twin cohort, whilst the singleton survivors were more representative of all singleton births, thus introducing a possible bias.

Birth Weight

Coaggregation among periodontal pathogens, emphasizing Bacteroides gingivalis--Actinomyces viscosus cohesion on a saliva-coated mineral surface.

Teeth offer nonshedding surfaces on which a wide range of bacterial species accumulate as thick, cohesive plaques. Intergeneric coaggregation mediated by specific recognition between surface "cohesins" is thought to contribute to both the cohesiveness of plaque and the sequence in which bacteria colonize the tooth surface. There is some evidence that Gram-positive species, like the efficient tooth colonizer Actinomyces viscosus, enhance subsequent tooth colonization by the more virulent periodontal pathogen Bacteroides gingivalis. To study their mechanism of cohesion, we have developed an in vitro assay that measures the sequential binding of tritium-labeled B. gingivalis to A. viscosus adsorbed to saliva-coated hydroxyapatite beads, mimicking teeth (actinobeads). The assay yields equilibrium and kinetics data amenable to statistical analysis. The presence of A. viscosus significantly increased the number of B. gingivalis cells bound. Inhibition studies were conducted to test the sensitivity of binding to heat; to various saccharides and sugar amines; to proteolytic treatment of Bacteroides; and to incorporation of various chaotropic agents, increased KCl, and saliva in the suspension buffer. Heating the Bacteroides cells but not the actinobeads diminished Bacteroides adherence. Proteolysis and various saccharides had little, if any, effect. Among chaotropic agents, NaSCN and LiCl reduced numbers of cells bound by 40%, but tetramethylurea had no effect. Increasing the ionic concentration of KCl reduced binding by 50 to 60%. Diluted saliva showed a concentration-dependent inhibition of B. gingivalis adherence to actinobeads. To begin examining B. gingivalis surface molecules significant to these reactions, lipopolysaccharide was extracted by the phenol-water method and analyzed by biochemical assays and polyacrylamide gel electrophoresis.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces

Effect of granulocytopenia on oral microbial relationships in patients with acute leukemia.

Risk for acute infection increases as granulocyte levels decrease secondary to myelosuppressive chemotherapy in patients with acute nonlymphocytic leukemia (ANLL). Acute exacerbations of concomitant inflammatory periodontal diseases can result in systemic infections in these patients. However, host-oral bacterial relationships in the periodontium in patients with ANLL are not well understood. Twenty-one adult patients with ANLL with periodontal disease ranging from gingivitis to severe periodontitis were studied. Supragingival and subgingival plaque specimens were collected before chemotherapy (prechemotherapy), and at a defined midpoint of myelosuppression (midchemotherapy; day 14). All specimens were extensively cultured both aerobically and anaerobically. Data were submitted to a partial correlational analysis, controlling for covariation relation to oral hygiene intervention and antibiotic administration. Levels of total yeast exhibited a significant association with Staphylococcus sp. at supragingival sites midchemotherapy (r = 0.68, p less than or equal to 0.05). Levels of total yeast also correlated positively with Pseudomonas aeruginosa at subgingival sites both prechemotherapy (r = 0.70, p less than or equal to 0.01) and midchemotherapy (r = 0.61, p less than or equal to 0.05). Significant correlations of levels of Veillonella sp. with Neisseria sp. and gram-negative enteric bacilli were observed in both supragingival (r = 0.95, 0.77, p values less than or equal to 0.01) and subgingival (r = 0.69, 0.61, p values less than or equal to 0.05) plaque specimens midchemotherapy but not prechemotherapy. These data suggest that potentially pathogenic bacteria occur in plaque simultaneous with granulocytopenia in these patients. Multiple mechanisms, including intergeneric coaggregation and other symbiotic relationships, may influence infectivity of the mixed plaque flora and thus contribute to the oral ecology observed in these patients.

Adult

Impaired spermatogenesis in the finch hybrid L. castaneothorax by L. punctulata: transmission electron microscopy and genetic analysis.

As part of a project to determine whether there is any correlation between the form of hybrid sterility and the genetic relatedness of the parental species, we studied a male intrageneric hybrid between two finch species (Lonchura castaneothorax X L. punctulata), and compared the ultrastructural basis of hybrid sterility in this species with that reported by Swan [1985] for an intergeneric bird hybrid. In the latter study the sterility appeared to have an autoimmune basis, due to lack of Sertoli-Sertoli tight junctions. In the hybrid examined in the present study, lanthanum tracing showed that the junctions were tight. There was no testicular immune reaction; the parental species were almost identical in chromosomal constitution, having only a small inversion difference on chromosome 5, and only two structural protein differences could be detected through examination of the variation at 38 protein loci. Nevertheless, the hybrid appeared sterile and had the following ultrastructural testicular features. Intercellular bridges where present were usually abnormal in structure; centrioles in a centriole pair were arranged in parallel. Many spermatocytes and spermatids degenerated and were phagocytosed by Sertoli cells. Some spermatids progressed to mature testicular spermatozoa in sperm bundles, but commonly had multiple (2-4) axonemes or disrupted doublets and accessory fibers. The multiple axonemes present in most spermatids inserted separately into the base of the nucleus and the multiple centrioles were capable of organizing separate neck structures. We conclude that these cytological abnormalities were caused by genic effects and discuss why they appeared to be restricted to the germ line.

Animals

Maternal work outside the home and its effect on women and their families.

Up to 65% of American women work outside the home in paid employment, thus it is essential to examine the effect of that employment on the health of both women and their families. Employed women of all ages and occupations have a lower mortality rate and better reported and perceived health than women who do not work outside the home. The incidence of cardiovascular disease in women has not increased because of their increased participation in the work force. For hypertension, for psychological health, and for the incidence of coronary heart disease, women's emotional response to work is more important in predicting ill health than work itself. Working does not worsen women's health during pregnancy, and perinatal outcome may be improved for employed mothers. Middle-aged women who work have better measures of psychological and physical well-being. Employment seems to ahve a beneficial effect on the woman's family as well; more employed women confide in their husbands and report helpful or supportive responses from them. Multiple studies found no difference in many psychological and educational characteristics between children of working and nonworking mothers. One difference discovered was that children of working mothers are less likely to believe in "traditional" sex roles. There is no age group for which the employment of the mother is harmful, and at many ages if employment resulted in better maternal well-being, there is a definite gain for the children. More important than work itself is the mother's satisfaction with work, child care arrangements, and the home situation.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation Studies as Topic

Children's relationships with maternal grandparents: a longitudinal study of family structure and pubertal status effects.

This longitudinal study assessed the effects of parents' marital transitions and pubertal development on grandparent-grandchild relationships. 9- to 13-year-old children, their mothers, and maternal grandparents from 186 Caucasian, middle-class families including 73 intact families, 64 mother-custody, single-parent families and 49 stepfamilies completed questionnaires focusing on the degree of children's "relationship involvement" (perceived closeness and frequency of contact) with maternal grandparents at 2 time periods 13 months apart. Children also completed questionnaires 9 months later during a third interview. Grandparents, and especially grandfathers, were more involved with grandchildren from single-parent families (supporting the "latent function" hypothesis). The pubertal status results supported the "emotional distancing" hypothesis for grandfather-granddaughter relationships (higher pubertal status, less involvement) and the "stress buffer" hypothesis for grandsons' relationships with both grandparents (greater change in physical development, more involvement and greater perceived closeness).

Aged

Childhood history of abuse and child abuse screening.

Although a childhood history of abuse is related to parental child abuse, many parents with a history of abuse are not abusive. To determine the effects of a childhood history of abuse on adult child abuse potential, a modified Conflict Tactics Scale (CTS) and the Child Abuse Potential (CAP) Inventory were administered to matched groups of physically abusive mothers with a childhood history of abuse, nonabusive comparison mothers with a childhood history of abuse, and nonabusive comparison mothers without a childhood history of abuse. The modified CTS asked about childhood events and was used to confirm a childhood history of abuse. As expected, the CTS verbal and violence scales were higher for the abusive and nonabusive mothers with a childhood history of abuse. None of the CTS scores were different for the abusive and nonabusive mothers with a childhood history of abuse. In contrast, the CAP abuse scores distinguished between all three study groups. However, on the CAP factor scales, only the rigidity and unhappiness factors discriminated between abusive and nonabusive mothers with a childhood history of abuse. Nonabusive mothers with a childhood history of abuse were less rigid in their child expectations and were happier in their interpersonal relationships than abusive mothers with a childhood history of abuse.

Adult