[Unveiled : the look of seniors and caregivers on daily communication and manifestations of implicit ageism]. / À mots couverts: le regard des aînés et des soignants sur la communication quotidienne et ses manifestations d'âgisme implicite.

The aim of this exploratory study was to better understand interpersonal communication between frail elders and caregivers in the context of long-term care giving. In addition, in light of the Communication Accommodation Theory, the goal was to determine the extent to which communication can be a transmitter of ageism, particularly of implicit ageism. A total of 26 semi-structured interviews were conducted among elders and caregivers of a Quebec long-term care facility. Results suggest a close convergence between the perception of seniors and caregivers in regards to a quasi total absence of daily communication and moreover, in regards to the highly instrumental nature of this same communication. Finally, results of the content analysis also suggest that implicit ageism is indeed reflected in interpersonal communication between frail elders and caregivers.

Baroreflex resetting after successful surgical repair of tetralogy of Fallot.

BACKGROUND: Tetralogy of Fallot (TOF) and its surgical repair are associated with alterations in right ventricular systolic and diastolic functions. The cardiopulmonary baroreflex describes the peripheral vasoconstriction response to the volume-unloading deactivation of left and possibly right ventricular receptors. Alterations in cardiac geometry or distensibility and pulmonary vasculature of operated TOF may affect the mechanical stimulation of sensitive cardiopulmonary receptors leading to an impaired baroreflex function. There has to date been no report on the integrity of baroreflex function in postoperative TOF. OBJECTIVE: To characterize the combined cardiopulmonary and baroreflex response of patients successfully operated for TOF in early childhood to central volume unloading using graded lower body negative pressure (LBNP) application. METHODS: Fifteen patients operated on for TOF (mean+/-SEM) 15.7+/-1.4 years previously and 13 healthy age-matched control subjects were submitted to four consecutive 5 min LBNP applications at -10, -20, -30 and -40 mmHg. Forearm blood flow and vascular resistance, left ventricle end-diastolic diameter (LVEDD), arterial blood pressure and heart rate were obtained. RESULTS: TOF exhibited a lower LVEDD (42.7+/-1.5 mm) than control subjects (51.9+/-1.6). The forearm vascular resistance to LVEDD relationship was shifted left and upward in TOF compared with that of control subjects, but the slope of the relationship was not different between groups. LBNP -40 mmHg induced a lesser change in heart rate in TOF (+10.6+/-1.5%) than in control subjects (+14.7 +/-2.4%) and an increase (P<0.05) in diastolic blood pressure in TOF (-2.4+/-2.5%), which was not seen in control subjects (+4.3+/-2.9%). CONCLUSIONS: Young adults successfully operated on for TOF in early childhood exhibit a resetting of the cardiopulmonary baroreflex to operate at smaller LVEDD and at a higher level of forearm vascular resistance. The blunted heart rate response to LBNP -40 mmHg is consistent with previous observations pointing to disturbances in the efferent arm of the baroreflex.