The Impact of a Naturally Occurring Retirement Community Supportive Services Program on Older Adult Participants' Social Networks: Semistructured Interview Study.

BACKGROUND: Most older adults want to age in place, in their homes and communities. However, this can be challenging for many, frequently owing to lack of supports that allow for aging in place. Naturally occurring retirement community supportive services programs (NORC-SSPs) offer an approach to help older adults age in place. Although qualitative studies have examined the experiences of NORC-SSP participants, little is known about how participation in NORC-SSP programming affects participants' social networks. OBJECTIVE: This study aimed to explore the experiences of 13 NORC-SSP residents who participated in Oasis Senior Supportive Living (Oasis) and how participating in NORC-SSP programming, specifically based on the Oasis model, influenced their social networks. METHODS: Participants were recruited, using convenience sampling, from 4 naturally occurring retirement communities (NORCs) in Ontario, Canada. All participants (13/13, 100%) had participated in Oasis programming. Semistructured qualitative interviews were conducted with participants. Social network theory informed the interview guide and thematic analysis. RESULTS: In total, 13 participants (n=12, 92% women and n=1, 8% men) were interviewed. These participants were from 4 different NORCs where Oasis had been implemented, comprising 2 midrise apartment buildings, 1 low-rise apartment building, and 1 mobile home community. Overall, 3 main themes were identified from the interviews with Oasis participants: expansion and deepening of social networks, Oasis activities (something to do, someone to do it with), and self-reported impact of Oasis on mental health and well-being (feeling and coping with life better). Participants noted that Oasis provided them with opportunities to meet new people and broaden their social networks, both within and outside their NORCs. They also indicated that Oasis provided them with meaningful ways to spend their time, including opportunities to socialize and try new activities. Participants stated that participating in Oasis helped to alleviate loneliness and improved their quality of life. They noted that Oasis provided them with a reason to get up in the morning. However, the experiences described by participants may not be reflective of all Oasis members. Those who had positive experiences may have been more likely to agree to be interviewed. CONCLUSIONS: On the basis of the participants' interviews, Oasis is an effective aging-in-place model that has been successfully implemented in low-rise apartment buildings, midrise apartment buildings, and mobile home communities. Participating in Oasis allowed participants to expand their social networks and improve their mental health and well-being. Therefore, NORCs may offer an ideal opportunity to build strong communities that provide deep, meaningful social connections that expand social networks. NORC-SSPs, such as Oasis, can support healthy aging and allow older adults to age in place.

Folliculotropism Does Not Affect Overall Survival in Mycosis Fungoides: Results from a Single-Center Cohort and Meta-Analysis.

BACKGROUND: Folliculotropic mycosis fungoides (FMF) is a distinct subtype of mycosis fungoides (MF) with unique clinicopathological features. The medical literature suggests that FMF has a more aggressive course and worse survival than classic MF. Previous studies do not use standardized treatment, and no studies have reported an association between treatment response and overall survival (OS). OBJECTIVE: To compare OS for MF, FMF, and Sézary syndrome (SS) patients. METHODS: Data were collected retrospectively from 218 patients (171 MF, 15 SS, 32 FMF) treated in a single academic center between 1970 and 2016. RESULTS: Negative predictors of OS were age (OR = 1.07), male sex (OR = 1.63), and stage IIB, III, and IV (OR = 4.10, 5.42, and 7.54, respectively, vs. stage IA). Lack of initial PUVA response was strongly associated with negative OS (OR = 3.08). Kaplan-Meier analysis of age-, sex-, and stage-matched MF and FMF patients found similar OS between the 2 groups. The 5-year OS was 91% for FMF and 74% for MF. Meta-analysis of current data and 2 published studies where survival of FMF patients was compared to MF did not reveal statistically significant differences between these 2 diseases. CONCLUSIONS: When patients were matched for age, sex, and disease stage, folliculotropism did not affect OS in MF.

Hyper-IgE Syndrome in an Infant.

BACKGROUND: Hyper-immunoglobulin E syndrome (HIES) is a rare primary immunodeficiency disorder that affects multiple systems. One of the early findings is a papulopustular rash, which has a wide differential diagnosis. METHOD: The authors report the case of a male newborn diagnosed with HIES. He presented with papulopustular dermatitis on the scalp. The authors also present a review of current theory on the pathophysiology, clinical presentation, and management of HIES. CONCLUSION: Although HIES is a multisystem disorder, many of the manifestations of HIES may present after the neonatal period. The cutaneous manifestations of HIES are usually present shortly after birth, and the presentation of pustules in a newborn may be one of the reasons a dermatologist would be asked to assess a patient in the neonatal period.

Physician recruitment and retention in New Brunswick: a medical student perspective.

BACKGROUND: Physician recruitment and retention is a priority for many Canadian provinces. Each province is unique in terms of recruitment strategies and packages offered; however, little is known about how medical students evaluate these programs. The purpose of the current study was to determine which factors matter most to New Brunswick (NB) medical students when considering their location of future practice. METHOD: A survey of NB medical students was conducted. Descriptive statistics were produced and a linear regression model was developed to study factors predictive of a student's expressed willingness to practice in NB. RESULTS: 158 medical students completed the online survey, which is a response rate of 55%. Job availability and spouse's ability to work in the province were ranked as the top factors in deciding where to practice. In the final regression model, factors predictive of an expressed desire to practice in NB include being female, living in NB prior to medical school, attending medical school at Université de Sherbrooke, participation in the NB Preceptorship program, and a desire to practice family medicine. CONCLUSIONS: This study provides insight into what medical students consider when deciding where to practice. This research may be used to inform physician recruitment efforts and guide future research into medical education and policy.

Infantile hemangioma in a v2 distribution: treatment with nadolol.

Infantile hemangiomas are common benign tumours of infancy affecting up to 10% of children. They are typically not present at birth but undergo a rapid proliferation stage and then plateau in growth before resolving spontaneously. Recently, beta-blockers have been favoured over systemic corticosteroids for treatment of disfiguring or life-threatening infantile hemangiomas. We present a case of an 11-week-old female with a 7 week history of an evolving hemangioma along a facial V2 distribution. Physical exam revealed a well-defined bright red plaque over the right zygoma and lower eyelid. MRI, echocardiograph, and liver ultrasound were normal. Patient was treated with nadolol and had a rapid and substantial regression of the hemangioma. Nadolol is an effective treatment option for disfiguring facial infantile hemangioma. The use of beta-blockers as treatment offers clues into the pathogenesis of infantile hemangioma, which is not yet completely understood.