AARP is the nation's leading organization of people age 50 and older. It serves their needs and interests through information and education, research, advocacy and community services which are provided by a network of local chapters and experienced volunteers throughout the country. The organization also offers members a wide range of special benefits and services, including Modern Maturity magazine and the monthly Bulletin. As individuals increasingly manage their affairs through the use of information technology, public and private sector decision makers must grapple with the consequences of such activity-the benefits, the risks, the costs, the roles. AARP commissioned a national survey of computer users age 45 and older concerning their views on key issues surfacing in the electronic-commerce debate and their potential readiness as consumers to deal with the changing commercial environment. This survey, conducted by Market Facts, Inc., examines skill levels of mid-life and older computer users and their opinions on pertinent issues concerning Internet-based business and the potential replacement of paper records (including contracts, warranties, disclosures, and notices) with electronic records that are computer-transmittable. The survey also looks at opinions about privacy of personal financial information, particularly online privacy concerns.In February 2000, Market Facts conducted this survey of 1,002 computer users age 45 and older, including 375 members of AARP. According to the most recent (1998) Current Population Survey (CPS) data from the U.S. Census, 40% of adults age 45 and older (a total of 35.6 million) have computers in their households. The current survey includes those who have access to computers, whether at home (81% of those surveyed) or somewhere else (50%). These respondents were identified through random digit dialing to reach a nationally representative sample of computer users age 45 and older. Key FindingsComputer and Internet Use ♦ Only one in three computer users (32%) are "very confident" in their ability to use their personal computers for financial transactions, while another 25% are "somewhat confident." Older computer users (65+), those less highly educated (high school or less), and earning lower incomes ($50,000 or less) express significantly lower confidence levels than those under age 65 and those with higher income and educational levels.♦ Nearly one in four computer users age 45 and older (23%) say they never back up their information on an external storage device and 16% say they never update their programs or applications.♦ On average, computer users age 45 and older spent $35 last year on software upgrades and $42 on hardware upgrades. However, these averages include 32% who spent less than $10 on software and 58% who spent less than $10 on hardware upgrades.♦ Computer users age 45 and older report having used computers for an average of 8.5years. Eight in ten (81%) report having access to the Internet, spending an average of five hours per week using the Internet f...

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Nurses should consider discussing the mirror experience with women who are having a mastectomy pre- and postoperatively. Nurses also may choose to offer a mirror to their patients when doing the initial dressing change and teaching wound care. Educational materials are needed for patients and nurses. In addition, future research is warranted on the use of mirrors when caring for patients who have had a mastectomy.

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BackgroundVariations in care for pregnant women have been reported to affect pregnancy outcomes.MethodsThis study examined data for all 3136 Medicaid beneficiaries enrolled at American Association of Birth Centers (AABC) Center for Medicare and Medicaid Innovation Strong Start sites who gave birth between 2012 and 2014. Using the AABC Perinatal Data Registry, descriptive statistics were used to evaluate socio‐behavioral and medical risks, and core perinatal quality outcomes. Next, the 2082 patients coded as low medical risk on admission in labor were analyzed for effective care and preference sensitive care variations. Finally, using binary logistic regression, the associations between selected care processes and cesarean delivery were explored.ResultsMedicaid beneficiaries enrolled at AABC sites had diverse socio‐behavioral and medical risk profiles and exceeded quality benchmarks for induction, episiotomy, cesarean, and breastfeeding. Among medically low‐risk women, the model demonstrated effective care variations including 82% attendance at prenatal education classes, 99% receiving midwifery‐led prenatal care, and 84% with midwifery‐ attended birth. Patient preferences were adhered to with 83% of women achieving birth at their preferred site of birth, and 95% of women using their preferred infant feeding method. Elective hospitalization in labor was associated with a 4‐times greater risk of cesarean birth among medically low‐risk childbearing Medicaid beneficiaries.ConclusionsThe birth center model demonstrates the capability to achieve the triple aims of improved population health, patient experience, and value.

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Age and development stage should be considered when developing an individualized plan of care. Because recurrence is common among this population, the fear of death exists regardless of age and should be explored by nurses, particularly during periods of remission.