Predicting Outcomes in Patients With AsymptomaticModerate to Severe Aortic Stenosis.

Outcomes in asymptomatic patients with aortic stenosis (AS) have been reported primarily from tertiary centers. Whether observations from a community hospital cohort would be similar or if clinical variables would assume a more important role remains uncertain. This retrospective cohort study from one community hospital followed asymptomatic patients with moderate to severe AS for 3 years following an index echocardiogram.

Qualifying for bariatric surgery: is preoperative weight loss a reliable predictor of postoperative weight loss?

Background: Over the last 20 years, bariatric surgery has emerged as a highly effective weight loss intervention that can also improve co-morbid medical conditions. However, some payors have required preoperative supervised diets and weight loss.

Objective: To determine if preoperative weight loss is the best predictor of postoperative weight loss.

A 60-Week Prospective RCT of a Self-Management Intervention for Individuals With Serious Mental Illness and Diabetes Mellitus.

Objectives: A 60-week randomized controlled trial assessed the effects of targeted training in illness management (TTIM) versus treatment as usual among 200 individuals with serious mental illness and diabetes mellitus.

Methods: The study used the Clinical Global Impression (CGI), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Brief Psychiatric Rating Scale (BPRS) to assess psychiatric symptoms; the Global Assessment of Functioning (GAF) and the Sheehan Disability Scale (SDS) to assess functioning; the 36-Item Short-Form Health Survey (SF-36) to assess general health, and serum glycosylated hemoglobin (HbA1c) to assess diabetes control.

Results: Participants' mean±SD age was 52.

Computer-aided design/computer-aided manufacturing skull base drill.

The authors have developed a simple device for computer-aided design/computer-aided manufacturing (CAD-CAM) that uses an image-guided system to define a cutting tool path that is shared with a surgical machining system for drilling bone. Information from 2D images (obtained via CT and MRI) is transmitted to a processor that produces a 3D image. The processor generates code defining an optimized cutting tool path, which is sent to a surgical machining system that can drill the desired portion of bone.

Cultural Competency Education for Researchers: A Pilot Study Using a Neighborhood Visit Approach.

Background: Little attention has been given to the cultural competence education needs for researchers.

Objectives: To describe the planning and implementation of a neighborhood visit approach to cultural competency education in the community.

Methods: A committee of community partners and academics planned, conducted and evaluated the visit.

Trends in maxillofacial trauma: a comparison of two cohorts of patients at a single institution 20 years apart.

Purpose: The purpose of this study was to compare and characterize 2 cohorts of patients with maxillofacial fractures within the same institution over 2 6-year time frames 20 years apart.

Materials And Methods: A retrospective review of patients with maxillofacial fractures at the authors' institution from 2004 to 2010 was performed, and a comparison was made with the authors' experience from 1984 to 1990.

Results: The 1990 study showed 458 maxillofacial fractures (152 midface and 306 mandibular fractures).

Impact of polyparasitic infections on anemia and undernutrition among Kenyan children living in a Schistosoma haematobium-endemic area.

We measured prevalence of Schistosoma haematobium, Wuchereria bancrofti, Plasmodium falciparum, hookworm, and other geohelminths among school-aged children in four endemic villages in Kwale County, Kenya and explored the relationship between multiparasite burden, undernutrition, and anemia. In 2009-2010 surveys, cross-sectional data were obtained for 2,030 children 5-18 years old. Infections were most prevalent for S.

Psychosocial correlates of alcohol use and reduction for individuals with hepatitis C.

Objective: Patients with hepatitis C virus (HCV) are advised to refrain from alcohol consumption. A questionnaire was developed to measure concepts associated with alcohol use for individuals with HCV.

Method: Subjects with HCV (N = 527) completed a telephone survey.

Measuring fitness of Kenyan children with polyparasitic infections using the 20-meter shuttle run test as a morbidity metric.

Background: To date, there has been no standardized approach to the assessment of aerobic fitness among children who harbor parasites. In quantifying the disability associated with individual or multiple chronic infections, accurate measures of physical fitness are important metrics. This is because exercise intolerance, as seen with anemia and many other chronic disorders, reflects the body's inability to maintain adequate oxygen supply (VO(2) max) to the motor tissues, which is frequently linked to reduced quality-of-life in terms of physical and job performance.

Alcohol Consumption Decisions among Nonabusing Drinkers Diagnosed with Hepatitis C: An Exploratory Sequential Mixed Methods Study.

Most studies of decisions to curtail alcohol consumption reflect experiences of abusing drinkers. We employ an exploratory sequential research design to explore the applicability of this research to the experience of nonabusing drinkers advised to curtail alcohol consumption after a Hepatitis C diagnosis. A qualitative component identified 17 new decision factors not reflected in an inventory of factors based on synthesis of existing scales.

Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in young adults.

Diagnostic criteria for postmenopausal osteoporosis using central dual-energy X-ray absorptiometry (DXA) T-scores have been widely accepted. The validity of these criteria for other populations, including premenopausal women and young men, has not been established. The International Society for Clinical Densitometry (ISCD) recommends using DXA Z-scores, not T-scores, for diagnosis in premenopausal women and men aged 20-49 yr, though studies supporting this position have not been published.

Generalized anxiety disorder: connections with self-reported attachment.

Even though generalized anxiety disorder (GAD) is one of the most common of the anxiety disorders, relatively little is known about its precursors. Bowlby's attachment theory provides a framework within which these precursors can be considered. According to Bowlby, adult anxiety may be rooted in childhood experiences that leave a child uncertain of the availability of a protective figure in times of trouble.

DXA-generated Z-scores and T-scores may differ substantially and significantly in young adults.

Central dual-energy X-ray absorptiometry (DXA) is the gold standard for non-invasive measurement of bone mineral density (BMD). Using this value and subject demographics, DXA software calculates T-scores and Z-scores. Professional society guidelines for the management of osteoporosis are based on T-scores and Z-scores, rather than on the actual BMD value.

Effects of a teen pregnancy prevention program on teens' attitudes toward sexuality: A latent trait modeling approach.

The purpose of this study was to examine the effects of program interventions in a school-based teen pregnancy program on hypothesized constructs underlying teens' attitudes toward sexuality. An important task related to this purpose was the validation of the constructs and their stability from pre- to postintervention measures. Data from 1,136 middle grade students were obtained from an earlier evaluation of an abstinence-based teen pregnancy prevention program (S.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

Background: The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS.

Setting: Free-standing Medicare and/or Medicaid certified nursing homes in Ohio.

Translating the science of quality of life into practice: What do dermatology life quality index scores mean?

This study's aim was to determine the relationship between Dermatology Life Quality Index (DLQI) scores and a Global Question (GQ) concerning patients' views of the overall impairment of their skin-related quality of life (QoL), and to express this relationship by identifying bands of DLQI scores equivalent to each GQ descriptor. A DLQI questionnaire and the GQ were mailed to 3834 adult general dermatology outpatients. There were 1993 (52%) responses: male 841; female 1152.

Are we selecting the right patients for stroke rehabilitation in nursing homes?

Objective: To examine the effect of stroke rehabilitation in the nursing home on community discharge rates and functional status among patients stratified by propensity to receive rehabilitation.

Design: Retrospective cohort.

Setting: Medicaid-certified nursing homes (N=945) in Ohio.

Outcomes up to 5 years after severe, acute respiratory failure.

Study Objective: To use an existing database from a large cohort study with follow-up as long as 5.5 years to assess the extended prognosis of patients who survived their hospitalizations for severe acute respiratory failure (ARF).

Design, Setting, And Patients: Secondary analysis of an inception cohort of 1,722 patients with ARF requiring mechanical ventilation from five major medical centers who were entered into the prospective Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.

Outcomes of rehabilitation services for nursing home residents.

Objective: To examine survival and community discharge outcomes related to rehabilitation services among patients admitted to nursing homes before the implementation of the Balanced Budget Amendment of 1997.

Design: Retrospective cohort.

Setting: A total of 945 Medicaid-certified nursing homes in Ohio.

Mortality trends during a program that publicly reported hospital performance.

Background: It is unclear whether publicly reporting hospitals' risk-adjusted mortality leads to improvements in outcomes.

Objectives: To examine mortality trends during a period (1991-1997) when the Cleveland Health Quality Choice program was operational.

Research Design: Time series.