Hip Abductor Strength Asymmetry: Relationship to Upper Extremity Injury in Professional Baseball Players.

Background: Hip strength is an important factor for control of the lumbo-pelvic-hip complex. Deficits in hip strength may affect throwing performance and contribute to upper extremity injuries.

Hypothesis: Deficits in hip abduction isometric strength would be greater in those who sustained an upper extremity injury and hip strength would predict injury incidence.

Medicare Cost at End of Life.

As the Medicare program struggles to control expenditures, there is increased focus on opportunities to manage patient populations more efficiently and at a lower cost. A major source of expense for the Medicare program is beneficiaries at end of life. Estimates of the percentage of Medicare costs that arise from patients in the last year of life differ, ranging from 13% to 25%, depending on methods and assumptions.

Using dual-purpose crops in sheep-grazing systems.

The utilisation of dual-purpose crops, especially wheat and canola grown for forage and grain production in sheep-grazing systems, is reviewed. When sown early and grazed in winter before stem elongation, later-maturing wheat and canola crops can be grazed with little impact on grain yield. Recent research has sought to develop crop- and grazing-management strategies for dual-purpose crops.

Risk-adjusted indices for measuring the quality of inpatient care.

This article describes a risk-adjustment method for profiling hospitals and physicians on key measures of clinical quality using readily available administrative data. By comparing actual and expected rates of mortality, complications, readmissions, and patient safety events, this method enables providers to identify both favorable and adverse outcomes performance.

Using the alkanes and long-chain alcohols of plant cuticular wax to estimate diet composition and the intakes of mixed forages in sheep consuming a known amount of alkane-labelled supplement.

In a feeding trial with 24 sheep, we used the alkanes, long-chain alcohols (LCOH) or both of these plant wax markers, to estimate the diet composition of animals offered diets comprising alkane-labelled cottonseed meal (CSM) together with up to four forages. The diets used were: Diet 1 subterranean clover (Trifolium subterraneum); Diet 2 subterranean clover + phalaris (Phalaris aquatica); Diet 3 subterranean clover, phalaris + annual ryegrass (Lolium rigidum); and Diet 4 subterranean clover, phalaris, annual ryegrass + wheat straw (Triticum aestivum). Estimates of diet composition were made following correction of faecal alkane or LCOH concentrations for incomplete faecal recovery, using recovery estimates derived from individual animals, mean recoveries for a given dietary treatment or grand mean recoveries.

Faecal alkane recoveries from multi-component diets and effects on estimates of diet composition in sheep.

In a feeding trial with sheep, four animals each were fed one of the three roughages (perennial ryegrass (PR), meadow fescue (MF) and red clover (RC)) or one of the four different mixtures (g/day 250 : 250 : 250, 375 : 75 : 300, 525 : 187.5 : 37.5 and 75 : 525 : 150, respectively) of those three roughages, both with and without the inclusion of 100 g of beeswax-labelled barley.

Subjective evaluations of research participation by persons with mental illness.

The present study focuses on the subjective experience of psychiatric patients who participate in psychobiological research, based on patients' self-reported evaluations of the experience. We studied 313 persons with mental illness admitted to an inpatient research unit. Each participant was administered the Patient Satisfaction Questionnaire, a structured self-report questionnaire designed to assess satisfaction with research participation and clinical care.

Protocol for the analysis of n-alkanes and other plant-wax compounds and for their use as markers for quantifying the nutrient supply of large mammalian herbivores.

Plant-wax markers can be used for estimating forage intake, diet composition and supplement intake in grazing livestock, wild ruminants and other mammals. We describe protocols for using the saturated hydrocarbons (alkanes) of plant wax as markers for estimating fecal output, intake and digestibility. Procedures for investigating digestion kinetics are also discussed.

Evaluating freestanding ambulatory surgery center ventures.

Projecting revenues and expenses The second of a two-part series, this article discusses the projected revenues and expenses of a hypothetical ambulatory surgery center and analyzes the potential impact of a hypothetical new payment method by the Centers for Medicare & Medicaid Services.

Evaluating freestanding ambulatory surgery center ventures. Background and payment systems.

Group practices seeking to increase income may consider investing in freestanding ambulatory surgery centers (ASCs) as advances in technology enable more procedures to be performed in an outpatient setting. The authors describe the background of ASCs, with an emphasis on the payment systems used by Medicare and private payers.

Sulphur and nitrogen nutrition influence the response of chickpea seeds to an added, transgenic sink for organic sulphur.

In order to increase the concentration of the nutritionally essential sulphur amino acids in seed protein, a transgene encoding a methionine- and cysteine-rich protein, sunflower seed albumin (SSA), was transferred to chickpeas (Cicer arietinum L). Transgenic seeds that accumulated SSA contained more methionine and less oxidized sulphur than the controls, suggesting that additional demand for sulphur amino acids from the expression of the transgene stimulated sulphur assimilation. In addition, the activity of trypsin inhibitors, a known family of endogenous, sulphur-rich chickpea seed proteins, was diminished in transgenic, SSA-containing seeds compared with the non-transgenic controls.

A prediction model for targeting low-cost, high-risk members of managed care organizations.

Objective: To describe the development and validation of a predictive model designed to identify and target HMO members who are likely to incur high costs.

Study Design: Split-sample multivariate regression analysis.

Patients And Methods: We studied enrollees in a 350000-member HMO with > or = 1 claim in 1998 and 1999.

Comparative analysis of neurogenesis in the myriapod Glomeris marginata (Diplopoda) suggests more similarities to chelicerates than to insects.

Molecular data suggest that myriapods are a basal arthropod group and may even be the sister group of chelicerates. To find morphological indications for this relationship we have analysed neurogenesis in the myriapod Glomeris marginata (Diplopoda). We show here that groups of neural precursors, rather than single cells as in insects, invaginate from the ventral neuroectoderm in a manner similar to that in the spider: invaginating cell groups arise sequentially and at stereotyped positions in the ventral neuroectoderm of Glomeris, and all cells of the neurogenic region seem to enter the neural pathway.

Voice amplification versus vocal hygiene instruction for teachers with voice disorders: a treatment outcomes study.

Voice problems are common among schoolteachers. This prospective, randomized clinical trial used patient-based treatment outcomes measures combined with acoustic analysis to evaluate the effectiveness of two treatment programs. Forty-four voice-disordered teachers were randomly assigned to one of three groups: voice amplification using the ChatterVox portable amplifier (VA, n = 15), vocal hygiene (VH, n = 15), and a nontreatment control group (n = 14).

A self-assessment program for multidisciplinary mental health teams.

Objective: The authors describe a self-assessment training program for multidisciplinary mental health teams that was developed in a public multihospital system, the process of implementing the training at a state psychiatric hospital, and a measurement instrument, the Scale for Leadership Assessment and Team Evaluation (SLATE), which they have used for self-assessment of multidisciplinary teams and which is currently being studied. They assessed whether changes in team self-assessments could be seen after the training program.

Methods: A total of 102 mental health professionals from 12 inpatient units representing the disciplines of psychiatry, psychology, nursing, social work, and occupational and activity therapy completed the SLATE before and after participation in a training program that consisted primarily of team self-assessment in the context of treatment planning sessions.

Clicking in the throat: cinematic fiction or surgical fact?

The complaint of a clicking in the throat when swallowing is uncommon but very discomforting and painful for those who experience it. It is such an unusual complaint that symptoms may be dismissed as psychogenic because a cause for the problem may not be readily apparent. We present a series of 11 cases in which all patients had an audible clicking or popping noise in the throat associated with neck and throat pain when swallowing or turning the neck.

Alkanes as internal markers to estimate digestibility of hay or hay plus concentrate diets in horses.

Dry matter intake (DMI), dry matter digestibility (DMD), and fecal output (FO) are difficult to measure directly in the field, and indirect methods using external and internal markers have thus been developed. An experiment was conducted consisting of two digestion trials with two periods in each trial to examine the use of five odd-chain alkanes (C25 to C33) of plant cuticular wax as internal markers to estimate DMD of hay or hay plus concentrate diets in horses. Eight mature Thoroughbred geldings were housed in 4- x 4-m stalls and randomly assigned to one of two mixed grass/legume hays (Diets 1 and 2) in Trial 1 and to mixed grass/legume hay plus one of two concentrates (Diets 3 and 4) in Trial 2.

An evaluation of the effects of two treatment approaches for teachers with voice disorders: a prospective randomized clinical trial.

Teachers commonly report voice problems and often seek medical assistance for voice-related complaints. Despite the prevalence of voice disorders within this occupation, there are no studies evaluating the effectiveness of treatment programs designed to remedy the voice problems of teachers. To assess the functional effects of two voice therapy approaches, 58 voice-disordered teachers were randomly assigned to 1 of 3 groups: vocal hygiene (VH, n = 20), vocal function exercises (VFE, n = 19), and a nontreatment control group (CON, n = 19).

Episode Treatment Groups (ETGs): a patient classification system for measuring outcomes performance by episode of illness.

The Episode Treatment Group (ETG) methodology is a patented case-mix adjustment and episode-building system that uses routinely collected inpatient and ambulatory claims data. The resulting clinically homogenous groups, of which there are approximately 600, adjust for severity by the presence of complicating conditions, comorbidities, and other characteristics of a patient's condition that affect resource utilization.

Benchmarking medical group practices using claims data: methodological and practical problems.

As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data.

Psychiatric leadership and the clinical team: simulated in vivo treatment planning performance as teamwork proxy and learning laboratory.

Leadership is an important consideration at many levels within behavioral healthcare systems. The authors developed a training program in a large public hospital system that focused on psychiatric leadership and clinical team functioning. In a learning laboratory format, they used videotaped patient simulations as a stimulus for multidisciplinary treatment planning sessions.

Measurement of dietary nutrient intake in free-ranging mammalian herbivores.

The nutrient intakes of mammalian herbivores depend on the amount and the nutrient content of the plant species and plant parts which they eat. We review the merits of oesophageal-fistulated (OF) animals, microhistological procedures, stable C-isotope discrimination and plant cuticular-wax markers as methods for estimating diet composition and intake in both ruminant and non-ruminant herbivores. We also briefly discuss methods based on grazing behaviour measurements or on H2O or Na turnover, and methods for estimating supplement or soil intake.

Postgraduate education and training in addiction disorders. Defining core competencies.

The rising prevalence of substance abuse disorders in the general medical population makes it essential that more active training be initiated during general residency training across all specialties. Core competencies for general residencies are outlined and the need for advocacy for continuation of postgraduate fellowship in Addiction Psychiatry is recommended as a means of increasing the numbers of faculty to provide leadership teaching and research in the area of Addiction Psychiatry.

Experimental approaches to vocal fold alteration: introduction to the minithyrotomy.

Treatment of challenging laryngeal disorders, such as lamina propria loss or neuromuscular dysfunction, may require novel approaches and techniques. This paper discusses an evolution of experimental techniques for treatment of lamina propria loss and use of the minithyrotomy. These techniques have been used for surgical access for lamina propria substitution, as well as placement of stimulating electrodes.