The Impact of Consolidating AAA on the Delivery of HCBS: Evidence From Iowa.

In this study, the authors evaluate the 2013 consolidation of Iowa's Area Agencies on Aging (AAA) on the delivery of home and community-based services (HCBS) to older adults in the state. A mixed-methods approach combined a quasi-experimental design using longitudinal service delivery data with qualitative analyses of surveys and interviews with AAA staff and clients. Overall, consolidation had no detectable effect on the proportion of older adults served by the AAAs.

Percutaneous Rescue for Critical Mitral Stenosis Late After Mitral Valve Repair.

We report a case of catastrophic hemodynamic compromise secondary to pannus ingrowth and severe mitral stenosis occurring years after repair of a nonrheumatic mitral valve. The initial repair included closure of a posterior leaflet cleft and implantation of an annuloplasty ring. We describe a hybrid treatment strategy for this severely compromised patient, which included initial placement of a right ventricular assist device followed by percutaneous balloon mitral valvuloplasty and, eventually, a definitive mitral valve reoperation.

Glucagon-like peptide 2 therapy reduces negative effects of diarrhea on calf gut.

Damage to the intestinal epithelium reduces nutrient absorption and animal growth, and can have negative long-term health effects on livestock. Because the intestinotropic hormone glucagon-like peptide 2 (GLP-2) has been shown to contribute to gut integrity, reduce inflammation, and improve nutrient absorption, the present study was designed to determine whether administration of GLP-2 to calves with coccidiosis in the first month of life affects intestinal growth and mediates negative effects of the proinflammatory response. Holstein bull calves (n=19) were assigned to 4 treatment groups of 4 to 5 calves each: (1) infected with Eimeria bovis, GLP-2 treated; (2) noninfected, GLP-2 treated; (3) infected with E.

The effect of intrauterine growth retardation on the expression of developmental factors in porcine placenta subsequent to the initiation of placentation.

Intrauterine growth retardation (IUGR) hinders fetal growth and postnatal development in swine; however the etiology of IUGR is essentially unknown. Expression of fourteen candidate genes associated with placental development or IUGR was examined in gestational day 50 (gd50) control and IUGR fetus whole placental tissue or areolae by real-time PCR. Endothelial nitric oxide synthase (ENOS) mRNA expression was elevated in gd50 IUGR placenta and areola compared to gd50 control.