Paraesophageal hernia.

The treatment of PEHs is challenging. They tend to occur in patients in their 60s and 70s with multiple medical problems and a variety of associated symptoms. Detailed preoperative evaluation is crucial to determining a safe and effective strategy for repair in the operating room.

Drug and alcohol trajectories among adults with schizophrenia: data from the CATIE study.

Objective: The primary aim is to describe drug and alcohol trajectories in adults with schizophrenia.

Method: Growth mixture models were used to examine disordered and non-disordered use and abstinence in the Clinical Antipsychotic Trials of Intervention Effectiveness study.

Results: Five classes - always abstinent; fluctuating use, abuse, and occasional abstinence; occasional (ab)use; stopped (ab)use; abusing - fit best.

Hospital readmission for fluid and electrolyte abnormalities following ileostomy construction: preventable or unpredictable?

Background: Ileostomy creation has complications, including rehospitalization for fluid and electrolyte abnormalities. Although studies have identified predictors of this morbidity, readmission rates remain high.

Methods: The researchers conducted a retrospective chart review of all patients with ileostomy creation at a tertiary institution from January 2008 to June 2011.

Racial bias in child protection? A comparison of competing explanations using national data.

Objective: Cases of child abuse and neglect that involve black children are reported to and substantiated by public child welfare agencies at a rate approximately twice that of cases that involve white children. A range of studies have been performed to assess the degree to which this racial disproportionality is attributable to racial bias in physicians, nurses, and other professionals mandated to report suspected child victimization. The prevailing current explanation posits that the presence of bias among reporters and within the child welfare system has led to the current large overrepresentation of black children.

Desistance from intimate partner violence: the role of legal cynicism, collective efficacy, and social disorganization in Chicago neighborhoods.

This paper examined the relationship between reported Intimate Partner Violence (IPV) desistance and neighborhood concentrated disadvantage, ethnic heterogeneity, residential instability, collective efficacy and legal cynicism. Data from the Project on Human Development in Chicago Neighborhoods (PHDCN) Longitudinal survey were used to identify 599 cases of IPV in Wave 1 eligible for reported desistance in Wave 2. A Generalized Boosting Model was used to determine the best proximal predictors of IPV desistance from the longitudinal data.

A Commentary on Age Segregation for Older Prisoners: Philosophical and Pragmatic Considerations for Correctional Systems.

The growing number of older prisoners in state and federal prisons has fostered an important discussion in literature regarding the potential benefits of age-segregated living arrangements for older inmates. This article begins with a brief review of the reasons for America's aging prison population. Thereafter, it uses a multidisciplinary literature review to clarify a 4-point rationale for age-segregated prisons: (a) cost savings via centralized health care for older prisoners; (b) the reduction of civil liabilities for correctional systems that centralize disability services as per requirements of the Americans with Disabilities Act of 1990; (c) the advancement of prisoner safety for older inmates; and (d) the promotion of rehabilitation by advancing treatment opportunities with a group that is most likely to desist from future criminal activity (in part) due to age-related desistance from crime.