Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17.

The response of a bone resorption marker to marine recruit training.

Objectives: This study measured the response of deoxypyridinoline, a biomarker of bone resorption, during 11 weeks of Marine recruit training.

Methods: Urine samples were obtained from 155 female and 58 male Marine recruits from the first morning void every 3 days during training. Training miles of weight-bearing exercise were recorded daily, and injury data were obtained from the medical clinic staff.

Gender differences in regional body composition and somatotrophic influences of IGF-I and leptin.

This study evaluated the arm, trunk, and leg for fat mass, lean soft tissue mass, and bone mineral content (BMC) assessed via dual-energy X-ray absorptiometry in a group of age-matched (approximately 29 yr) men (n = 57) and women (n = 63) and determined their relationship to insulin-like growth factor I (IGF-I) and leptin. After analysis of covariance adjustment to control for differences in body mass between genders, the differences that persisted (P < or = 0.05) were for lean soft tissue mass of the arm (men: 7.