RightPath: a model of community-based musculoskeletal care for children.

Objectives: Musculoskeletal (MSK) presentations are common (reported prevalence of one in eight children) and a frequent cause of consultations (6% of 7-year-olds in a cohort study from the UK). Many causes are self-limiting or raised as concerns about normal development (so-called normal variants). We aimed to describe a new model of care to identify children who might be managed in the community by paediatric physiotherapists and/or podiatrists rather than referral to hospital specialist services.

The type of caloric sweetener added to water influences weight gain, fat mass, and reproduction in growing Sprague-Dawley female rats.

Caloric sweetened beverages have been suggested to be a major dietary contributor to weight gain, particularly among adolescents. Dietary recommendations are for moderating intakes of added sugars; however, the question remains whether certain types of sugars should be limited. The objective of this study was to determine the effect of drinking different caloric sweetened beverages on the development of adiposity, metabolic, and endocrine disorders.

The effect of feeding different sugar-sweetened beverages to growing female Sprague-Dawley rats on bone mass and strength.

Consumption of sugar beverages has increased among adolescents. Additionally, the replacement of sucrose with high fructose corn syrup (HFCS) as the predominant sweetener has resulted in higher fructose intake. Few studies have investigated the effect of drinking different sugar-sweetened beverages on bone, despite suggestions that sugar consumption negatively impacts mineral balance.

Sex differences in indicators of well-being in adolescents.

The 1999 Youth Risk Behavior Survey, administered to 964 females and 852 males in randomly selected high schools in a midwestern state, indicated significantly greater negative indicators of mental and physical well-being for adolescent girls than adolescent boys. Results of the 1997 survey finding that significantly more adolescent girls reported engaging in several high risk sexual and drug behaviors such as having their first drink of alcohol at an earlier age, driving a vehicle in the past 30 days when they had been drinking, smoking at an earlier age, smoking more cigarettes per day, and using over-the-counter drugs to get high more often, were supported and enlarged.

Maternal immunity to measles and infant immunity at less than twelve months of age relative to maternal place of birth.

Sera from infants aged 5 to 11 months and from their mothers were used to investigate the level and duration of transplacentally derived measles antibody. The infants of foreign-born, inner-city mothers were more likely to have measles antibody and were less likely to get measles. Infants of foreign-born mothers, because they are less likely to respond to measles vaccine, may require different vaccine strategies than infants of mothers born in the United States.

A secure end colostomy technique.

A secure end colostomy technique preventing the common complications of intestinal prolapse and paracolostomy hernia is presented. Prosthetic mesh is fitted and secured to the intestine and the underside of the abdominal wall, giving considerable strength to the area and avoiding complications.

Benzidine activation in the Ames test: roles of hepatic N-acetyltransferase and other cytosolic and microsomal factors.

Benzidine (BZ) is a known animal and human carcinogen, and is mutagenic in the Ames test using strain TA 98. Several workers have shown that hepatic S9 fraction from hamster is much more effective than is rat S9, as an activation system for BZ in the Ames test. We show that rat microsomal fraction inhibits hamster S9 activation of BZ.

Factors related to eating disorders in young adolescent girls.

The objective of this study was to identify factors related to eating disorders in young adolescent girls. Three hundred eighty-five girls who were attending a career conference at a midwestern university completed the Eating Disorder Instrument (EDI) along with a biographical data sheet. The EDI is designed for the assessment of psychological and behavior traits common in eating disorders.

Hernia of the inferior lumbar space. A cause of back pain.

Twenty hernias of incarcerated fat at the inferior lumbar space were seen during a 23-year period. The usual complaint was a painful mass that caused a backache. The condition was more common in women and girls than in men (18 v two).

Pathomechanics, gait deviations, and treatment of the rheumatoid foot: a clinical report.

This article describes the five major foot deformities or problems often seen in patients with rheumatoid arthritis: hallux valgus, pronation of the foot, depression of the metatarsal heads, hammer or claw toes, and tendocalcaneal bursitis or subplantar spur formation. These deformities contribute to the development of common rheumatoid gait deviations such as decreased velocity, cadence, and stride length; poor heel-toe pattern; and abnormal patterns of weight bearing. Nonsurgical treatment for these problems includes joint protection methods, assistive gait devices, orthotic intervention, and physical therapy procedures.

The potential of the teaching hospital for the development of prepaid group practices.

This paper deals with the development of a hospital based prepaid group practice at Long Island Jewish-Hillside Medical Center. The paper provides an historical perspective of the factors leading to the decision to develop such a Medical Group practice, the difficulties encountered in obtaining conceptual approval from the Medical Center's Board of Trustees and its medical staff, the negotiations between the Medical Center and Blue Cross-Blue Shield of Greater New York as the insurance company which agreed to market the program and to subsidize it in its developmental stage, factors relating to the contractual negotiations between the Medical Center and Blue Cross, the key elements of the negotiated contract from the standpoint of the prepaid group, and the nature of the subsidies provided to ensure a healthy fiscal beginning. The paper highlights the methods used in achieving the desired goals and the development of the Group, sets forth the resistance which other, similar hospitals might anticipate in undertaking such a venture of their own, and highlights the nature and the degree of commitment necessary to bring such a program into being.

Satisfaction with medical care during pregnancy and delivery.

Societal attitudes toward the medical profession are apparently undergoing a change from awe and total respect to a more critical assessing of accountability and credibility. Based on mass media reports and the increasing number of malpractice suits, it would appear that a rational, unbiased review of medical doctors, hospital personnel, and care received is in order. This review should be concerned with technical aspects of medicine as determined by highly competent professionals and the consumer's view of the medical care he receives.