Preliminary report of a palliative care and case management project in an emergency department for chronically ill elderly patients.

The Palliative Care Service at Montefiore Medical Center (MMC) established a pilot project in the emergency department (ED) to identify chronically ill older adults in need of palliative care, homecare, and hospice services and to link such patients with these services. Two advance practice nurses conducted consultations on elderly patients who were found to have one or more "palliative care triggers" on initial screening. A standardized medical record abstraction form was developed.

Effect of knee flexion angle on Achilles tendon force and ankle joint plantarflexion moment during passive dorsiflexion.

Early mobilization exercises are advocated following Achilles tendon (AT) repair, but forces on the repair during passive range of motion are unknown. The extent to which these forces change with flexion of the knee is also not known. Estimated AT forces were measured using 3 models: cadaveric, uninjured subjects, and in both legs of subjects 6 weeks following unilateral AT repair.

On-orbit calibration of HALOE detector linearity.

The Halogen Occultation Experiment (HALOE) conducted satellite solar occultation measurements for 14 years ending on 21 November 2005. HALOE contained a calibration wheel, which included three neutral density filters that were used to examine response linearity through a combination of ground and on-orbit measurements. Although measurement uncertainties preclude a confident assessment of the true extent of nonlinearity, the on-orbit data lead to the conclusion that any existing response nonlinearity has changed by less than 2% over the mission lifetime.

Improved surface EMG electrode for measuring genioglossus muscle activity.

Activation of the genioglossus (GG) muscles is necessary to maintain the patency of the upper airway. In the condition of obstructive sleep apnea (OSA) this mechanism fails and the possible role of fatigue in its pathogenesis is still not fully understood. In this paper, a new electrode design for recording the genioglossus surface electromyogram (sEMG) is presented.

Clinical outcomes of coracoclavicular ligament reconstructions using tendon grafts.

Background: Numerous techniques for reconstruction of the coracoclavicular ligaments have been developed to treat acromioclavicular joint separations. A new, stronger method to reconstruct the coracoclavicular ligaments using semitendinosus tendon allografts has been previously described. No outcome studies have been published on this new procedure.

Synthesis and characterization of low surface energy fluoropolymers as potential barrier coatings in oral care.

A series of low surface energy fluorinated homopolymers and copolymers has been synthesized and characterized using thermal, optical, spectroscopic, and chromatographic techniques. Their utility as barrier technologies in oral care has been considered, and aqueous nanosuspensions of the materials have been deposited as films on model dental hard surfaces in the presence and absence of a salivary pellicle. Calcium hydroxyapatite has been used as a model for enamel, as has PMMA due to its widespread use in denture fabrication.

Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa.

Objective: To determine if readiness for change (RFC) at admission predicted length of stay (LOS) and short-term outcomes among female adolescents in residential treatment for anorexia nervosa (AN).

Method: Using a prospective cohort design to collect data from participants (N = 65) at admission and discharge, Kaplan-Meier survival analysis and Cox regression tested whether RFC on admission predicted time in LOS to a favorable short-term outcome--a composite endpoint based on minimum criteria for weight gain, drive for thinness, depression, anxiety, and health-related quality of life (HRQOL).

Results: Participants with low RFC had a mean survival time to a favorable short-term outcome of 59.

The health status of retired American football players: Super Bowl III revisited.

Background: Despite a perception that retired professional football players have poor health, there are little supporting data.

Hypothesis: Retired football players have poor health compared with age-matched population norms.

Study Design: Cross-sectional study; Level of evidence, 4.

Long-term T cell memory to human leucocyte antigen-A2 supertype epitopes in humans vaccinated against smallpox.

Identification of human leucocyte antigen (HLA) class I-restricted T cell epitopes is important to develop methods to track the evolution of T cell memory to new generation smallpox vaccines and allow comparison to older vaccinia virus preparations known to induce protection against smallpox. We evaluated the relative predictive values of four computational algorithms to identify candidate 9-mer HLA-A2 supertype epitopes that were confirmed to stimulate preferentially T cell interferon (IFN)-gamma responses by subjects last vaccinated with Dryvax 27-54 years previously. Six peptides encoded by I4L, G1L, A8R, I8R, D12L and H3L open reading frames that were identical for Vaccinia (Copenhagen), Variola major (Bangledesh 1975) and modified vaccinia Ankara strain preferentially stimulated IFN-gamma responses by healthy HLA-A2 supertype adults last given Dryvax 27-49 years earlier relative to remotely vaccinated non-HLA-A2 supertype and unvaccinated HLA-A2 supertype adults.

Shoulder musculature activity and stabilization during upper extremity weight-bearing activities.

Background: Upper extremity weight-bearing exercises are routinely used in physical therapy for patients with shoulder pathology. However, little evidence exists regarding the demand on the shoulder musculature.

Objective: To examine changes in shoulder muscle activity and center of pressure during upper extremity weight-bearing exercises of increasing difficulty.

The effectiveness of a balance training intervention in reducing the incidence of noncontact ankle sprains in high school football players.

Background: A high body mass index and previous ankle sprains have been shown to increase the risk of sustaining noncontact inversion ankle sprains in high school football players.

Hypothesis: Stability pad balance training reduces the incidence of noncontact inversion ankle sprains in football players with increased risk.

Study Design: Cohort study; Level of evidence, 2.

Surface electromygraphic analysis of the lower trapezius muscle during exercises performed below ninety degrees of shoulder elevation in healthy subjects.

Background: The lower trapezius is an important muscle for normal arthrokinematics of the scapula. In the early stages of rehabilitation, it is generally accepted to perform exercises with the shoulder kept below 90° of elevation in order to minimize risk for shoulder impingement. Few exercises for the lower trapezius have been studied which maintain the shoulder below 90° of humeral elevation.

Intimate partner violence: new directions.

This review examines multiple forms of intimate partner violence, including women's use of violence, and argues for development of more complex conceptualizations of intimate partner violence. As new victims are identified, partner violence has been reconceptualized. Research findings indicate that women are both victims and perpetrators in intimate partner violence, challenging previous conceptualizations and explanations.

A computer method for assessing satisfaction with hearing aids.

The purpose of this study was to evaluate a new clinical assessment, the Dynamic Assessment of Hearing Aids (DAHA), for a large clinical population. Unlike traditional questionnaire methods, the DAHA has patients use an intuitive graphical computer interface to record visual analogue ratings of satisfaction with various features of their hearing aids (e.g.

Performance demands of professional male tennis players.

Objective: To quantify the performance demands in professional male tennis.

Methods: Games from three grand slam tournaments were analysed by an elite tennis player from video recordings. Game related data were collected on 22 players (French Open, 8 (186 games); Wimbledon, 11 (206 games); US Open, 9 (224 games)).

Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage.

Background: Numerous antioxidant and anti-inflammatory agents have been identified in tart cherries.

Objective: To test the efficacy of a tart cherry juice blend in preventing the symptoms of exercise induced muscle damage.

Methods: This was a randomised, placebo controlled, crossover design.

Outbreak of methicillin-resistant Staphylococcus aureus colonization and infection in a neonatal intensive care unit epidemiologically linked to a healthcare worker with chronic otitis.

Objective: To describe the investigation and interventions necessary to contain an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a neonatal intensive care unit (NICU).

Design: Retrospective case finding that involved prospective performance of surveillance cultures for detection of MRSA and molecular typing of MRSA by repetitive-sequence polymerase chain reaction (rep-PCR).

Setting: Level III NICU in a tertiary care center.

Fit or fat? A review of the debate on deaths attributable to obesity.

Scientific debate surrounding the burden of obesity on the population's health has escalated in recent months following the release of differing reports on the population attributable fraction of obesity mortality. Differing views on statistical methodology for estimating the number of deaths attributable to being overweight and obese were widely reported in the popular media. There was concern that the public was left unsure of how to perceive the health information about obesity.

Electromyography of Selected Shoulder Musculature During Un-weighted and Weighted Pendulum Exercises.

Background: Codman's pendulum exercises are commonly prescribed after shoulder surgery and injury to provide grade I and II distraction and oscillation resulting in decreased pain, increased flow of nutrients into the joint space, and early joint mobilization. Many shoulder protocols suggest that weight may be added to these pendulum exercises as rehabilitation progresses, however, very few guidelines exist to stipulate how much weight should be added.

Objectives: To determine if added weight affected the subject's ability to relax the shoulder musculature during pendulum exercises.

Concentric and eccentric muscle fatigue of the shoulder rotators.

Previous research has demonstrated fatigue resistance for eccentric compared with concentric muscle contractions in the lower extremity. The purpose of this study was to determine if eccentric fatigue resistance was also evident in the internal and external rotators of the shoulder. Ten subjects performed three sets of 32 maximum isokinetic contractions in shoulder internal and external rotation at 120 degrees /s.