COVID-19 vaccination in the Federal Bureau of Prisons, December 2020-April 2021.

Objectives: To describe COVID-19 vaccine distribution operations in United States Federal Bureau of Prisons (BOP) institutions and offices from December 16, 2020-April 14, 2021, report vaccination coverage among staff and incarcerated people, and identify factors associated with vaccination acceptance among incarcerated people.

Methods: The BOP COVID-19 vaccination plan and implementation timeline are described. Descriptive statistics and vaccination coverage were calculated for the BOP incarcerated population using data from the BOP electronic medical record.

Predicting knee osteoarthritis risk in injured populations.

Background: Individuals who suffered a lower limb injury have an increased risk of developing knee osteoarthritis. Early diagnosis of osteoarthritis and the ability to track its progression is challenging. This study aimed to explore links between self-reported knee osteoarthritis outcome scores and biomechanical gait parameters, whether self-reported outcome scores could predict gait abnormalities characteristic of knee osteoarthritis in injured populations and, whether scores and biomechanical outcomes were related to osteoarthritis severity via Spearman's correlation coefficient.

Antimicrobial stewardship in the Federal Bureau of Prisons: Approaches from the national and local levels.

Objectives: To determine the impact of national and local antimicrobial stewardship measures on overall antibiotic prescribing in the Federal Bureau of Prisons (BOP).

Setting: Care was delivered to more than 160,000 inmates in 122 BOP facilities in the United States and Puerto Rico.

Practice Description: Medical centers and health services clinics staffed by in-house medical staff, consultants, and specialists.

The effect of obesity on quality-of-life improvement after total knee arthroplasty.

Obesity has been consistently implicated as a major risk factor in the development and progression of osteoarthritis (OA), and total joint arthroplasty (TJA) has emerged as one of the most efficacious and cost-effective OA treatments. The effectiveness of this treatment manifests itself in both clinical and quality of life (QOL) measures. Given the interrelatedness of obesity and OA, and given the success of TJA in improving QOL, we conducted a study to determine whether obesity would adversely affect QOL improvement in 50 patients who underwent primary total knee arthroplasty for primary knee OA.

Capturing the full measure of patient outcome improvement using a self-assessed health adjustment.

Rationale: Self-assessed health (SAH) status is a very simple four-, or five-category self-reported measure of health status that has been shown to be a powerful predictor of mortality, service use and total cost of medical care treatment. It is therefore reasonable to suggest that pre-intervention SAH may influence the extent to which patient outcomes improve following surgery.

Methods: Using the four-category measure of SAH of Excellent; Good; Fair; Poor, we developed an adjustment factor based on the mean improvement of the SAH category relative to the mean improvement of the overall sample.

An electrified catheter to resist encrustation by Proteus mirabilis biofilm.

Purpose: We investigated the effect of iontophoresis produced by passing an electric current through silver electrodes attached to catheters on catheter encrustation by crystalline Proteus mirabilis biofilm.

Materials And Methods: Four glass bladder models were catheterized with 16Fr silicone catheters, of which 3 had 0.25 mm silver wires running through and beside the lumen.

Does age influence the intensity of care in a managed care organization?

The primary objective of this study was to determine whether an inverse relationship between age and the intensity of care prevailed in an elderly, functionally impaired population enrolled in a managed care organization. The secondary objective was to determine whether those who died during the study were treated more intensively than the survivors. A total of 278 enrollees in a managed care organization who were 75 years and over, had a severe functional disability, excessive hospital or Emergency Department use, volunteered to take part in a 2-year study.

Using self-assessed health to predict patient outcomes after total knee replacement.

Self-assessed health status has been shown to be a powerful predictor of mortality, service use, and total cost of medical care treatment. We investigated the potential for self-assessed health to further serve as a predictor of improvement in health status after a clinical intervention. Using the five-category measure of self-assessed health (excellent, very good, good, fair, or poor), we examined patients' improvements in health status after total knee arthroplasty in each of the WOMAC-defined categories for health status in patients.

Selecting a subjective health status measure for optimum utility in everyday orthopaedic practice.

Background: The time required to complete patient outcome questionnaires such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form General Health Survey (SF-36) and the Musculoskeletal Function Assessment (MFA) can sometimes threaten elderly, compromised patients sufficiently to compromise compliance with follow-up clinics. Incomplete questionnaires can also present problems of data bias. A little used (in the USA), patient-friendly questionnaire, the Nottingham Health Profile (NHP) has the potential to reduce the statistical and practical problems associated with the more generally used instruments.

Ultrasonic deposition of cells on a surface.

Bacteria in water have been driven to a glass surface by an ultrasonic standing wave. On an antibody coated surface capture of Bacillus subtilis var niger (BG) spores (6.6 x 10(6) ml(-1)) was increased more than 200-fold over above the efficiency in the absence of ultrasound.

Marital status and health care expenditures among the elderly in a managed care organization.

The purpose of this study was to determine the relationship of marital status in and health care expenditures among the elderly in a managed care organization. The study population consisted of 277 functionally impaired elderly people who were 75 years and older enrolled in a managed care organization. In separate analyses, the relationship between marital status and total expenditure per enrollee, the number of outpatient visits, hospital admissions, and emergency department (ED) visits during the two-year study period was examined.

Case management model or case manager type? That is the question.

Case management models have been categorized many different ways, but classification into two generic models is proposed here: an interrogative model that relies on intense oversight with expected cost reduction and a patient advocacy model that relies on a brokering arrangement for services in the best interest of the patient. A randomized trial in an elderly, functionally impaired population resulted in the implementation of a patient advocacy model and suggests that this model results in increased service use and costs, but that increased survival rates may justify the additional cost.

An explanatory model of medical practice variation: a physician resource demand perspective.

Practice style variation, or variation in the manner in which physicians treat patients with a similar disease condition, has been the focus of attention for many years. The research agenda is further intensified by the unrealistic assumption that by reducing variation, quality will be improved, costs will be reduced, or both. There is a wealth of literature that identifies differences in health care use of many kinds, in apparently similar communities.