HTRA1, an age-related macular degeneration protease, processes extracellular matrix proteins EFEMP1 and TSP1.

High-temperature requirement protein A1 (HTRA1) is a serine protease secreted by a number of tissues including retinal pigment epithelium (RPE). A promoter variant of the gene encoding HTRA1 is part of a mutant allele that causes increased HTRA1 expression and contributed to age-related macular degeneration (AMD) in genomewide association studies. AMD is characterized by pathological development of drusen, extracellular deposits of proteins and lipids on the basal side of RPE.

Multimodal Imaging of Central Retinal Disease Progression in a 2-Year Mean Follow-up of Retinitis Pigmentosa.

Purpose: To determine the rate of progression and optimal follow-up time in patients with advanced-stage retinitis pigmentosa (RP) comparing the use of fundus autofluorescence imaging and spectral-domain optical coherence tomography.

Design: Retrospective analysis of progression rate.

Methods: Longitudinal imaging follow-up in 71 patients with retinitis pigmentosa was studied using the main outcome measurements of hyperautofluoresent ring horizontal diameter and vertical diameter along with ellipsoid zone line width from spectral-domain optical coherence tomography.

Rod metabolic demand drives progression in retinopathies.

Various factors are thought to cause the development and progression of disease in macular degeneration, diabetic retinopathy, and retinitis pigmentosa. Some of the deleterious processes include oxidative stress, hypoxia, metabolic derangement, genetics, and vasculopathy. In this review, we present a unified theory for the pathophysiology of several retinopathies based on the unique and intense metabolism of rod photoreceptors.

The role of organizational culture in retaining nursing workforce.

Purpose Of The Study: We examined how organizational culture in nursing homes affects staff turnover, because culture is a first step to creating satisfactory work environments.

Design And Methods: Nursing home administrators were asked in 2009 to report on facility culture and staff turnover. We received responses from 419 of 1,056 administrators contacted.

The Quality Indicator Survey: background, implementation, and widespread change.

The Quality Indicator Survey (QIS) is the most comprehensive regulatory change to the nursing home survey process since the Omnibus Budget Reconciliation Act of 1987 (OBRA-87). In this article we describe the policy evolution that led to the QIS, summarize the QIS method and implementation, and profile the QIS survey results. Following over a decade of development, in 2007 the Centers for Medicare and Medicaid Services (CMS) began the national rollout of QIS.

Adherence to Pap test guidelines: variation among Asians in California.

Objectives: To compare Pap screening in the previous 3 years among subgroups of Asian American women, aged 18 to 65 years.

Design: Analysis of data from the 2001 and 2003 California Health Interview Survey (CHIS), a cross-sectional population-based telephone survey.

Main Measures: The survey elicited information from major Asian subgroups, including Chinese, Filipina, Japanese, Korean, South Asian, and Vietnamese.

Motivation to change chronic illness care: results from a national evaluation of quality improvement collaboratives.

This article examines the motivation of health care professionals to improve quality of chronic illness care using the Chronic Care Model and Plan-Do-Study-Act cycles. The findings suggest that organizational attempts to redesign care require support of activities initiated by practitioners and managers and an organizational commitment to quality improvement.

Pressure ulcer prevalence in long-term nursing home residents since the implementation of OBRA '87. Omnibus Budget Reconciliation Act.

Objectives: To evaluate change in pressure ulcer prevalence in long-term nursing home residents since the implementation of the Omnibus Budget Reconciliation Act of 1987 (OBRA '87).

Design: Cross-sectional comparison of two time periods.

Setting: Ninety-two nursing homes scheduled for a quality-of-care survey randomly selected from 22 representative states.