Postpartum Mothers' Experiences With Newborn Weight Checks in the Home.

Few researchers have examined the perspectives of breastfeeding mothers about using a pediatric scale in the home to monitor infant weight. A cross sectional design was used to measure helpfulness, impact on newborn feeding, and confidence among mothers who used a digital scale to monitor newborn weight. Women (N = 69) who had given birth in a community hospital in the Northeast region of the United States used a pediatric scale in the home daily for 2 weeks after birth.

Venous thromboembolism incidence, recurrence, and mortality based on Women's Health Initiative data and Medicare claims.

Introduction: Our objective was to compare Medicare claims to physician review and adjudication of medical records for identifying venous thromboembolism (VTE), and to assess VTE incidence, recurrence, and mortality in a large national cohort of post-menopausal women followed up to 19years.

Materials And Methods: We used detailed clinical data from the Women's Health Initiative (WHI) linked to Medicare claims. Agreement between data sources was evaluated among 16,003 women during 1993-2010.

The Maximal Expiratory-to-Inspiratory Pressure Ratio and Supine Vital Capacity as Screening Tests for Diaphragm Dysfunction.

Purpose: The change in vital capacity from the seated to supine position (∆VC-supine) is used to screen for diaphragm dysfunction (DD), but some individuals are unable to tolerate the supine position. Since expiratory muscle function is often preserved in patients with isolated DD and inspiratory strength is reduced, the purpose of this study was to examine if the ratio of maximal expiratory pressure to maximal inspiratory pressure (MEP/MIP) may provide an alternative to ∆VC-supine when screening patients for DD.

Methods: We performed a cross-sectional analysis on 76 patients referred for evaluation of unexplained dyspnea and possible DD.

Preparing psychologists in academic health centers for the rapidly changing health care environment.

The Association of Psychologists in Academic Health Centers (APAHC) convened its 5th National APAHC Conference in Boston March 3-5 2011. The conference and its theme, "Preparing Psychologists for a Rapidly Changing Health Care Environment," brought psychologists from academic health centers together to examine how psychology can adapt to and help lead health care efforts in the face of health care reform. This paper reports on the conference and introduces the special issue of JCPMS that is dedicated to the conference.

Functional roles and foundational characteristics of psychologists in integrated primary care.

Psychologists are presented with unprecedented opportunities to integrate their work in primary care settings. Although some roles of psychologists in primary care overlap with those in traditional psychology practice settings, a number are distinct reflecting the uniqueness of the primary care culture. In this paper, we first describe the integrated primary care setting, with a focus on those settings that have components of patient centered medical home.

Doctors' perceptions of laboratory monitoring in office practice.

Background: Laboratory monitoring has been increasingly recognized as an important area for improving patient safety in ambulatory care. Little is known about doctors' attitudes towards laboratory monitoring and potential ways to improve it.

Methods: Six focus groups and one individual interview with 20 primary care doctors and nine specialists from three Massachusetts communities.

Gradual electronic health record implementation: new insights on physician and patient adaptation.

Purpose: Although there is significant interest in implementation of electronic health records (EHRs), limited data have been published in the United States about how physicians, staff, and patients adapt to this implementation process. The purpose of this research was to examine the effects of EHR implementation, especially regarding physician-patient communication and behaviors and patients' responses.

Methods: We undertook a 22-month, triangulation design, mixed methods study of gradual EHR implementation in a residency-based family medicine outpatient center.

Relationship of periodontal attachment loss to peripheral vascular disease: an analysis of NHANES 1999-2002 data.

Introduction: Peripheral vascular disease (PVD) is a common disabling condition associated with many of the same risk factors as coronary heart disease. It has been suggested that periodontal disease is a risk factor for coronary heart disease but its relationship to peripheral vascular disease is under-researched. We therefore sought to evaluate the relationship of periodontal disease to PVD.

Endotoxin and cytokine detection systems as biomarkers for sepsis-induced renal injury.

Background: A reliable biomarker as an indicator of the presence of severe sepsis is an unmet medical need.

Methods: Review of recent literature on this topic focusing upon endotoxin and cytokine assays.

Results: The ideal biomarker for sepsis would be readily available, technically easy to perform with a quick turn-around time, inexpensive, highly specific, very sensitive, and preferably highly correlated in quantitative terms with disease severity.

Diaphragm recruitment during nonrespiratory activities.

We previously found that weight lifters could generate greater inspiratory pressures and had more diaphragm mass than control subjects. We postulated that the weight-lifting activity itself provided a strength-training stimulus to the diaphragm. To evaluate the extent to which the diaphragm is recruited during strenuous nonrespiratory activities, we measured transdiaphragmatic pressure (Pdi) in six healthy subjects during biceps curls, bench press, power lift, and sit-ups.

Results of report cards for patients with congestive heart failure depend on the method used to adjust for severity.

Background: The validity of outcome report cards may depend on the ways in which they are adjusted for risk.

Objectives: To compare the predictive ability of generic and disease-specific survival prediction models appropriate for use in patients with heart failure, to simulate outcome report cards by comparing survival across hospitals and adjusting for severity of illness using these models, and to assess the ways in which the results of these comparisons depend on the adjustment method.

Design: Analysis of data from a prospective cohort study.

Airway hyperresponsiveness and airway obstruction in transgenic mice. Morphologic correlates in mice overexpressing interleukin (IL)-11 and IL-6 in the lung.

Understanding the sources of variation in airway reactivity and airflow is important for unraveling the pathophysiology of asthma, obstructive lung disease, and other pulmonary disorders. Transgenic expression of two closely related cytokines in the mouse lung produced opposite effects on these parameters. Interleukin (IL)-6 did not alter basal airways resistance and decreased methacholine responsiveness, whereas IL-11 caused airways obstruction and increased airway responses to methacholine.

Relationship between plasma levels of lipopolysaccharide (LPS) and LPS-binding protein in patients with severe sepsis and septic shock.

Plasma endotoxin and lipopolysaccharide-binding protein (LBP) levels were measured in a group of 253 patients at the onset of severe sepsis and/or septic shock. Endotoxin levels were significantly greater than control levels (n=33; mean +/- SD, 5.1+/-7.

Confirmatory interleukin-1 receptor antagonist trial in severe sepsis: a phase III, randomized, double-blind, placebo-controlled, multicenter trial. The Interleukin-1 Receptor Antagonist Sepsis Investigator Group.

Objective: To determine the therapeutic efficacy and safety of recombinant human interleukin-1 receptor antagonist (rhIL-1ra) in the treatment of patients with severe sepsis.

Design: Prospective, randomized, double-blind, placebo-controlled, multicenter trial with a planned, midstudy, interim analysis.

Setting: Ninety-one academic medical center intensive care units in North America and Europe.

Spontaneous bacterial peritonitis: Analysis of treatment and outcome.

Spontaneous bacterial peritonitis occurred on 44 separate occasions in 43 patients during a five year period, including 27 culture positive and 17 probable cases of spontaneous bacterial peritonitis. Alcoholic liver disease was the underlying cause of 72% of cases. Of the 27 culture positive cases, Escherichia coli was the most common isolate (14 cases), followed by Klebsiella pneumoniae (three cases), group G streptococci (three cases), group B streptococci (two cases) and one case each of five other organisms.