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Youth suicide is increasing in the United States, with deaths among younger people of color driving this upward trend. For more than four decades, American Indian and Alaska Native (AIAN) communities have suffered disproportionate rates of youth suicide and years of productive life lost compared to other U.S. Races. The National Institute of Mental Health (NIMH) recently funded three regional Collaborative Hubs to carry out suicide prevention research, practice, and policy development with AIAN communities in Alaska and rural and urban areas of the Southwestern United States. The Hub partnerships are supporting a diverse array of tribally-driven studies, approaches, and policies with immediate value for increasing empirically driven public health strategies to address youth suicide. We discuss unique features of the cross-Hub work, including: (a) long-standing Community-Based Participatory Research processes that led to the Hubs' innovative designs and novel approaches to suicide prevention and evaluation, (b) comprehensive ecological theoretical approaches that contextualize individual risk and protective factors in multilevel social contexts; (c) unique task-shifting and systems of care approaches to increase reach and impact on youth suicide in low-resource settings; and (d) prioritization of strengths-based approaches. The work of the Collaborative Hubs for AIAN youth suicide prevention is generating specific and substantive implications for practice, policy, and research presented in this article at a time when youth suicide prevention is a dire national priority. Approaches also have relevance for historically marginalized communities worldwide. [ABSTRACT FROM AUTHOR]

Having more healthful options at campus eateries is a viable way to meet consumer demand, as well as to promote health on campus. Our study tested three healthier alternatives (low-fat beef, turkey, and soy/rice burgers) against the conventional full-fat hamburger patty (control). We examined consumer acceptance of the four burger patties with 48 untrained student panelists. A 9-point scale hedonic test was used to measure consumer acceptance. Quantitative descriptive analysis (QDA) was also conducted with six trained panelists to evaluate the intensity of sensory properties. Analysis of variance was used to detect significant differences among the treatments. Consumer acceptance mean scores for full-fat beef, lean beef, turkey, and soy/rice patties were 5.98, 6.68, 5.50 and 5.56, respectively, with no preference of the control patty over turkey or soy/rice, but a significant preference of the lean beef over turkey and soy/rice. QDA results showed flavor, spiciness, and elasticity significantly varied across the treatments. Panelists rated lean beef as significantly more elastic than all other patties. It is uncertain whether those sensory attributes contributed to consumer acceptance. In conclusion, our research indicates that college consumers may accept these healthier substitutes for traditional full-fat beef patties. Consumer acceptance of healthier patty substitutes should be further investigated in primary and secondary schools as well. With proper marketing, healthier alternatives to the conventional, full-fat hamburger patty could become competitive choices. [ABSTRACT FROM AUTHOR]

Current guidelines and literature on screening for coronary artery calcium for cardiac risk assessment are reviewed for both general and special populations. It is shown that for both general and special populations a zero score excludes most clinically relevant coronary artery disease. The importance of standardization of coronary artery calcium measurements by multidetector CT is discussed. [ABSTRACT FROM AUTHOR]

Discusses how the widely influential Ann Douglas-Jane Tompkins debate on the literary value of American domestic fiction attributes a broad range of cultural effectiveness to nineteenth-century novels. Ann Douglas' `The Feminization of American Culture'; Jane Tompkins' `Sensational Designs'; Tompkins' provocative reassessment of the social function of literary sterotypes; Other authors supporting American sentimentalism; Influence of Harriet Beecher Stowe; More.

In a preliminary evaluation of the use of dynamic computed tomography (CT) for the detection of patent aortocoronary bypass grafts, 30 patients were scanned either during the early postoperative period or after graft patency was determined by angiography. To visualize the proximal grafts, CT scans were taken through the aortic root following an intravenous bolus injection of contrast medium. Patent bypass grafts to the left anterior descending and right coronary arteries were demonstrated in 77.5%, while posterior grafts to the circumflex and obtuse marginal coronary arteries were detected in 40%. With its potential for extracting dynamic events, CT scanning provides a new, noninvasive modality for the diagnosis of patent bypass grafts, which heretofore have only been visualized by selective angiography. [ABSTRACT FROM AUTHOR]

This paper brings up to date a 1970 study of suicide attempters coming to a major emergency room in an United States urban community and reviews international trends in suicide attempts. Results of the study and the review of the international literature indicate that the high rates of suicide attempts that were observed in 1970 are continuing into 1975. The incidence of suicide attempts continues to be a public health problem primarily amoung young women. Pill ingestion, usually barbiturates and psychotropic drugs, continues to be the most common method used. [ABSTRACT FROM AUTHOR]

Objectives: --To determine the extent to which interinstitutional variations in length of stay are explained by differences in patient characteristics and to determine whether patients in hospitals with shorter lengths of stay had worse outcomes.Design: --We reviewed patients' medical records and surveyed patients between 3 and 12 months after hospital discharge using a questionnaire.Setting: --Six teaching hospitals in California and Massachusetts.Patients: --A cohort of 2484 selected patients who had been hospitalized for acute myocardial infarction or to rule out acute myocardial infarction, coronary artery bypass graft surgery, total hip replacement, cholecystectomy, or transurethral prostatectomy. Between 73% and 84% of the patients with each condition completed a follow-up questionnaire.Outcome Measures: --In-hospital complications, deaths, length of stay, functional status after hospital discharge, readmission, and patient satisfaction with hospital care were analyzed.Results: --Significant interinstitutional differences in length of stay were noted for all conditions except rule-out acute myocardial infarction. Statistical adjustment for case-mix differences accounted for most of the interinstitutional differences in length of stay for total hip replacement but explained little of the differences in the other conditions. When we controlled statistically for other predictors, length of stay did not have a significant impact on deaths, functional status after hospital discharge, the probability of readmission, or patient satisfaction with hospital care.Conclusion: --More research is needed to determine the medical practices that are related to variations in lengths of stay. Routinely available outcome data may help preserve quality in the face of efforts to decrease costs by effecting more standardized practices of care. [ABSTRACT FROM AUTHOR]

The complex embryological development of the inferior vena cava is responsible for a variety of malformations of the mature form. Recognition of these variations is important clinically, in particular when surgical procedures upon the inferior vena cava are contemplated. In appropriate cases angiographic and venographic evaluation is urged. [ABSTRACT FROM AUTHOR]

Data on disease severity, co-morbidity, and process of care were obtained from the medical records of 356 patients without rheumatoid arthritis undergoing a first unilateral total hip replacement at four teaching hospitals in California and Massachusetts. Socio-demographic characteristics, functional status prior and subsequent to hospitalization, and improvement in health status were measured with a patient questionnaire 12 months after discharge. Completed questionnaires were received from 284 patients, a response rate of 79.8%. The questionnaire was acceptable to patients, reliable, and had good construct validity. The data indicate substantial benefits from hip arthroplasty. As expected, pre-surgical functioning was a strong predictor of outcomes 1 year after surgery. Controlling for pre-surgical functioning, age was not related to outcomes. [ABSTRACT FROM AUTHOR]

Presents an approach to resolve the potential dilemma of treating patients with vascular disease in the U.S. Development of low-profile, high-pressure coronary balloon catheters; Use of laser-assisted angioplasty; Clinical evaluation of patients by a vascular surgeon or a cardiologist specializing in peripheral vascular disease.

Discusses a case study on reversible orthodeoxia and platypnea due to right-to-left intracardiac shunting related to pericardial effusion. Medical condition of an elderly man with a history of severe dyspnea and hypoxemia; Treatment; Conclusion.