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The purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) from 2010–2014, and included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rate. Secondary outcomes included reasons and costs of readmissions. Hierarchical logistic regression model was used to identify the factors associated with 30-day readmission following craniotomy for brain metastasis. During the study period, 44,846 index hospitalizations occurred for patients who underwent resection of brain metastasis. In this cohort, 17.8% (n = 7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the five-year study period (p-trend = 0.286). The median per-patient cost for 30-day unplanned readmission was $11,109 and this amounted to a total of $26.4 million per year, which extrapolates to a national expenditure of $269.6 million. Increasing age, male sex, insurance status, Elixhauser comorbidity index, length of stay, teaching status of the hospital, neurological complications and infectious complications were associated with 30-day readmission following discharge after an index admission for craniotomy for brain metastasis. Unplanned readmission rates after resection of brain metastasis remain high and involve substantial healthcare expenditures. Developing tools and interventions to prevent avoidable readmissions could focus on the high-risk patients as a future strategy to decrease substantial healthcare expense. [ABSTRACT FROM AUTHOR]

This study investigates the role of financial knowledge in various short-term and long-term financial behaviors among Millennials in the United States. Results from the 2015 National Financial Capability Study (NFCS) indicate that Millennials have lower levels of objective financial knowledge and similar levels of perceived financial knowledge as compared to all households. Consistent multivariate results find financial knowledge to be positively associated with performing positive short-term and long-term financial behaviors. Results are found to be robust across different measurements of financial knowledge and behavior, and the issue of the potential for reverse causality is specifically addressed. This study provides a comprehensive financial profile of Millennials with important insight for policymakers as well as financial practitioners. [ABSTRACT FROM AUTHOR]

BACKGROUND:Abdominal obesity predicts a wide range of adverse health outcomes. Over the past several decades, prevalence of abdominal obesity has increased markedly in industrialized countries like the United States No previous analyses, however, have evaluated whether there are birth cohort effects for abdominal obesity. Estimating cohort effects is necessary to forecast future health trends and understand the past population-level trends.METHODS:This analysis evaluated whether there were birth cohort effects for abdominal obesity for the Silent Generation (born 1925-1945), children of the Great Depression; Baby Boomers (born 1946-1964); or Generation X (born 1965-1980). Cohort effects for prevalence of abdominal obesity were estimated using the median polish method with data collected from the National Health and Nutrition Examination Survey (NHANES) between 1988 and 2008. Respondents were aged 20-74 years.RESULTS:After taking into account age effects and ubiquitous secular changes, the Silent Generation and Generation X had higher cohort-specific prevalence of abdominal obesity than the Baby Boomers. Effects were more pronounced in women than men.CONCLUSIONS:This work presents a novel finding: evidence that the birth cohorts of the post-World War II Baby Boom appeared to have uniquely low cohort effects on abdominal obesity. The growing prosperity of the post-World War II US may have exposed the baby-boom generation to lower levels of psychosocial and socioeconomic stress than the previous or subsequent generations. By identifying factors associated with the Baby Boomers' low cohort-specific sensitivity to the obesogenic environment, the obesity prevention community can identify early-life factors that can protect future generations from excess weight gain. [ABSTRACT FROM AUTHOR]

Background:Obesity prevalence stabilized in the US in the first decade of the 2000s. However, obesity prevalence may resume increasing if younger generations are more sensitive to the obesogenic environment than older generations.Methods:We estimated cohort effects for obesity prevalence among young adults born in the 1980s. Using data collected from the National Health and Nutrition Examination Survey between 1971 and 2008, we calculated obesity for respondents aged between 2 and 74 years. We used the median polish approach to estimate smoothed age and period trends; residual non-linear deviations from age and period trends were regressed on cohort indicator variables to estimate birth cohort effects.Results:After taking into account age effects and ubiquitous secular changes, cohorts born in the 1980s had increased propensity to obesity versus those born in the late 1960s. The cohort effects were 1.18 (95% CI: 1.01, 1.07) and 1.21 (95% CI: 1.02, 1.09) for the 1979-1983 and 1984-1988 birth cohorts, respectively. The effects were especially pronounced in Black males and females but appeared absent in White males.Conclusions:Our results indicate a generational divergence of obesity prevalence. Even if age-specific obesity prevalence stabilizes in those born before the 1980s, age-specific prevalence may continue to rise in the 1980s cohorts, culminating in record-high obesity prevalence as this generation enters its ages of peak obesity prevalence. [ABSTRACT FROM AUTHOR]

NASA’s Chandra X-ray Observatory and the ESA’s X-ray Multi-Mirror Mission (XMM-Newton) made their first observations ten years ago. The complementary capabilities of these observatories allow us to make high-resolution images and precisely measure the energy of cosmic X-rays. Less than 50 years after the first detection of an extrasolar X-ray source, these observatories have achieved an increase in sensitivity comparable to going from naked-eye observations to the most powerful optical telescopes over the past 400 years. We highlight some of the many discoveries made by Chandra and XMM-Newton that have transformed twenty-first century astronomy. [ABSTRACT FROM AUTHOR]

Unlabelled: The public health infrastructure of the former Soviet Union was impacted by both the Chernobyl disaster in 1986 and the Soviet breakup in 1991. This paper examines mortality patterns among children aged 1-14 years within the Mogilev region of Belarus between 1980 and 2000. This study utilized a regional cohort design that included all childhood deaths (ages 1-14 years) occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across three intervals: 1980-1985 (pre-Chernobyl), 1986-1991 (post-Chernobyl and pre-Former Soviet Union (FSU) breakup) and 1992-2000 (post-Chernobyl and post-FSU breakup) based upon administrative death files. Annual death rates among children aged 1-4 years declined between 1980 and 2000, while mortality rates among children aged 5-9 years and 10-14 years remained steady over this time period. Average annual mortality rates among males aged 5-9 years and 10-14 years increased significantly between 1986 and 1991. Compared to the baseline interval, mortality among both males and females aged 1-4 years was significantly decreased during 1986-1990 and 1992-2000. In general, mortality rates among males were 24%-95% greater compared to females. Injuries and poisonings accounted for the largest proportion of deaths across all age and gender groups examined. Subsequent to the Chernobyl disaster, significant decreases were noted in mortality rates among children aged 1-4 years while mortality rates among children aged 5-9 and 10-14 remained stable.Conclusion: Similar to the findings in other countries, injuries and poisonings predominated as the leading cause of death among Belarussian children. [ABSTRACT FROM AUTHOR]

Presents a letters to the editor about predicting survival for myeloid leukemia after Human Leukocyte Antigen-identical sibling donor allergenic stem cell transplantation in the U.S.

Few studies have explored the impact of health insurance on patients with severe, chronic diseases. This retrospective study examined the association between health insurance and the risk of potentially avoidable rehospitalization in the 3 years following validated acute myocardial infarction (AMI) for a community-based probability sample of 683 patients admitted to 30 California hospitals in 1990-1991. In a multivariate analysis adjusted for measures of comorbidity burden, severity of illness, and AMI-related inpatient care, the risk of readmission was not significantly different among patients with no insurance, Medicare insurance, and non-Medicaid, non-Medicare ("private or other") insurance. However, compared to the latter group, patients with Medicaid were 2.6 times more likely to be readmitted for an AMI-related process (risk ratio, 2.61; 95% confidence interval, 1.33 to 5.11). Additional studies are needed to define the role of health insurance on clinical outcomes and health care access across a broader range of conditions and communities. [ABSTRACT FROM AUTHOR]

Gallstones are a major heath problem in the United States. More than 20 million Americans have gallstones, and a million new cases are discovered each year. A resurgence of interest in this field has been stimulated by advances in understanding the pathogenesis of cholesterol gallstones and in nonsurgical treatments. The purpose of this symposium is to update these advances. [ABSTRACT FROM AUTHOR]

This article describes the implementation of Community Treatment Teams as a strategy to provide services to patients discharged from a state psychiatric hospital. The closing of Philadelphia State Hospital was the impetus for the development of an alternative long term care treatment system for the seriously mentally ill which was based on a variation of the community treatment team model. This article provides a description of the teams, their functioning, structure, and the impact they have had on the service system. [ABSTRACT FROM AUTHOR]