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Objective: To test the hypothesis that profoundly deaf persons would have better preventive care compliance and improved physician communication if enrolled in a primary care program providing American Sign Language (ASL) interpreters.Design: A case-cohort community-based study. The authors had ASL-fluent research assistants interview 90 randomly selected patients (the cases) enrolled in a unique primary care program for the deaf (Deaf Services Program), which provided full-time ASL interpreters and subsidized health care costs for some patients. Eighty-five deaf controls were friends of the cases drawn from the community.Results: The cases were poorer and less often married than were the controls, but other baseline characteristics were similar. The cases were more likely (p < 0.05) to report receiving within the preceding three years Pap tests (90% vs 72%), mammography (86% vs 53%), and rectal examinations (72% vs 25%), but not breast examinations (76% vs 71%, p = 0.7). The cases were more likely than the controls to report receiving counseling in ASL for psychiatric and substance abuse problems (49% vs 5%, p < 0.001). Although only 18% of the controls were fluent in written English, 67% of them used written notes to communicate with their physicians. Twenty percent of the controls used ASL interpreters compared with 84% of the cases (p < 0.001). More cases than controls were moderately or extremely satisfied with communication with their physicians (92% vs 42%, p < 0.001).Conclusion: Deaf persons enrolled in a primary care program that included full-time interpreters were more likely to use ASL, were more satisfied with physician communications, and had improved preventive care outcomes. [ABSTRACT FROM AUTHOR]

This paper is a part of a larger study of economic growth in Canada, following the methods developed by Edward Denison in his book The Sources of Economic Growth in the United States and the publication Why Growth Rates Differ. The new material in this paper relates to Canada and the Canadian/U.S. comparison, while the material on Northwest Europe is drawn from the Brookings study. The present paper sets out the results to date on the differences in real output per employed person between Canada and the United States for one year, 1960. At this stage in our research the results indicate that the level of real output per employed person in Canada was about 20 per cent lower than in the United States in that year. On the basis of historical output data, it would appear that this margin of difference in Canadian/U.S. product levels has persisted throughout the present century. The central part of this paper examines the significance of differences in factor inputs in Canada and the United States and their contribution to the difference in income. The level of inputs per employed person in Canada accounts for only about 2 percentage points of the income difference between Canada and the United States. These results indicate that the overwhelming part of the difference in output per employed person between the two countries reflects the differences in output in relation to total factor inputs, rather than the magnitude of other factor inputs used in combination with labour. This result is consistent with earlier studies by Denison and others which have indicated the crucial importance of output in relation to total factor inputs, both in output growth over time and intercountry comparisons of output level. The body of the paper can give only brief attention to the numerous conceptual and statistical questions that arise in such a wide-ranging study, and the authors do not pretend to have tackled, let alone resolved, all of the wide range of problems related to this study. Nor do they claim any high degree of precision for the results, especially in the light of the statistical limitations of the basic data. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the coronary computed tomographic angiography (CCTA) of patients presented with stable chest pain to an emergency department (ED).

Tabular imputation models were developed and tested to estimate postharvest forest stand characteristics in Minnesota. The models were based on a sorting of statewide inventory plot data into sets of tablescontaining estimates of number of trees and basal area per hectare by covertype, species, and diameter class for young postharvest stands. The primary bases for sorting within the sets of tables were stand age following harvest, and site index. The output tables were organized to facilitate their use as young stand input data to existing growth and yield models. Analysis of these tables indicated that basal area increased rapidly for young stands and then began to level off as stand ages approached 20 years; furthermore, the variability within the tables decreased as forest stands matured. Implications for alternative methods of implementing the models are also discussed. [ABSTRACT FROM AUTHOR]

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context., (© The Author(s) 2021. Published by Oxford University Press.)

Introduction: Fractional flow reserve (FFR) assessment has been validated as an effective tool to guide revascularization of stable coronary artery disease. The role of utilizing FFR in acute coronary syndrome (ACS) is less established., Methods: The study population was extracted from the National Readmissions Data (NRD) 2014 using International Classification of Diseases, ninth edition, clinical modification (ICD-9-CM) codes for ACS, percutaneous coronary intervention (PCI), FFR, and periprocedural complications. Study endpoints included all-cause of in-hospital mortality, length of index hospital stay (LOS), acute kidney injury (AKI), bleeding, coronary dissection, total number of stents used, stroke, vascular complications (VCs), and the total charges of index hospitalization., Results: A total of 304,548 discharges that had the diagnosis of ACS and treated invasively within the same index hospitalization (average age 65.1 years; 64% male) were identified. Among these, 7,832 had FFR guided invasive treatment (2.6%) which was associated with significantly lower in-hospital all-cause mortality (1.1 vs. 3.1%, p < .01), shorter LOS (4.6 vs. 5.3 days, p < .01), less AKI (12.5 vs. 14.6%, p < .01), less bleeding (7.0 vs. 8.5%, p < .01), and lower total charges ($99,805 vs. $105,736). There was no significant difference between both groups in terms of stroke (2.2 vs. 2.3%, p = .41), coronary dissection (0.7 vs. 0.8%, p = .34), VC (1.3 vs. 1.0% p = .01) or the total number of stents used (55.5 vs. 54.5% p = .34)., Conclusion: In patients presenting with an ACS FFR- guided PCI, as compared to angiography guided PCI, was associated with lower rates of in-hospital mortality, shorter LOS, less AKI, bleeding and lower hospital charges. There was no significant difference in terms of the incidence of stroke, coronary dissection, VC or the total number of stents used., (© 2019 Wiley Periodicals, Inc.)

The aim of this study was to review and describe indications for intraaortic balloon counterpulsation (IABP) use and identify the impact these have on outcomes at an Australian cardiothoracic tertiary referral hospital. A secondary aim was comparison of the Australian practice with a large multinational IABP data registry. Patient demographics, IABP indication, IABP complication rate and mortality in 662 patients treated with IABP at The Prince Charles Hospital (TPCH), Brisbane, between January 1994 and December 2004 inclusive were compared with The Benchmark Counterpulsation Outcomes Registry. Data were collected between 1994 and 2000 by retrospective patient record review and prospectively using the Benchmark database from 2001 to 2004. Statistical analysis was undertaken using SAS (v8.2) software. The mean age of patients managed with IABP at TPCH (71.6% male) was 63.4 years (SD 12.4). In-hospital mortality rate was 22% and the complication rate was 10.3%. TPCH indications for IABP were: weaning from cardiopulmonary bypass (34.2%); cardiogenic shock (24.4%); preoperative support (13%); catheter laboratory support (10.6%); refractory ventricular failure (7.3%); ischaemia related to intractable ventricular arrhythmias (4.5%); unstable refractory angina (4%); mechanical complications due to acute myocardial infarction (1.2%) and other (0.4%) (0.4% not reported). In comparison to Benchmark, IABP at TPCH demonstrated a prejudice toward intraoperative use (34.2% versus 16.6%; P < or = 0.0001) and an aversion to catheter laboratory support (10.6% versus 19%; P < or = 0.0001). TPCH and Benchmark IABP outcomes demonstrated comparable mortality (22% versus 20.8%; P = ns) but increased TPCH complications (10.3% vs. 6.2%; P < or = 0.0001) owing to a 2% difference in observed insertion site bleeding.

Although erratic at times, a poison center's (PC) call volume is generally predictable, but an emergent increase in call volume from an alarmed public can rapidly overwhelm existing personnel making it difficult to manage true emergencies. This is illustrated by a product recall concerning food allegedly contaminated with asbestos occurring in January 1998. Utilizing an on-line database, all calls over a 5-d period concerning this recall were reviewed and tabulated by both the date and time received. Corporate communications polled the print, radio and TV media to determine when the product recall stories were presented. This information was compared to and correlated with the Regional Poison Information Center (RPIC) call volume. Over a 5-d period the RPIC responded to 487 calls regarding the recall with 86.2% received in the first 33 h after the initial broadcast. During this 33-h period a total of 797 calls were documented at the RPIC indicating 52.7% of the call volume being related to the recall. Over the same period 4 local TV and radio stations broadcast the story 33 times with 1 station airing it 19 times in a 24-h period. Two newspaper stories were published. The public has a right to be alerted to potential health hazards, but a sudden increase in calls to a PC can be crippling. Based on this and similar experiences our PC developed a strategy, in concert with corporate communications, to respond to future incidents with the goal of reducing the adverse impact on PC call volume through the promotion of balanced and responsible information.

Multiemployer fund trustees have a significant responsibility to the plans and beneficiaries they serve. Fortunately, the law allows trustees to retain professionals to assist them in this important function. This article reviews trustees' relationships with these professional advisors, provides an overview of the general legal standards that govern this area and offers a brief description of the types of services trustees can expect from their advisors.

Objective: To test the hypothesis that profoundly deaf persons would have better preventive care compliance and improved physician communication if enrolled in a primary care program providing American Sign Language (ASL) interpreters., Design: A case-cohort community-based study. The authors had ASL-fluent research assistants interview 90 randomly selected patients (the cases) enrolled in a unique primary care program for the deaf (Deaf Services Program), which provided full-time ASL interpreters and subsidized health care costs for some patients. Eighty-five deaf controls were friends of the cases drawn from the community., Results: The cases were poorer and less often married than were the controls, but other baseline characteristics were similar. The cases were more likely (p < 0.05) to report receiving within the preceding three years Pap tests (90% vs 72%), mammography (86% vs 53%), and rectal examinations (72% vs 25%), but not breast examinations (76% vs 71%, p = 0.7). The cases were more likely than the controls to report receiving counseling in ASL for psychiatric and substance abuse problems (49% vs 5%, p < 0.001). Although only 18% of the controls were fluent in written English, 67% of them used written notes to communicate with their physicians. Twenty percent of the controls used ASL interpreters compared with 84% of the cases (p < 0.001). More cases than controls were moderately or extremely satisfied with communication with their physicians (92% vs 42%, p < 0.001)., Conclusion: Deaf persons enrolled in a primary care program that included full-time interpreters were more likely to use ASL, were more satisfied with physician communications, and had improved preventive care outcomes.

This paper concerns itself with the personal life and professional contributions of one of the great men in optometry, R. C. Augustine. This short biography includes discussions on his childhood, his introduction to the field of optometry, his early contributions in his community, his book, his achievements during the presidency of the American Optometric Association and also his extension work the following two years. In summation, a discussion of his professional philosophy will follow.

Containment of active employee health care costs is also a continuing employer concern. This author outlines a positive, comprehensive approach to the problem.