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Leslie Bloom,1 Kathleen E Boyle,2 Andrew E Myers,1 Claire Blacketer,3 Rachel Weinstein3 1Johnson & Johnson Consumer Inc, McNeil Consumer Healthcare Division, Fort Washington, PA, USA; 2KE Boyle Consultants, Exton, PA, USA; 3Janssen Research and Development, Titusville, NJ, USA Background: Coexisting medical conditions and concomitant medications contribute to treatment challenges primary-care professionals (PCPs) face daily. The current study assessed the extent and distribution of nonaspirin NSAID-relevant coexisting medical conditions of interest (CMCOI) in patients visiting PCPs. Methods: This retrospective database review analyzed data from three large health-care claim databases to identify the frequency of nonaspirin NSAID-relevant CMCOI among adults aged ≥18 years with a PCP visit in 2013. Claim databases employed were the Truven Health MarketScan® Commercial Claims and Encounters database, representative of the privately insured (PI) population; Truven Health MarketScan Multi-State Medicaid, representative of the Medicaid population (Medicaid); and Truven MarketScan Medicare Supplemental, representative of the Medicare population with employer-based supplemental Medicare insurance (Medicare-Supplement). Nonaspirin NSAID-relevant CMCOI, asthma, cardiovascular risk factors, gastrointestinal bleeding risk factors, and renal insufficiency were chosen based on US NSAID over-the-counter Drug Facts label warnings. Frequency of CMCOI was determined for those without and with a musculoskeletal diagnosis. Results: In each database, ≥19% (19.0% PI, 29.9% Medicaid, 33.6% Medicare-Supplement) had a musculoskeletal diagnosis. A greater proportion of individuals with a musculoskeletal diagnosis had one or more CMCOI compared with those without a musculoskeletal diagnosis (61.3% vs 50.4% PI, 78.1% vs 66.8% Medicaid, 87.1% vs 82.3% Medicare-Supplement). The frequency of one or more CMCOI increased with age in each database. Across databases among CMCOI, cardiovascular risk factors were most common, followed by gastrointestinal bleeding risk factors, and proportions were higher among those with a musculoskeletal diagnosis. Conclusion: These data confirm the high frequency of nonaspirin NSAID-relevant CMCOI among patients presenting to PCPs for musculoskeletal diagnosis, as well as among older patients. These analyses reinforce the critical role health-care professionals can play in identifying patients with nonaspirin NSAID-relevant CMCOI, providing those patients with ongoing guidance on appropriate choice and use of over-the-counter analgesics, and educating patients about the impact aging, health status, concomitant conditions, and medicines have on selection of all medicines, including analgesics. Keywords: coexisting medical conditions, NSAIDs, musculoskeletal disease, health claim databases, OTC analgesics

African Americans are over-represented in school suspensions, yet little is known about the underlying contributing dynamics. Study 1 reviewed a high school's annual discipline data and 442 students referred for defiance. African Americans were over-represented in referrals for defiance and most students received referrals from one or several teachers. This suggests that defiance referrals are specific to the classroom situation. Examining the situational specificity of referrals, Study 2 used repeated measures and multilevel modeling with a sub-sample of 30 African American students. Attendance, grades, and teacher reports showed that students behaved more defiantly and less cooperatively with teachers perceived as having untrustworthy authority. Predictors of African American student trust in teacher authority included teacher caring and high expectations, offering implications for lowering the discipline gap. (Contains 2 tables and 2 figures.)

Many national meetings and speaker series feature an “Annual Review of the Literature” (ARL) session in which an individual or team presents a sampling of articles, selected and prepared because they represent important current topics or new ideas in the discipline of interest. Despite this, there is little in the medical literature describing how to thoughtfully and systematically develop these sessions. We identify best practices that we have developed and used in the United States Clerkship Directors of Internal Medicine (CDIM) over many years. These include identification of a theme, team assembly, timeline development, search strategy and rubric development and employment, and presentation planning strategies. Employing the steps described can help facilitate this otherwise arduous process.

Research has been conducted on the classical receptors and their transcriptional activity. The effect of sex steroids on the osteoblasts, osteocytes, embrionic fibroblasts and HeLa cells which involve Src/Shc/ERK signaling pathway and attenuating apoptosis activation has been investigated and the results are reported.