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Background: The results of mitral valve repair operations conducted at community hospitals in rural states are not well studied or reported in the literature. Methods: We retrospectively assessed consecutive patients who underwent isolated mitral valve repair operations performed by a single experienced cardiothoracic surgeon at a large community hospital from May 1, 2006 - April 30, 2010. Patients were monitored for up to three years (average 2.2 years) following surgery for a variety of surgical variables, including morbidity, mortality, and serial two-dimensional transthoracic echocardiographic findings. Comparisons were made with the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD). Results: Sixty-three consecutive patients underwent isolated complex mitral repair operations. Echocardiographic and morbidity data demonstrated successful outcomes, with no operative mortality and a single cardiac-related death within three years postoperatively. Other variables, especially those that relate to post-repair outcomes, showed no significant differences between our patients and comparison data from the ASCD. Conclusions: Our study demonstrates equivalent risks and outcomes for complex mitral valve repair performed in a community hospital setting as those found in a national database. The appropriate institutional setting for performing highly complex procedures has substantial implications for health policy, especially regarding access and quality issues. [ABSTRACT FROM AUTHOR]

To explore 3- to 7-year-old children's developing understanding of human and non-human minds, a battery of "background knowledge" tasks was administered to 51 American children. The children were asked to speculate about how three other intentional agents (mother, dog, and God) would understand various visual displays. First, children answered when they themselves did not understand the displays, then they answered after they had been given information necessary to understand the displays. Results revealed that children begin to understand the role of background knowledge around the same age that they pass false-belief tasks; and that before thoroughly understanding the role of background knowledge they already begin to discriminate between different types of minds. By age four, children began to show some understanding that because of having different minds than people, God is more able and dogs are less able to understand some visual displays even with full visual access. [ABSTRACT FROM AUTHOR]