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This paper studies student performance predictions based on the United States Medical Licensure Exam (USMLE) Step 1. Subjects were second-year medical students from academic years of 2002 through 2006 (n = 711). Three measures of basic science knowledge (two curricular and one extracurricular) were evaluated as predictors of USMLE Step 1 scores. The USMLE Step 1 scores correlated with performance on Organ Systems (r = 0.76), Human Structure (r = 0.65), and CBSE (r = 0.69). Accounting for 59% of variance in the USMLE Step 1 scores, Organ Systems course was a better predictor compared 2 2 to Human Structure (R[superscript 2] = 42%), or CBSE (R[superscript 2] = 51%). Combined, the curricular and extracurricular courses accounted for nearly 70% of total variance in the Step 1 scores. The study concluded that curricular courses are good predictors of student performance on the USMLE Step 1, and their value as identifiers of students at risk for failure is promising. (Contains 3 tables.)

Determines the nature and extent of illnesses and injuries among hospital workers in Ohio. Review of workers' compensation (WC) claims for 22 hospitals in Ohio from 1993-1996; Responsibility of the Ohio Bureau of Workers' Compensation (OBWC); Statistical analysis.

Background: Obesity, like multiple trauma, is associated with an inflammatory condition that leads to an immunodeficient state. Obese trauma patients are thus thought to be at higher risk of infection compared to patients of normal body mass. Despite this risk, studies to date have not defined obesity as an independent risk factor for infection in trauma patients., Study Design: Retrospective data were collected on 1,024 patients admitted to a Level I trauma center during a 12-month period. Obesity was defined as a body mass index (BMI) >or= 30 kg/m(2). Outcomes analyzed included urinary tract infection, pneumonia, septicemia, and wound infection and Clostridium difficile infection. Multiple logistic regression was used to evaluate the contribution of each BMI category to infection while adjusting for comorbidities, age, gender, Injury Severity Score (ISS), hospital and ICU lengths of stay, and number of ventilator days., Results: Obesity prevalence was 30.6%. Obese patients had longer hospital length of stay, with similar ISS, number of ventilator days, and ICU length of stay. The overall rate of infections was 8.7%. Variables independently associated with increased risk of infections were BMI, age, ISS, ICU length of stay, hospital length of stay, and multiple comorbidities. The risks of infections according to each BMI category were: BMI or= 40 kg/m(2), 20.3%, OR 5.91 (CI 2.18 to 16.01). Pulmonary and wound infections were significantly more frequent in obese patients., Conclusions: In this retrospective study, obesity was shown to be an independent risk factor for nosocomial infection after trauma. Prospective studies would clarify the reasons associated with this increased risk of infections in obese trauma patients., (Copyright (c) 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

This study examined the prevalence and correlates of smoking initiation among adolescents. We have used data from adolescents (n=5,392) ages 10-18 who participated in the 2003 Tobacco Survey, a representative sample of adolescents in Northwest Ohio. A self-report of cigarette smoking was obtained using a questionnaire administered in classrooms. Data were analyzed using weighted chi-square and multiple logistic regressions in SAS that accounted for the survey design. The prevalence rates for adolescents that ever tried smoking were 7.4% in elementary (grades 4-5); 17.7% in middle (grades 6-8), and 41.4% in high (grades 9-12) schools, respectively. The highest prevalence rate was among Hispanics. Having a close friend that smoked and a smoker at home correlated significantly with both initiation of smoking and smoking at an earlier age. Smoking was correlated with low academic achievement among adolescents in all grades. Students who reported smoking by parents or siblings were significantly more likely to start smoking at an earlier age, compared to other students living in a non-smoking home environment. Smoking prevention program should include components focused on adolescents' home environment and should start as early as the 4th grade.

Objective: In March 2002, the city of Bowling Green, Ohio, implemented a clean indoor air ordinance banning smoking in workplaces and public places. This study evaluates the effect of this ordinance on hospital admissions for smoking-related diseases., Methods: A quasi-experimental design with interrupted time-series was used including a matched control city (Kent, Ohio) with no clean indoor air ordinance. Data on hospital admissions during the period of January 1999 to June 2005 were analyzed using Autoregressive Integrated Moving Average (ARIMA) models., Results: A reduction in admission rates for smoking-related diseases was achieved in Bowling Green compared to the control city. The largest reduction was for coronary heart disease, where rates were decreased significantly by 39% after 1 year and by 47% after 3 years following the implementation of the ordinance. ARIMA models revealed a statistically significant downward trend in monthly admission rates for coronary heart disease (Bowling Green, omega=-1.69, p=0.036 vs. Kent, omega=-1.14, p=0.183) and support the hypothesis that the ordinance had a significant impact on admission rates for coronary heart disease., Conclusion: The findings of this study suggest that clean indoor air ordinances lead to a reduction in hospital admissions for coronary heart disease, thus reducing health care costs.

Although treatment of renal artery stenosis (RAS) with stents has been shown to improve blood pressure (BP) and renal function in some patients, little is known about the effect on health-related quality of life. A composite quality of life survey was administered in a cross-sectional cohort fashion to 149 patients presenting with angiographically and hemodynamically confirmed RAS either before (baseline, n = 37) or after (follow-up, n = 112) stent revascularization. BP, renal function, and antihypertensive medication use were also assessed. Systolic BP was lower in the revascularized patients (166 +/- 23 vs. 153 +/- 26, p < .01). The Short Form-36 Physical Component Summary (PCS) scores were higher (better) in revascularized patients (37 +/- 9 vs. 31 +/- 9, p < .01), whereas Mental Component Summary scores were equivalent (49 +/- 13 vs. 51 +/- 11, p = ns). Sleep dysfunction scores were lower (better) in the revascularized patients (32 +/- 26 vs. 48 +/- 32, p < .001), whereas self-reported appetite was higher (better; 62% +/- 29% vs. 73% +/- 27%,p < .05). After matching for age and gender, Short Form-36 PCS remained higher in the revascularized cohort (37 +/- 8 vs. 32 +/- 8, p < .05). Importantly, in multivariate analysis, revascularization was the most significant determinant of a higher PCS score (r2 = .07, beta = 5.21, p < .01). The current data suggest that renal artery stenting may improve health-related quality of life in patients with renovascular disease.