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Recent behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment and with all training components delivered by an expert staff trainer. The purpose of the current study was to replicate and extend this literature by substituting video‐based training for behavioral skills training. We assessed whether expectant caregivers could arrange safe infant sleeping environments following video‐based training. The results suggested that video‐based training alone resulted in positive outcomes for a portion of participants, whereas a subset of participants required feedback to reach mastery criteria. The social validity data suggest that the participants found the training procedures favorable. [ABSTRACT FROM AUTHOR]

The article discusses how federal and state laws to combat doxing, swatting and other malicious cyberharassment fail to protect their victims. Topics covered include background and history of laws pertaining to cyberharassment, courses of action the Texas legislature may take in addressing and crafting laws proscibing cyberharassment, and updates to language in existing laws to better address particular issues caused by various forms of cyberharassment.

Aims We sought to describe our experience with major coronary anomalies (MCAs) diagnosed in transthoracic echocardiography (TTE) in a large adult and paediatric population. MCAs may have serious clinical consequences. No echocardiographic studies have prospectively screened MCA in a general adult and paediatric population. Methods and results From June 2008 to January 2012, a systematic search for MCA was prospectively conducted in children and adult patients, coming for a TTE. Three thousand five hundred and two patients (84% adults and 16% children) underwent a TTE. Fourteen coronary anomalies (0.39%) were diagnosed: nine anomalous origins of coronary artery from the opposite sinus with inter-arterial course, one abnormal left coronary artery from the pulmonary artery, three single coronary ostia, and one coronary fistula. Cardiac symptoms initiated investigation in seven patients. Five patients underwent specific surgery: two coronary reimplantations and three coronary bypass grafting. Ten patients had already undergone at least one TTE with the anomalous coronary artery being neither diagnosed nor suspected. Conclusions MCA is a rare condition. TTE appears to be a potentially useful modality for the initial screening of MCA in adults and children, provided special attention is paid to coronary artery analysis. [ABSTRACT FROM PUBLISHER]

Objective. To assess the use and validity of prediction models to estimate the risk of cardiovascular disease (CVD) in Latin America and among Hispanic populations in the United States of America. Methods. This was a systematic review of three databases: Ovid MEDLINE (1 January 1950-15 April 2010), LILACS (1 January 1988-15 April 2010), and EMBASE (1 January 1988-15 April 2010). MeSH search terms and domains were related to CVD, prediction rules, Latin America (including the Caribbean), and Hispanics in the United States. Database searches were supplemented by correspondence with experts in the field. Results. A total of 1 655 abstracts were identified, of which five cohorts with a total of 13 142 subjects met inclusion criteria. A Mexican cohort showed that the predicted/observed event-rate ratio for coronary heart disease (CHD) according to the Framingham risk score (FRS) was 1.68 (95% CI, 1.26-2.11); incident myocardial infarction, 1.36 (95% CI, 0.90-1.83); and CHD death, 1.21 (95% CI, 0.43-2.00). In Ecuador, a prediction model for CVD and total deaths in hypertensive patients had an area under the curve (AUC) of 0.79 (95% CI, 0.72-0.86), while the World Health Organization method had an AUC of 0.74 (95% CI, 0.67-0.82). A study predicting mortality risk in people with Chagas' disease had an AUC of 0.81 (95% CI, 0.72-0.90). Among a United States cohort that included Hispanics, FRS overestimated CVD risk for Hispanics with an AUC of 0.69. Another study in the United States that assessed FRS factors predicting CVD death among Mexican-Americans had an AUC of 0.78. Conclusions. The evidence regarding CVD risk prediction rules in Latin America or among Hispanics in the United States is modest at best. It is likely that the FRS overestimates CVD risk in Hispanics when not properly recalibrated. [ABSTRACT FROM AUTHOR]

The purpose of this article is to determine, from the biographical material contained in socially important marriage announcements, what characteristics are common to the group assumed to be at the top of the social system in New York City, and what, if any, are the integrating standards of the group. The information used was taken from a total of 413 marriage announcements featured by the social editors of "The New York Times" in lead articles. The period of time covered was 1932-1942, and the material was limited to Sundays in June of these years. Marriage announcements have come to follow a stereotyped form and consistently include certain information regarding the bride, the groom and their families. In addition to descriptions of the costumes of the bridal party and of the marriage ceremony, the announcement, as a rule, contains a brief summary of the background of the bride and groom and facts concerning their families, notably, residence, and social and occupational distinction of the families.

Background: Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non–cardiothoracic teaching hospitals nationwide. Study Design: From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non–cardiothoracic teaching hospitals were identified using the Association of American Medical College''s Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Results: Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Conclusions: Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. [Copyright &y& Elsevier]

Background: Many factors affect outcomes after congenital cardiac surgery.Objectives: The RLS (Residual Lesion Score) study explored the impact of severity of residual lesions on post-operative outcomes across operations of varying complexity.Methods: In a prospective, multicenter, observational study, 17 sites enrolled 1,149 infants undergoing 5 common operations: tetralogy of Fallot repair (n = 250), complete atrioventricular septal defect repair (n = 249), arterial switch operation (n = 251), coarctation or interrupted arch with ventricular septal defect (VSD) repair (n = 150), and Norwood operation (n = 249). The RLS was assigned based on post-operative echocardiography and clinical events: RLS 1 (trivial or no residual lesions), RLS 2 (minor residual lesions), or RLS 3 (reintervention for or major residual lesions before discharge). The primary outcome was days alive and out of hospital within 30 post-operative days (60 for Norwood). Secondary outcomes assessed post-operative course, including major medical events and days in hospital.Results: RLS 3 (vs. RLS 1) was an independent risk factor for fewer days alive and out of hospital (p ≤ 0.008) and longer post-operative hospital stay (p ≤ 0.02) for all 5 operations, and for all secondary outcomes after coarctation or interrupted arch with VSD repair and Norwood (p ≤ 0.03). Outcomes for RLS 1 versus 2 did not differ consistently. RLS alone explained 5% (tetralogy of Fallot repair) to 20% (Norwood) of variation in the primary outcome.Conclusions: Adjusting for pre-operative factors, residual lesions after congenital cardiac surgery impacted in-hospital outcomes across operative complexity with greatest impact following complex operations. Minor residual lesions had minimal impact. These findings may provide guidance for surgeons when considering short-term risks and benefits of returning to bypass to repair residual lesions. [ABSTRACT FROM AUTHOR]