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Background: The therapy for differentiated thyroid tumors is currently built upon two cornerstones: the stage of the disease and the new guidelines of the American Thyroid Association, jointly converging to lobohystmectomy for selected cases that meet certain criteria. The aim of the study was to relate these guidelines to the activity of an Italian center with a medium-high volume of thyroidectomies in a region with a high rate of endemic disease of the thyroid., Methods: In order to conduct the analysis, the clinical records of the last 3 years, including 194 cases of total thyroidectomy and 3 lobohystmectomy, were taken into consideration. There were 46 cases of differentiated thyroid cancer (18 incidental tumors were found during thyroidectomies for benign diseases). Postoperative complications, patient characteristics and the stage of the tumor were assessed in relation to the new ATA guidelines., Results: All patients underwent total thyroidectomy, with 2 of them also undergoing lymphadenectomy. The incidence of transient hypoparathyroidism was 19% with 1 case of permanent deficit. No cases of recurrent nerve injury were reported. Twenty-five out of the 28 patients with cancer preoperatively diagnosed were found with more nodules and in 15 of them the nodule had a diameter bigger than 1 cm. All the parameters suggested lobohystmectomy only for one case. The treatment for the differentiated thyroid tumor is still widely discussed. Above all, differences between populations, screening methods and surveillance programs are still evident., Conclusions: The ATA guidelines applied to our cases, even if limited, have shown limited applicability to our study, mainly due to the high incidence of multinodularity and the size of the nodule: typical characteristics of a region with a high rate of endemic thyroid pathology.

Childhood obesity is a major public health challenge. This article describes an overview of the National Institutes of Health (NIH) behavioral and social sciences childhood obesity research efforts. The overview will highlight five areas of childhood obesity research supported by the NIH: (a) basic behavioral and social sciences; (b) early childhood; (c) policies, programs, and environmental strategies; (d) health disparities; and (e) transagency and public-private collaboration. The article also describes potential gaps and opportunities in the areas of childhood obesity and severe obesity, measurement, and sleep.

The goal of the NIH Science of Behavior Change (SOBC) Common Fund Program is to provide the basis for an experimental medicine approach to behavior change that focuses on identifying and measuring the mechanisms that underlie behavioral patterns we are trying to change. This paper frames the development of the program within a discussion of the substantial disease burden in the U.S. attributable to behavioral factors, and details our strategies for breaking down the disease- and condition-focused silos in the behavior change field to accelerate discovery and translation. These principles serve as the foundation for our vision for a unified science of behavior change at the NIH and in the broader research community., (Copyright © 2017. Published by Elsevier Ltd.)

Interest in the application of systems science (SS) to obesity and noncommunicable chronic disease (NCD) research has been growing rapidly over the past decade as the epidemic of obesity and NCDs continues to grow globally. This article summarizes the key messages of the presentations made in the special symposium “Applications of Complex Systems Science in Obesity and Noncommunicable Chronic Disease Research,” held during the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014. Invited leaders from various fields presented cutting-edge aspects of the applications of SS in public health research, with a focus on obesity and NCDs. In addition, the symposium was capped with a discussion on funding opportunities from the NIH. The speakers described the nature of SS, how it could be applied to biomedical and public health research, lessons from SS to inform obesity and NCD interventions, and the promises, challenges, and recommendations going forward.

Background: Globally, natural and created events have underscored the vulnerability of children in disasters. There is an unmet need for a standardized pediatric disaster medicine (PDM) curriculum., Objective: To create and implement a PDM course, measure course efficacy, and assess residents' attitudes toward and experience in disaster medicine., Design/methods: An educational intervention was conducted for pediatric and emergency medicine residents at a tertiary care teaching hospital. Participants completed a precourse survey of PDM attitudes and experience. Paired t tests were used to compare pretest, immediate posttest, and delayed posttest scores. Test performance was assessed by resident type and postgraduate year. A postcourse survey gauged reaction to the course and interest in further PDM training., Results: Among the participants, 11 residents (9.4%) have treated disaster victims, and 5 (4.3%) had formal disaster medicine education. Most (83%) felt PDM is an important part of their training. Seventy-five eligible residents (64.6%) completed the intervention. Pairwise comparison of scores showed a mean improvement in scores of 24.5% immediately after taking the course (95% confidence interval, 22.9%-30.1%; P < 0.001). Two months later, residents scored a mean of 69.0% for the delayed posttest, with a retained improvement in scores (18.3%; 95% confidence interval, 14.3%-22.3%; P < 0.001). Residents preferred future PDM exercises to additional didactic training (72.0% vs. 32.7%; P < 0.001%)., Conclusions: Residents who complete this curriculum increase their knowledge of PDM with moderate retention of information. Most residents lack PDM training, believe it is important, and request disaster-training exercises.

Nurses in newborn nurseries and neonatal intensive care units are instrumental in educating parents about reducing the risk for SIDS. Nurse participation is acknowledged and encouraged in the current policy statement on SIDS Risk Reduction put forth by the American Academy of Pediatrics. Despite the decline in SIDS, it remains the leading cause of postneonatal infant mortality, and despite greater public compliance with the risk reduction guidelines there is room for improvement in how effectively and consistently they are disseminated. To facilitate nursing participation as educators, role models, and collaborators in the development of relevant hospital policies and procedures, we review the current recommendations, addressing issues that may serve as barriers to participation, describing the biological plausibility underlying risk-reducing practices, and presenting resources from which nurses may obtain teaching materials and model policies.

Good media relations can help providers thrive in this era of intense scrutiny. By following a few simple pointers agency executives can foster positive relationships with the media and ensure fair and accurate reporting of agency activities.

Are home care patients as knowledgeable about their medications and do they take them with as much adherence to prescription as their counterparts in senior citizen housing do? A study concentrates on knowledge and compliance in two geriatric populations.

Proposals for changes in the earnings test continue to be made. An important element in a decision to change the test is who receives the increased benefits resulting from the change. This article estimates and analyzes the distribution of increased benefits resulting from: (a) The liberalization in the test contained in the 1977 social security amendments, (b) possible future liberalizations of the earnings test, and (c) repeal of the earnings test. The authors conclude that any changes in the earnings test will not affect 90 percent of the aged population with respect to the level of benefits received because most have little or no earnings. The effect on the other 10 percent of the aged population will depend on which parameter opf the earnings test is changed. Lowering the age at which the earnings test no longer applies will be primarily advantageous to the 5 percent of the aged population at the top of the earnings distribution. Increasing the exempt amount within the range considered in this article (from $6,000 to $10,000) will be primarily advantageous to the 5 percent of the aged population in the middle of the earnings distribution. Lowering the tax rate on earnings above the exempt amount would affect high and middle earners equally.

During debate on the 1977 Social Security Amendments, it was suggested that the impact on firms of a change in the mamximum taxable amount under the social security program would in part depend on the size of the firm. This study analyzes the relationship between increases in employer payroll-tax liability and both firm size and industry group. The authors conclude that there are substantial firm-size and industry effects on the increases in employer payroll-tax liability resulting from the 1977 amendments, with the largest firms experiencing, on the average, increases about three percentage points higher than those for the smaller firms. If the taxable maximum were changed (either doubled or removed) from the base established by the 1977 amendments, the industry effect would again be substantial, although there would be little or no firm-size effect.