69; 95% CI, 0.54 to 0.88; P = 0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or

perinatal death.

CONCLUSIONS

The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates.”
“Objectives. The National Social Life. Health, and Aging Project (NSHAP) data contain multiple indicators of social connectedness, social participation, social learn more support, and loneliness

among older adults. We suggest that these indicators call be combined to measure two aspects of social isolation: social disconnectedness (i.e., physical separation from others) and perceived isolation (i.e.. feelings of loneliness and a lack of social support). We use the NSHAP data to create scales measuring social disconnectedness and perceived isolation and examine their distribution among older adults.

Methods. We assess the reliability of the scales using find more Cronbach’s alpha and item-total correlations and perforin confirmatory factor analysis to test the model against the data. Finally, we test differences in scale means across subgroups to assess the distribution of social disconnectedness and perceived isolation among older adults.

Results. We find that 17 indicators combine into two reliable scales. The social disconnectedness scale has a two-factor structure, L-NAME HCl including the restricted social network dimension and the social inactivity dimension. The perceived

isolation scale also comprises two dimensions: lack of support and loneliness. We find that social disconnectedness does not vary across age groups, but the oldest old feel more isolated than the young old. Social disconnectedness and perceived isolation are greater among those who have worse health.

Discussion. The creation of scales measuring social disconnectedness and perceived isolation provides, one way to utilize the wide variety of indicators of social isolation collected in the NSHAP study. Although individual indicators of social connectedness or isolation are useful in their own right, these scales provide parsimonious, continuous variables that account for a variety of aspects of social isolation, which may be especially useful for inclusion ill multivariate analyses predicting health outcomes.”
“A 65-year-old man with a history of well-controlled hypertension presents for a follow-up visit after an incidental finding of a small mass in the right kidney on an abdominal computed tomographic (CT) scan. (The scan had been ordered to evaluate pain in the lower quadrant, which resolved.) The mass is 3.