Prevalence of manometric abnormalities in the morbidly obese is high. Presence of a nut cracker-like distal esophagus in the morbidly obese is significant and warrants further evaluation.

Background: Outcomes in patients having surgery for gastroesophageal reflux disease are most commonly determined by symptomatic assessment. Objective testing is usually reserved for symptomatic patients. Hypothesis: To evaluate the relationship between symptomatic and objective outcomes after antireflux surgery. Design: Retrospective analysis of prospectively collected data. Setting: A tertiary care teaching hospital with a comprehensive esophageal physiology laboratory. Interventions: A 360°(Nissen) fundoplication or a 270°(Toupet) posterior fundoplication was performed based on esophageal motility. Twenty-four-hour pH monitoring was used as a gold standard for assessing postoperative acid reflux.

No abstract

Context: As educators, athletic trainers should familiarize athletes with the concepts of self-acceptance self-esteem and identity to assuage psychological trauma accompanying injury because the more a person identifies with being an athlete, the more difficult it is to deal with athletic injury. Objective: The objective of this article is to provide practical information to athletic trainers to assist them with their educative role in addressing athletes' identity loss that often accompanies athletic injury. Background: Measures of psychological trauma accompanying physical trauma show that psychological trauma can be extreme. Furthermore, the loss of identity is a major factor for athletes who are dealing with the psychological trauma of athletic injuries. Athletic trainers who assume responsibility to address issues of psychological loss from athletic injury can be a great benefit to the injured individual. Description: The use of the Worth Index, which differentiates between self-acceptance self-esteem and achievement self-esteem, demonstrates that it is possible for people to perceive their personal worth and identity as distinct from their behavior. Athletic trainers are in an excellent position to interact with athletes and utilize specific questions to facilitate dialogue related to identity and self-esteem. Clinical Advantages: In practice, clinical advantages may include improving an athlete's ability to put a physical injury in proper perspective, strengthening their commitment to rehabilitation, and avoiding complications due to emotional trauma. Conclusions: Athletic trainers must recognize their educative responsibilities and assist injured athletes in addressing issues of identify loss.

A measure of the perception of the source of one's worth was developed. The Worth Index focussed on whether people think that the value or worth of their lives is something which they must earn or is something that is innate and therefore cannot be earned. Estimates of validity and reliability are reported.