compared to usual care, a multi-faceted intervention increased referrals to physiotherapy and occupational therapy but did not reduce risk of falls. Similar falls reduction interventions cannot be recommended based on the results of this study.

BackgroundOsteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures.MethodsThis was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management.Results101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65).ConclusionsA multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care.Trial RegistrationThis trial has been registered with clinicaltrials.gov (ID: NCT00465387)

Objectives: Focused deterrence seeks to change the violent behavior of gangs not directly targeted by the intervention by leveraging network ties between groups. This study appraises group-based and place-based methodologies in detecting direct and spillover crime reduction impacts of a focused deterrence strategy implemented in Oakland, California. Method: Quasi-experimental designs and panel regression models were used to compare shooting trends for directly treated gangs and census block groups to shooting trends for comparison gangs and block groups that did not directly receive the treatment. The design further analyzed whether vicariously treated gangs and untreated block groups immediately surrounding treated block groups experienced spillover shooting reductions. Results: The focused deterrence program generated statistically significant direct reductions in shootings in treated block group areas and by treated gangs relative to shootings in untreated block group areas and by untreated gangs, respectively. Spillover deterrent effects of varying magnitudes were found when shooting trends by vicariously treated gangs and in surrounding block groups were compared to shootings trends in comparison units. Conclusions: Group-based evaluation methodologies were better positioned to detect changes in violent gang behaviors after treatment and to shed light on deterrence mechanisms supporting program efficacy. Future focused deterrence studies should be theory driven rather than black box evaluations.

Implementing a protocol to screen for woman abuse into an existing maternal child home visiting program demonstrated improved practices related to the safety and privacy of women, and an increase in abuse disclosures.

Robot-assisted ureterectomy and ureteral reconstruction is safe and feasible, and offers patients the advantages of minimally invasive surgery. Future studies with additional patients and longer follow-up will determine the oncologic effectiveness of this procedure.