Objective.To identify what consumers want to know about nursing homes (NHs) before choosing one and to determine whether information preferences vary across race/ethnicity. Data Sources/Study Setting. Primary data were collected in Greater Boston ( January 2013-February 2014) from community-dwelling, white, black, and Latino adults aged 65+ and 40-64 years, who had personal/familial experience with a NH admission or concerns about one. Study Design. Eleven focus groups and 30 interviews were conducted separately by race/ethnicity and age group. Principal Findings. Participants wanted detailed information on the facility, policies, staff, and residents, such as location, staff treatment of residents, and resident conditions. They wanted a sense of the NH gestalt and were interested in feedback/reviews from residents/families. Black and Latino participants were especially interested in resident and staff racial/ethnic concordance and facility cultural sensitivity. Latino participants wanted information on staff and resident language concordance. Conclusions. Consumers want more information about NHs than what is currently available from resources like Nursing Home Compare. Report card makers can use these results to enhance their websites, and they should consider the distinct needs of different racial/ethnic groups. Future research should test methods for collecting and reporting resident and family feedback/reviews. Key Words. Nursing homes, consumer information, public reporting, race/ ethnicityThe health care market has embraced public reporting, and The Centers for Medicare and Medicaid (CMS) alone has report card websites for hospitals, home-health providers, nursing homes (NHs), dialysis facilities, and physicians, with more to come for other providers like hospice and inpatient

Objective: To investigate the current practice of intratympanic steroid (ITS) injection for sudden sensorineural hearing loss (SSNHL) in the United Kingdom and link the data with data from the United States and continental Europe. Methods: A survey of 21 questions was distributed to members of the British Society of Otology using an online survey platform via ENT UK. Data obtained from UK otolaryngologists (n = 171) were integrated with previously published data from other countries, including the United States (n = 63) and continental Europe (n = 908). Results: In the United Kingdom, 62% of responding otolaryngologists use ITS injection for SSNHL, while 38% do not. Of those using ITS, 59% use it as first-line treatment, either using it in conjunction with oral steroids (51%) or using it as monotherapy (8%). Of those that use ITS, a majority (83%) use it as salvage therapy when primary treatment with systemic steroids has failed, and similar results are found in the continental Europe and US surveys. The most commonly used preparation is dexamethasone. Responses to questions regarding treatment regimes used are enlightening and show considerable variation in the treatment regimes used within and between countries. Conclusions: There is a wide variation in practice with regards to ITS for SSNHL hearing loss in the United Kingdom, United States, and continental Europe. In the absence of protocols or definitive guidance from published literature, knowledge of contemporary practice may help guide or encourage reevaluation of clinical practice and will help guide the design of future clinical trials.

ObjectivesTo determine: (1) the incidence of incidental ‘mastoiditis’ reported on magnetic resonance imaging scans performed in patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus; (2) how many of those patients have actual otological pathology and/or require treatment; and (3) the financial implications of such a reporting practice.MethodRetrospective case series.ResultsBetween October 2015 and November 2016, 500 patients underwent magnetic resonance imaging of the internal auditory meatus to rule out cerebellopontine angle lesions. There was an incidental finding of increased mastoid signalling in 5.8 per cent (n= 29), of which 20.7 per cent (6 of 29) were reported as bilateral cases. The diagnosis of ‘mastoiditis’ was found in 39.7 per cent (29 of 73). None of these patients had any pathology identified clinically. Other significant pathology was identified in a further 8.8 per cent (n= 44).ConclusionThe diagnosis of mastoiditis is primarily clinical. An incidental finding of high signalling in the mastoid region on magnetic resonance imaging is highly unlikely to represent actual clinical disease. In patients who are scanned for other reasons and who do not complain of otological symptoms, such findings are unlikely to require otolaryngology input.

OBJECTIVES:To assess item analysis and dimensional validity of a new questionnaire developed to measure Satisfaction with medical care in patients with atrial fibrillation, in order to accomplish item reduction. METHODS: The initial instrument was composed by 37 items, arranged in 6 dimensions: 1-Efficacy (4 items), 2-Ease and convenience (7 items), 3-Impact on daily activities (11 items), 4-Satisfaction with medical care (6 items), 5-Medication undesired effects (6 items), and 6-Overall satisfaction (4 items). Items and dimensions where extracted from reviewing previous English instruments, 3 focus groups with chronic patients, and a panel composed by 8 experts. Additionally 3 Visual Analog Scales (VAS) measuring Quality of Life, Effectiveness and Overall Satisfaction were applied. A convenience sample of 118 patients was used. Classic psychometric theory item analysis techniques, exploratory factor and confirmatory factor analysis, test-retest and correlation with VAS scales were used. RESULTS: The questionnaire was reduced in length to 25 items, but the Impact dimension had to be divided in 2 dimensions: Treatment inconvenience and Treatment Control. The reduced version presents an overall Cronbach alpha of 0.861, with acceptable dimensional reliabilities (0.764-0.908). Individual dimensions were well formed and correlated in different degrees, being the dimension of Satisfaction with medical care the most independent one. Test-retest correlations were high (0.784-0.965) and correlations with VAS scales were meaningful. CONCLUSIONS: The 25-item questionnaire shows good reliability and validity to assess satisfaction with medical care in patients with atrial fibrillation. Further research is needed to examine if the questionnaire could be generalized to different populations of patients with atrial fibrillation. OBJECTIVES:To describe demographical and medical characteristics of patients treated with bi-or multi-antihypertensive therapies and to outline the link between therapeutic scheme, blood pressure control and patients co morbidities. METHODS: A retrospective study was undertaken, based on the IMS Lifelink Electronic Medical Records database (Disease Analyzer), investigating age, gender, blood pressure control and co morbidities according to the number and type of associated antihypertensive therapies. RESULTS: A total of 13,618 patients, treated by bi-or multi-antihypertensive therapies and for whom blood pressure levels were available have been included in a 2008 study cohort (mean age ϭ 66.8, 48% men). Respectively 39% and 58% of patients had a controlled blood pressure depending on the threshold of the control (Ͻ140/90 or Ͻϭ140/90), showing the importance of the precise threshold in real-life. Respectively 1.5% and 0.3% of patients had a blood pressure of over 160/100 and over 180/110. Significantly more patients (p Ͻ0.05) have a controlled blood pressure under tri-therapy (41.6%/64.2% according to the two previous thresholds) rather than under bi-therapy (37.9%/57.8%), but no control difference is se...