In 2006,

we began a cluster-randomized controlled trial of GC at eight practices (n = 49 physicians). Older patients of these practices were eligible to participate if they were at risk for using health services heavily during the coming year. Teams of two to five physicians and their at-risk older patients were randomized to either GC or usual care (UC). Six months after baseline, participants rated the quality of their health care by answering validated closed-ended questions from telephone interviewers who were masked to group assignment.

Results. Of the 13,534 older patients screened, 2391 (17.7%) were eligible buy MRT67307 to participate in the study, of which 904 (37.8%) gave informed consent and were cluster-randomized. After 6 months, 93.8% and 93.2% of the GC and UC participants who remained alive and eligible completed

telephone interviews. GC participants were more likely than UC participants to rate their care highly (adjusted odds ratio = 2.0, 95% confidence interval, 1.2-3.4, p = .006), and primary care physicians were more likely to be satisfied with their interactions with chronically ill older patients and Sonidegib supplier their families (p <.05).

Conclusions. GC improves important aspects of the quality of health care for multimorbid older persons. Additional data will become available as this trial continues.”
“Low density lipoprotein receptor-related protein, megalin, is a multifunctional lipoproptein receptor expressed by absorptive epithelia for endocytosis of numerous ligands. Megalin is widely expressed during embryonic life and is essential for development of the nervous system as evidenced by severe forebrain abnormalities in megalin (-/-). Astemizole Here, we investigated the influence of megalin deficiency on prenatal spinal cord development in mice. In contrast to wild-type mice, cells expressing Olig2 and NG2, that is, oligodendroglial precursor cells, are absent from embryonic stage E16 in megalin

(-/-) mice. At the end of prenatal development, there is a failure in vertebral development, and the number of astrocytes are markedly reduced in megalin (-/-) mice. These findings indicate that megalin is essential in astro-oligodendroglial interactions during development of the spinal cord.”
“We investigated mental health and cognitive function in 195 community-dwelling adults aged 18 to 92 years (M = 46.64). We assessed several cognitive domains, including psychomotor, executive function, and episodic memory. We found a significant Age X Mental Health interaction in relation to within-person (WP) variability (trial-to-trial variability in reaction time performance) in a four-choice psychomotor task and a Stroop task, but not in relation to mean reaction time measures from those tasks. Poorer mental health was associated with greater WP variability in older adults. We did not rind this effect in relation to memory.