Era Of Birth Research Articles

A Focus on the Reminiscence Bump to Personalize Music Playlists for Dementia.

PurposeMusic and memory are inextricably linked, and the recollection of music varies according to age. In order to create personalized music playlists tailored for people living with dementia, this study aimed to determine the age at which healthy individuals could best recall music that was popular at the time.MethodsA survey was designed asking participants to identify the number of songs they recalled from a random selection of 10 from the 100 most popular songs from each year, presented in random order of years, from 1945 to 2015. Of the 311 individuals born between 1929 and 2002, who responded to the survey, 157 met the inclusion criteria.ResultsThe median peak of recollection was between the ages of 13 and 19 across all age-cohorts, with participants recalling a maximum median number of 6–8 songs in all of the age-cohorts. There was no evidence of a difference in the peak age of recollection between those who recognized seven or more songs in at least 1 year and those who recognized fewer than seven songs in all years.ConclusionThe peak of recollection of popular music occurs in the teenage years, regardless of era of birth. Music from this “reminiscence bump” provides a rich source of retained music that should be tapped when creating playlists of meaningful music for people living with dementia.

Neurodevelopmental Outcome in Very Low Birth Weight Infants Exposed to Donor Milk.

This study was aimed to evaluate the impact of donor milk (DM) received in the first 28 days of life (DOL) on neurodevelopmental (ND) outcome at 20-months corrected age (CA) in very low birth weight (VLBW) infants. A total of 84 infants born in 2011 to 2012 who received only mother's own milk (MOM) and/or preterm formula (PF) was compared with 69 infants born in 2013 to 2014 who received MOM and/or DM. Daily enteral intake of MOM, DM, and PF was collected through 28 DOL. ND outcomes were assessed with the Bayley-III. Multiple regression analyses adjusted for the effect of social and neonatal risk factors alongside era of birth on ND outcome. Infants exposed to DM were born to older mothers (p < 0.01) and had higher incidence of severe brain injury (p = 0.013). Although DM group infants received first feed at earlier DOL (p < 0.001), there were no differences in MOM intake at DOL 14 or 28 between the two groups. In regression analyses, DM group did not predict 20-month ND outcome. There were no differences in ND outcome between infants born before and after the introduction of DM. This may have been due to the similar percent of MOM at DOL 14 and 28 in the two eras. · Donor milk use is increasing in VLBW infant. The impact of donor milk on neurodevelopment is unclear.. · Provision of mother's own milk was high at days of life 14 and 28 for both groups of infants.. · Donor milk was not associated with improved neurodevelopmental outcome..

In Memoriam: Mortimer L. Mendelsohn: (1 December, 1925-8 January, 2020).

In Memoriam: Mortimer L. Mendelsohn: (1 December, 1925-8 January, 2020).

Abstract P105: Associations of Childhood Obesity With Cardiometabolic Risk Factors by Era of Birth: The I3c Consortium

Introduction: The prevalence of childhood obesity has increased dramatically over the past several decades, but it is unclear whether children and adolescents with obesity are experiencing more or fewer cardiometabolic risks from obesity now compared with several decades ago. This study leverages data from over 2600 children and adolescents with obesity born from 1951-1996 to determine whether relationships of obesity with cardiometabolic risk have changed over time. Methods: The first study visit, age 3-19, was used to classify individuals by era of birth (quartiles: 1951-1963, 1964-1969, 1970-1974, 1975-1996), weight status (obesity defined as BMI&gt;CDC 95 th %ile and &lt;120% of the 95 th %ile), high BP (SBP or DBP&gt;95 th %ile), high total cholesterol (TC&gt;170 mg/dl), high LDL-C (&gt;110 mg/dl), high triglycerides (TG&gt;100 mg/dl), high glucose (&gt;100 mg/dl), and low HDL-C (&lt;40 mg/dl males, &lt;50 mg/dl females). Participants with obesity (excluding severe obesity) were included in this analysis. Logistic regressions were adjusted for age, sex, race and study cohort to calculate odds ratios relative to the most recent era of birth (1975-1996). Results: The prevalence of childhood obesity increased from 6.1% in the earliest birth era to 7.7% in the most recent (p&lt;0.0001). The adjusted odds of children with obesity having high TC (p&lt;0.0001), high TG (p&lt;0.0001), and high BP (p=0.003) were half as likely among children born between 1964-69 or 1970-74, compared with the most recent birth era (Table). The odds of children with obesity having high LDL (p=0.59), low HDL (p=0.17) or high glucose (0.33) did not differ across birth eras. Conclusions: Childhood obesity in more recent decades has not only become more prevalent, but is associated with greater risks of high TC, high TG and high BP. However, the risks of high LDL, low HDL and high glucose have not significantly changed among children with obesity who were born between 1951 and 1996. Thus, comparisons of children or adolescents with obesity across eras should consider these differing risk profiles.

Predicting Home Run Production in Major League Baseball Using a Bayesian Semiparametric Model

ABSTRACTThis article attempts to predict home run hitting performance of Major League Baseball players using a Bayesian semiparametric model. Following Berry, Reese and Larkey we include in the model effects for era of birth, season of play, and home ball park. We estimate performance curves for each player using orthonormal quartic polynomials. We use a Dirichlet process prior on the unknown distribution for the coefficients of the polynomials, and parametric priors for the other effects. Dirichlet process priors are useful in prediction for two reasons: (1) an increased probability of obtaining more precise prediction comes with the increased flexibility of the prior specification, and (2) the clustering inherent in the Dirichlet process provides the means to share information across players. Data from 1871 to 2008 were used to fit the model. Data from 2009 to 2016 were used to test the predictive ability of the model. A parametric model was also fit to compare the predictive performance of the models. We used what we called “pure performance” curves to predict future performance for 22 players. The nonparametric method provided superior predictive performance.

Umat Kristiani dan Politik Praktis di Indonesia: Dari Politik Minoritas ke Politik Pluralisme

Abstract: Theological attitude and political position of Christians in Indonesia is ambivalent, wich cause these people to be cornered as minority parasite. This situation needs to be adressed, and deeper understanding of Reformed heritage and Sam Ratulangis struggle in the dire era of Indonesian birth in 1945 can inspire a new mode of theology and Indonesian Christian political presence today. In this light, the strategic direction of Christian politics lies in the pluralism political movement. KEYWORS: incognito, civil obedience, minority politics, majoritarianism, politics of citizenship plurality

Pathologic Study of Intracranial Large Artery Atherosclerosis in 7260 Autopsy Cases

Atherosclerotic changes in the cerebral arteries may differ with era of birth. Herein, we analyzed the chronological changes of intracranial atherosclerosis in consecutive autopsy cases. A total of 7260 autopsy cases from 1972 to 2014 were analyzed. Severity of atherosclerosis was classified using a semi-quantitative scale of pathologic observation of each artery after formalin fixation: 0 = no stenosis; .5 = fatty streaks but no stenosis; 1 = <50% stenosis; 2 = 50%-90% stenosis; 3 = ≥90% stenosis. The bilateral vertebral, anterior, middle, and posterior cerebral arteries and the basilar artery were scored. The sum of each individual was defined and compared by age at death, sex, and era of birth. The atherosclerosis score increased with age at death, as follows: age in the 50s, 0 [0-2]; 60s, 3 [.5-7]; 70s, 5 [2-9.5]; 80s, 6.5 [3.5-11.5]; 90s, 7.75 [4-12]; and 100s, 8 [5.5-13.5] (median value [interquartile range], P< .0001). The percentage of cases with a score of 2 or 3 in each artery also increased with age (P< .0001). Atherosclerosis score was higher in men than women in their 60s at death, and was higher in women than men in their 80s and 90s at death. In each age at death group (from 60s to 100s), the score declined with later year of birth (P < .05). Intracranial atherosclerosis advances with age and is more severe in subjects born earlier.

Mental health of extremely low birth weight survivors: A systematic review and meta-analysis.

Although individuals born at extremely low birth weight (ELBW; < 1,000 g) are the most vulnerable of all preterm survivors, their risk for mental health problems across the life span has not been systematically reviewed. The primary objective of this systematic review and meta-analysis was to ascertain whether the risk for mental health problems is greater for ELBW survivors than their normal birth weight (NBW) peers in childhood, adolescence, and adulthood. Forty-one studies assessing 2,712 ELBW children, adolescents, and adults and 11,127 NBW controls were reviewed. Group differences in mental health outcomes were assessed using random effects meta-analyses. The impacts of birthplace, birth era, and neurosensory impairment on mental health outcomes were assessed in subgroup analyses. Children born at ELBW were reported by parents and teachers to be at significantly greater risk than NBW controls for inattention and hyperactivity, internalizing, and externalizing symptoms. ELBW children were also at greater risk for conduct and oppositional disorders, autistic symptoms, and social difficulties. Risks for parent-reported inattention and hyperactivity, internalizing, and social problems were greater in adolescents born at ELBW. In contrast, ELBW teens self-reported lower inattention, hyperactivity, and oppositional behavior levels than their NBW peers. Depression, anxiety, and social difficulties were elevated in ELBW survivors in adulthood. Group differences were robust to region of birth, era of birth, and the presence of neurosensory impairments. The complex needs faced by children born at ELBW continue throughout development, with long-term consequences for psychological and social well-being. (PsycINFO Database Record

Abstract WP139: Pathological Study of Intracranial Artery Atherosclerosis in 7307 Autopsy Cases

Introduction: It has not been analyzed whether atherosclerotic changes in the major cerebral arteries differ with age or with era of birth. Hypothesis: To examine our hypothesis that such changes would vary with age at death and era of birth, we studied chronological changes in intracranial artery atherosclerosis in consecutive autopsy cases. Methods: We analyzed 7307 autopsy cases of our brain bank from 1972 to 2014. Severity of atherosclerosis was classified on the following semi-quantitative scale based on pathological observation of each artery after formalin fixation: 0 = no stenosis; 0.5 = fatty streaks but no stenosis; 1 = less than 50% stenosis; 2 = 50% to 90% stenosis; 3 = 90% or more stenosis. We scored the cerebral arteries (anterior, middle, and posterior) and vertebral arteries bilaterally and the basilar artery. Then we summed the scores in each patient and defined the sum as the atherosclerosis score. We compared atherosclerosis scores by age at death and era of birth. Results: Atherosclerosis scores increased with age at death, as follows: age 50s, 1.9 ± 3.8; 60s, 4.6 ± 5.2; 70s, 6.1 ± 5.3; 80s, 7.6 ± 5.4; 90s, 8.2 ± 5.3; and 100s, 9.2 ± 5.3 (mean ± SD, P &lt; 0.0001). The percentage of cases with a score of 2 or 3 in each artery also increased with age (P &lt; 0.0001). Interestingly, in each age group (from the 60s to 90s) at the time of death, the score declined as the birth year became later (Figure. P &lt; 0.0001, box plots for each group showing atherosclerosis score). Conclusions: Our analysis from a brain bank cohort showed that intracranial artery atherosclerosis 1) advanced with age, and 2) was more severe in subjects born earlier.

Impact of Era, Type of Isomerism, and Ventricular Morphology on Survival in Heterotaxy: Implications for Therapeutic Management.

Heterotaxy has been demonstrated to reduce survival. There are several different subgroups of patients, however, and no single study has had a large number of patients and analyzed survival across the different subgroups such as patients born in different eras, patients with right and left isomerism, and patients with biventricular or functionally univentricular hearts. This study pools previously reported data from Kaplan-Meier curves and performs such subgroup analysis. A systematic review of the literature was performed to identify studies reporting survival of patients with the so-called "heterotaxy" by means of Kaplan-Meier survival curves. Data were extracted from these survival curves and then pooled together. A polynomial regression was then used to generate a pooled survival curve. This was done for all patients, those born in a more recent era, those with right and left isomerism, and those with biventricular or functionally univentricular hearts. Those born in the more recent era (after 2000) had increased survival compared to the overall cohort. Those with left isomerism tended to have a survival benefit compared to those with right isomerism until about 16 years of age, beyond which those with right isomerism developed a survival benefit. Those with biventricular hearts had a survival benefit compared to those with left isomerism. Survival in the so-called heterotaxy syndrome is based on several factors, which include era of birth, sidedness of isomerism, and whether the heart is biventricular or functionally univentricular.

Fetal ultrasound markers of severity predict resolution of pulmonary hypertension in congenital diaphragmatic hernia

Congenital diaphragmatic hernia (CDH) results in morbidity and death from lung hypoplasia and persistent pulmonary hypertension (PH). We sought to define the relationship between fetal ultrasound markers of severity in CDH and the time to resolution of neonatal PH. We conducted a retrospective study of fetuses with an antenatal ultrasound scan and left-sided CDH cared for at the University of California San Francisco (2002-2012). Fetal liver position was classified on ultrasound scan as abdominal (entire liver within the abdomen) or thoracic (any portion of the liver within the thorax). Fetal stomach position was classified from least to most aberrant: abdominal, anterior left chest, mid-posterior left chest, or retrocardiac (right chest). Lung-to-head ratio (LHR) was determined from available scans at 20-29 weeks of gestational age (GA). Routine neonatal echocardiograms were performed weekly for up to 6 weeks or until PH resolved or until discharge. PH was assessed by echocardiogram with the use of a hierarchy of ductus arteriosus level shunt, interventricular septal position, and tricuspid regurgitant jet velocity. Days to PH-free survival was defined as the age at which pulmonary artery pressure was estimated to be <2/3 systemic blood pressure. Cox proportional hazards models adjusted for GA at birth, era of birth, fetal surgery, and GA at ultrasound scan (LHR model only), with censoring at 100 days. Of 118 patients, the following fetal markers were available: LHR (n = 53), liver position (n = 112), and stomach position (n = 80). Fewer infants experienced resolved PH if they had LHR <1 (P = .006), thoracic liver position (P = .001), or more aberrant stomach position (P < .001). There was also a decreased rate of resolution of PH in infants with LHR <1 (hazard ratio, 0.30; P = .007), thoracic liver position (hazard ratio, 0.38; P < .001), and more aberrant stomach position (hazard ratios, 0.28 [P = .002]; 0.1 [P < .001]; and 0.07 [P < .001]). Fetal ultrasound markers of CDH severity are predictive not only of death but also of significant morbidity. LHR <1, thoracic liver, and aberrant stomach position are associated with delayed time to resolution of PH in infants with CDH and may be used to identify fetuses at high risk of persistent PH.

Permissive tolerance of the patent ductus arteriosus may increase the risk of Chronic Lung Disease

Permissive tolerance of the patent ductus arteriosus may increase the risk of Chronic Lung Disease Joseph W Kaempf,1 Robert Huston,2 YingXing Wu,1 Andrew J Kaempf,1 Lian Wang,1 Gary Grunkemeier,1 Rebecca Mischel,2 Howard Cohen,3 Bret Freitag41Providence St Vincent Medical Center, Portland, OR, 2Randall Children&rsquo;s Hospital at Legacy Emanuel, Portland, OR, 3Salem Hospital, Salem, OR, 4Legacy Salmon Creek Hospital, Vancouver, WA, USAPurpose: Because early closure therapies of the patent ductus arteriosus (PDA) have not been shown to confer benefit to premature infants, the authors&rsquo; four neonatal intensive care units adopted a less aggressive PDA management protocol.Study design: A before&ndash;after investigation in infants with PDAs born 501&ndash;1500 g. Era 1 (January 2005 to December 2007) featured traditional management with indomethacin and/or surgical ligation used early to close PDAs; Era 2 (January 2008 to June 2009) featured fluid restriction and watchful waiting for PDA closure, limiting indomethacin or surgical ligation to only those infants with large PDAs needing significant respiratory support.Results: Era 2 infants (n = 129, mean &plusmn; standard deviation 27 &plusmn; 2 weeks) received less and later indomethacin and less Day 1&ndash;28 total fluids as compared to Era 1 infants (n = 240, mean &plusmn; standard deviation 27 &plusmn; 2 weeks). The Chronic Lung Disease (CLD) rate was higher in Era 2 (48% versus 34%, P &lt; 0.01) as was the combined outcome of Death after Day 7 or CLD (57% versus 42%, P &lt; 0.01). Multiple regression analysis showed Era 2 birth was a predictor of CLD. However, Poisson regression analysis determined the predictors of all seven major Vermont Oxford Network morbidities were earlier gestational age, lower birth weight, and male gender, not the era of birth. Significantly more infants were discharged home with PDAs in Era 2.Conclusion: Permissive tolerance of PDAs may increase the risk of CLD and Death after Day 7 or CLD but is not associated with significant changes in other Vermont Oxford Network morbidities.Keywords: premature infant, indomethacin, surgical ligation, quality improvement

Outcome and Resource Utilization of Infants Born With Hypoplastic Left Heart Syndrome in the Intermountain West

The objective of the present study was to characterize the outcomes and resource utilization of all infants born with hypoplastic left heart syndrome (HLHS) in the Intermountain West. This was a retrospective cohort study of all infants born with HLHS in the Intermountain West from January 1995 and January 2010. The cohort was divided into 3 eras: era 1, 1995 to 1999; era 2, 2000 to 2004; and era 3, 2005 to 2010. Cox proportional hazards regression analysis was performed to assess mortality. The lifetime hospitalization days and charges were also determined. Of the 245 infants identified, 65% were male infants and 172 (70%) underwent Stage 1 palliation. The transplant-free survival rate for the entire cohort was 33% at 14 years. The 1-year transplant-free survival rate for the surgical cohort was 60% in era 3. The infants whose initial presentation included shock, restrictive or intact atrial septum, chromosomal defects, or multiorgan dysfunction had an increased risk of death. A recent era of birth, greater birthweight, and older gestational age were associated with improved survival. The factors associated with mortality after stage 1 included surgical procedure type (Blalock-Taussig vs Sano shunt, hazard ratio 2.1), requirement for postoperative extracorporeal membrane oxygenation (hazard ratio 4.2), postoperative renal dysfunction (hazard ratio 3.0), anomalous pulmonary venous return (hazard ratio 2.9), and moderate or greater tricuspid valve regurgitation at any point (hazard ratio 2.0). For patients who had undergone stage 1, 2, or 3 palliation, the median cumulative lifetime hospitalization was 32, 48, and 65 days, and the median cumulative lifetime charges for hospitalization were $201,812, $253,183, and $296,213, respectively. In conclusion, although hospital-based studies of HLHS have shown significantly improved survival after surgical palliation, population-based studies have shown that HLHS continues to have a high mortality and high resource utilization.

A personal philosophy of a radiation oncologist

All humans are of one species and are near identical genetically, viz. >99.5%. Also note, the Chimp is >96% genetically identical to humans. There has been extremely rapid increase in information and knowledge and this is accelerating. Several points: time is absolutely equalitarian. There is and has not been an unnatural event in this universe. Luck is the dominant factor in an individual’s success in life. At birth, the infant has zero choice of genes, parents, siblings, relatives, era and site of birth. In addition, the young child has essentially no choice in school [if any], health, etc. The key to advancing knowledge is asking decisive questions, proceeding to investigate and generate answers to the question posed and publishing the investigation, data and interpretation. The number 1 interest and concern of the physician is the care of the individual patient. The potential of “humanized experimental animals” for selected Phase III clinical trial within 2–3 decades is judged feasible. Physicians should view our current best treatment as obsolete and use this as a provocation for active effort to develop superior management strategies.

Lost and Found: The Adoption Experience by Betty Jean Lifton

Review of Lost and Found: The Adoption Experience. 3rd ed. By Betty Jean Lifton. Ann Arbor: U of Michigan P, 2009. 330 pp. Jill R. Deans The 2009 reissue of Lost & Found, first published in 1979, is a testament to the significance and the staying power of the book’s author, Betty Jean Lifton. One of the original voices of what is now identified as the “Adoption Liberation Movement”1 of the 1970s, Lifton advocated for access to birth records based on the adoptee’s apparent and sometimes overwhelming need to know his or her origins in order to thrive. In 1975, she chronicled her own probing search for answers in her memoir, Twice Born (reissued by St. Martin’s in 1998). Lifton, who is married to psychoanalyst Robert Jay Lifton, went on to become herself a psychotherapist, and her understanding of the nuances of the psychology of adoption is already apparent in Lost & Found. She expands on this psychological dimension in her later book, Journey of the Adopted Self (1994). In addition, she is author of several children’s books, a biography of Janusz Korczak, Polish children’s advocate and victim of the Holocaust, among many other interdisciplinary contributions that revolve in one way or another around displacement and the search for identity. AllofthesewritingsbenefitfromLifton’sprobingintellectandliterary sensibilities. In Twice Born, she describes transferring to Barnard where she found “real sisters who spoke my language,” who read poetry and wrote plays together (38). Unfortunately, their bonding over authors and ideas stopped short at the subject of adoption. This didn’t stop Lifton later from recognizing her own story for the drama it invariably was. While the rest of Twice Born explores the author’s personal transformation as she engages in the search for her origins and her biological parents, Lost and Found represents Lifton’s informed critical voice, stepping back to make sense of the adoption experience. LostandFounddependslargelyonthevoicesofdozensofindividuals— adoptees, birth parents, adoptive parents, adoption professionals—who have shared their stories with Lifton. Each vignette contains the code for unlocking the mysteries of adoption. Lifton’s project is to begin deciphering this code. Her own penchant for metaphors and her Adoption & Culture 2 (2009) 270 understanding of adoption as a practice dependent upon language and “playing the game” enables her to weave together countless threads of narrative into a rich explanation of the many challenges and intricacies of the adoption experience. Nearly every case is qualified as “individual,” yet there is something in common born from the fact that all of these experiences emerge from an era of sealed birth records. The secrecy underpinning this institutional practice of sealing records is ripe for cultural critics who can read between the lines. Lifton is one such critic and she invites those who likewise appreciate irony and a good plot twist, who can laugh as much as be appalled by the kind of deception practiced in sealed-record adoption, to participate in the unraveling of culturally-sanctioned lies. As adoptee “Karla” illustrates: “Two other people [at a dinner party] turned out to be adopted, and we began talking about the circumstances. We each said our parents were killed in a car crash. Suddenly the absurdity hit us. We burst out laughing. It was then I knew I had to learn the truth of what happened” (83). Finding the “truth” is the tricky part, for even after the records are pried open, adoptees realize that they are still part of a narrative, only now they become authors of their own complicated lives. Of course adoption has changed a lot since 1979, namely in terms of the hard-won openness that Lifton and others have promoted. More and more states allow adult adoptees access to their birth records and some level of openness in adoption is fast becoming standard in both public and private domestic adoption. The “adoption experience” that Lifton describes in this book is still relevant, she argues, not only for remaining sealed-record adoptees, including the new wave of international adoptees, but also for those “brave new babies” born through the use of reproductive technologies that once again shroud origins in secrecy. Lost and Found was first updated in 1988 to include this perspective and...

Criminal justice pioneers: A content analysis of biographical data

This study used relational content analysis to assess the relative importance of criminal justice pioneers (N = 44) as identified by Jones (2005). Comparisons were made in terms of race, gender, area of focus, level of education, era of birth, longevity, and the amount of space (i.e., pages) devoted to each biography. The results were threefold: (1) most of the designated pioneers were born between 1901 and 1950 where a significant number contributed in the area of law enforcement, (2) all women pioneers were Caucasian and outnumbered African American pioneers by more than more than a 2:1 ratio, and (3) men were ten times more likely than women to be regarded as pioneers. The implications of these findings are discussed regarding the perceived relative importance of certain personalities based on the amount of space devoted to their bibliography.

Outcome of patients with double-inlet left ventricle or tricuspid atresia with transposed great arteries

ObjectivesWe sought to determine the long-term outcomes and risk factors for mortality in patients with double-inlet left ventricle (DILV) or tricuspid atresia with transposed great arteries (TA-TGA). BackgroundPatients with DILV or TA-TGA are at risk of systemic outflow obstruction and a poor outcome. The impact of various management strategies on the long-term outcomes of these patients remains unknown. MethodsWe reviewed the outcomes of 164 consecutive pediatric patients with DILV or TA-TGA who underwent surgical palliation between 1983 and 2002. Patients with a Holmes heart or heterotaxy syndrome or who were lost to follow-up (n = 24) were excluded. Risk factors for mortality or the need for orthotopic heart transplantation (OHT) were assessed by multivariate analysis. ResultsThere were 105 patients with DILV and 35 patients with TA-TGA. The overall mortality rate, including OHT, was 29%. Patients with DILV had a lower mortality rate than patients with TA-TGA (23% vs. 49%, p = 0.007). Multivariate analysis showed the presence of arrhythmia and pacemaker requirement as independent risk factors for mortality, whereas pulmonary atresia or stenosis and pulmonary artery banding were associated with decreased mortality. Gender, era of birth, aortic arch anomaly, and systemic outflow obstruction were not risk factors. The perioperative and overall mortality were similar between patients who underwent the Damus-Kaye-Stansel procedure beyond the neonatal period and those had subaortic resection. ConclusionsThe mortality of patients with DILV or TA-TGA remains high. The outcomes of these patients are influenced by restriction of pulmonary blood flow, arrhythmia, and pacemaker requirement. Surgical palliation to relieve systemic outflow obstruction is not associated with a poor outcome.

Book Reviewing in American History: A Thirty-Year Examination

Historians who review books for major history journals often are power brokers who in 400 words or less are able to make or break reputations for budding scholars. Who are the reviewers, and what factors influence their assessments? This article, based in part upon a content analysis of 560 reviews published in the Journal of American History, attempts answers to these questions. The results of the collective biography indicate that JAH reviewers are by and large mid-career males from large, prestigious institutions. Moreover, the statistical analysis suggests that the outcome of a review is often a function of the reviewer's age and era of birth. The study concludes that despite the efforts of editors to secure impartiality, the goal of total objectivity has not been fully reached.