Ratio of emergency department visits to deaths for opioid overdose.

BACKGROUND: Data on fatal and non-fatal overdose provide important information about the magnitude of the overdose crisis. We consider these metrics in tandem and estimated the ratio of opioid overdose-related emergency department (ED) visits to opioid overdose deaths. A lower ratio could indicate more fatal overdoses, fewer overdose reversals with naloxone or a combination of both. METHODS: Data are from the Maryland Vital Statistics Administration (opioid overdose deaths), the Health Services Cost Review Commission (non-fatal ED visits for opioid overdose). We generated 2020 annual rates of fatal and non-fatal opioid overdose deaths for the state of Maryland and its 24 jurisdictions and estimated the ratio of opioid overdose-related ED visits to deaths. RESULTS: The 2020 visit-to-death ratio for Maryland was 1.7, and ranged from 0.9 to 3.8 across jurisdictions. We identified five counties that had above-median rates of opioid overdose-related ED visits and deaths, and low visit-to-death ratios. CONCLUSIONS: Our findings indicate that there were nearly two ED visits for each opioid overdose death in Maryland, and there was substantial variation across counties. The visit-to-death ratio enables a better understanding of the relationship between fatal and non-fatal opioid overdose and is essential to averting deaths and evaluating overdose prevention efforts.

Implicit Motor Imagery of the Foot and Hand in People with Achilles Tendinopathy: A Left Right Judgement Study.

OBJECTIVE: To determine if impairment in motor imagery processes is present in Achilles tendinopathy (AT), as demonstrated by a reduced ability to quickly and accurately identify the laterality (left-right judgement) of a pictured limb. Additionally, this study aimed to use a novel data pooling approach to combine data collected at 3 different sites via meta-analytical techniques that allow exploration of heterogeneity. DESIGN: Multi-site case-control study. METHODS: Three independent studies with similar protocols were conducted by separate research groups. Each study-site evaluated left/right judgement performance for images of feet and hands using Recognise© software and compared performance between people with AT and healthy controls. Results from each study-site were independently collated, then combined in a meta-analysis. RESULTS: In total, 126 participants (40 unilateral, 22 bilateral AT cases, 61 controls) were included. There were no differences between AT cases and controls for hand image accuracy and reaction time. Contrary to the hypothesis, there were no differences in performance between those with AT and controls for foot image reaction time, however there were conflicting findings for foot accuracy, based on four separate analyses. There were no differences between the affected and unaffected sides in people with unilateral AT. CONCLUSIONS: Impairments in motor imagery performance for hands were not found in this study, and we found inconsistent results for foot accuracy. This contrasts to studies in persistent pain of limbs, face and knee osteoarthritis, and suggests that differences in pathoetiology or patient demographics may uniquely influence proprioceptive representation.

A Randomized, Split-Face, Evaluator-Blind Clinical Trial Comparing Monopolar Radiofrequency Versus Microfocused Ultrasound With Visualization for Lifting and Tightening of the Face and Upper Neck.

BACKGROUND: Over the past decade, 2 major modalities for noninvasive skin tightening have emerged: monopolar capacitive-coupled radiofrequency (MRF) and microfocused ultrasound with visualization (MFU-V). Up to date, no comparative clinical trials have been performed. OBJECTIVE: To compare the efficacy and safety of MRF versus MFU-V for the lifting and tightening of the face and neck. MATERIALS AND METHODS: Twenty subjects with mild to moderate skin laxity received MFU-V over one-side of the face and MRF over the other side of the face at the same time. Subjects were followed for 6 months. RESULTS: Both MRF and MFU-V led to a decrease in the Fasil Face and Neck Laxity Grading Scale (FLR). These differences became significant at Day 30 and remained significantly improved through Days 90 and 180 in both groups. There was no statistically significant difference in the FLR Scale between MRF-treated and MFU-V-treated sides. Subjects' Global Aesthetic Improvement Scale showed improvement at Day 30, 90, and 180. CONCLUSION: Both MRF and MFU-V led to significant improvement in face and neck laxity. There were no statistical differences between MRF and MFU-V in standardized investigator measures of face and neck laxity, patient satisfaction, and adverse events.

Prospective studies of the efficacy and safety of the picosecond 755, 1,064, and 532 nm lasers for the treatment of infraorbital dark circles.

BACKGROUND: Infraorbital dark circles result from a combination of factors. The fractionated picosecond 755 nm alexandrite laser and dual wavelength picosecond Nd:YAG laser have not been examined as a method of addressing infraorbital hyperpigmentation. OBJECTIVE: To determine the efficacy and safety of treatment of infraorbital dark circles using fractionated picosecond 755 nm and dual wavelength picosecond Nd:YAG laser. METHODS AND MATERIALS: These trials did not utilize a comparative design; rather, these were separate, prospective, open-label, evaluator-blinded trials utilizing two treatment regimens: (i) 19 adult subjects were treated in a single session with the dual wavelengths of 532 nm and 1,064 nm in consecutive passes using the fractionated lens; (ii) 10 adult subjects were treated using the picosecond 755 nm laser via the fractionated lens in three treatment sessions at 3 week intervals. Subjects in both studies were followed-up for blinded-investigator assessment of infraorbital hyperpigmentation, adverse events, and improvement compared to baseline. RESULTS: The dual wavelength picosecond Nd:YAG laser, blinded-investigator assessment did not demonstrate a significant improvement in infraorbital hyperpigmentation at day 60 (P = 0.16). The picosecond 755 nm alexandrite laser significantly improved infraorbital hyperpigmentation by day 42, with improvement maintained through day 132 (P = 0.07 and 0.00001, respectively). Adverse events were mild and temporary. CONCLUSION: A single treatment with the fractionated picosecond 1,064/532 nm lasers did not produce a significant improvement in infraorbital hyperpigmentation. A series of three treatments with the fractionated picosecond 755 nm laser resulted in significant improvement in hyperpigmentation. Lasers Surg. Med. 50:45-50, 2018. © 2017 Wiley Periodicals, Inc.

A split-body study evaluating the efficacy of a conformable surface cryolipolysis applicator for the treatment of male pseudogynecomastia.

BACKGROUND: Cryolipolysis is a non-invasive method of body shaping that has been used for male pseudogynecomastia. However, traditional vacuum suction cryolipolysis requires a minimum pinchable fat layer which may not always be present in this area. OBJECTIVE: To evaluate the efficacy and safety of a conformable surface cryolipolysis applicator for the reduction of male pseudogynecomastia. MATERIALS AND METHODS: Ten male subjects with pseudogynecomastia received two cycles of cryolipolysis to the breast 6 weeks apart. Ultrasound was used to measure the thickness of adipose tissue. RESULTS: Seven of 10 patients completed the study. Compared to baseline, the mean ± SD change in adipose tissue thickness was 8.12 ± 6.94 mm for the treated versus 1.03 ± 6.03 mm for the control breast at week 6 (p = 0.014), and 8.71 ± 7.04 mm for the treated vs. 2.66 ± 7.04 mm for the control breast at week 12 (P = 0.16). Four (4) of seven (57%) patients were at least slightly satisfied with the treated breast, and although subject satisfaction was higher in the treated breast, this did not reach significance (0.085). Adverse events were mild and transient. CONCLUSION: A conformable surface cryolipolysis applicator was effective in reducing the mean adipose tissue thickness in subjects with male pseudogynecomastia. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.

The Safety and Efficacy of Treatment With a 1,927-nm Diode Laser With and Without Topical Hydroquinone for Facial Hyperpigmentation and Melasma in Darker Skin Types.

BACKGROUND: The nonablative, fractional, 1,927-nm diode laser is theoretically a safe and effective treatment for hyperpigmentation and melasma in darker skin and may potentiate topical cosmeceutical delivery. OBJECTIVE: To evaluate the use of a nonablative, fractional, 1,927-nm diode laser with and without topical 2% hydroquinone (HQ) cream for moderate-to-severe facial hyperpigmentation in Fitzpatrick skin Types III-V. METHODS: Forty adults underwent 4 laser treatments at 2-week intervals and were randomized to daily application of 2% HQ cream or moisturizer. Follow-ups were conducted 4 and 12 weeks after the final laser treatment. RESULTS: Hydroquinone and moisturizer groups demonstrated Mottled Pigmentation Area and Severity Index improvements of approximately 50% at post-treatment Weeks 4 and 12. Blinded investigator-assessed hyperpigmentation and photodamage improved significantly for both the groups at post-treatment Weeks 4 and 12. Subject satisfaction improved significantly in both the groups by post-treatment Week 4. Although investigator-rated Global Aesthetic Improvement Scale scores were significantly better in the HQ group at post-treatment Week 12, satisfaction was higher among those using moisturizer. No adverse events were noted. CONCLUSION: The nonablative, fractional, 1,927-nm diode laser produced significant improvement in hyperpigmentation in Fitzpatrick skin Types III-V by 4 weeks, with maintenance of results at 12 weeks after treatment even without HQ.

Role of Nonsurgical Chin Augmentation in Full Face Rejuvenation: A Review and Our Experience.

BACKGROUND: The chin is a critical component to the perception of facial attractiveness. Dermal fillers offer a nonsurgical, temporary method of correcting mild to moderate chin retrusion and resorption. Thus far, discussion of this procedure has been largely limited to the plastic surgery and otolaryngology literature. OBJECTIVE: To review pertinent aspects of anatomy, patient evaluation, injection technique, concomitant therapies, and complications in chin augmentation using injectable fillers. METHODS: A brief review of the literature surrounding chin augmentation using injectable fillers, as well as the authors' experience in this area, is provided. RESULTS: Chin augmentation using injectable fillers can be performed effectively and safely with adequate background knowledge of the regional anatomy and appropriate patient selection. The authors discuss both injection techniques in the published literature and their own approach. Potential complications and concomitant therapies are also reviewed. CONCLUSION: As chin augmentation is increasingly recognized as an essential component to complete facial aesthetic rejuvenation, dermatologic surgeons should be familiar with how to safely and effectively perform augmentation with injectable fillers to achieve an optimal cosmetic outcome.

A Single Center, Prospective, Randomized, Sham-Controlled, Double-Blinded, Split-Face Trial Using Microinjections of Transparent Hyaluronic Acid Gel for Cheek Rejuvenation.

BACKGROUND: "Skin boosting" with injections of hyaluronic acid has been demonstrated to improve aged skin. OBJECTIVE: The aim of this study was to determine the efficacy and safety of small-particle hyaluronic acid with lidocaine (SP-HAL) microaliquots for the correction of fine lines of the cheeks. MATERIALS AND METHODS: Twenty subjects with mild to moderate static mid to lower cheek rhytides were enrolled. The right or left cheek was randomized to receive 1 mL of SP-HAL using a microdroplet technique, with the contralateral cheek treated with sham injection of sterile normal saline. The degree of cheek wrinkling and elastosis based on the Fitzpatrick-Goldman Wrinkle and Elastosis Scale was assessed at baseline and 7, 14, 30, 90, and 180 days after treatment. Subjects rated their satisfaction at days 90 and 180. RESULTS: Fourteen patients completed the study. There were no statistically significant improvements in wrinkling or elastosis of the SP-HAL-treated cheek or control cheek at any time point. In addition, there were no significant differences in wrinkling, elastosis, or patient satisfaction between the treatment cheek and control cheek. CONCLUSION: One treatment of intradermal microdroplet injections of SP-HAL to the mid to lower cheek failed to show superiority over normal saline in improving clinical signs of skin wrinkling and elastosis.

Histologic and Clinical Changes in Vulvovaginal Tissue After Treatment With a Transcutaneous Temperature-Controlled Radiofrequency Device.

BACKGROUND: Although transcutaneous temperature-controlled radiofrequency (TTCRF) may effectively treat vulvovaginal laxity (VVL), atrophic vaginitis (AV), orgasmic dysfunction (OD), and stress urinary incontinence (SUI), there is a lack of histopathologic evidence to validate its use. OBJECTIVE: Evaluate clinical and histological changes induced by vulvovaginal TTCRF. MATERIALS AND METHODS: This was a prospective, nonrandomized trial. Ten female subjects with mild-to-moderate VVL, with or without AV, OD, and/or SUI underwent 3 TTCRFs at 4-week intervals. Five subjects underwent pre- and post-treatment biopsies of the labia majora and vaginal canal for histology. Assessments were performed at baseline and Days 10, 30, 60, and 120. RESULTS: Investigator-rated VVL improved significantly from baseline to Day 10, with improvement maintained through Day 120 (p = .001 and .001, respectively). Sexual satisfaction improved significantly by Day 60 (p = .001). Improvement in AV reached significance at Day 120 (p = .048). Although OD and SUI improved steadily, the difference in improvement did not reach statistical significance. Histology revealed that post-treatment increases in collagen, elastin, vascularity, and small nerve fibers. CONCLUSION: Transcutaneous temperature-controlled RF resulted in significant improvements in AV, VVL, and sexual satisfaction with milder improvements in OD and SUI. Post-treatment histology demonstrated neocollagenesis, neoelastogenesis, neoangiogenesis, and the first reported finding of TTCRF-related neurogenesis.

A randomized, double-blind, placebo-controlled clinical trial evaluating the role of systemic antihistamine therapy for the reduction of adverse effects associated with topical 5-aminolevulinic acid photodynamic therapy.

BACKGROUND AND OBJECTIVE: Following photodynamic therapy with 5-aminolevulinic acid (ALA-PDT), patients experience inflammation that may be partially attributable to H1 histamine receptor activation. The objective of this study was to evaluate the impact of antihistamines upon adverse effects following ALA-PDT. STUDY DESIGN/MATERIALS AND METHODS: This was a randomized, placebo-controlled clinical trial conducted at a single study site. Twenty subjects with facial actinic keratoses were randomized to ALA-PDT plus cetirizine 10 mg (n = 10) versus placebo daily (n = 10) from 3 days pre-treatment to 3 days post-treatment for a total of 7 days. Signs of inflammation including erythema, edema, crusting, exudation, vesiculation, and erosion were evaluated on post-treatment days 1, 2, 3, 7, 30, 90, and 180. Actinic keratosis counts, investigator-rated Global Assessment Improvement Score (GAIS), healing, tolerability, and subject satisfaction were also assessed. RESULTS: Erythema, edema, crusting, exudation, vesiculation, and erosion were not different between treatment groups. Actinic keratoses were significantly reduced by day 30 in both the antihistamine and placebo groups (P = 0.01 and 0.0009, respectively), with results sustained to day 60 in the antihistamine group and day 180 for the placebo group. However, counts were not different between groups at any time point. Investigator-rated GAIS, subject satisfaction, healing, and tolerability were similar between treatment groups. CONCLUSION: This study suggests that while H1 antihistamines do not impair the efficacy of ALA-PDT, they also do not relieve post-treatment inflammation and discomfort. Lasers Surg. Med. 49:738-742, 2017. © 2017 Wiley Periodicals, Inc.

Rejuvenation of the male scalp using 1,927 nm non-ablative fractional thulium fiber laser.

OBJECTIVE: The male scalp undergoes extensive photodamage due to a high prevalence of androgenic alopecia and exposure to ultraviolet radiation. This photodamage presents as solar lentigines, fine rhytides, and keratosis, and can prematurely age a patient. In this study, we demonstrate the safety and efficacy of the fractionated 1,927 nm thulium fiber laser using high density and high energy settings to achieve rejuvenation of the male scalp after a single treatment session. METHODS: Four male patients with Fitzpatrick skin types II-III and extensive photodamage on the scalp underwent one treatment with the fractional non-ablative 1,927 nm thulium fiber laser. RESULTS: The patients had a 60-90% improvement in dyspigmentation, lentigines, and keratosis. No adverse events were observed and the patients tolerated the procedure well. CONCLUSION: This case series is the first report in the literature demonstrating the successful rejuvenation of the scalp using the 1,927 nm thulium fiber laser. Lasers Surg. Med. 49:475-479, 2017. © 2017 Wiley Periodicals, Inc.

A Randomized, Investigator-Blinded Comparison of Two Topical Regimens in Fitzpatrick Skin Types III-VI With Moderate to Severe Facial Hyperpigmentation.

Purpose: Though hydroquinone (HQ) remains the gold standard for treatment of hyperpigmentation, concerns about its safety have prompted the development of HQ-free topical skin lightening systems. OBJECTIVE: To compare the efficacy and tolerability of a new HQ-free system and a popular HQ-based system for the improvement of facial hyperpigmentation and photoaging in darker skin types. METHODS: This investigator-blinded trial randomized 30 subjects of Fitzpatrick skin types III to VI with moderate to severe hyperpigmentation to a new 7-product HQ-free system or a 7-product HQ-based system for 12 weeks. At 4, 8, and 12 week follow-up visits, a blinded investigator assessed efficacy and tolerability using standardized scales. Subjects also performed a self-assessment at each visit. SUMMARY: Both the HQ-free and HQ-based systems produced significant improvements in Overall Hyperpigmentation that were sustained through week 12 (P=0.008, 0.0003). The HQ-based system demonstrated better improvement in overall hyperpigmentation at weeks 4, 8, 12 (P=0.01, 0.001, 0.003, respectively). Mottled Pigmentation Area Severity Index (MoPASI) scores improved with both systems (P=0.02, 0.01), with no statistically significant differences between the two treatment groups. Subject-rated hyperpigmentation was not different between groups. Subjects reported significantly more discomfort with the HQ-free system at week 8 (P=0.02); otherwise, measures of irritation were the same between groups. All irritation was described as mild to moderate. At week 12, 100% of subjects in the HQ-free group and 92.3% of subjects in the HQ-based group were satisfied with their outcome. CONCLUSION: Both a new HQ-free skincare system and a widely-available HQ-based system improved hyperpigmentation in Fitzpatrick skin types III to VI. Though the HQ-based system produced greater improvement in hyperpigmentation when compared to the HQ-free system, there was no difference in MoPASI scores between the treatment groups. Subjects were satisfied with both treatments and reported only mild to moderate irritation using either system.

J Drugs Dermatol. 2017;16(11):1127-1132.

Skin tightening-does it really exist?

Skin tightening is one of the cornerstones of skin rejuvenation and is defined as the improvement of skin laxity and crepiness of the skin. There are several energy-based devices that can produce significant skin tightening without surgery, both on and off the face. The mechanisms of skin tightening involve collagen denaturation resulting in collagen shrinkage and tissue tightening, and the wound healing response that generates new collagen and elastin. These hypothesized mechanisms of skin contraction leading to clinical skin tightening have been derived from histological, immunohistochemical, and electron microscope analysis, as well as in vitro and in vivo experiments. This review is aimed at evaluating and analyzing the literature on the proposed mechanisms for skin tightening by minimally invasive energy-based technologies.

The effectiveness of peer support interventions for community-dwelling adults with chronic musculoskeletal pain: a systematic review and meta-analysis of randomised trials.

ABSTRACT: This systematic review and meta-analysis critically examined the evidence for peer support interventions to reduce pain and improve health outcomes in community-dwelling adults with chronic musculoskeletal pain (PROSPERO CRD42022356850). A systematic search (inception-January 2023) of electronic databases and grey literature was undertaken to identify relevant randomised controlled trials, with risk of bias and GRADE assessments performed on included studies. Meta-analyses used a generic, inverse-variance, random-effects model, calculating mean difference (MD) or standardised mean difference (SMD). Of 16,445 records identified, 29 records reporting on 24 studies (n = 6202 participants) were included. All evidence had unclear/high risk of bias and low-very low certainty. Peer support interventions resulted in small improvements in pain (medium-term: MD -3.48, 95% CI -6.61, -0.35; long-term: MD -1.97, 95% CI -3.53, -0.42), self-efficacy (medium-term: SMD 0.26, 95% CI 0.16, 0.36; long-term: SMD 0.21, 95% CI 0.07, 0.36), and function (long-term: SMD -0.10, 95% CI -0.19, -0.00) relative to usual care and greater self-efficacy (medium-term: SMD 0.36, 95% CI 0.20, 0.51) relative to waitlist control. Peer support interventions resulted in similar improvement as active (health professional led) interventions bar long-term self-efficacy (MD -0.41, 95% CI -0.77, -0.05), which favoured active interventions. No point estimates reached minimal clinically important difference thresholds. Pooled health service utilisation outcomes showed unclear estimates. Self-management, quality of life, and social support outcomes had mixed evidence. Despite low-very low evidence certainty, peer support interventions demonstrated small improvements over usual care and waitlist controls for some clinical outcomes, suggesting that peer support may be useful as an adjunct to other treatments for musculoskeletal pain.

Rapid HIV testing for individuals on probation/parole: outcomes of an intervention trial.

Many probationers and parolees do not receive HIV testing despite being at increased risk for obtaining and transmitting HIV. A two-group randomized controlled trial was conducted between April, 2011 and May, 2012 at probation/parole offices in Baltimore, Maryland and Providence/Pawtucket, Rhode Island. Male and female probationers/parolees were interviewed (n = 1,263) and then offered HIV testing based on random assignment to one of two conditions: (1) On-site rapid HIV testing conducted at the probation/parole office; or (2) Referral for rapid HIV testing off site at a community HIV testing clinic. Outcomes were: (1) undergoing HIV testing; and (2) receipt of HIV testing results. Participants were significantly more likely to be tested on-site at a probation/parole office versus off-site at a HIV testing clinic (p < 0.001). There was no difference between the two groups in terms of receiving HIV testing results. Findings indicate that probationers/parolees are willing to be tested on-site and, independent of testing location, are equally willing to receive their results. Implications for expanding rapid HIV testing to more criminal justice related locations and populations are discussed.

Gender Differences Among Prisoners With Pre-Incarceration Heroin Dependence Participating in a Randomized Clinical Trial of Buprenorphine Treatment.

The primary focus of the current study is to examine whether gender and other baseline characteristics were significantly associated with more severe patterns of drug use. It involves data from 260 male and female pre-release prison inmates with pre-incarceration heroin dependence who enrolled in a randomized clinical trial of prison-initiated buprenorphine. Three outcomes are examined: 1) Lifetime Intravenous drug use; 2) Lifetime number of drugs used; and 3) Heroin use in prison. Regarding lifetime intravenous drug use; race (p = .0001), education (p = .009), age (p = .0001), and psychological treatment (p = .028) were significant. Concerning lifetime number of drugs used; race (p =.0001) and age of first crime (p = .001) were significant. Finally, gender (p = .004), was the only significant variable in terms of using heroin while in prison. All of these differences may have important clinical, treatment, and research implications, which are discussed.

Postprison release HIV-risk behaviors in a randomized trial of methadone treatment for prisoners.

BACKGROUND: This secondary analysis examined the impact of methadone initiated in prison on postrelease HIV risk behaviors. The parent study was a three-group randomized clinical trial in which participants received drug abuse counseling in prison and were randomly assigned to: (1) passive referral to substance abuse treatment upon release; (2) guaranteed methadone treatment admission upon release; and (3) methadone in prison and guaranteed continuation of methadone upon release. METHODS: Participants were 211 adult males with preincarceration histories of opiate dependence. The AIDS Risk Assessment was administered at baseline (in prison) and at 1-, 3-, 6-, and 12-month postrelease. Data were analyzed for the entire sample (N = 211) as well as the subsamples who reported injecting drugs in the 30 days prior to incarceration (n = 131) and who reported having unprotected sex in that time frame (n = 144) using generalized linear mixed model on an intent-to-treat basis. RESULTS: There were no significant changes in sex- or drug-risk by Condition over Time. There were significant Time and Condition main effects for the total sample as well as the injector subsample for drug-risk behaviors. There were no significant Condition main effects for HIV sex-risk behaviors, but there were significant Time main effects. CONCLUSIONS: Methadone initiated in prison or immediately postrelease is associated with reduced HIV drug-risk compared to counseling in prison without methadone and passive referral to treatment at release. Participation in several drug- and sex-risk behaviors also showed significant declines during the postrelease time periods.

Rey-Osterrieth complex figure normative data for the psychiatric population.

Objective: Appropriate normative data are crucial for competent neuropsychological assessment. Although individuals with psychiatric illness often perform more poorly than healthy adults on neuropsychological testing, data that reflect the psychiatric population are often lacking. We present a normative dataset and calculation tools for the Rey-Osterrieth Complex Figure Test (RCFT) derived from the psychiatric inpatient population. Method: A sample of 301 psychiatric inpatients completed the RCFT and the Test of Memory Malingering (TOMM) between 1999 and 2018. Participants were 59.5% male, 82.1% Caucasian, 13.3% black, and 4.6% identified as another racial demographic, largely consistent with recent Substance Abuse and Mental Health Services Administration (2018) data for inpatients in U.S. psychiatric facilities. Scores for RCFT Copy, Short-Delay Free Recall, Long-Delay Free Recall, Total Recognition, and Percent Retained were modeled via multiple regression with age and education as predictors. Base rates were computed for subscores comprising Total Recognition to aid clinical decision making. Results: Age and education served as significant individual predictors for all models except one model predicting percent retained across delay that included only age. Regression equations and regression standard errors were used to produce a score calculator using a commonly available spreadsheet software package. Healthy adult norms under-estimated performance in our sample, underscoring the importance of these normative data. Conclusions: These normative data for the RCFT represent a large cohort of psychiatric inpatients. For clinical practice and research, both the data and the tools provided are likely to be of particular usefulness among individuals with serious mental illness.