scholarly journals Ambulance Crash Characteristics in the US Defined by the Popular Press: A Retrospective Analysis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Teri L. Sanddal ◽  
Nels D. Sanddal ◽  
Nicolas Ward ◽  
Laura Stanley
Keyword(s):  
Prehospital Care ◽  
Significant Risk ◽  
The United States ◽  
Care Providers ◽  
Medical Database ◽  
Time Period ◽  
The Us ◽  
Dangerous Place ◽  
Safety Restraints ◽  
Crash Characteristics

Ambulance crashes are a significant risk to prehospital care providers, the patients they are carrying, persons in other vehicles, and pedestrians. No uniform national transportation or medical database captures all ambulance crashes in the United States. A website captures many significant ambulance crashes by collecting reports in the popular media (the website is mentioned in the introduction). This report summaries findings from ambulance crashes for the time period of May 1, 2007 to April 30, 2009. Of the 466 crashes examined, 358 resulted in injuries to prehospital personnel, other vehicle occupants, patients being transported in the ambulance, or pedestrians. A total of 982 persons were injured as a result of ambulance crashes during the time period. Prehospital personnel were the most likely to be injured. Provider safety can and should be improved by ambulance vehicle redesign and the development of improved occupant safety restraints. Seventy-nine (79) crashes resulted in fatalities to some member of the same groups listed above. A total of 99 persons were killed in ambulance crashes during the time period. Persons in other vehicles involved in collisions with ambulances were the most likely to die as a result of crashes. In the urban environment, intersections are a particularly dangerous place for ambulances.

scholarly journals THU0442 GOUT AND HEART FAILURE IN THE US: A NATIONAL PERSPECTIVE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 458.2-458
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Confidence Intervals ◽  
Burden Of Illness ◽  
Average Length ◽  
Private Insurance ◽  
Significant Risk ◽  
Case Fatality ◽  
The United States ◽  
The Us

Background:Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1). Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities.Objectives:To study heart failure hospitalizations in patients with gout in the United States (US) and estimate their clinical and economic impact.Methods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. We examined all inpatient hospitalizations in the NIS in 2017, the most recent year of available data, with a primary or secondary diagnosis of gout and heart failure. Over 69,800 ICD 10 diagnoses were collapsed into a smaller number of clinically meaningful categories, consistent with the CDC Clinical Classification Software.Results:There were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 - $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion - $24.0 billion).Conclusion:While gout and hyperuricemia have long been recognized as potential risk factors for heart failure, the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities (1). This calls for an increased awareness and management of serious co-morbid conditions in patients with gout.References:[1]Sidney, S., Go, A. S., Jaffe, M. G., Solomon, M. D., Ambrosy, A. P., & Rana, J. S. (2019). Association Between Aging of the US Population and Heart Disease Mortality From 2011 to 2017. JAMA Cardiology. doi:10.1001/jamacardio.2019.4187[2]Krishnan E. Gout and the risk for incident heart failure and systolic dysfunction. BMJ Open 2012;2:e000282.doi:10.1136/bmjopen-2011-000282Disclosure of Interests: :Gurkirpal Singh Grant/research support from: Horizon Therapeutics, Maanek Sehgal: None declared, Alka Mithal: None declared

scholarly journals The prevalence of MS in the United States

Neurology ◽  
2019 ◽  
Vol 92 (10) ◽  
pp. e1029-e1040 ◽  
Author(s):  
Mitchell T. Wallin ◽  
William J. Culpepper ◽  
Jonathan D. Campbell ◽  
Lorene M. Nelson ◽  
Annette Langer-Gould ◽  
...  
Keyword(s):  
United States ◽  
Census Data ◽  
Adult Population ◽  
The United States ◽  
Health Claims ◽  
The North ◽  
Time Period ◽  
The Us ◽  
Group A ◽  
Us Census

ObjectiveTo generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.MethodsA validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.ResultsThe estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1–310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1–451.6) for women and 159.7 (95% CI 158.7–160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.ConclusionThe estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

scholarly journals Assessment of Patient Experiences in Otolaryngology Virtual Visits During the COVID-19 Pandemic

OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2093357 ◽  
Author(s):  
Kyohei Itamura ◽  
Franklin L. Rimell ◽  
Elisa A. Illing ◽  
Thomas S. Higgins ◽  
Jonathan Y. Ting ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Interpersonal Communication ◽  
Health Care Providers ◽  
Descriptive Analysis ◽  
The United States ◽  
Patient Experiences ◽  
Care Providers ◽  
Time Period ◽  
Virtual Visits

This study evaluates the patient experience during virtual otolaryngology clinic visits implemented during the coronavirus disease 2019 (COVID-19) pandemic. Patient satisfaction surveys were queried from January 1, 2020, to May 1, 2020, for both telehealth and in-person visits. A descriptive analysis of the question responses was performed. There were 195 virtual and 4013 in-person visits with surveys completed in this time period. Ratings related to provider-patient communication were poor for virtual visits. Telehealth has become the new norm for most health care providers in the United States. This study demonstrates some of the initial shortcomings of telehealth in an otolaryngology practice and identifies challenges with interpersonal communication that may need to be addressed as telehealth becomes increasingly prevalent.

Central American-American Identity and Politics

2019 ◽  
Author(s):  
Maritza E. Cárdenas
Keyword(s):  
United States ◽  
Identity Politics ◽  
Asian American ◽  
The United States ◽  
Central American ◽  
Geographic Space ◽  
Cultural Specificity ◽  
Time Period ◽  
The Us ◽  
Identity Category

The use of the term “Central American” as an identity category is neither new nor restricted to the US diaspora. However, it is within the last forty years and in the geopolitical setting of the United States that a thriving identity politics has developed. It is during this time period that the use of the term Central American has emerged to denote a tactical American pan-ethnic social identity. This act of consciously employing the term “Central American” as a unification strategy for peoples from the isthmus in the United States echoes other US-based ethnoracial identity politics. Such movements often utilize a pan-ethnic term not only to advocate on the behalf of a racialized minoritarian community but also seeking to provide them a space of belonging by focusing on sociopolitical, cultural, and ethnic commonalities. As other identity markers in the United States such as “Asian American” and “African American” illustrate, Central Americans are not the first population to utilize a region as a strategic unifying term of self-identification. Yet, unlike these other US ethnoracial categories, for those who identify as “Central American” the term “Central America” often connotes not simply a geographic space but also a historical formation that advances the notion that individuals from the isthmus comprise a distinct but common culture. Another key difference from other US ethnoracial identities is that use of the term “Central American” in US cultural politics emerged during a historical era where the broader collective terms “Hispanic” or “Latino” were already in place. The creation and deployment of “Central American” is therefore an alternative to this other supra-ethnic identity category, as subjects view this isthmian-based term as being able to simultaneously create a broader collective while still invoking a type of geographic and cultural specificity that is usually associated with national identities.

scholarly journals Mapping a Pandemic: SARS-CoV-2 Seropositivity in the United States

2021 ◽  
Author(s):  
Heather Kalish ◽  
Carleen Klumpp-Thomas ◽  
Sally Hunsberger ◽  
Holly Ann Baus ◽  
Michael P Fay ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Regional Variability ◽  
Seropositivity Rate ◽  
Black African ◽  
Link Type ◽  
Weighted Analysis ◽  
Time Period ◽  
The Us ◽  
Quota Sampling

ABSTRACTAsymptomatic SARS-CoV-2 infection and delayed implementation of diagnostics have led to poorly defined viral prevalence rates. To address this, we analyzed seropositivity in US adults who have not previously been diagnosed with COVID-19. Individuals with characteristics that reflect the US population (n = 11,382) and who had not previously been diagnosed with COVID-19 were selected by quota sampling from 241,424 volunteers (ClinicalTrials.govNCT04334954). Enrolled participants provided medical, geographic, demographic, and socioeconomic information and 9,028 blood samples. The majority (88.7%) of samples were collected between May 10th and July 31st, 2020. Samples were analyzed via ELISA for anti-Spike and anti-RBD antibodies. Estimation of seroprevalence was performed by using a weighted analysis to reflect the US population. We detected an undiagnosed seropositivity rate of 4.6% (95% CI: 2.6 – 6.5%). There was distinct regional variability, with heightened seropositivity in locations of early outbreaks. Subgroup analysis demonstrated that the highest estimated undiagnosed seropositivity within groups was detected in younger participants (ages 18-45, 5.9%), females (5.5%), Black/African American (14.2%), Hispanic (6.1%), and Urban residents (5.3%), and lower undiagnosed seropositivity in those with chronic diseases. During the first wave of infection over the spring/summer of 2020 an estimate of 4.6% of adults had a prior undiagnosed SARS-CoV-2 infection. These data indicate that there were 4.8 (95% CI: 2.8-6.8) undiagnosed cases for every diagnosed case of COVID-19 during this same time period in the United States, and an estimated 16.8 million undiagnosed cases by mid-July 2020.

scholarly journals Causal Analysis of Health Interventions and Environments for Influencing the Spread of COVID-19 in the United States of America

2020 ◽  
Author(s):  
zhouxuan Li ◽  
Tao Xu ◽  
Kai Zhang ◽  
Hong-Wen Deng ◽  
Eric Boerwinkle ◽  
...  
Keyword(s):  
Risk Factor ◽  
Unemployment Rate ◽  
Additive Model ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The United States ◽  
Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Pharmaceutical Interventions

As of August 27, 2020, the number of cumulative cases of COVID-19 in the US exceeded 5,863,363 and included 180,595 deaths, thus causing a serious public health crisis. Curbing the spread of Covid-19 is still urgently needed. Given the lack of potential vaccines and effective medications, non-pharmaceutical interventions are the major option to curtail the spread of COVID-19. An accurate estimate of the potential impact of different non-pharmaceutical measures on containing, and identify risk factors influencing the spread of COVID-19 is crucial for planning the most effective interventions to curb the spread of COVID-19 and to reduce the deaths. Additive model-based bivariate causal discovery for scalar factors and multivariate Granger causality tests for time series factors are applied to the surveillance data of lab-confirmed Covid-19 cases in the US, University of Maryland Data (UMD) data, and Google mobility data from March 5, 2020 to August 25, 2020 in order to evaluate the contributions of social-biological factors, economics, the Google mobility indexes, and the rate of the virus test to the number of the new cases and number of deaths from COVID-19. We found that active cases/1000 people, workplaces, tests done/1000 people, imported COVID-19 cases, unemployment rate and unemployment claims/1000 people, mobility trends for places of residence (residential), retail and test capacity were the most significant risk factor for the new cases of COVID-19 in 23, 7, 6, 5, 4, 2, 1 and 1 states, respectively, and that active cases/1000 people, workplaces, residential, unemployment rate, imported COVID cases, unemployment claims/1000 people, transit stations, mobility trends (transit) , tests done/1000 people, grocery, testing capacity, retail, percentage of change in consumption, percentage of working from home were the most significant risk factor for the deaths of COVID-19 in 17, 10, 4, 4, 3, 2, 2, 2, 1, 1, 1, 1 states, respectively. We observed that no metrics showed significant evidence in mitigating the COVID-19 epidemic in FL and only a few metrics showed evidence in reducing the number of new cases of COVID-19 in AZ, NY and TX. Our results showed that the majority of non-pharmaceutical interventions had a large effect on slowing the transmission and reducing deaths, and that health interventions were still needed to contain COVID-19.

Using a framework for resource stratification to adapt palliative care guidelines to Sub-Saharan Africa.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 145-145
Author(s):  
Maria Cristina Dans ◽  
Kunuz Abdella ◽  
Dinah Baah-Odoom ◽  
Rinty Kintu ◽  
Israel Kolawole ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Care ◽  
The United States ◽  
Sub Saharan Africa ◽  
Rational Approach ◽  
Care Providers ◽  
Nccn Guidelines ◽  
Cancer Management ◽  
The Us ◽  
Sub Saharan

145 Background: The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of 27 leading cancer centers in the United States (US), but the NCCN’s mission to improve cancer care extends world-wide. Nearly half of the registered users of the NCCN Guidelines are based outside the US, and the NCCN has developed a process for adapting its Guidelines to lower-resourced settings. The cancer burden in Sub-Saharan Africa (SSA) is significant – by 2030, annual cancer deaths in the region are projected to reach 1,000,000 people – and most cancers diagnosed in SSA are late-stage. Methods: The NCCN Framework outlines a rational approach for constructing cancer management systems to provide the highest achievable care. Each of the 4 NCCN Framework levels builds on the one before it, so care can evolve as resources grow: “Basic Resources” are essential for care; “Core Resources” add services improving disease outcomes; and “Enhanced Resources” include more cost-prohibitive services. The Guidelines themselves are the final level: evidence-based, consensus-driven recommendations from each NCCN Panel. Resource-stratification begins with modification of the Guidelines by a NCCN Framework Committee within each Panel. Results: In the case of SSA, organizers from the NCCN, American Cancer Society, Clinton Health Access Initiative, and IBM arranged 3 consensus meetings in which resource-stratified drafts of the Guidelines for Palliative Care and Cancer Pain will be refined by a committee of NCCN representatives, oncologists, and palliative care providers from Burundi, Ethiopia, Ghana, Kenya, Nigeria, Uganda, and the US. Important themes emerging from the first meeting included early screening for palliative care needs, even before tissue diagnosis, in areas with limited availability of anti-cancer therapy. In addition, cultural differences on the topic of “Physician-Aid-in-Dying” led to its replacement with guidance on caring for patients expressing a wish to die. Conclusions: Collaboration with colleagues in SSA, and other areas around the globe, to resource-stratify NCCN Guidelines will allow more systematic use of the guidelines and improve the quality, effectiveness, and efficiency of cancer care.

Abortion in the United States: The continuing controversy

2017 ◽  
Vol 27 (1) ◽  
pp. 101-113 ◽  
Author(s):  
Linda J Beckman
Keyword(s):  
United States ◽  
Social Issues ◽  
Ethnic Disparities ◽  
The United States ◽  
Current Status ◽  
Medication Abortion ◽  
Abortion Debate ◽  
Time Period ◽  
The Us ◽  
Underlying Causes

In the United States, abortion rates have been falling for several decades while attitudes have remained relatively stable. Given this background, this paper examines the current status of the fluid and contentious US abortion debate. Five relevant questions are examined: (1) What is responsible for the new wave of restrictive laws and what are their effects? (2) What is most likely responsible for changes in abortion rates? (3) What are the effects of the addition of medication abortion into the mix of abortion services? (4) What forces continue to fuel economic, geographic and racial/ethnic disparities in access to abortion services? (5) Why have gay rights been embraced by a majority of the US public and supported in legislation and judicial decisions, while during this same time period abortion rights have stagnated or declined? It is crucial for feminists to continue to promote the cause of abortion and other reproductive rights. Most important, however, is a focus on broader social issues for women (e.g., adequate education, affordable day care) and the underlying causes of unequal power in society.

Trends in the treatment of lumbar spine fractures in the United States: a socioeconomics perspective

2011 ◽  
Vol 15 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Ali A. Baaj ◽  
Katheryne Downes ◽  
Alexander R. Vaccaro ◽  
Juan S. Uribe ◽  
Fernando L. Vale
Keyword(s):  
Health Care ◽  
Lumbar Spine ◽  
Vertebral Body ◽  
The United States ◽  
Hospital Charges ◽  
Spine Fractures ◽  
Time Period ◽  
The Us ◽  
Spinal Fusions ◽  
Lumbar Fractures

Object The objective of this study was to investigate a national health care database and analyze demographics, hospital charges, and treatment trends of patients diagnosed with lumbar spine fractures in the US over a 5-year period. Methods Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 2003 through 2007. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with lumbar spine fractures were identified using the appropriate ICD-9-CM code. Data on the number of vertebral body augmentation procedures were also retrieved. National estimates of discharges, hospital charges, discharge patterns, and treatment with spinal fusion trends were retrieved and analyzed. Results More than 190,000 records of patients with lumbar spine fractures were abstracted from the database. During the 5-year period, there was a 17% increase in hospitalizations for lumbar spine fractures. This was associated with a 27% increase in hospital charges and a 55% increase in total national charges (both adjusted for inflation). The total health care bill associated with lumbar spine fractures in 2007 exceeded 1 billion US dollars. During this same time period, there was a 24% increase in spinal fusions for lumbar fractures, which was associated with a 15% increase in hospital charges. The ratio of spinal fusions to hospitalizations (surgical rate) during this period, however, was stable with an average of 7.4% over the 5-year period. There were an estimated 13,000 vertebral body augmentation procedures for nonpathological fractures performed in 2007 with a total national bill of 450 million US dollars. Conclusions An increasing trend of hospitalizations, surgical treatment, and charges associated with lumbar spine fractures was observed between 2003 and 2007 on a national level. This trend, however, does not appear to be as steep as that of surgical utilization in degenerative spine disease. Furthermore, the ratio of spinal fusions to hospitalizations for lumbar fractures appears to be stable, possibly indicating no significant changes in indications for surgical intervention over the time period studied.

scholarly journals Is Congenital Syphilis Really Congenital Syphilis?

2006 ◽  
Vol 2006 ◽  
pp. 1-4 ◽  
Author(s):  
Yi Li ◽  
Bernard Gonik
Keyword(s):  
Congenital Syphilis ◽  
Health Department ◽  
The United States ◽  
Health Concern ◽  
Local Health ◽  
Public Health Concern ◽  
Live Births ◽  
Time Period ◽  
The Us ◽  
True Occurrence

Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per100 000live births in Detroit versus 10.3 in the US). However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital syphilis CDC collection forms (form 73.126) were reviewed for the years in question. The reported congenital syphilis cases in the year 2002–2004 in Detroit were reviewed. No cases met confirmed case criteria and few probable cases were based on neonatal evaluations. The majority of “congenital syphilis” cases were established based on incomplete maternal data such as missing followup serologic titers in the absence of complete neonatal information. In conclusion, although the reported congenital syphilis rate in Detroit is alarmingly high, the true occurrence of congenital syphilis is likely to have been overstated. A health department reporting program that includes more diligent neonatal followup would allow for a more accurate representation of this public health concern.

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