Trends in testosterone prescription amongst medical specialties: a 5-year CMS data analysis

Author(s):  
Isabelle V. Carter ◽  
Michael J. Callegari ◽  
Tarun K. Jella ◽  
Amr Mahran ◽  
Thomas B. Cwalina ◽  
...  
2020 ◽  
Author(s):  
Sebastian Bergrath ◽  
Tobias Strapatsas ◽  
Michael Tuemen ◽  
Thorsten Reith ◽  
Marc Deussen ◽  
...  

Abstract Background: The outbreak of the coronavirus disease 2019 (COVID-19) caused by the severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) led to severe disruption in social life and economics. The present study should analyze the impact of the local COVID-19 epidemic on emergency resources for all hospitals in a major urban center (Moenchengladbach, Germany). Methods: An observational multicenter study was performed involving all four acute care hospitals. Systemic parameters department (ED) parameters from week 4 to 24 in 2020 were compared to the corresponding period in 2019 for each hospital and in a summative data analysis using a logistic regression model. Outcomes: ED visits, ED to hospital admission, ED to Intensive Care Unit (ICU) admission, medical specialties of admitted patients, work related accidents. Results: In week 9/2020 the first SARS-CoV-2 positive patients were detected in our region. All hospitals decided to minimize elective admissions to ensure operational capability for COVID-19 patients. The summative number of ED visits dropped from 34,659 to 28,008. Numbers decreased from week 8 on between 38% and 48% per week per hospital at the maximum and began to rise again from week 16 on. The pooled data analysis showed statistically significant decreases in outpatient ED visits (20,152 vs. 16,477, p=<0.001), hospital admissions of ED patients (14,507 vs. 11,531, p=<0.001), and work-related accidents (2,290 vs. 1,468, p=<0.001). The decrease in admissions from ED to ICU did not reach statistical significance (2,093 vs. 1,566, p=0.255). The decline in ED cases was mainly caused by a decrease in non-trauma and non-surgical patients. Conclusion: The regional COVID-19 outbreak led to significantly reduced ED contacts after the first COVID-19 cases appeared. Even the admissions to the hospitals and the number of ED to ICU-admissions decreased, which is potentially dangerous, because the ratio of emergency outpatients vs. inpatients remained stable. Therefore, one can assume that patients with severe medical problems did not seek ED care in many cases. The decline of patients was earlier than in other German hospitals and in contrast to the findings in the U.S. and Italy where ED visits and hospital admissions in medical disciplines increased.


2021 ◽  
Vol 18 (3) ◽  
pp. S19-S20
Author(s):  
M. Callegari ◽  
T. Jella ◽  
A. Mahran ◽  
W. Muncey ◽  
K. Gupta ◽  
...  

Author(s):  
P. Ingram

It is well established that unique physiological information can be obtained by rapidly freezing cells in various functional states and analyzing the cell element content and distribution by electron probe x-ray microanalysis. (The other techniques of microanalysis that are amenable to imaging, such as electron energy loss spectroscopy, secondary ion mass spectroscopy, particle induced x-ray emission etc., are not addressed in this tutorial.) However, the usual processes of data acquisition are labor intensive and lengthy, requiring that x-ray counts be collected from individually selected regions of each cell in question and that data analysis be performed subsequent to data collection. A judicious combination of quantitative elemental maps and static raster probes adds not only an additional overall perception of what is occurring during a particular biological manipulation or event, but substantially increases data productivity. Recent advances in microcomputer instrumentation and software have made readily feasible the acquisition and processing of digital quantitative x-ray maps of one to several cells.


2020 ◽  
Vol 5 (1) ◽  
pp. 290-303
Author(s):  
P. Charlie Buckley ◽  
Kimberly A. Murza ◽  
Tami Cassel

Purpose The purpose of this study was to explore the perceptions of special education practitioners (i.e., speech-language pathologists, special educators, para-educators, and other related service providers) on their role as communication partners after participation in the Social Communication and Engagement Triad (Buckley et al., 2015 ) yearlong professional learning program. Method A qualitative approach using interviews and purposeful sampling was used. A total of 22 participants who completed participation in either Year 1 or Year 2 of the program were interviewed. Participants were speech-language pathologists, special educators, para-educators, and other related service providers. Using a grounded theory approach (Glaser & Strauss, 1967 ) to data analysis, open, axial, and selective coding procedures were followed. Results Three themes emerged from the data analysis and included engagement as the goal, role as a communication partner, and importance of collaboration. Conclusions Findings supported the notion that educators see the value of an integrative approach to service delivery, supporting students' social communication and engagement across the school day but also recognizing the challenges they face in making this a reality.


1989 ◽  
Vol 54 (3) ◽  
pp. 403-421 ◽  
Author(s):  
Beth M. Dalton ◽  
Jan L. Bedrosian

The communicative performance of 4 preoperational-level adolescents, using limited speech, gestures, and communication board techniques, was examined in a two-part investigation. In Part 1, each subject participated in an academic interaction with a teacher in a therapy room. Data were transcribed and coded for communication mode, function, and role. Two subjects were found to predominantly use the speech mode, while the remaining 2 predominantly used board and one other mode. The majority of productions consisted of responses to requests, and the initiator role was infrequently occupied. These findings were similar to those reported in previous investigations conducted in classroom settings. In Part 2, another examination of the communicative performance of these subjects was conducted in spontaneous interactions involving speaking and nonspeaking peers in a therapy room. Using the same data analysis procedures, gesture and speech modes predominated for 3 of the subjects in the nonspeaking peer interactions. The remaining subject exhibited minimal interaction. No consistent pattern of mode usage was exhibited across the speaking peer interactions. In the nonspeaking peer interactions, requests predominated. In contrast, a variety of communication functions was exhibited in the speaking peer interactions. Both the initiator and the maintainer roles were occupied in the majority of interactions. Pertinent variables and clinical implications are discussed.


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