Differences in the Management of Perforated Appendicitis in Children by Race and Insurance Status

2017 ◽  
Vol 83 (9) ◽  
pp. 996-1000 ◽  
Author(s):  
Randi L. Lassiter ◽  
Robyn M. Hatley
Keyword(s):  
Household Income ◽  
Percutaneous Drainage ◽  
Management Strategies ◽  
Disease Process ◽  
Perforated Appendicitis ◽  
Black Children ◽  
Primary Diagnosis ◽  
Insurance Status ◽  
Similar Disease ◽  
Using Data

This study was conducted to assess whether race and socioeconomic status influence the management method used to treat pediatric perforated appendicitis. Nonelective pediatric admissions with a primary diagnosis of appendicitis were analyzed using data from the 2001–2010 Nationwide Inpatient Sample. Bivariate and multivariate analyses were used to determine the association between race, insurance status, median household income, rural/metropolitan location, and the risk adjusted odds of undergoing surgery, laparoscopic appendectomy, percutaneous drainage, or neither surgery nor percutaneous drainage. A total of 46,211 admissions of perforated appendicitis were identified. Surgery was performed in 90.5 per cent of them. Black children were less likely to have surgery [adjusted odds ratio (AOR) = 0.53] and more likely to be managed non-surgically with percutaneous drainage (AOR = 1.79). Self-pay patients were less likely to have laparoscopic surgery (AOR = 0.80). Children from rural counties were more likely to undergo surgery than those from larger metropolitan areas (AOR = 1.30). Higher estimated household income did not predict the method of treatment. Although previous studies have attributed racial disparities in outcomes for appendicitis to different rates of perforation and access to care, these findings demonstrate significantly dissimilar management strategies for patients presenting with a similar disease process.

scholarly journals RACE INDEPENDENTLY PREDICTS UNSUCCESSFUL HEALING OF OSTEOCHONDRITIS DISSECANS IN THE PEDIATRIC KNEE

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0003
Author(s):  
Jigar S. Gandhi ◽  
Theodore J. Ganley
Keyword(s):  
Osteochondritis Dissecans ◽  
Household Income ◽  
Univariate Analysis ◽  
Sports Participation ◽  
Black Children ◽  
Multivariate Model ◽  
Insurance Status ◽  
Median Household Income ◽  
The Impact

BACKGROUND: Previous studies have reported disparities in medical and surgical care along the lines of race and socioeconomic status. The purpose of this study is to evaluate the impact of these factors on successful or unsuccessful healing of juvenile osteochondritis dissecans (OCD) lesions in the knee. METHODS: We retrospectively reviewed patients younger than 18 years that were treated for a knee OCD lesion at our urban, tertiary children’s hospital between 2006 and 2017. Demographic data included patient-reported race, median household income for the patient’s zip code, and insurance status. We also collected information regarding clinical history, imaging, treatment course, and post-treatment outcomes. The primary outcome of interest was healing of the OCD lesion based on radiographic and clinical examination. Univariate analysis was followed by purposeful entry multivariate regression to control for confounders. RESULTS: A total of 205 children with mean follow-up of 15.8 ± 6.5 months were included in the analysis. The mean age was 12.4 ± 2.8 years and 145 (71%) were male. At their most recent follow-up, 28 subjects (13.7%) did not show radiographic or clinical evidence of healing. In univariate analysis, non-healing lesions were found in 25% of black children compared to 9.4% of white children (p=0.02). There was no difference in insurance status or median household income between patients who successfully and unsuccessfully healed their OCD lesion. After controlling for age, sex, sports participation, lesion size and stability, skeletal maturity, and operative vs. non-operative treatment in a multivariate model, black children had 6.7 times higher odds of unsuccessful healing compared to their white counterparts (95% CI 1.1, 41.7; p=0.04). CONCLUSION: In this study, black children with OCD of the knee were less likely to heal than white patients even when accounting for socioeconomic and other factors in a multivariate model.

Land Loss with Compensation: What Are the Determinants of Income Among Households in Central Vietnam?

2021 ◽  
Vol 12 (1) ◽  
pp. 40-55
Author(s):  
Nguyen Quang Phuc ◽  
A. C. M. (Guus) van Westen ◽  
Annelies Zoomers
Keyword(s):  
Household Income ◽  
Urban Areas ◽  
Urban Expansion ◽  
Skill Training ◽  
Land Loss ◽  
Central Vietnam ◽  
Compensation Packages ◽  
Household Members ◽  
The Government ◽  
Using Data

The purpose of this study is to investigate the determinants of household income following the loss of land owing to urban expansion in central Vietnam. Using data mainly from household surveys in the peri-urban areas of Hue city, the regression model indicates that demographic factors and livelihood strategy choices have important impacts on household income; financial compensation and support packages do not appear to be strong determinants of household income after the loss of land. This implies a failure of the current compensation programmes in the process of compulsory land acquisition, because the government believes that compensation packages make important contributions to livelihood reconstruction. This study suggests that investing in education and skill training for household members affected by land loss as well as assistance in converting compensation money into an adequate livelihood should be taken into consideration.

Evidence that iron accelerates Alzheimer’s pathology: a CSF biomarker study

2017 ◽  
Vol 89 (5) ◽  
pp. 456-460 ◽  
Author(s):  
Scott Ayton ◽  
Ibrahima Diouf ◽  
Ashley Ian Bush
Keyword(s):  
Disease Process ◽  
Threshold Value ◽  
Simulation Modelling ◽  
Longitudinal Changes ◽  
Accelerated Depreciation ◽  
History Of ◽  
Amyloid Aβ ◽  
Β Amyloid ◽  
Using Data ◽  
Alzheimer’S Pathology

ObjectiveTo investigate whether cerebrospinal fluid (CSF) ferritin (reporting brain iron) is associated with longitudinal changes in CSF β-amyloid (Aβ) and tau.MethodsMixed-effects models of CSF Aβ1-42 and tau were constructed using data from 296 participants who had baseline measurement of CSF ferritin and annual measurement of CSF tau and Aβ1-42 for up to 5 years.ResultsIn subjects with biomarker-confirmed Alzheimer’s pathology, high CSF ferritin (>6.2 ng/mL) was associated with accelerated depreciation of CSF Aβ1-42 (reporting increased plaque formation; p=0.0001). CSF ferritin was neither associated with changes in CSF tau in the same subjects, nor longitudinal changes in CSF tau or Aβ1-42 in subjects with low baseline pathology. In simulation modelling of the natural history of Aβ deposition, which we estimated to occur over 31.4 years, we predicted that it would take 12.6 years to reach the pathology threshold value of CSF Aβ from healthy normal levels, and this interval is not affected by CSF ferritin. CSF ferritin influences the fall in CSF Aβ over the next phase, where high CSF ferritin accelerated the transition from threshold preclinical Aβ levels to the average level of Alzheimer’s subjects from 18.8 to 10.8 years.ConclusionsIron might facilitate Aβ deposition in Alzheimer’s and accelerate the disease process.

Cyber Place Management and Crime Prevention: The Effectiveness of Cybersecurity Awareness Training Against Phishing Attacks

2021 ◽  
pp. 104398622110016
Author(s):  
Sinchul Back ◽  
Rob T. Guerette
Keyword(s):  
Crime Prevention ◽  
Research University ◽  
Management Strategies ◽  
Large Body ◽  
The United States ◽  
Place Management ◽  
Online Setting ◽  
Using Data ◽  
Virtual Domain ◽  
The Impact

Criminologists and crime prevention practitioners recognize the importance of geographical places to crime activities and the role that place managers might play in effectively preventing crime. Indeed, over the past several decades, a large body of work has highlighted the tendency for crime to concentrate across an assortment of geographic areas, where place management tends to be absent or weak. Nevertheless, there has been a paucity of research evaluating place management strategies and cybercrime within the virtual domain. The purpose of this study was to investigate the effectiveness of place management techniques on reducing cybercrime incidents in an online setting. Using data derived from the information technology division of a large urban research university in the United States, this study evaluated the impact of an anti-phishing training program delivered to employees that sought to increase awareness and understanding of methods to better protect their “virtual places” from cybercrimes. Findings are discussed within the context of the broader crime and place literature.

How Much Does Public School Facility Funding Depend on Property Wealth?

2021 ◽  
pp. 1-52
Author(s):  
Eric Brunner ◽  
David Schwegman ◽  
Jeffrey M. Vincent
Keyword(s):  
Public School ◽  
Students Of Color ◽  
Household Income ◽  
School Facilities ◽  
Disadvantaged Students ◽  
School Construction ◽  
Property Wealth ◽  
Capital Funding ◽  
School Facility ◽  
Using Data

Abstract We examine how funding for public school facilities varies with school district property wealth and household income. Using data on school facility (i.e., capital) funding in California from fiscal years 1986-87 to 2015-16, we find that funding for school construction and modernization varies widely across districts. Disparities in funding are driven primarily by inter-district differences in property wealth with the highest property wealth districts raising significantly more funding for school facilities. Assessed value per-pupil in California is also negatively correlated with the share of disadvantaged students and students of color. As a result, school facility funding tends to be substantially lower in districts with the highest concentrations of disadvantaged students and students of color.

Role of Image-Guided Percutaneous Drainage in Pancreatic Collections

2018 ◽  
Vol 02 (02) ◽  
pp. 125-130
Author(s):  
Katayoun Samadi ◽  
Ronald Arellano
Keyword(s):  
United States ◽  
Acute Pancreatitis ◽  
Percutaneous Drainage ◽  
Hospital Admissions ◽  
Disease Process ◽  
The United States ◽  
Morbidity And Mortality ◽  
Image Guided ◽  
Gastrointestinal Conditions

AbstractAcute pancreatitis is one of the major gastrointestinal conditions that lead to around 300,000 hospital admissions per year in the United States. While mild inflammation of the pancreas is often managed conservatively, progression of the disease process to necrosis significantly increases the overall morbidity and mortality and often requires surgical or other interventional techniques for management. The purpose of this review is to describe the role of percutaneous drainage for the management of complicated pancreatitis.

scholarly journals Pan-European sustainable forest management indicators for assessing Climate-Smart Forestry in Europe

2020 ◽  
pp. 1-10
Author(s):  
G. Santopuoli ◽  
C. Temperli ◽  
I. Alberdi ◽  
I. Barbeito ◽  
M. Bosela ◽  
...  
Keyword(s):  
Forest Management ◽  
Sustainable Forest Management ◽  
Management Strategies ◽  
Forest Policy ◽  
The State ◽  
Forest Damage ◽  
Tree Species Composition ◽  
Mitigation And Adaptation ◽  
Management Indicators ◽  
Using Data

The increasing demand for innovative forest management strategies to adapt to and mitigate climate change and benefit forest production, the so-called Climate-Smart Forestry, calls for a tool to monitor and evaluate their implementation and their effects on forest development over time. The pan-European set of criteria and indicators for sustainable forest management is considered one of the most important tools for assessing many aspects of forest management and sustainability. This study offers an analytical approach to selecting a subset of indicators to support the implementation of Climate-Smart Forestry. Based on a literature review and the analytical hierarchical approach, 10 indicators were selected to assess, in particular, mitigation and adaptation. These indicators were used to assess the state of the Climate-Smart Forestry trend in Europe from 1990 to 2015 using data from the reports on the State of Europe’s Forests. Forest damage, tree species composition, and carbon stock were the most important indicators. Though the trend was overall positive with regard to adaptation and mitigation, its evaluation was partly hindered by the lack of data. We advocate for increased efforts to harmonize international reporting and for further integrating the goals of Climate-Smart Forestry into national- and European-level forest policy making.

scholarly journals Impact Evaluation of Raskin Program using Matching Method: Case of IFLS 5

JEJAK ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 207-223
Author(s):  
Endiarjati Dewandaru Sadono
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Family Life ◽  
Household Income ◽  
Impact Evaluation ◽  
Matching Method ◽  
Indonesia Family Life Survey ◽  
Small Benefit ◽  
Using Data ◽  
The Impact

Beras untuk Keluarga Miskin (RASKIN) program has been applied since 1998 and has been renamed as Beras Sejahtera (RASTRA) in early 2017, but their effectiveness is still debatable. This study tries to evaluate the impact of RASKIN program on household income. Using data from 3,745 households in Indonesia Family Life Survey (IFLS) 5 that has been estimated using propensity score matching, this study has identified precisely that RASKIN program has a negative and significant effect on household income. This happens because the benefits that reveived by Rumah Tangga Sasaran (RTS) are very small. The small benefit is affected by the amount of rice received, frequency and price that have been paid to get RASKIN is not in accordance with the guidelines. The result of this study is along with previous studies, where the amount and price of rice that distributed through RASKIN program is not exactly correct. Therefore, there must be a change in program format, not just renaming from RASKIN to RASTRA only.

Abstract W P154: Increase in the Rate of Comorbid Diabetes in Stroke Hospitalizations From 1998 to 2011: The National Inpatient Sample

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Philip R Khoury ◽  
Jane C Khoury
Keyword(s):  
Primary Diagnosis ◽  
National Inpatient Sample ◽  
Stroke Subtype ◽  
Obesity Epidemic ◽  
The Us ◽  
Control Of Diabetes ◽  
Icd Codes ◽  
Using Data ◽  
Related Increase

Due to the obesity epidemic in the US Population, there has been a related increase in type 2 diabetes. We sought to examine the trend within patients hospitalized due to stroke in a representative population. Methods: Using data from 1998 through 2011 from the National Inpatient Sample (NIS), we aimed to see the trends in diabetes for patients hospitalized with a primary discharge diagnosis of stroke (SAH (ICD code 430), ICH (ICD codes 431 and 432.9) and Ischemic (ICD codes 433x1, 434.11and 434.91). Secondary ICD codes were used to define diabetes. Hospitalizations used in this analysis included patients aged 20 years and over at date of admission. Results: For the 14 years examined, there were a total of 1,360,839 records with primary diagnosis of stroke, distributed as; 5.4% SAH, 15% ICH, and 79.6% Ischemic. The sample was 46% male; and 29% had diabetes (93% type 2). The rate of diabetes for each stroke subtype was: 12.2% SAH, 22.2% of ICH, and 31.5% of Ischemic. The proportion of stroke discharges with diabetes showed a significant increase with time, with a year over year increase in 12 of the 13 periods, from 26.5 in 1998 to 30.0 in 2011. Conclusions: The proportion of patients hospitalized for stroke who had comorbid diabetes continue to increase year over year, with almost one third of patients hospitalized for Ischemic stroke also having diabetes in 2011. This suggests that control of diabetes, and associated reduction of obesity may lead to reduction of stroke in the US.

Sign in / Sign up

Export Citation Format

Share Document