Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012-2016

2020 ◽  
Vol 163 (5) ◽  
pp. 1029-1031
Author(s):  
Eric X. Wei ◽  
David Tunkel ◽  
Emily Boss ◽  
Jonathan Walsh
Keyword(s):  
United States ◽  
Hospital Setting ◽  
The United States ◽  
Geographic Region ◽  
Healthcare Research ◽  
Inpatient Setting ◽  
Median Income ◽  
Sex Type ◽  
Tongue Mobility ◽  
Zip Code

Ankyloglossia, or “tongue-tie,” refers to limited tongue mobility caused by a restrictive lingual frenulum. Previous studies have demonstrated rapid increases in diagnosis and treatment of ankyloglossia in the United States up to 2012. We performed an updated retrospective review of data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) to evaluate trends in diagnosis of ankyloglossia and use of lingual frenotomy in the hospital setting. From 2012 to 2016, there was an 110.4% increase in reported diagnosis of ankyloglossia in the inpatient setting with similar increases in lingual frenotomy procedures. As seen previously, sex, type of insurance, median income ZIP code, and geographic region were associated with diagnosis of ankyloglossia. The observed trends from prior to 2012 have continued to increase, while unanswered questions about diagnostic criteria and about which infants should undergo frenotomy remain.

CMS ESRD quality incentive program has not improved patient dialysis vascular access

2021 ◽  
pp. 112972982110270
Author(s):  
Sapan Shah ◽  
Paul J Feustel ◽  
Christina E Manning ◽  
Loay Salman
Keyword(s):  
United States ◽  
The United States ◽  
Geographic Region ◽  
Dialysis Access ◽  
Median Income ◽  
Hemodialysis Catheter ◽  
Incentive Program ◽  
Significant Difference ◽  
Quality Incentive

Purpose: Over 468,000 patients in the United States use hemodialysis to manage End Stage Renal Disease (ESRD). The purpose of this study was to determine whether the dialysis access Clinical Performance Measures (CPMs) of Centers for Medicare & Medicaid Services (CMS) ESRD Quality Incentive Program (QIP) have increased arteriovenous fistula (AVF) rates and decreased long-term tunneled hemodialysis catheter (TDC) rates among hemodialysis patients in United States. Methods: Retrospective observational study: evaluated reported AVF and long-term TDC rates of 4804 dialysis facilities which reported dialysis access data as part of the ESRD QIP from Payment Year (PY) 2014–2020. Facilities were also sorted by specific additional criteria to examine disparities in dialysis access. Results: Mean AVF rates of included facilities increased from 63.7% in PY 2014 to 67.2% in PY 2016 ( p < 0.05), did not change in PY 2017 ( p > 0.05), and declined significantly in PY 2018–2020 to 64.1% in PY 2020, near AVF rates at the inception of program. Long-term TDC rates decreased from 10.4% in PY 2014 to 9.88% in PY 2015 ( p < 0.05), then increased in PY 2015–PY 2020 to rates higher than at the inception of program, at 11.8% in PY 2020 ( p < 0.05). Facilities serving majority Black ZIP Code Tabulation Areas (ZCTAs) or ZCTAs with median income <$45,000 achieved significantly lower AVF rates ( p < 0.05) with no significant difference in long-term TDC rates ( p > 0.05). AVF rates correlated positively and long-term TDC rates correlated negatively with star rating of facilities ( p < 0.05). Conclusion: As one of the first financial QIPs in healthcare, the ESRD QIP has not achieved the stated goals of the CMS to increase AVF access rates above 68% and reduce long-term TDC clinical rates below 10%. Systemic disparities in race, geographic region, economic status, healthcare access, and education of providers and patients prevent successful attainment of goal metrics.

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and &gt;9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

Quality of Life and the Carbon Footprint: A Zip-Code Level Study Across the United States

2021 ◽  
Vol 30 (4) ◽  
pp. 323-343
Author(s):  
Matthew Thomas Clement ◽  
Chad L. Smith ◽  
Tyler Leverenz
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Carbon Footprint ◽  
Ecological Impact ◽  
Well Being ◽  
The United States ◽  
Alternative Measure ◽  
Level Data ◽  
Zip Code

Much sustainability scholarship has examined the environmental dimensions of subjective and objective well-being. As an alternative measure of human well-being, we consider the notion of quality of life and draw on a framework from the sustainability literature to study its association with ecological impact, specifically the carbon footprint. We conduct a quantitative analysis, combining zip-code level data on quality of life and the carbon footprint per household for the year 2012 across the continental United States ( n=29,953). Findings consistently show a significant, negative association between quality of life and the carbon footprint. Our findings point to the potential advantages of utilizing robust objective measures of quality of life that extends beyond economic well-being and life expectancy alone. Furthermore, our findings question the conventional wisdom that sustainability requires sacrifices, while suggesting opportunities for how increased levels of sustainability may be achieved while retaining high levels of quality of life.

The cost of linguistic loyalty

2009 ◽  
Vol 6 (1) ◽  
pp. 7-25 ◽  
Author(s):  
Devin L. Jenkins
Keyword(s):  
United States ◽  
Language Maintenance ◽  
Census Data ◽  
The United States ◽  
Spanish Language ◽  
Median Income ◽  
Social Variables ◽  
Model Set ◽  
The Cost ◽  
The Relationship

In a census-related study on language maintenance among the Hispanic/Latino population in the southwest United States, Hudson, Hernández-Chávez and Bills (1995) stated that, given negative correlations between language maintenance and years of education and per capita income, “educational and economic success in the Spanish origin population are purchased at the expense of Spanish language maintenance in the home” (1995: 179). While census figures from 1980 make this statement undeniable for the Southwest, the recent growth of the Spanish-language population in the United States, which has grown by a factor of ~2.5 over the last twenty years, begs a reexamination of these correlations. A recent study on the state of Colorado (McCullough & Jenkins 2005) found a correlational weakening, especially with regard to the relationship between language maintenance and median income.
 The current study follows the model set forth by Hudson et al. (1995) in examining the interrelationship between the measures of count, density, language loyalty and retention based on 2000 census data, as well as the relationship between these metrics and socioeconomic and demographic variables, including income and education. While some relationships existed in 2000 much in the same way that they did in the 1980 data, especially with regard to count and density, the measures of loyalty and retention saw marked reductions in their correlations with social variables.

scholarly journals Identification and Management of Sepsis in the Interventional Radiology Patient

2017 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Jacqueline Murtha ◽  
Vinit Khanna ◽  
Talia Sasson ◽  
Devang Butani
Keyword(s):  
United States ◽  
Health Care ◽  
Septic Shock ◽  
Interventional Radiology ◽  
Hospital Setting ◽  
The United States ◽  
Clinical Aspects ◽  
Inhospital Mortality ◽  
United States Population ◽  
Hospital Acquired

Sepsis is frequently encountered in the hospital setting and can be community-acquired, health-care-associated, or hospital-acquired. The annual incidence of sepsis in the United States population ranges from 300 to 1031 per 100,000 and is increasing by 13% annually. There is an associated inhospital mortality of 10% for sepsis and >40% for septic shock. Interventional radiology is frequently called on to treat patients with sepsis, and in rarer circumstances, interventional radiologists themselves may cause sepsis. Thus, it is essential for interventional radiologists to be able to identify and manage septic patients to reduce sepsis-related morbidity and mortality. The purpose of this paper is to outline procedures most likely to cause sepsis and delineate important clinical aspects of identifying and managing septic patients.

scholarly journals FSMB Census of Licensed Physicians in the United States, 2018

2019 ◽  
Vol 105 (2) ◽  
pp. 7-23 ◽  
Author(s):  
Aaron Young ◽  
Humayun J. Chaudhry ◽  
Xiaomei Pei ◽  
Katie Arnhart ◽  
Michael Dugan ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medical School ◽  
Census Data ◽  
Medical Schools ◽  
The United States ◽  
Geographic Region ◽  
Physician Workforce ◽  
Care Needs ◽  
State Medical Boards

ABSTRACT There are 985,026 physicians with Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees licensed to practice medicine in the United States and the District of Columbia, according to physician census data compiled by the Federation of State Medical Boards (FSMB). These qualified physicians graduated from 2,089 medical schools in 167 countries and are available to serve a U.S. national population of 327,167,434. While the percentage of physicians who are international medical graduates have remained relatively stable over the last eight years, the percentage of physicians who are women, possess a DO degree, have three or more licenses, or are graduates of a medical school in the Caribbean have increased by varying degrees during that same period. This report marks the fifth biennial physician census that the FSMB has published, highlighting key characteristics of the nation's available physician workforce, including numbers of licensees by geographic region and state, type of medical degree, location of medical school, age, gender, specialty certification and number of active licenses per physician. The number of licensed physicians in the United States has been growing steadily, due in part to an expansion in the number of medical schools and students during the past two decades, even as concerns of a physician shortage to meet health care demands persist. The average age of licensed physicians continues to increase, and more licensed physicians appear to be specialty certified, though the latter finding may reflect more comprehensive reporting. This census was compiled using the FSMB's Physician Data Center (PDC), which collects, collates and analyzes physician data directly from the nation's state medical and osteopathic boards and is uniquely positioned to provide a comprehensive snapshot of information about licensed physicians. A periodic national census of this type offers useful demographic and licensure information about the available physician workforce that may be useful to policy makers, researchers and related health care organizations to better understand and address the nation's health care needs.

scholarly journals Planetarium commute accessibility in the United States of America

2021 ◽  
Author(s):  
Alexander A. Kaurov ◽  
Vyacheslav Bazhenov ◽  
Mark SubbaRao
Keyword(s):  
United States ◽  
United States Of America ◽  
Science Communication ◽  
The United States ◽  
Census Bureau ◽  
Global Pandemic ◽  
Commute Time ◽  
Pandemic Response ◽  
Zip Code ◽  
The U.S

The COVID-19 global pandemic unprecedently disturbed the education system in the United States and lead to the closure of all planetariums that were providing immersive science communication. This situation motivates us to examine how accessible the planetarium facilities were before the pandemic. We investigate the most important socioeconomic and geographical factors that affect the planetarium accessibility using the U.S. Census Bureau data and the commute time to the nearest planetarium for each ZIP Code Tabulated Area. We show the magnitude of the effect of permanent closure of a fraction of planetariums. Our study can be informative for strategizing the pandemic response.

Antiepileptic Medication Use in Neurosurgical Patients

2019 ◽  
pp. 74-87
Author(s):  
Megan Margiotta ◽  
Timothy Ambrose
Keyword(s):  
United States ◽  
Antiepileptic Drugs ◽  
Medication Use ◽  
The United States ◽  
Inpatient Setting ◽  
Risks And Benefits ◽  
Antiepileptic Medication ◽  
Neurosurgical Patients ◽  
Potential Risks ◽  
Antiepileptic Medications

When caring for neurosurgical patients, many will either be started on a new antiepileptic medication or will be continued on a regimen that had been started prior to hospitalization. Because of this, it is important for a hospitalist to be familiar with the potential risks and benefits of these medications, even though they may be initiated by a neurosurgeon or neurologist. This chapter discusses several common antiepileptic drugs and their uses in the inpatient setting. This is not intended to be an exhaustive discussion; as of this writing, there are at least 27 unique antiepileptic medications available in the United States alone, with more being studied and produced.

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