scholarly journals Patient-Rated Trust of Spine Surgeons: Influencing Factors

2018 ◽  
Vol 8 (7) ◽  
pp. 728-732 ◽  
Author(s):  
Jack M. Haglin ◽  
Adam E. M. Eltorai ◽  
Saisanjana Kalagara ◽  
Brandon Kingrey ◽  
Wessley M. Durand ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
The United States ◽  
Study Region ◽  
Perceived Trust ◽  
The North ◽  
Physician Review ◽  
Patient Reported ◽  
Physician Rating ◽  
Female Surgeons ◽  
Number Of Publications

Study Design: Descriptive analysis using publicly available data. Objectives: The purpose of this study was 2-fold: to assess patient-rated trustworthiness of spine surgeons as a whole and to assess if academic proclivity, region of practice, or physician sex affects ratings of patient perceived trust. Methods: Orthopedic spine surgeons were randomly selected from the North American Spine Society directory. Surgeon profiles on 3 online physician rating websites, HealthGrades, Vitals, and RateMDs were analyzed for patient-reported trustworthiness. Whether or not the surgeon had published a PubMed-indexed paper in 2016 was assessed with regard to trustworthiness scores. Total number of publications was also assessed. Individuals with >300 publications were excluded due to the likelihood of repeat names. Results: Recent publication and total number of publications has no relationship with online patient ratings of trustworthiness across all surgeons in this study. Region of practice likewise has no influence on mean trust ratings, yet varied levels of correlation are observed. Furthermore, there was no difference in trust scores between male and female surgeons. Conclusion: Total academic proclivity via indexed publications does not correlate with patient perceived physician trustworthiness among spine surgeons as reported on physician review websites. Furthermore, region of practice within the United States does not have an influence on these trust scores. Likewise, there is no difference in trust score between female and male spine surgeons. This study also highlights an increasing utility for physician rating websites in spine surgery for evaluating and monitoring patient perception.

scholarly journals Application of Classical Coastal Trapped Wave Theory to High-Scattering Regions

2019 ◽  
Vol 49 (9) ◽  
pp. 2201-2216 ◽  
Author(s):  
Kelsey Brunner ◽  
David Rivas ◽  
Kamazima M. M. Lwiza
Keyword(s):  
Wave Theory ◽  
The United States ◽  
Analytical Models ◽  
Theoretical Formulation ◽  
Study Region ◽  
Outer Banks ◽  
The North ◽  
Coastal Trapped Wave ◽  
Seasonal Wind ◽  
Wave Limit

AbstractSince the 1970s, analytical models of coastal trapped waves (CTWs) have been developed using a first-order wave equation in the long-wave limit. Formulations of this kind require assumptions of a straight coastline with similar shelf bathymetry. These assumptions prevent the models from capturing the scattering and backscattering behavior of propagating CTWs that encounter changing coastlines, bathymetry, or shelf width. CTW modes from two different analytical models, one of which includes friction and stratification, are compared with CTW observations of velocity and pressure from a study region near the Outer Banks off the North Carolina coast in the United States. The coastline in the study region is relatively straight locally but is bounded by an estuary to the north and shelf narrowing to the south, both of which induce scattering. The models suggest that the CTWs in this region are insensitive to changes in stratification, implying that observed seasonal differences in wave magnitude are due to seasonal wind forcing. Furthermore, friction is found to be important, particularly for mode-1 propagation, but higher-order modes are prevalent despite the importance of friction. There is very poor agreement between the observed and modeled free and forced CTWs because of scattering. This lack of agreement indicates that this is not a globally applicable theoretical formulation because many global coastlines violate the basic assumptions.

scholarly journals The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS)

2021 ◽  
Vol 23 (6) ◽  
pp. 269-275
Author(s):  
Kottil W. Rammohan ◽  
June Halper ◽  
Steven Lang ◽  
Sara McCurdy Murphy ◽  
Lisa Patton ◽  
...  
Keyword(s):  
United States ◽  
Multiple Sclerosis ◽  
Puerto Rico ◽  
Pharmaceutical Industry ◽  
North American ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Magnetic Resonance Images ◽  
The North ◽  
Patient Reported

Abstract Although many regional multiple sclerosis (MS) databases existed in the United States and Canada, there was no single clinician-derived registry that examined this disease as a group across the North American continent. This distinction is important because information that results from such a database can potentially give perspectives about MS that cannot be derived from any single regional registry. A partnership was forged between the pharmaceutical industry and the Consortium of Multiple Sclerosis Centers (CMSC) to create a registry of patients with MS from Canada and the United States, including Puerto Rico. Case report forms were created to collect physician-derived information, and the Patient-Reported Outcomes Measurement Information System (PROMIS) was selected to capture patient-reported outcomes. As of November 2021, 754 of 1000 patients have been enrolled. Completion of recruitment is expected by the end of 2021. Twenty-five centers are participating, with an expected total of 30, including five centers from Canada. Clinical status, health economic outcomes, magnetic resonance images, and, soon, biomarkers relevant to understanding relapses and progression are collected. The short-term goal is to understand and better treat MS disease progression, and the long-term goal is its prevention. The North American Registry for Care and Research in Multiple Sclerosis (NARCRMS) is one of few clinician/patient-generated registries that examines MS across North America, including Puerto Rico. Information derived from the natural history studies should help physicians, the pharmaceutical industry, and regulatory bodies understand MS better and improve quality of life for patients with MS worldwide.

scholarly journals A descriptive analysis of clinical application of patient-reported outcome measures and screening tools for low back pain patients in US chiropractic teaching institutions

2020 ◽  
Author(s):  
Jesse C. Cooper ◽  
Jordan A. Gliedt ◽  
Katherine A. Pohlman
Keyword(s):  
Descriptive Analysis ◽  
The United States ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Screening Tools ◽  
Clinical Use ◽  
Low Back ◽  
Patient Reported ◽  
Psychosocial Influences ◽  
Teaching Clinics

Objective To describe the clinical use of patient-reported outcome measures (PROMs) and screening tools (STs) for low back pain (LBP) in clinics of chiropractic teaching institutions in the United States. Methods A descriptive analysis was completed with data collection achieved between June 2018 and March 2019. PROMs/STs were classified as disability/functional measures, pain measures, psychosocial measures, and other measures. Frequencies of use of PROM/ST instruments were calculated. Results Representatives from 18 of 19 chiropractic institutions (94.75%) provided a description of PROM/ST use for LBP in their teaching clinics. Seventeen institutions (94.4%) reported the routine clinical use of PROMs/STs for LBP. Disability/functional measures were the most common type of instruments used, followed by pain measures, psychosocial measures, and others. The 4 most common individual PROMs/STs reported were (1) Oswestry Disability Index, (2) a variation of a pain rating scale, (3) Keele STarT Back Tool, and (4) Patient Specific Functional Scale. Six out of 18 (33%) institutions reported the use of a PROM/ST specifically designed to focus on psychosocial influences. Conclusion Most chiropractic institution teaching clinics in the United States reported the clinical use of PROMs/STs for patients presenting with LBP. This mirrors trends in chiropractic literature of increasing use of PROMs/STs. A minority of institutions described the clinical use of a PROM/ST specifically designed to detect psychosocial influences.

Mafias on the Move

2011 ◽  
Author(s):  
Federico Varese
Keyword(s):  
United States ◽  
New York ◽  
Organized Crime ◽  
The United States ◽  
The West ◽  
Market Expansion ◽  
The North ◽  
Economic Transformations ◽  
At Will

Organized crime is spreading like a global virus as mobs take advantage of open borders to establish local franchises at will. That at least is the fear, inspired by stories of Russian mobsters in New York, Chinese triads in London, and Italian mafias throughout the West. As this book explains, the truth is more complicated. The author has spent years researching mafia groups in Italy, Russia, the United States, and China, and argues that mafiosi often find themselves abroad against their will, rather than through a strategic plan to colonize new territories. Once there, they do not always succeed in establishing themselves. The book spells out the conditions that lead to their long-term success, namely sudden market expansion that is neither exploited by local rivals nor blocked by authorities. Ultimately the inability of the state to govern economic transformations gives mafias their opportunity. In a series of matched comparisons, the book charts the attempts of the Calabrese 'Ndrangheta to move to the north of Italy, and shows how the Sicilian mafia expanded to early twentieth-century New York, but failed around the same time to find a niche in Argentina. The book explains why the Russian mafia failed to penetrate Rome but succeeded in Hungary. A pioneering chapter on China examines the challenges that triads from Taiwan and Hong Kong find in branching out to the mainland. This book is both a compelling read and a sober assessment of the risks posed by globalization and immigration for the spread of mafias.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

Die Konstruktion von Natur – Central Park neu besichtigt | The Construction of Nature – Central Park Revisited

2005 ◽  
Vol 156 (8) ◽  
pp. 288-296
Author(s):  
Vittorio Magnago Lampugnani
Keyword(s):  
New York ◽  
Hudson River ◽  
The United States ◽  
Central Park ◽  
Housing Developments ◽  
Hudson River School ◽  
The North ◽  
Man And Nature ◽  
The 19Th Century ◽  
The Relationship

In the first half of the 19th century scientific philosophers in the United States, such as Emerson and Thoreau, began to pursue the relationship between man and nature. Painters from the Hudson River School discovered the rural spaces to the north of New York and began to celebrate the American landscape in their paintings. In many places at this time garden societies were founded, which generated widespread support for the creation of park enclosures While the first such were cemeteries with the character of parks, housing developments on the peripheries of towns were later set in generous park landscapes. However, the centres of the growing American cities also need green spaces and the so-called «park movement»reached a first high point with New York's Central Park. It was not only an experimental field for modern urban elements, but even today is a force of social cohesion.

scholarly journals Identifying Foot and Ankle Patients at Risk to Fall Based on Patient Reported Outcomes Assessments

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0002
Author(s):  
Judith Baumhauer ◽  
Jack Teitel ◽  
Allison McIntyre ◽  
David Mitten ◽  
Jeff Houck
Keyword(s):  
At Risk ◽  
Effect Size ◽  
Fall Risk ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Foot And Ankle ◽  
Falls Risk ◽  
Orthopaedic Patients ◽  
Patient Reported ◽  
Patients At Risk

Category: Other Introduction/Purpose: Each year approximately 30-40% of people over the age of 65 fall. Approximately one half of these falls result in an injury with the estimated annual direct medical costs of $30 billion. Pain, mobility issues, neuropathy and post-operative weight bearing limitations make foot and ankle patients particularly vulnerable to falls. Current approaches to determine at risk patients are cumbersome and time consuming requiring performance testing and “hands on” clinical assessment. The efficiency of obtaining PRO, such as PROMIS, in the clinical arena has been well documented. The purpose of this study is determine if patient reported outcomes (PROMIS) can identify orthopaedic and specifically foot and ankle patients at risk to fall. Methods: Prospective patient reported outcomes (PROMIS CAT physical function, pain interference and depression and CMS fall risk assessment questions) and patient demographics were collected for all patients at each clinic visit from an academic orthopaedic multi-specialty practice between January 2015 and November 2017. Standardized yes/no validated self-reported fall risk questions include: “Have you fallen in the last year?” and “Do you feel you are at risk of falling?” Histograms, t-tests, confidence intervals and effect size were used to determine the fall risk “YES” patients were different than the “NO” for ALL orthopaedic patients and specifically foot and ankle patients. Logistic Regression was used to determine if age, gender, height, weight, and PROMIS scales predicted self-reported falls risk. Results: 94,761 orthopaedic patients comprising 315,273 visits (44% male, mean age 53.7+/-17 years) and 13,720 foot/ankle patients comprising 33,480 visits (37% male, mean age 52.7+/-16.1 years) had complete data for analysis. Table 1 provides the means/SD/p-values/effect sizes for patient self-identifying at risk to fall stratified by PROMIS PF/ PI/Dep t-scores. Although all PROMIS scores demonstrated significant impairment between patients at risk designation (yes/no), PROMIS PF had the largest effect size for ALL Ortho and FOOT AND ANKLE patients (0.8 and 0.7 respectively). Patients who are at risk to fall have PROMIS PF t-scores >1.5 lower than the United States normative population while the patients not at risk are less <1 SD. In the adjusted regression models gender and PROMIS PF had the largest coefficients. Conclusion: Falls are a major threat to quality of life and independence yet prevention/treatment strategies are difficult to implement across a health system. There is also a tremendous societal cost with orthopaedic surgeons often the recipient of these debilitated patients. PROMIS assessments are part of the AOFAS OFAR initiative to track patient recovery with treatment and can additional be used to fulfill a quality indicator requirement by CMS. This study demonstrates these assessments (PROMIS threshold values) can also be linked to self-report falls risk (yes/no) and may identify patients at risk with no face to face time required from the provider.

scholarly journals Progress in Diagnosing Primary Ciliary Dyskinesia: The North American Perspective

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1278
Author(s):  
Michael Glenn O’Connor ◽  
Amjad Horani ◽  
Adam J. Shapiro
Keyword(s):  
Genetic Testing ◽  
North America ◽  
North American ◽  
Primary Ciliary Dyskinesia ◽  
Clinical Phenotype ◽  
The United States ◽  
Diagnostic Process ◽  
The North ◽  
Diagnostic Guideline ◽  
Ciliary Dyskinesia

Primary Ciliary Dyskinesia (PCD) is a rare, under-recognized disease that affects respiratory ciliary function, resulting in chronic oto-sino-pulmonary disease. The PCD clinical phenotype overlaps with other common respiratory conditions and no single diagnostic test detects all forms of PCD. In 2018, PCD experts collaborated with the American Thoracic Society (ATS) to create a clinical diagnostic guideline for patients across North America, specifically considering the local resources and limitations for PCD diagnosis in the United States and Canada. Nasal nitric oxide (nNO) testing is recommended for first-line testing in patients ≥5 years old with a compatible clinical phenotype; however, all low nNO values require confirmation with genetic testing or ciliary electron micrograph (EM) analysis. Furthermore, these guidelines recognize that not all North American patients have access to nNO testing and isolated genetic testing is appropriate in cases with strong clinical PCD phenotypes. For unresolved diagnostic cases, referral to a PCD Foundation accredited center is recommended. The purpose of this narrative review is to provide insight on the North American PCD diagnostic process, to enhance the understanding of and adherence to current guidelines, and to promote collaboration with diagnostic pathways used outside of North America.

scholarly journals Accessibility in Inclusive Tourism? Hotels Distributed Through Online Channels

Societies ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 34
Author(s):  
Eva Martin-Fuentes ◽  
Sara Mostafa-Shaalan ◽  
Juan Pedro Mellinas
Keyword(s):  
United Arab Emirates ◽  
Local Level ◽  
Descriptive Analysis ◽  
Distribution Channel ◽  
People With Disabilities ◽  
The United States ◽  
Travel Agency ◽  
International Studies ◽  
The Status ◽  
Accommodation Sector

There is a lack of comprehensive international studies on accommodations for people with disabilities; only small, local-level studies exist. This study aims to show the status of the tourist accommodation sector through the online distribution channel in terms of accessibility to offer more inclusive tourism. A descriptive analysis has been carried out with more than 31,000 hotels from the online travel agency Booking.com, in the 100 most touristic cities in the world. For the first time, an accurate picture of adaptation in the hotel sector for people with disabilities is presented. Results show that the adapted hotel infrastructures by countries are uneven. The main adaptations are those that help to avoid mobility barriers, and in contrast, hotels offer very few adaptations for sensory disabilities such as visual disabilities. Moreover, this study shows that, worldwide, countries with the highest income per capita, such as the United States of America, Canada, Ireland, Australia, New Zealand, Qatar or the United Arab Emirates, have the highest degree of hotel adaptation.

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